Deformación plástica del antebrazo: revisión y caso clínico

La deformidad plástica de un hueso es una rara entidad, que en ocasiones pasa desapercibida. Se trata de una lesión típica del niño, con un hueso más elástico que los adultos. La mayoría de las deformidades plásticas del antebrazo se producen por caídas con el brazo en extensión, causando deformidad, dolor y una limitación de la pronosupinación. Para reducir la curvatura del hueso se precisan fuerzas contrarias a las que produjeron la lesión, mantenidas en el tiempo. En niños menores de 4 años, con enorme capacidad de remodelación, sólo grandes deformidades >20º deberían ser reducidas. En los mayores de 10 años, con escaso potencial remodelador, deben manipularse aquellas angulaciones >10-15º. La mayor complicación derivada de una mala reducción es la limitación de la pronosupinación, que en la mayoría de las ocasiones no altera la funcionalidad de la extremidad.Plastic bowing of a bone is a rare entity that some- times goes unnoticed. It’s a typical injury in children, who have more elastic bones than adults. Most of the plastic bowing of the forearm take place by falls with an outstretched arm, causing deformities, pain and a limitation of pronation and supination. In order to reduce the curvature of the bone, opposing forces to those that produced the injury are needed, maintained for a long time. In children younger than 4 years, with an enormous remodelling capacity, only great deformi- ties >20º should be reduced. For those older than 10 years, with little remodelling capacity, angulations >10-15º must be manipulated. The greatest complication derived from a bad reduction is the limitation of the pronation and supination, which in most cases does not modify the functionality of the extremity

SISTEMA DE ADQUISICIÓN DE SEÑALES ELECTROCARDIOGRÁFICAS DE BAJO COSTO (LOW-COST SYSTEM FOR ELECTROCARDIOGRAPHIC SIGNAL ACQUISITION )

En el presente artículo se presenta nueva una metodología de bajo costo para la obtención de señales electrocardiográficas de laboratorio usando un electrocardiógrafo (ECG) de propósito general y la tarjeta de sonido estándar de la computadora. Una vez que se adquieren las señales con el ECG, estas son posteriormente filtradas con ayuda del software Adobe Audition 1.5 (AA). Con este método se obtiene una señal de características aceptables, bajo costo y fácil obtención.Palabra(s) clave: bajo costo, filtrado, señal electrocardiográfica, tarjeta de sonido. AbstractIn the present paper, a new low-cost method to obtain raw electrocardiographic (ECG) signals is presented, using a general-purpose electrocardiograph. These signals are later filtered using Adobe Audition 1.5 software (AA). With this method a signal with acceptable features is obtained by an easy way and a low cost.Keywords: electrocardiographic signal, filtering, low-cost, sound card

A Critical Gap in Seagrass Protection: Impact of Anthropogenic Off-Shore Nutrient Discharges on Deep Posidonia oceanica Meadows

In the Mediterranean, anthropogenic pressures (specifically those involving nutrient loads) have been progressively moved to deeper off-shore areas to meet current policies dealing with the protection of marine biodiversity (e.g., European Directives). However, conservation efforts devoted to protecting Posidonia oceanica and other vulnerable marine habitats against anthropogenic pressures have dedicated very little attention to the deepest areas of these habitats. We studied the remote influence of off-shore nutrient discharge on the physiology and structure of deep P. oceanica meadows located nearest to an urban sewage outfall (WW; 1 km) and an aquaculture facility (FF; 2.5 km). Light reduction and elevated external nutrient availability (as indicated by high δ15N, total N and P content and N uptake rates of seagrass tissues) were consistent with physiological responses to light and nutrient stress. This was particularly evident in the sites located up to 2.5 km from the WW source, where carbon budget imbalances and structural alterations were more evident. These results provide evidence that anthropogenic nutrient inputs can surpass critical thresholds for the species, even in off-shore waters at distances within the km scale. Therefore, the critical distances between this priority habitat and nutrient discharge points have been underestimated and should be corrected to achieve a good conservation status.J.-C.J.’s PhD was funded by a grant from the University of Alicante. This research was funded by the POSINET2 project (Monitoring network of Posidonia oceanica meadow and climate change of the Murcia Region) of the Spanish Institute of Oceanography (CN IEO-CSIC), the Department of Fishery and Aquaculture of the Regional Ministry of Agriculture and Water of the Murcia Region and by the UMBRAL project (Responses of marine benthic macrophytes to stress: critical transitions, resilience and management opportunities) financed by the National Plan of Research of the Spanish Government (CTM2017-86695-C3-2-R) to R.J.M. The research was also supported by project 19-ESMARES2-ANG funded by the Ministry of Ecological Transition and Demographic Challenge of the Spanish government for the application of the Marine Strategy Framework Directive (MSFD) in Spanish waters

