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Management and Outcome of Pregnant Women with HIV Acquired by Vertical Transmission  [PDF]
Verónica Serrano de la Cruz Delgado, Alicia Martínez Varea, María José Nú?ez Valero, Vicente Diago Almela, Vicente Maiques Montesinos, Amparo García Tejedor, Alfredo Perales Marín
Open Journal of Obstetrics and Gynecology (OJOG) , 2015, DOI: 10.4236/ojog.2015.59068
Abstract: The majority of children with perinatally acquired human immunodeficiency virus (HIV) do not survive beyond childhood but this is changing due to the benefit of antiretroviral therapy for the perinatally infected cohort, so affected children are now approaching the age to be mothers. The aim of this article is to evaluate the outcomes of pregnant women with HIV acquired by vertical transmission in our centre and encourage the results obtained in “Thirty Years Later: Pregnancies in Female Perinatally Infected with Human Immunodeficiency Virus-1”, a review article published in this journal in 2012 [2]. We report 6 patients with eight pregnancies with HIV acquired by vertical transmission. They delivered a total of nine newborns between 2004 and 2013. In any case, mother-to-child transmission was reported. The management of pregnant women with HIV acquired by vertical transmission is complicated, since the patients are the most of the cases young and the compliance to the treatment may be poor. The prematurity was the more frequent complication and the cesarean section was the more frequent form of ending. In our case series, mother-to-child transmission was absent.
Arabin Cerclage Pessary as a Treatment of an Acute Urinary Retention in a Pregnant Woman with Uterine Prolapse
Alicia Martínez-Varea,Francisco Nohales-Alfonso,Vicente José Diago Almela,Alfredo Perales-Marín
Case Reports in Obstetrics and Gynecology , 2013, DOI: 10.1155/2013/161376
Abstract: A 35-year-old gravida 7, para 1, and abortus 5?female with hypogastric pain and inability to void urine after 14?+?3 weeks of amenorrhea was examined in the emergency department. One year before, a uterine prolapse had been diagnosed in another hospital. Examination showed a uterine prolapse grade 2 with palpable bladder. The patient was unable to void urine. After a manual reduction of the uterine prolapse, the patient underwent an emergency catheterization for bladder drainage. A Hodge pessary (size 70) was placed, which led to spontaneous micturitions. Due to the persistence of the symptoms the following day, Hodge pessary was replaced by an Arabin cerclage pessary. Although the pessary could be removed from the beginning of the second trimester, due to the uterine prolapse as a predisposing factor in the patient and the uncomplicated progression of pregnancy, it was decided to maintain it in our patient. Therefore, Arabin cerclage pessary allowed a successful pregnancy outcome and was not associated with threatened preterm delivery or vaginal infection. 1. Introduction Acute urinary retention (AUR) is defined as the inability to void urine, with a retained volume of urine of 200?mL or greater [1]. AUR in early pregnancy is a very rare complication which leads to a real emergency [2]. 2. Case Presentation A 35-year-old gravida 7, para 1, and abortus 5 female with hypogastric pain and inability to void urine after weeks of amenorrhea was examined in the emergency department. One year before, a uterine prolapse had been diagnosed in another hospital. Examination showed an anteverted uterus and uterine prolapse grade 2 with palpable bladder. The patient was unable to void urine. Ultrasound revealed a cervical length of 30?mm and a singleton, cephalic fetus. A manual reduction of the uterine prolapse was made, and the patient underwent an emergency catheterization for bladder drainage (500?mL urine). No urinary tract infection was found. Then, it a Hodge pessary (size 70), and was placed after a spontaneous micturition, the woman was discharged for further ambulatory followup. The following day, the patient was admitted in to the emergency department because of a new AUR. Hodge pessary was replaced by another one of size 75, and due to the persistence of the symptoms, finally an Arabin cerclage pessary was placed (Figure 1). The patient was discharged after a rapid resolution of symptoms. Figure 1: Arabin cerclage pessary as a treatment for uterine prolapse in a pregnant woman. Obstetric controls, which included vaginal cultures, were made every two
