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?Es necesario heparinizar el suero de cebado del dializador?
Sánchez Villar,Isidro; Estupi?án Torres,Sara; Ledesma Galindo,David; García de La Cruz Maestro,Nuria; Vera Negrín,Leticia; Ramírez Zuluaga,Isabel Cristina; álvarez López Ibarra,Pilar; Fuente Rubio,Cristina De La; Abreu Pérez,Jenifer; álamo Fari?a,Davinia; Ortolá Serra,Vicenta; Pérez Fernández,Jesús Rafael;
Revista de la Sociedad Espa?ola de Enfermería Nefrológica , 2011, DOI: 10.4321/S1139-13752011000400002
Abstract: introduction: haemodialysis (hd) lines are traditionally primed with sodium heparin and saline solution, which entails the haemorrhagic risk associated to the passing of heparin into the blood. aim: to compare hd dialyser priming with and without sodium heparin, in terms of coagulation, dialytic efficacy, and economic efficacy. material and method: a randomized, prospective studio of 3482 sessions with 109 hd patients (x 66.8±15 years, 40% women, 44% diabetic, 45% with high-flow tunnelled catheter, 50% native iaf, 5% prosthetic iaf). 1827 sessions carried out with fifty-nine patients were included in the control group (primed with saline solution + sodium heparin) and 1455 sessions with patients in the study group (primed with saline solution). the monitoring period was 5 months. variables related to the coagulation of the circuit and the efficacy of the dialysis were analysed: selected blood flow (qb) and effective qb, final status of the dialyser, number of changes of dialyser, number of changes of the arterial line, number of changes of the venous, average kt/hour measured by ionic dialysance and heparinization of the circuit. the efficacy in economic terms was also studied. results: there are no significant differences in the results related to coagulation and efficacy of the dialysis obtained in both groups, except x of heparin with low molecular weight (2476±1089 iu in the study group compared to 2854±1414 iu in the control group). priming without heparin represents a saving of 0.50 € per session. conclusions: priming with saline solution does not affect the hd dose, and does not entail a greater risk of coagulation of the system compared to a priming solution to which heparin has been added, avoids the risk of heparin passing into the bloodstream, reduces handling in the connection protocols and reduces costs.
Is there a direct role for erythrocytes in the immune response?
Davinia Morera, Simon A MacKenzie
Veterinary Research , 2011, DOI: 10.1186/1297-9716-42-89
Abstract: 1. Introduction2. Erythrocyte-pathogen interaction3. Immunity4. Insights from genomic and proteomic studies5. Future directions6. Competing interests7. Authors' contributions8. Acknowledgements9. ReferencesIn all vertebrates, blood is composed of cells and plasma protein (90% in volume is water). By far the most abundant cell type in circulation is the erythrocyte, present in the nucleated form in the majority of vertebrates with the notable exception of the mammals. All vertebrates also have distinct populations of circulating leukocytes and non-mammalian vertebrates have nucleated thrombocytes instead of platelets. Erythrocytes are generally characterized as oval in shape and their characteristic red color is due to the respiratory globin pigments including the hemoglobins, the most abundant protein in these cells. All non-mammalian (birds, reptiles, amphibians and fish) erythrocytes with a few isolated exceptions are nucleated and contain organelles in their cytoplasm [1]. Erythrocyte longevity varies across the major vertebrate groups where in humans the cellular half life of erythrocytes is about 120 days and is about 40, 600-800, 300-1400 and 80-500 days in birds, reptiles, amphibians and fish respectively [1-5]. Furthermore and with a direct relationship to longevity, different maturation states are observed in the circulating erythrocytes of non-mammalian species including; changes in cytoplasmatic shape, staining, nuclear size and chromatin density. Total RNA and organelles content follow an inverse relationship with cellular age where young red blood cells contain a higher total concentration of RNA and aging cells display a loss of cellular organelles including ribosomes and mitochondria [6]. Interestingly, in endothermic species cellular longevity is similar indicative of a parallel evolutionary trend toward respiratory specialization linked in parallel to increased metabolic demand. However in view of the vast diversity of vertebrate species where the e
