Understanding public perception of hydraulic fracturing: a case study in Spain.

Public acceptance is crucial for the implementation of energy technologies. Hydraulic fracturing is a technology widely used in the USA for natural gas production from shale formations, but currently finds strong public opposition worldwide, especially in Europe. Shale gas exploitation and exploration have the potential to significantly reduce import dependency in several countries, including Spain. To better understand public opinion on this issue, this article reports a survey targeting both the entire Spanish population and the inhabitants of the province of Burgos, the location where shale gas exploration permits have already been issued. Results demonstrate that half of the Spanish population opposes shale gas, and this opposition increases in autonomous communities that are closer to possible exploration sites. The results also show that socio-demographic aspects are not strong predictors of opposition. In addition, Burgos' population show different behaviours toward shale gas that demonstrates that proximity and prospect of shale gas development affects opinion. Finally, there is still a great level of unfamiliarity with high volume hydraulic fracturing and shale gas in both populations sampled.

Clostridium difficile colitis acquired in the intensive care unit: outcome and prognostic factors.

PURPOSE: We assessed factors associated with mortality and complicated course in the case of Clostridium difficile infection (CDI) acquired in the intensive care unit (ICU). METHOD: Retrospective cohort study conducted from 1 January 2002 through 1 January 2012. All patients who acquired CDI in our ICU were included. RESULTS: Thirty-one patients were included. Twenty patients (65 %) had mild colitis, 8 (25 %) moderate colitis, and 3 (10 %) severe colitis. Initial antibiotherapy was metronidazole (n = 30, 97 %) and vancomycin (n = 1, 3 %). Seventeen patients (55 %) experienced at least one complication: failure of initial treatment (n = 16, 52 %), shock (n = 11, 34 %), need for surgery (n = 1, 3 %) or renal replacement (n = 4, 13 %), or death (n = 8, 26 %). Risk factors of ICU mortality were history of corticosteroids prescription, prolonged ICU stay, low serum albumin level, and high Sequential Organ Failure Assessment (SOFA) score at the time of CDI diagnosis. Factors associated with a complicated course were high Simplified Acute Physiology Score (SAPS II), high SOFA score, and low serum albumin level at the time of CDI onset. CONCLUSION: Risk factors of poor outcome in patients with CDI acquired in the ICU are different from those in the general population suffering from CDI. The implementation of treatment algorithms taking into account these factors may reduce complication rates in this specific population.

Assessment of psychosocial adjustment in patients with temporal lobe epilepsy using a standard measure.

Despite the growing evidence of poor psychosocial adjustment, at present there is no formal method of assessment of social adjustment in patients with temporal lobe epilepsy (TLE). First, we assessed social adjustment in patients with TLE using a self-report questionnaire and compared the results with those from quality-of-life (QOL) scales. Second, we verified the influence of cognitive performance and clinical variables of epilepsy on social adjustment and QOL. We evaluated 35 people with TLE and 38 healthy controls. Patients had worse social adjustment, and it was correlated with worse perception of cognitive function. Attention and verbal memory dysfunctions were negatively correlated with social adjustment. However, there was no significant correlation between cognitive performance and QOL. Regarding clinical variables, persons with left TLE showed worse social adjustment and patients with frequent seizures showed worse QOL. These findings indicate the relevance of evaluating social adjustment and emphasize the importance of cognitive rehabilitation to improved social adjustment.

A "luta contra a morte": os corpos, modernidade brasileira e uma história da velhice, São Paulo e Rio de Janeiro, década de 1930 / The "fight against death: " bodies, Brazilian modernity, and a history of old age, São Paulo and Rio de Janeiro, 1930s

Resumo O estudo investiga como a velhice era representada em uma modernidade brasileira na década de 1930. Foi realizada uma pesquisa histórica que teve como fontes periódicos médicos e, principalmente, jornais e revistas das cidades de São Paulo e do Rio de Janeiro. A pesquisa demonstrou que as particularidades e contradições de uma modernidade brasileira contribuíram para uma variedade de representações da velhice. A análise do corpo documental impediu uma descrição homogênea da velhice, mas atestou considerável aumento do poder dos saberes científico e médico sobre os comportamentos considerados adequados em relação aos corpos na década de 1930.

Abstract The way old age was depicted during the 1930s, in Brazilian modernity, is investigated. A historical study was conducted using as its sources newspapers and magazines published in São Paulo and Rio de Janeiro, as well as medical periodicals. It showed that the particularities and contradictions of Brazilian modernity contributed to a variety of representations of old age. The analysis of the documentary corpus failed to reveal a homogenous description of old age, but identified a considerable increase in the power of scientific and medical knowledge about behaviors considered adequate with regard to bodies in the 1930s.