Ultrasound Evaluation of Congenital Cervical Teratoma and Therapeutic Management (Ex Utero Intrapartum Treatment)
Pablo Padilla Iserte,Amparo Sanroma Pérez,Blanca Ferri Folch,Juan Rubio Moll,Vicente Diago Almela,Alfredo Perales-Marín
Case Reports in Obstetrics and Gynecology , 2012, DOI: 10.1155/2012/597489
Abstract: The ultrasound evaluation of the fetal neck has a high importance as a key point of the airway and digestive tract. We report the case of a fetus diagnosed with a cervical teratoma by ultrasound, which generated a compressive effect on airway, requiring a surgical approach EXIT (ex utero intrapartum treatment) to ensure the extrauterine viability. 1. Introduction The ultrasound evaluation of the fetal neck is increasingly important, because it has a high impact on fetal adaptation to extrauterine life. The presence of masses in this location can cause obstructive problems at airway, producing complications during the course of pregnancy, as the development of polyhydramnios. But the biggest problem is after delivery, with the appearance of acute neonatal asphyxia with newborn death, if you do not carry out invasive techniques for resolution. One of these approaches is the realization of EXIT surgery, a technique designed to allow partial fetal delivery by cesarean section, with establishment of a secure airway, using intubation, bronchoscopy, or tracheostomy, while fetal oxygenation is maintained by the uteroplacental circulation. 2. Case Presentation A primigravida, 25-years-old patient, it showed a cervical tumor heterogeneous solid-liquid content of 43 × 44?mm, moderately vascularized, in ultrasound study in week 22 (Figure 1), with male fetus and normal anatomical exploration, visualizing gastric chamber. We propose to make a genetic amniocentesis, but the patient rejected it. Magnetic resonance (MR) was requested in the 25th week of gestation, describing 56 × 43 × 38?mm heterogeneous mass in anterior cervical position, with high bilateral extension, solid-cystic component, without thoracic infiltration (Figure 2). We suspect a congenital cervical teratoma by ultrasound and MR images. Figure 1: Ultrasound at 22 weeks, where heterogeneous tumor is found in cervical position, moderately vascularized. Figure 2: Nuclear magnetic resonance at 25 weeks, showing heterogeneous mass in cervical situation. New ultrasound study in 26 +5 weeks, shows a significant growth of the mass, 69 × 53?mm size (Figure 3). The patient wishes to continue the pregnancy. New MR control in week 29, shows an increase of significant size, high anterior growth, without existing intrathoracic extension. Similar proportion of solid and cystic component, with a sagittal plane measurement of 61 × 63?mm and coronal plane 51 × 93?mm, with partial compression of the air-digestive track, but an adequate fetal stomach fullness. Figure 3: 3D ultrasound. During follow-up controls, we
Desenvolvimento Vegetativo e morfologia radicular de citrange carrizo afetado por ácido indolbutírico e micorrizas arbusculares
Souza, Paulo Vitor Dutra de;Abad, Manuel Agustí Manuel;Almela, Vicente;
Ciência Rural , 2000, DOI: 10.1590/S0103-84782000000200009
Abstract: this study was carried out in alcanar (tarragona - spain) to evaluate the effect of five indolebutyric acid (iba) concentrations (0.0; 0.5; 1.0; 1.5; 2.0 g/l) and inoculation with arbuscular mycorrhizae fungi (amf) (glomus intraradices schenck & smith) on carrizo citrange (citrus sinensis (l.) x poncirus trifoliata (l.) raf.) vegetative development, p and k foliar contents and root morphology. the experimental design was in a completly randomized block design with 10 seedlings per plot and 4 replicates. the iba concentrations had no effect on vegetative development of nonmycorrhizal seedlings, althougt it had increased p and k foliar contents and primary xylem tickness. amf increased p foliar content. iba x amf interaction was observed, increasing iba concentrations on mycorrhizal seedlings resulted in increased in vegetative development, p and k foliar contents and primary xylem thickness.