Evolution in the Management of Acute Myocardial Infarction in the Autonomous Community of Valencia (Spain): Ten Years of the Primvac Registry (1995-2004)
Adolfo Cabadés,Victoria Ortolá,José Valencia,Francisco Sogorb
International Journal of Biomedical Science , 2011,
Abstract: Introduction and objectives: Several registries of acute myocardial infarction (AMI) have been carried out in Spain, but few remain active. This work analyses the evolution of the characteristics and control of patients with AMI during the first 10 years of the PRIMVAC registry, initiated in 1995. Methods: The demographical and clinical characteristics, therapeutic-diagnostic procedures and pharmacological treatment of patients admitted with AMI between January 1995 and December 2004, were analysed in 17 coronary centres in the Autonomous Community of Valencia (South eastern Spain). Results: The mean age of the 19,719 patients recruited was of 65. The percentage of women, hypertension, hypercholestrolemia and diabetes increased during registry period. The median time of symptoms onset-hospital arrival was 151 minutes, without a decrease over the time, and the delay of thrombolysis fell from 200 to 154 minutes (p<0.01). Percentage of thrombolytic treatment oscillated between 39% and 48%. The mortality in the coronary units decreased (14.1% vs. 8.9%; p<0.001). The number of coronary angiography and percutaneous revascularisation performed increased up to 61% and 32%, respectively, of patients included. On discharge, the use of beta-blockers (29.3% vs. 66.7%), angiotensin-converting enzyme (ACE) inhibitors (41.7% vs. 57.9%) and statins (29.3% vs. 71%) went up. Conclusions: Overall mortality in the coronary unit decreased, without any variation in the incidence of serious complications. Time to thrombolysis was reduced over the time, with no significant increment in its use. The performance of coronary angiography and percutaneous revascularisation increased, with a low use of primary angioplasty. The use of beta-blockers, ACE inhibitors and statins increased at discharge.
Optimum Shape of High Speed Impactor for Concrete Targets Using PSOA Heuristic  [PDF]
Francesco Ragnedda, Mauro Serra
Engineering (ENG) , 2010, DOI: 10.4236/eng.2010.24035
Abstract: The present paper deals with the optimum shape design of an absolutely rigid impactor which penetrates into a semi-infinite concrete shield. The objective function to maximize is the depth of penetration (DOP for short) of the impactor; in the case of impactors with axisymmetric shapes DOP is calculated using formulas obtained by Ben-Dor et al. [1-3] with the method of local variations [4] and based on the mechanical model proposed by Forrestal and Tzou [5]. In the present paper we show that using a different class of admissible functions, more general than the axisymmetric one, better results can be obtained. To solve the formulated optimization problem we used a custom version of the particle swarm optimization method (briefly denoted by PSOA), a very recent numerical optimization algorithm of guided random global search. Numerical results show the optimal shape for various types of shields and corresponding DOP; some Ben-Dor et al. [1-3] results are compared to solutions obtained.
A Process for Extracting Non-Taxonomic Relationships of Ontologies from Text  [PDF]
Ivo Serra, Rosario Girardi
Intelligent Information Management (IIM) , 2011, DOI: 10.4236/iim.2011.34014
Abstract: Manual construction of ontologies by domain experts and knowledge engineers is an expensive and time consuming task so, automatic and/or semiautomatic approaches are needed. Ontology learning looks for identifying ontology elements like non-taxonomic relationships from information sources. These relationships correspond to slots in a frame-based ontology. This article proposes an initial process for semiautomatic extraction of non-taxonomic relationships of ontologies from textual sources. It uses Natural Language Processing (NLP) techniques to identify good candidates of non-taxonomic relationships and a data mining technique to suggest their possible best level in the ontology hierarchy. Once the extraction of these relationships is essentially a retrieval task, the metrics of this field like recall, precision and f-measure are used to perform evaluation.