[Prevalence of primary dyslipidemia in subjects with and without family history of coronary disease, based on the reference values of the "National Cholesterol Education Program" (NCEP)]. / Prevalência de dislipidemias primárias em indivíduos com e sem história familiar de coronariopatia, tendo como referência os valores do "National Cholesterol Education Program" (NCEP).

PURPOSE--To compare the prevalence of primary dyslipidemia in 2 groups, based on NCEP guidelines: a) first degree relatives of revascularized patients and b) hospital employees without family history of coronary heart disease (CHD). METHODS--1162 subjects aged over 20 years, were divided in two groups: G Fam consisted of 312 women and 221 men, mean age 30.8 years, siblings, brothers or sisters of revascularized patients (under 55 years old); G Serv consisted of 425 women and 204 men, mean age 30.7 years, all of them being healthy employees of Hospital das Clínicas (Clinics Hospital) with no family history of CHD. There were performed clinical, electrocardiographic and laboratory tests (total blood cholesterol--CT, triglycerides--TG and HDL cholesterol--HDL-C): and VLDL-C and LDL-C values were calculated according to Friedwald, besides CT/HDL-C and LDL-C/HDL-C ratios. Based on NCEP guidelines, the frequencies on values ranges for each parameter were determined. RESULTS--G Fam group showed a higher incidence of women and men with CT and LDL-C levels above 240 mg/dl and 160 mg/dl, respectively; CT/HDL-C and LDL-C/HDL-C values over 5.0 and 3.5, respectively, were seen more often in G Fam group. There were no significant differences on HDL-C and TG. About 35% of men and women in G Serv group showed CT levels higher than 200 mg/dl. CONCLUSION--First-degree relatives, aged over 20 years, from revascularized patients under 55 years old, showed more often lipid levels above those established by NCEP. In accordance to them, 62% of men and 28% of women of this group should undergo to LDL-C analysis, as well as 35% of men and 28% of women in teh G Serv group. It is called the attention for the importance of cholesterolemia evaluation in high risk groups for CHD.

Management and control of a carbapenem-resistant Acinetobacter baumannii outbreak in an intensive care unit.

OBJECTIVE: We had for aim to describe the identification and management of a 14-clonal carbapenem-resistant Acinetobacter baumannii (CRAB) outbreak, following admission of a known CRAB-infected patient in an ICU. METHODS: We reviewed the carriers' files and outbreak management procedures. RESULTS: The index patient was admitted with strict isolation precautions. The outbreak started 2 months after his discharge. It persisted despite reinforcement of strict isolation precautions, staff and patient cohorting, and extensive environmental decontamination including 2 rounds of routine terminal cleaning and disinfection or 1 round of cleaning and disinfection followed by hydrogen peroxide treatment. A second epidemic peak, after 4 weeks without any case, led to another wide environmental sampling and decontamination rounds. The source of the CRAB outbreak was suspected to be the blood pressure cuffs Velcro. Switching to cuffs submersible in a disinfectant stopped the outbreak. CONCLUSIONS: CRAB outbreaks are difficult to manage and sources of persistent colonization can be unexpected.

Biomarcadores y marcadores de imagen de la enfermedad de Alzheimer / Biomarkers and image markers of Alzheimer's disease

Este artículo presenta un análisis desde el punto de vista bibliográfico de marcadores y biomarcadores de la enfermedad de Alzheimer (EA). Las metodologías usadas fueron los marcadores de imágenes (Resonancia Magnética y Tomografía por emisión de positrones) y biomarcadores de la proteína BA42, de la proteína Tau y de la Apoliproteína E (ALPE). De esta manera, son de importancia los niveles de BA42 disminuidos, la Tau incrementada, los polimorfismos de ALPE y las alteraciones constatadas en los marcadores de imagen, como factores de riesgo esenciales para el desarrollo de la EA. Se realiza una revisión de la literatura con respecto a los hallazgos clínicos de esta enfermedad.

This article presents a bibliographical analysis of markers and biomarkers of Alzheimer's disease (AD). The methodologies used were the imaging markers (Magnetic Resonance and Positron Emission Tomography) and biomarkers of the BA42 protein, Tau protein and Apoliprotein E (ALPE). Thus, decreased levels of BA42, increased Tau, ALPE polymorphisms, and alterations in imaging markers are important as risk factors for the development of AD. A review of the literature is made regarding the clinical findings of this disease.

Síndrome de Frey / Frey's syndrome

É apresentada uma revisäo sobre sudorese gustatória (síndrome de Frey) após cirurgias sobre a glândula parótida. O histórico, a fisiopatologia, o diagnóstico, incluindo uma nova modalidade terapêutica usando toxina botulínica, säo abrangentemente discutidos.