Value of α‑fetoprotein as an early biomarker for treatment response to sorafenib therapy in advanced hepatocellular carcinoma

Sorafenib is an oral multikinase inhibitor with antiangiogenic and antiproliferative properties, and is used as the first‑line treatment for patients with advanced hepatocellular carcinoma (HCC). Previous studies have identified an improvement in overall survival and progression‑free survival in patients with a manageable toxicity profile. α‑fetoprotein (AFP) has been revealed to be of great diagnostic and predictive value for tumour staging in multiple studies; however, its role as a predictive factor of response to treatment with sorafenib is not entirely clear. The present study aimed to determine the effectiveness of sorafenib and investigate the value of AFP as a predictive factor of early response to sorafenib in patients with HCC. Effectiveness was analysed based on median overall survival (mOS) time, while to analyse the possible predictive value of AFP, patients were classified into two groups: Non‑responders (≤20% AFP reduction) and responders (>20% AFP reduction) at 6‑8 weeks of treatment when compared with basal AFP level. For assessment of toxicity, any adverse effects were recorded. A total of 167 patients were included, who collectively exhibited a mOS time of 11 months with a median treatment duration of 5 months. The mOS time was significantly higher for patients with better hepatic function (12 months in cases of Child‑Pugh score A vs. 8 months in cases of Child‑Pugh score B; P=0.03) and with basal AFP values ≤200 ng/ml (14 months vs. 8 months in patients with AFP levels >200 ng/ml; P=0.01). A >20% reduction of AFP at 6‑8 weeks was determined to be a positive predictive factor upon multivariate analysis (P=0.002), obtaining, for the responder patients, an mOS of 18 months compared with 10 months (P=0.004) for the non‑responders. The main adverse reactions were hand‑foot syndrome (35/167; 21%), diarrhoea (39/167; 23.4%), anorexia (29/167; 17.4%) and arterial hypertension (30/167; 18%). In conclusion, a >20% drop in AFP at 6‑8 weeks may be useful as a predictive factor of response to sorafenib, as indicated by its association with longer survival times in patients with advanced HCC following treatment with sorafenib in the present study

Revisão sistemática sobre a aplicação da Realidade Virtual no Ensino Universitário

