Analysis of two kinds of tree as physical barriers against erythemal UVB radiation received.

Differences between global radiation UVER (erythemal ultraviolet solar radiation) received under full sun and diffuse radiation received under the shadow of two types of tree are analyzed to check the importance of these components on human exposure to UV radiation. Blue Line spores dosimeters of VioSpor were used for measurement of erythemal dose of UV radiation (able to produce erythema in human skin.) The response profile of these devices is extremely similar to human skin, thus they are suitable to determine and predict the interactions between UV erythema and human skin. Measurements were obtained in relatively clear days from February to December 2009 between 9:30 and 15:30 h. Three dosimeters were placed on a horizontal surface: one in full sun and the other two under the shadow of each tree. Values of UVER in both cases, in full sun and under the shadow of pine and Sauce, were obtained. In addition, the comparison was made between values of dose received in each case and the exposure limits recommended by the International Commission on Non-Ionizing Radiation Protection (ICNIRP). Finally, average daily irradiance received under the shadow of each tree in comparison with those received in full sun, was also analyzed using two PMA2100 radiometers situated on a horizontal surface.

Complications related to less-invasive haemodynamic monitoring.

BACKGROUND: The aim of this study was to evaluate the type and incidence of complications during insertion, maintenance, and withdrawal of central arterial catheters used for transpulmonary thermodilution haemodynamic monitoring (PiCCO™). METHODS: We conducted a prospective, observational, multicentre study in 14 European intensive care units (six countries). A total of 514 consecutive patients in whom haemodynamic monitoring by PiCCO™ was indicated were studied. RESULTS: Five hundred and fourteen PiCCO catheters (475 in femoral, 26 in radial, nine in axillary, and four in brachial arteries) were inserted. Arterial access was obtained on the first attempt in 86.4% of the patients. Minor problems such as oozing after insertion (3.3%) or removal of the catheter (3.5%) were observed, but no episodes of serious bleeding (more than 50 ml) were recorded. Small local haematomas were observed after insertion (4.5%) and after removal (1.2%) of the catheter. These complications were not more frequent in patients with coagulation abnormalities. The incidence of site inflammation and catheter-related infection was 2% and 0.78%, respectively. Other complications such as ischaemia (0.4%), pulse loss (0.4%), or femoral artery thrombosis (0.2%) were rare, transient, and all resolved with catheter removal or embolectomy, respectively. CONCLUSIONS: In this series of patients, central arterial catheters used for PiCCO™ monitoring were demonstrated to be a safe alternative for advanced haemodynamic monitoring.

[Study of the introduction of the European Credit Transfer System (ECTS) in pediatrics and modification of the teaching methodology]. / Estudio sobre la introducción del Sistema de Transferencia de Créditos Europeo en Pediatría y modificaciones de la metodología docente.

INTRODUCTION: Spanish medical faculties have initiated the new curriculum reform process within the framework of the European Higher Education Area and are required to incorporate the European Credit Transfer System (ECTS) to new syllabi before 2010. OBJECTIVES: To test the introduction of the ECTS in pediatrics and modify the teaching methodology. STUDY DESIGN: The theoretical and practical programs were adapted; academic objectives and a student evaluation system were established. Students were surveyed on starting the second term of the 2004-05 academic year before the theory examination and again on terminating the academic year: a 5-point Likert-type scale was used for responses. Priorities for generic and specific competencies selected by students were compared with those selected by the National Deans Conference (NDC). The results were analyzed using non-parametric tests. RESULTS: Fifteen credits became 11 ECTS, with 297 student working hours. The theory program was reduced from 80 to 52 lessons. The students prepared 14 tutor-supervised case presentations. The teaching staff considered that learning of theory was similar to previous years (66 %) and that practical learning improved (73.3 %). The students thought the program should continue (73.2 %) but 98.8 % considered the workload excessive. The students believed that their practical training and their ability to prepare and make case presentations significantly improved during the semester. Academic performance was significantly higher than that in students of the previous year. Students agreed with NDC priorities for 9/9 general and 4/17 specific competencies. Estimation of workload by students was significantly higher than that by staff, and 73.3 % of the students believed that workload should be reduced and the examination system improved. CONCLUSIONS: Introducing the ECTS improved academic performance, practical training, and self-directed learning. The project was satisfactory for staff and students. Student workload was underestimated.