Datación por ESR del yacimiento arqueológico del Pleistoceno inferior de Vallparadís (Terrassa, Catalu a, Espa a)
Duval, Mathieu,Moreno, Davinia,Shao, Qingfeng,Voinchet, Pierre
Trabajos de Prehistoria , 2011, DOI: 10.3989/tp.2011.11056
Abstract: Excavated between 2005 and 2007, the site of Vallparadís (Terrassa, Spain) has given an abundant and diversified fauna associated with a rich Mode 1 industry. In order to complete the chronostratigraphic framework, we performed ESR and combined US-ESR dating applied to quartz grains extracted from sediments and fossil teeth, respectively. The results obtained are very significant, giving a weighted mean ESR age of 0.83 ± 0.13 Ma (2σ) for the reference archaeological level of the site (level 10) and another of 0.79 ± 0.23 Ma (2σ) for the archaeological level 12 of the Vallparadís sequence. These ESR results are in total agreement with the ones derived from biochronology and paleomagnetism. This whole dataset allows the elaboration of a reliable and consistent chronostratigraphic framework which chronologically places Vallparadís site in the late Early Pleistocene period, i.e. within a time range comprised between Jaramillo and Brunhes geomagnetic events. Consequently, as well as Gran Dolina-TD6 and Sima del Elefante- TE9 sites, in Atapuerca, Burgos, Vallparadís can be therefore considered as a key site for the study of early hominid settlements in Europe. Excavado entre 2005 y 2007, el yacimiento de Vallparadís (Terrassa, Espa a) ha aportado una fauna rica y diversa en asociación con un importante conjunto lítico de Modo 1. Con el objetivo de completar el marco cronoestratigráfico, se hicieron dataciones por los métodos de Resonancia Paramagnética Electrónica (Electron Spin Resonance, ESR) y ESR combinada con uranio-torio sobre algunas muestras de granos de cuarzo extraídos de sedimentos y dientes fósiles, respectivamente. Los resultados obtenidos son muy significativos, ofreciendo edades ESR promedias de 0,83 ± 0,13 Ma (2σ) para el nivel arqueológico de referencia del yacimiento (nivel 10) y de 0,79 ± 0,23 Ma (2σ) para el nivel arqueológico 12 de la secuencia de Vallparadís. Dichos resultados por ESR concuerdan con los obtenidos a partir de la biocronología y del paleomagnetismo. El yacimiento de Vallparadís dispone ahora de un marco cronoestratigráfico fiable y coherente, que permite situarlo cronológicamente a finales del Pleistoceno inferior, dentro de un rango temporal comprendido entre los eventos geomagnéticos de Jaramillo y Brunhes. Dicho yacimiento junto a los de Gran Dolina TD-6 y Sima del Elefante TE-9, en Atapuerca, Burgos, se posiciona como un yacimiento clave para el estudio de los primeros poblamientos humanos de Europa.
Indicadores para la evaluación de las instituciones universitarias: validación a través del método Delphi
García-Aracil, Adela,Palomares-Montero, Davinia
Revista Espa?ola de Documentación Científica , 2012,
Abstract: The evaluation of higher education activities is complex given their multiple objectives, which focus activities on the three principal academic missions of teaching, research and knowledge transfer. Various methodologies using indicators for the evaluation of universities have been proposed in the professional literature and there is intense debate over which are the most appropriate. Therefore, it is necessary to establish criteria against which to judge the existing indicators. This paper contributes directly to both theory and practice by providing a list of prioritized critical indicators for the evaluation of higher education institutions. For that purpose, we use the Delphi technique to try to achieve some sort of consensus among a group of experts with in-depth knowledge of higher education evaluation. Our results show that among the panel of experts there is no consensus and no clear cut division on the identification of which indicators are the most effective for the evaluation of university missions, the type of indicator and their degree of importance in the evaluation process. Evaluar el desempe o de las universidades es complicado ya que se trata de una institución multidimensional que desarrolla numerosas actividades en base a sus tres principales misiones: docencia, investigación y transferencia de conocimiento. En este contexto, diversas metodologías de evaluación de las universidades han sido propuestas en base al uso de indicadores, existiendo intensos debates acerca de qué indicadores son los más apropiados. Esta situación hace que resulte indispensable sistematizar la diversidad de indicadores para obtener una evaluación más rigurosa de las instituciones universitarias. El presente trabajo profundiza en esta cuestión, identificando un listado de indicadores relacionados con la evaluación de las universidades. El sistema de indicadores propuesto ha sido validado a través del método Delphi que ha permitido alcanzar cierto consenso entre los expertos participantes. La identificación realizada sirve de ayuda para tomar decisiones en torno a qué indicadores deben ser incluidos en los modelos de evaluación universitaria. Sin embargo, los resultados del estudio ponen de manifiesto que entre los gestores universitarios continúa habiendo discrepancias en cuanto a la identificación de los indicadores tanto a qué misión representan como en su tipología y grado de importancia.