Neonatal Alloimmune Thrombocytopenia Due to Maternal Anti HPA1a Antibodies: Case Report and Management of Subsequent Pregnancy  [PDF]
Verónica Serrano-dela Cruz, Alicia Martínez-Varea, María José Nú?ez-Valera, Antonio Abad-Carrascosa, Vicente Diago, Alfredo Perales-Marín
Open Journal of Obstetrics and Gynecology (OJOG) , 2014, DOI: 10.4236/ojog.2014.45035

Fetoneonatal alloimmune thrombocytopenia is an infrequent and severe disease that is unexpectedly found after an uncomplicated first pregnancy. Affected infants might show unexplained purpura, intracranial hemorrhage, and/or gastrointestinal or genitourinary hemorrhage. Nevertheless, in asymptomatic newborns the thrombocytopenia may be discovered incidentally. We describe a case report that highlights that the incidental diagnosis of FNAIT allows both properly managing the newborn, and detecting maternal anti-HPA1a antibodies in order to prevent the disease in subsequent pregnancies. A non-invasive treatment based on IVIgG allowed to this patient to prevent FNAIT in her second pregnancy.

The Treatment of Word Sense Inventories in the ‘LACELL WSD Project’
Moisés Almela
International Journal of English Studies (IJES) , 2009, DOI: 10.6018/ijes.1.1.99491
Abstract: The WSD community has long debated whether the criteria for representing polysemy in general purpose dictionaries meet the specific demands of sense disambiguation tasks. Concern is growing that pre-defined sense inventories might not adjust well to the needs of WSD, because word occurrences can rarely be paired with rigid sense classes in a one-toone fashion. A second cause for concern is the level of sense granularity adopted in conventional dictionary entries.Fine-grained distinctions can be useful for a dictionary user but complicate the design and evaluation of WSD systems in a way that is often unnecessary. As a result of these objections, many experts have voiced the opinion that dictionaries are not adequate sources of sense inventories for WSD. However, the problem of word sense overlaps can also be resolved by modifying the way in which dictionary entries are processed by WSD programs. This is the solution applied in the LACELL WSD system. The algorithm selects simultaneously two or more dictionary senses if the context does not allow sufficient discrimination between/among them. This article explains the underpinnings of such proposal, as well as discussing some advantages and disadvantages. En el ámbito de la investigación sobre desambiguación léxica automática (WSD), se ha venido debatiendo largo tiempo acerca de la adecuación de los modelos de análisispolisémico empleados en los diccionarios de carácter general. En particular, existe una creciente preocupación en torno a los problemas generados por la utilización de inventarios de acepciones léxicas, ya que no es frecuente hallar correspondencias biunívocas entre los usos de una palabra en contextos específicos y las clases semánticas preestablecidas en la entrada léxica. Además, se duda de que el nivel de granularidad semántica aplicado en la lexicografía convencional sea el más adecuado para las necesidades específicas de la WSD. Como consecuencia de estas objeciones, algunos expertos han llegado incluso a sugerir que los sistemas de WSD deberían prescindir de las entradas de los diccionarios como sus principales recursos léxicos. Sin embargo, hay otras soluciones alternativas, entre ellas modificar el modo como los programas de desambiguación automática procesan los repertorios de acepciones léxicas listados en las entradas de los diccionarios. El sistema de WSD creado por el Grupo LACELL está dise ado para seleccionar simultáneamente un grupo de subacepciones en aquellos casos en los que el contexto no proporciona suficiente información para discriminar entre ellas. En este artículo se
Baluartes, mosquetes y reclutas: cuestiones en torno a la historiografía militar modernista (siglos XVI-XVIII)
Salas Almela, Luis
Gladius , 2001, DOI: 10.3989/gladius.2001.92
Abstract: We have selected some questions of military historiography from XVIth to XVIIIth century according to their influence on the global comprehension of the early modern history. From this subject we have evaluated dificulties and goals in the last decades. We have specially paid attention to the British and French historiographycal traditions because of their development and significance on the Spanish way of facing the military history. In conclution, we suggest that the main methodological and conceptual contributions of the special field that concerns us in this article have to be related to the last years. This matched with the moment in which these historians have changed their attempt to focus the most important changes in the early modern period from their specialism. Best results have been achieved when they have recognized a more modest status for the military history. Dentro del campo de la historiografía militar —en un sentido amplio— de los siglos XVI al XVIII, se han seleccionado algunas cuestiones que por su influencia e innovación conceptual han supuesto mayores aportaciones a la comprensión general del período moderno en su conjunto. A partir de ellas, se ha tratado de valorar los principales logros y los escollos más enconados que los historiadores de la especialidad han ido ofreciendo y encontrando en las últimas décadas. Las escuelas historiográficas de lo militar que, en función precisamente de su desarrollo, han encontrado mayor cabida en estas páginas son la británica y, en menor medida, la francesa. Ambas, por otro lado, son las que más han influido en los historiadores espa oles. Como conclusión, el autor sugiere que las principales aportaciones metodológicas y conceptuales de la historiografía militar modernista se han producido precisamente en el momento en el que se ha abandonado la pretensión de hacer de lo específicamente militar el factor clave en el desarrollo histórico de las sociedades europeas. La justa ubicación dentro de la ciencia histórica es la que, paradójicamente, más está favoreciendo el desarrollo de la historia militar.