Estudio sobre la introducción del Sistema de Transferencia de Créditos Europeo en Pediatría y modificaciones de la metodología docente / Study of the introduction of the european credit transfer system (ECTS) in pediatrics and modification of the teaching methodology

Introducción Las Facultades Médicas españolas han comenzado el nuevo proceso de reforma curricular en el marco del proceso de implantación del Espacio Europeo de Educación Superior y deben incorporar el Sistema de Transferencia de Créditos Europeo (ECTS) a los nuevos planes del estudio antes de 2010. Objetivos El objetivo del trabajo fue experimentar la introducción de los créditos ECTS en la asignatura de Pediatría y modificar la metodología docente. Diseño del estudio Adaptación del programa teórico y práctico, estableciendo unos objetivos docentes y un sistema de evaluación. Se realizaron encuestas a los alumnos al inicio del segundo cuatrimestre del curso 2004-2005, antes de realizar el examen teórico de la asignatura y al finalizar el curso académico, utilizando para las respuestas una escala de tipo Likert con 5 grados. Se comparó la priorización de las competencias genéricas y específicas de los alumnos con la de los profesionales médicos en la encuesta de la Conferencia Nacional de Decanos (CND). Para el análisis de los resultados se aplicaron pruebas no paramétricas. Resultados Los 15 créditos actuales se transformaron en 11 ECTS, con 297 h de trabajo para los alumnos. Se redujo el programa teórico de 80 a 52 lecciones. Los alumnos prepararon y presentaron 14 casos clínicos, bajo la supervisión de sus tutores. Los profesores consideraron que el aprendizaje teórico había sido similar al de cursos anteriores (66,6 %) y había sido mejor el práctico (73,3 %). Los alumnos opinaron que el proyecto debía continuar (73,2 %), pero el 98,8 % consideraron que la carga de trabajo había sido excesiva. Los alumnos apreciaron de forma estadísticamente significativa que mejoró la docencia práctica y su capacidad para preparar y presentar casos clínicos. El rendimiento académico de los alumnos fue significativamente mejor que el de los alumnos del curso anterior. Los estudiantes estuvieron de acuerdo con la prioridad de competencias de la CND para 9/9 de las generales y 4/17 de las específicas. La estimación de horas de trabajo de los alumnos fue mayor por los alumnos que por los profesores. El 73,3 % de los alumnos contestaron que el proyecto debía mejorarse, reduciendo la carga de trabajo de los alumnos y mejorando el sistema de evaluación. Conclusiones La introducción de los ECTS mejoró el rendimiento académico, la formación práctica y el autoaprendizaje de los alumnos. La experiencia fue satisfactoria para profesores y alumnos. La estimación de la carga de trabajo de los alumnos fue subestimada

Introduction Spanish medical faculties have initiated the new curriculum reform process within the framework of the European Higher Education Area and are required to incorporate the European Credit Transfer System (ECTS) to new syllabi before 2010. Objectives To test the introduction of the ECTS in pediatrics and modify the teaching methodology. Study design The theoretical and practical programs were adapted; academic objectives and a student evaluation system were established. Students were surveyed on starting the second term of the 2004-05 academic year before the theory examination and again on terminating the academic year: a 5-point Likert-type scale was used for responses. Priorities for generic and specific competencies selected by students were compared with those selected by the National Deans Conference (NDC). The results were analyzed using non-parametric tests. Results Fifteen credits became 11 ECTS, with 297 student working hours. The theory program was reduced from 80 to 52 lessons. The students prepared 14 tutor-supervised case presentations. The teaching staff considered that learning of theory was similar to previous years (66 %) and that practical learning improved (73.3 %). The students thought the program should continue (73.2 %) but 98.8 % considered the workload excessive. The students believed that their practical training and their ability to prepare and make case presentations significantly improved during the semester. Academic performance was significantly higher than that in students of the previous year. Students agreed with NDC priorities for 9/9 general and 4/17 specific competencies. Estimation of workload by students was significantly higher than that by staff, and 73.3 % of the students believed that workload should be reduced and the examination system improved. Conclusions Introducing the ECTS improved academic performance, practical training, and self-directed learning. The project was satisfactory for staff and students. Student workload was underestimated

Biosynthesis of antitumoral and bactericidal sanguinarine.