Minimal exhaled nitric oxide production in the lower respiratory tract of healthy children aged 2 to 7 years
Al-Ayed Tareq,Withington Davinia,Davis G
Annals of Saudi Medicine , 2005,
Abstract: BACKGROUND : Exhaled nitric oxide (eNO) is elevated in inflammatory airway conditions, e.g. asthma. We measured eNO levels in normal preschool children for whom there is little data available and in whom the prevalence of asthma is high. SUBJECTS AND METHODS : Fifty children, 2-7 years old, undergoing elective surgery, excluding airway procedures, were recruited. Children with known respiratory disease or acute viral infections were excluded. Gas for eNO measurement was collected in a non-diffusion bag via 1) the mask after inhalation induction of anesthesia, 2) endotreacheal tube (ETT) or laryngeal mask airway (LMA), and 3) during emergence. Measurement was off-line by chemiluminescent analyzer. RESULTS : Mean eNO level by mask was 10.23 ppb (mean value±SD of 8.8-11.1 ppb) after induction and 8.35 ppb (mean value±SD of 5.9-10.8 ppb) on emergence. Mean eNO for the intubated group (n=25) was 0.75 ppb (mean value(SD of 0.4-1 ppb) ( P < 0.0001 vs mask); mean eNO for the LMA group (n=25) was 2.6 ppb (mean value±SD of 2-3.2 ppb), which differed from the mask ( P < 0.0001), and from ETT values ( P < 0.0001). CONCLUSIONS : Most eNO is produced by the upper airway in healthy pre-school children. The lower airway constitutive eNO production is very low. The LMA does not completely isolate the upper airway and current mask collection techniques allow significant contamination of samples by sino-nasal eNO production in young children.
The Clinical Utility of fMRI for Identifying Covert Awareness in the Vegetative State: A Comparison of Sensitivity between 3T and 1.5T
Davinia Fernández-Espejo, Loretta Norton, Adrian M. Owen
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0095082
Abstract: In the last few years, mental imagery fMRI paradigms have been used successfully to identify covert command-following and awareness in some patients who are thought to be entirely vegetative. However, to date there is only evidence supporting their use at magnetic fields of 3T, which limits their applicability in clinical settings where lower field strengths are typically used. Here, we test the ‘gold standard’ fMRI paradigm for detecting residual awareness in non-responsive patients by comparing its sensitivity at 1.5T and 3T in the same group of healthy volunteers. We were able to successfully detect brain activity showing command-following in most participants at both 3T and 1.5T, with similar reliability. These results demonstrate that fMRI assessment of covert awareness is clinically viable and therefore justify a broader use of these methods in standard assessments in severely brain injured patients.
Adenopatía inguinal silicótica: presentación de un caso
Martín Larra?aga,N.; Pérez Ortolá,R.; Díaz de Otazu,R.;
Anales de Medicina Interna , 2004, DOI: 10.4321/S0212-71992004000400009
Abstract: silicosis is a sistemic occupational disease, including in the group of pneumoconiosis, because is resulting from the inhalation of microscopic particles of crystalline silica, which deposition and histologic changes take place in lung tissue. a 30 year-old male, construction worker who presented many mediastinal, abdominal and groinal adenopathies without lung damaged. a groinal adenophaty biopsy showed the presence of numerous noncaseating granulomas containing scattered polarizable particles compatible with silica. this case has the particular feature of the exclusive extrapulmonary presentation of silicosis.
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