Time series forecasting methods in emergency contexts.

The key issues in any fire emergency are recognising fire hotspots, locating the emergency intervention team (EI), following the evolution of the fire, and selecting the evacuation path. This leads to the study and development of HelpResponder, a solution capable of detecting the focus of interest in hostile spaces derived from fire due to high temperatures without visibility. A study is conducted to determine which model best predicts measured [Formula: see text] levels. The variables used are temperature, humidity, and air quality, obtained from sensors installed in a fire tower. The statistical methods applied, namely ARIMAX, KNN, SVM, and TBATS, allow the adjustment and modelling of the variables. Explanatory variables with temporal structure are incorporated into SVM, a new improvement proposal. Moreover, combining different models showed the best efficiency in forecasting. In fact, another contribution of our work lies in offering a small-scale prediction system that is specifically designed to save batteries. The system has been tested and validated in a hostile environment (building), simulating real emergency situations. The system has been tested and validated in several hostile environments, simulating real emergency situations. It can help firefighters respond faster in an emergency. This reduces the risks associated with the lack of information and improves the time for tactical operations, which could save lives.

Prevalence of asthma in Catalonia (Spain): a retrospective, large-scale population-based study.

BACKGROUND AND OBJECTIVE: Asthma epidemiology reports an estimated global prevalence of about 4.3-8.6% in adults, with last differences among geographical regions. This study analyses a more significant population of asthma patients (473,737 individuals).To study the prevalence of medical diagnosis of asthma, overall and by age, gender, and disease severity, as well as comorbidities and type 2 biomarkers, and undergo medical treatments of a retrospective population-based asthma cohort from Catalonia (Spain). METHODS: Individuals with a diagnosis of asthma established by medical records at different healthcare levels (primary, hospital, and emergency) from the Catalan Health System (CHS) were included. Socio-demographic characteristics, prevalence, overall and by age and gender, disease severity, comorbidities, and biomarkers of type-2 inflammation were evaluated, together with appropriate medical treatment. RESULTS: The overall diagnosed asthma prevalence in the population of Catalonia was 6.3%, where patients mainly had mild asthma (5.3%) and were significantly higher in females (6.8%) than males (5.7%). By age groups, asthma was more prevalent in boys and young men adults; however, being more prevalent in females above the age of 30y. The prevalence of severe asthma was 0.4%, 42.6% had uncontrolled asthma, and a high proportion (84.2%) were under systemic corticosteroid prescription. As expected, SABAs were the most prescribed drug (62.6%), followed by systemic corticosteroids (43.3%). More than half (53.8%) of patients showed type 2 inflammation. CONCLUSION: Asthma prevalence in Catalonia is similar to other areas studied in Spain, with a high prevalence in women and of T2 asthma.

Prevalence of Atopic Dermatitis in the adult population of Catalonia (Spain): a retrospective, large-scale population-based study.

BACKGROUND AND OBJECTIVES: Studies on the prevalence of Atopic Dermatitis (AD) for the adult cohort in general-based populations are scarce worldwide. We performed a retrospective population-based observational cohort study of 537,098 adult patients diagnosed with AD in Catalonia (Spain), a larger population than in previous studies. To study the prevalence of AD generally by age, gender, disease severity, multi-morbidities, and serum total Immunoglobin E (tIgE) and undergo appropriate medical treatment (AMT) for the Catalan population. METHODS: Adult individuals (≥18 years old) diagnosed with AD by medical records at different health care levels (primary, hospital, emergency) from the Catalan Health System (CHS) were included. Statistical analyses were conducted to evaluate socio-demographic characteristics, prevalence, multi-morbidities, serum tIgE and AMT. RESULTS: The overall diagnosed AD prevalence in the adult Catalan population was 8.7%, being higher for the non-severe (8.5%) than for the severe (0.2%) populations and females (10.1%) than males (7.3%). Topical corticosteroids were the most prescribed drug (66.5%), and the use of all prescribed treatments was higher in severe AD patients, especially systemic corticosteroids (63.8%) and immunosuppressant agents (60.7%). More than half (52.2%) of severe AD patients reported serum tIgE ≥ 100 KU/L, and higher values were observed for those with multi-morbidities. Acute bronchitis (13.7%), allergic rhinitis (12.1%), and asthma (8.6%) were the most frequent comorbid respiratory diseases. CONCLUSIONS: Our study provides new and robust evidence of AD´s prevalence and related characteristics in adults using a large-scale population-based study and a more significant cohort of individuals.

Prevalence of Chronic Rhinosinusitis with Nasal Polyps in Catalonia (Spain): a retrospective, large-scale population-based study.