A simple, rapid, and reliable TLC method for the separation and determination of sanguinarine has been established. This intensively studied biologically active alkaloid has a wide range of potentially useful medicinal properties, such as antimicrobial, antiinflammatory, and antitumoral activities. Sanguinarine has also been incorporated into expectorant mixtures and has a strong bactericidal effect upon gram-positive bacteria, particularly Bacillus anthracis and staphylococci. These medicinal properties are due to the interaction of sanguinarine with DNA. A fibre-optic-based fluorescence instrument for in situ scanning was used for quantitative measurements. The sanguinarine was determined over the range 5-40 ng and a detection limit of 1.60 ng. The method was applied to the quantification of sanguinarine in tissue culture extracts of Chelidonium majus L.

DPPH radical scavenging activity of two flavonol glycosides from Aconitum napellus sp. lusitanicum.

The DPPH radical scavenging activity of two flavonol glycosides obtained from ethanolic extracts of Aconitum napellus sp. lusitanicum was studied. The results showed a high DPPH antiradical activity of compound 1 (quercetin 3-O-(6-trans-caffeoyl)-beta-glucopyranosyl-(1-->2)-beta-glucopyranosyl-7-O-alpha-rhamnopyranoside) when compared with compound 2 (quercetin-3-sophoroside-7-rhamnopyranoside), rutin and ascorbic acid. The relationship between the caffeoyl and rhamnopyranoside groups in the flavonol glycosides structures and the DPPH antiradical activity was also discussed.

Punción pleural como complicación de epidural torácica / Pleural puncture complicaing thoracic epidural analgesia

No disponible

[Quantitative aspects of osmotic opening of the blood-brain barrier in experimental hyperbilirubinemia]. / Aspectos cuantitativos de la apertura osmótica de la barrera hematoencefálica en hiperbilirrubinemia experimental.

The presence of a number of interesting factors in kernicteric newborns with low serum bilirubin levels has lead us to study one important aspect, the reversible osmotic opening of the blood-brain barrier. Initially, an experimental hyperbilirubinemia was developed by the infusion of a crystalline bilirubin solution. Next, an increased serum osmolality state was generated by the injection of two different levels of urea (348.9 +/- 12.4 and 388.9 +/- 11 mOsm/kg). The bilirubin binding reserve capacity was not affected; however, we found a significant elevation in bilirubin concentrations in the homogenized brains of the hyperosmolality groups (2.92 +/- 0.54 and 3.4 +/- 0.43 mg/gr versus control of 2.43 +/- 0.63 mg/gr, F = 8.43, p < 0.01). Cerebral125 albumin was increased to similar proportions in those groups submitted to hyperosmolality.

[Electroencephalographic effects of subhypnotic doses of midazolam in healthy subjects and in brain disease patients]. / Estudio de las repercusiones electroencefalográficas de dosis subhipnóticas de midazolam en pacientes sanos y con patología cerebral.

The aim of this study was to analyze the electroencephalographic alterations produced by minimum doses of midazolam and look for a theoretic base for these changes in the benzodiazepinic receptor. To do so, the possible abnormal responses provoked by midazolam on the EEG of patients with ischemic cerebral infarctions were studied. Sub-hypnotic infusions of midazolam (0.15 mg kg/min) were administered prior to anesthetic induction in three groups of patients: control group, patients with tumoral cerebral pathology group, and ischemic cerebral infarctions group. In addition to the known modifications obtained in the patients of the control group, those presenting bioelectric activity alterations due to tumoral pathology did not show modifications. In the group of patients with ischemic infarctions, the intravenous perfusion of midazolam induced moderate increase in the localized theta and delta frequency and a lower representation of the beta rhythm which was also of lower amplitude. Midazolam is capable of making slow rhythms on the EEG, following it administration at low doses, in ischemic zones of the brain.

[Acute perforated sigmoid diverticulitis in childhood]. / Diverticulitis aguda de sigma perforada en la infancia.