Un cargo para el duque de Medina Sidonia: Portugal, el Estrecho de Gibraltar y el comercio indiano (1578-1584)
Salas Almela, Luis
Revista de Indias , 2009,
Abstract: This article reveals and interprets the negotiations surrounding the nomination around 1580 of the Duke of Medina Sidonia as a candidate for the presidency of both the Consejo de Indias and the Casa de la Contratación. The historical context of those years, both that of the ducal house and that of the crown and its institutions, provide relevant clues regarding the contemporary debate about the duke’s suitability as a candidate for both posts. In turn, the duke’s refusal of these posts also sheds important light on the significance of this crucial historical juncture. Este artículo descubre e interpreta la negociación que se produjo en torno a la candidatura del duque de Medina Sidonia para presidir tanto el Consejo de Indias como la Casa de la Contratación en torno a 1580. A partir de la coyuntura histórica de aquellos a os, tanto para la Casa se orial como para la Corona y sus instituciones, analizamos los argumentos a favor y en contra de la idoneidad del duque para los cargos. De este modo, el rechazo de Medina Sidonia arroja nueva luz sobre el significado de aquella crucial coyuntura.
Moisés Almela
Revista de Lingüística y Lenguas Aplicadas , 2011, DOI: 10.4995/rlyla.2011.892
Abstract: This article explores a type of co-occurrence pattern which cannot be adequately described by existing models of collocation, and for which combinatory dictionaries have yet failed to provide sufficient information. The phenomenon of “oblique inter-collocation”, as I propose to call it, is characterised by a concatenation of syntagmatic preferences which partially contravenes the habitual grammatical order of semantic selection. In particular, I will examine some of the effects which the verb cause exerts on the distribution of attributive adjectives in the context of specific noun classes. The procedure for detecting and describing patterns of oblique inter-collocation is illustrated by means of SketchEngine corpus query tools. Based on the data extracted from a large-scale corpus, this paper carries out a critical analysis of the micro-structure in Oxford Collocations Dictionary.
Actitud del Artista. Mitos, Rutina y Neuroestética
Ramón Almela
Revista Observaciones Filosóficas , 2010,
Abstract: En el artículo anterior "LAAlvaca en Chiapas, desarraigo y site-specific" se apuntaba la necesidad de un replanteamiento de los conceptos de la Historia del Arte sustituyendo "arte" por "cultura" y "lenguaje" por "identidad". Esta perspectiva centra su interés mayormente en la obra de arte, el producto y la acción del artista.Pero, la obra es el símbolo de la que el artista es el síntoma. Un curso de verano "La actitud del artista" en la Universidad Carlos III, entre el 4 y el 8 de Julio, en Madrid (www.uc3m.es) se enfoca en la actitud del creador, el talante desde el que el artista trabaja, que constituye el punto de partida y el condicionante fundamental de la creación. La directora, Ana Iribas, profesora de pintura de la Universidad Complutense e investigadora en Arte y Psicología, ha convocado un plantel multidisciplinar de catedráticos de psicología, sociología, filosofía, arte, dibujo, artistas y un director de cine que abordarán la actitud del artista, la cual es determinada por factores psicológicos, culturales, estéticos, socio-antropológicos, e incluso didácticos.
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