Introduction. Currently there are studies that explore benefits, impacts and applications of Virtual Reality (VR) and Augmented Reality (AR) in different technological and professional areas. It has sparked interest in research due to its enormous potential and its application at all levels of education. The periods of analysis of the Bibliographic information have been from 2010 to 2021 as a reference. Objective. Describe the application of VR and AR in the learning process in university education. Identify the thematic areas by determining the application domains in different areas. Methodology. Systematic mixed mapping was used. Documents indexed in digital libraries were reviewed. It was systematically filtered using keywords. Results. There are large gaps in the applications of VR, mainly in the areas of neuroscience and nursing (3%), however, there are greater studies in computer sciences (40%). Conclusion. The main findings have been that in Scopus in the period 2010 to 2021, the highest percentage of mentions about the application of VR by thematic areas and application domains has predominated. In the analysis it has been discovered that there are several gaps in the application of VR and in learning theories that have not considered the development of VR applications to help and guide towards learning results, they have only been for simulation and training.Introducción. En la actualidad existen estudios que exploran beneficios, impactos y aplicaciones de la realidad virtual (RV) y la realidad aumentada (RA) en diferentes áreas tecnológicas y profesionales. Esta temática ha despertado interés en la investigación debido a su enorme potencial y a su aplicación en todos los niveles de la educación. Los períodos de análisis de la información bibliográfica han tenido como referencia desde el 2010 a 2021. Objetivo. Describir la aplicación de la RV y RA en el proceso de aprendizaje en educación universitaria. Identificar las áreas temáticas determinando los dominios de aplicación en diferentes áreas. Metodología. Se utilizó el mapeo mixto sistemático. Se revisaron documentos indexados en las bibliotecas digitales. Se filtraron sistemáticamente mediante palabras claves. Resultados. Existen grandes brechas en las aplicaciones de la RV, fundamentalmente en las áreas de neurociencia y enfermería (3%); no obstante, existen mayores estudios en las ciencias de computación (40%). Conclusión. Los principales hallazgos han sido que en Scopus en el periodo 2010 a 2021 ha predominado el mayor porcentaje de menciones sobre la aplicación de la RV por áreas temáticas de los dominios de aplicación. En el análisis se ha descubierto que existen varios vacíos en la aplicación de la RV y en las teorías del aprendizaje que no han considerado el desarrollo de aplicaciones de RV para ayudar y orientar los resultados del aprendizaje, solo han sido para la simulación y el entrenamiento.Introdução. Atualmente existem estudos que exploram benefícios, impactos e aplicações da Realidade Virtual (VR) e da Realidade Aumentada (AR) em diferentes áreas tecnológicas e profissionais. Tem despertado o interesse pela investigação devido ao seu enorme potencial e à sua aplicação em todos os níveis de ensino. Os períodos de análise da informação bibliográfica tiveram como referência o período de 2010 a 2021. Objetivo. Descrever a aplicação de VR e AR no processo de aprendizagem no ensino universitário. Identificar as áreas temáticas determinando os domínios de aplicação nas diferentes áreas. Metodologia. Foi utilizado mapeamento misto sistemático. Foram revisados ​​documentos indexados em bibliotecas digitais. Foi filtrado sistematicamente por meio de palavras-chave. Resultados. Existem grandes lacunas nas aplicações da RV, principalmente nas áreas de neurociências e enfermagem (3%), porém, há maiores estudos em ciências da computação (40%). Conclusão. As principais conclusões foram que na Scopus, no período de 2010 a 2021, predominou o maior percentual de menções sobre a aplicação de RV por áreas temáticas e domínios de aplicação. Na análise descobriu-se que existem várias lacunas na aplicação da RV e nas teorias de aprendizagem que não consideraram o desenvolvimento de aplicações de RV para ajudar e orientar nos resultados da aprendizagem, apenas para simulação e treinamento

Germline Predisposition to Pediatric Cancer, from Next Generation Sequencing to Medical Care

Knowledge about genetic predisposition to pediatric cancer is constantly expanding. The categorization and clinical management of the best-known syndromes has been refined over the years. Meanwhile, new genes for pediatric cancer susceptibility are discovered every year. Our current work shares the results of genetically studying the germline of 170 pediatric patients diagnosed with cancer. Patients were prospectively recruited and studied using a custom panel, OncoNano V2. The well-categorized predisposing syndromes incidence was 9.4%. Likely pathogenic variants for predisposition to the patient's tumor were identified in an additional 5.9% of cases. Additionally, a high number of pathogenic variants associated with recessive diseases was detected, which required family genetic counseling as well. The clinical utility of the Jongmans MC tool was evaluated, showing a high sensitivity for detecting the best-known predisposing syndromes. Our study confirms that the Jongmans MC tool is appropriate for a rapid assessment of patients; however, the updated version of Ripperger T criteria would be more accurate. Meaningfully, based on our findings, up to 9.4% of patients would present genetic alterations predisposing to cancer. Notably, up to 20% of all patients carry germline pathogenic or likely pathogenic variants in genes related to cancer and, thereby, they also require expert genetic counseling. The most important consideration is that the detection rate of genetic causality outside Jongmans MC et al. criteria was very low

Are there differences in acute phase inflammation markers regarding the type of heart failure?