Colonic diverticulosis is a pathology of high incidence in normal population during the last decades of life. About 2-5 per 100 of patients admitted because of this disease are below 40 years old, and in this group of patients diverticulitis tends to be very aggressive with a high number of complications. We report a clinical case of acute perforation of sigmoid colon due to diverticulitis in a ten year old child who was treated surgically by means of resection of the sigma and primary end-to-end anastomosis. We did not find in the literature consulted any cases of this illness under twenty years of age.

[An approximate survey of the state of vaccination of the infantile population of Tenerife]. / Estudio de aproximación sobre el estado de vacunaciones de la población infantil de Tenerife.

This is a study of the level of vaccination in a group of 5,909 schoolchildren from three municipalities in Tenerife, in which various methods of collecting information were used, obtaining different results (p less than 0.02), between the schoolchildren of 6 and 7 years old in schools where informative talks on the importance of vaccinations were given for parents before collecting the information on the level of vaccination and those in schools where talks were not given. We point out that the response of parents was much better in two schools within the area covered by the health centre where letters were sent out to the parents. No important differences were found in the groups of children between 12 and 15 years old. We propose that to keep up the level of vaccination the best methods are informative talks and letters to parents and that the (FAT) should be responsible for this.

[Electroencephalographic maturation in preterm newborn infants]. / Maduración electroencefalográfica en el recién nacido pretérmino.

We have studied 51 preterm infants [gestational age (GE) less than 32 weeks] by: a neurologic examination at 40 weeks of postconceptional age, serial cranial ultrasonographies, weekly electroencephalograms (EEG) until 42 weeks of postconceptional age, and Brunet-Lezine test of psychomotor developmental at 1 year old. Our objective is the longitudinal study of EEG maturation in preterm infants with or without neurologic injury. In preterm infants with the less gestational age are present the EEG characteristics reported for the older infants, the typical EEG pattern is the "sawtooth" (27-30 weeks GE). If these infants are "normal", the EEG maturation get adjusted to the previous reported pattern, except for the earlier presentation of transitory acute frontal waves and the disappearance of the preterm's discontinuous trace. The EEG maturation of preterm infants with perinatal neurologic injury are significantly delayed in contrast with "normal" preterm infants until 40 weeks of postconceptional age; this fact have a poor prognosis for these infants.

[Acute monocytic leukemia as secondary neoplasia in a girl with acute lymphocytic leukemia]. / Leucemia monocítica aguda (LMA-M5) como segunda neoplasia en una niña con LLA-L1.

The presence of second malignancies in children suffering from acute lymphoblastic leukemia (ALL) is becoming increasingly frequent. Nevertheless, the appearance of M5 type acute myeloid leukemia (AML) in patients being treated for ALL is very rare. We report the presence of AML-M5 as a second malignancy in a girl diagnosed of ALL-L1 56 months before. The clinical course of this rare association is discussed.

[Extrinsic allergic alveolitis: apropos of a case in a child]. / Alveolitis alérgica extrínseca: a propósito de un caso en edad pediátrica.

We present a young male (12 years) with low grade fever, weight loose, anorexia and progressive dyspnea. The clinical, roentgenological and pulmonary function pictures are close with interstitial pneumonitis. The patient had a pigeon loft on his house, thus we tried confirmed the diagnosis of extrinsic allergic alveolitis: pigeon breeder's lung. We believed at any patient age the pigeon breeder's lung must be considered in the differential diagnosis of interstitial pneumonitis. A good anamnesis will avoid unnecessary complementary test.

[Transient neonatal hyperthyroidism in the child of a treated hyperthyroid mother. Subsequent appearance of sexual precocity]. / Hipertiroidismo neonatal transitorio e hijo de madre hipertiroidea tratada. Posterior aparición de precocidad sexual.

We report a newborn female with neonatal hyperthyroidism, born to a mother with Graves disease treated with potassium iodide and carbimazole. At four months she had some breast development, a bone age advance of one year, and elevated levels of FSH and estradiol. Later on the prolactin level was also raised, while LH and TSH values continued low. Posteriorly, irregular cutaneous pigmentation, brown in colour, was evident on the neck and trunk, and a McCune-Albright syndrome was suspected. The relationship between these conditions and treatment of them is discussed.