This study aimed to determine if there are differences in inflammatory markers in the acute phase between systolic heart failure and heart failure with preserved systolic function. One hundred and thirty-one patients with acute heart failure were recruited consecutively. At admission, plasma fibrinogen, C-reactive protein, sialic acid, von Willebrand factor, vascular endothelial growth factor, interleukin-6 and NTproBNP were all evaluated. If the ejection fraction was 45% or over patients were included in the HF-PSF group; the remaining patients were included in the SHF group. The HF-PSF patients were older (72±10 vs 63±12 years, P<0.001), presented a higher rate of atrial fibrillation (56.1 vs 21.3%, P<0.001), and had a lower rate of hemoglobin (12.2±2 vs 13.3±2.1 g/dL, P<0.01). No significant differences were observed in the inflammation markers analyzed among SHF and HF-PSF groups. In the acute phase of heart failure there is a marked elevation of inflammatory markers but there are no differences in the inflammatory markers analyzed between the two different types of heart failure

Buenas Prácticas en los Programas Universitarios para Mayores en España

Ana Isabel Muñoz Alcón y Francisco Trullén Galve (Universidad Catolica de Ávila); María P. García de la Torre y Francisco Ascón Belver (Universidad de A Coruña); M. Isabel Luis Rico, Ángel Gañán Adánez, Tamara de la Torre Cruz, Vanesa Baños Martínez (Universidad de Burgos); Yolanda Lázaro Fernández y Jaime Cuenca Amigo (Universidad de Deusto); Camino Caballero Posado (Universidad de Extremadura); Mª Adoración Holgado Sánchez y Mª Teresa Ramos Bernal (Universidad Pontificia de Salamanca); Sara Serrate González, Javier Alba Barrios y José Manuel Muñoz Rodríguez; Miguel Ángel Nombela Castaño (Universidad de Vigo

Stochastic analysis of three-dimensional hydraulic conductivity upscaling in a heterogeneous tropical soil

[EN] Hydraulic conductivity (K) heterogeneity is seldom considered in geotechnical practice for the impossibility of sampling the entire area of interest and for the difficulty of accounting for scale effects. Stochastic three-dimensional K upscaling can tackle these two problems, and a workflow is described with an application in a tropical soil. The application shows that K heterogeneity can be incorporated in the daily practice of the geotechnical modeler while discussing the aspects to consider when performing the upscaling so that the upscaled models reproduce the average fluxes at the fine scale.The authors thank the financial support by the Brazilian National Council for Scientific and Technological Development (CNPq) (Project 401441/2014-8). The doctoral fellowship award to the first author by the Coordination of Improvement of Higher Level Personnel (CAPES) is gratefully acknowledged. The first author thanks the International Mobility Grant awarded by CNPq (200597/2015-9) and Santander mobility. The authors also thank DHI-WASI for providing a FEFLOW Software license.Almeida De-Godoy, V.; Zuquette, L.; Gómez-Hernández, JJ. (2018). Stochastic analysis of three-dimensional hydraulic conductivity upscaling in a heterogeneous tropical soil. Computers and Geotechnics. 100:174-187. https://doi.org/10.1016/j.compgeo.2018.03.004S17418710

Scale effect on hydraulic conductivity and solute transport: Small and large-scale laboratory experiments and field experiments

[EN] Hydraulic conductivity (K), dispersivity (alpha) and partition coefficient (K-d) can change according to the measurement support (scale) and that is referred to as scale effect. However, there is no clear consensus about the behavior of these parameters with the change in the scale. Comparison between results obtained in different support of measurements in the field and in the laboratory can promote the discussion about scale effects on K, alpha, and K-d, and contribute to understanding how these parameters behave with the change in the scale of measurement, the main objectives of the present paper. Small and large-scale laboratory tests using undisturbed soil samples and field experiments at different scales were performed. Results show that for the same measurement condition, K, alpha, and K-d increase with scale in all studied magnitudes. Caution should be taken when using K, alpha, and K-d values in numerical models with no concern about the scale effect. The lack of consideration of the difference of scale between field and laboratory measurements and numerical model may compromise the reliability of the predictions and misrepresent the responses.The authors thank the financial support by the Brazilian National Council for Scientific and Technological Development (CNPq) (Project 401441/2014-8). The doctoral fellowship awarded to the first author by the Coordination of Improvement of Higher Level Personnel (CAPES) is gratefully acknowledged. The first author also thanks the international mobility grant awarded by CNPq, through the Science Without Borders program (grant number: 200597/2015-9), and the international mobility grant awarded by Santander Mobility in cooperation with the University of Sao Paulo.Almeida De-Godoy, V.; Zuquette, L.; Gómez-Hernández, JJ. (2018). Scale effect on hydraulic conductivity and solute transport: Small and large-scale laboratory experiments and field experiments. Engineering Geology. 243:196-205. https://doi.org/10.1016/j.enggeo.2018.06.020S19620524