BACKGROUND: Studies on the prevalence of chronic rhinosinusitis (CRS) with nasal polyps (NP) in general-based populations are scarce in Europe and worldwide. We performed a retrospective population-based observational cohort study of 30,189 adult patients diagnosed with NP in Catalonia (Spain). METHODOLOGY: Adult individuals (≤18 years old) with a diagnosis of NP established by medical records at different health care levels (primary, hospital, and emergency) from the Catalan Health System (CHS) were included. Socio-demographic characteristics, prevalence, overall and by age and gender, disease severity, multi-morbidities, and biomarkers of type-2 inflammation were evaluated, together with appropriate medical treatment (AMT) and Endoscopic Sinus Surgery (ESS). RESULTS: In general population and severity sub-populations, the overall diagnosed NP prevalence was 0.49% and higher for males than females (0.60% vs 0.39%, p less than 0.0016). The prevalence for the severe NP population was 0.12%. The NP prevalence increased with age, the highest being at ≤60 years old for both gender and severity groups. Asthma (40.1%), acute rhinosinusitis (41.1%), and allergic rhinitis (32.1%) were among the most frequent comorbid respiratory diseases. ESS was performed in 15.4% of NP patients. Type 2 inflammation was present in 83.8% of the NP population and was more frequent in severe than non-severe (87.1% vs 82.7%, p less than 0.0001) patients and in those with respiratory multi-morbidities (91%). CONCLUSIONS: This is the first large-scale population-based NP epidemiology study conducted in Spain, including severity based on undergoing medical and surgical treatment and type 2 inflammation. Although the prevalence data are lower than in previous European studies, the large NP cohort studied represents an essential strength of the results.

Chemoselective and stereoselective lithium carbenoid mediated cyclopropanation of acyclic allylic alcohols.

The reaction of geraniol with different lithium carbenoids generated from n-BuLi and the corresponding dihaloalkane has been evaluated. The reaction occurs in a chemo and stereoselective manner, which is consistent with a directing effect from the oxygen of the allylic moiety. Furthermore, a set of polyenes containing allylic hydroxyl or ether groups were chemoselectively and stereoselectively converted into the corresponding gem-dimethylcyclopropanes in one single step in moderate to good yields mediated by a lithium carbenoid generated in situ by the reaction of n-BuLi and 2,2-dibromopropane.

Titanium carbenoid-mediated cyclopropanation of allylic alcohols: selectivity and mechanism.

A new method for the chemo- and stereoselective conversion of allylic alcohols into the corresponding cyclopropane derivatives has been developed. The cyclopropanation reaction was carried out with an unprecedented titanium carbenoid generated in situ from Nugent's reagent, manganese and methylene diiodide. The reaction involving the participation of an allylic hydroxyl group, proceeded with conservation of the alkene geometry and in a high diastereomeric excess. The scope, limitations and mechanism of this metal-catalysed reaction are discussed.

The synthesis of 3-hydroxy-2,4,8-trimethyldec-8-enolides and an approach to 3,4-dihydroxy-2,4,6,8-tetramethyldec-8-enolide.

The synthesis of several derivatives of 3-hydroxy-2,4,8-trimethyldec-8-enolide and attempts at the synthesis of 3,4-dihydroxy-2,4,6,8-tetramethyldec-8-enolide (1), a structure which has been assigned to a metabolite of the phytopathogenic fungus, Botrytis cinerea, gave products whose spectroscopic data had significant differences from those reported for the natural product 1. The rare 11-membered lactone rings were constructed by ring-closing metathesis reactions. The increase in conformational restrictions imposed by the substituents has a high influence on the stereochemistry of the ring-closing metathesis reaction and gives rise to a decrease in the yield for the synthesis of 11-membered lactones. The predominant alkene which was obtained was the (Z)-isomer. The observed spectroscopic differences between the synthesized lactones and the natural product and the spectroscopic data of its acetylated derivative 26a allowed us to revise the structure 1 to that of the γ-butyrolactone 26.

Exploring mutasynthesis to increase structural diversity in the synthesis of highly oxygenated polyketide lactones.

The enantioselective synthesis of (2R,3R,4E,8E)-3-hydroxy-2,4,8-trimethyldeca-4,8-dienolide (5) by ring-closing metathesis is described. This compound is an analogue of 3,4-dihydroxy-2,4,6,8-tetramethyldec-8-enolide (4) which is a rare 11-membered lactone produced by the fungus, Botrytis cinerea. Mutasynthetic studies with compound 5 using two mutants of B. cinerea led to the isolation of four new highly oxygenated 11-membered lactones (11-14) in which compound 5 has been stereoselectively epoxidized and hydroxylated at sites that were not easily accessible by classical synthetic chemistry.

[Anesthetic conserving device (AnaConDa) used after cardiac surgery: experience in a postoperative recovery unit]. / Experiencia clínica de la utilización del sistema AnaConDa en una unidad de reanimación de cirugía cardiaca.

OBJECTIVE: To assess the safety and efficacy of using the Anesthetic Conserving Device (AnaConDa) when maintaining sedation after cardiac surgery. MATERIAL AND METHODS: Descriptive study of 46 consecutive patients in the postoperative recovery unit after cardiac surgery between January and April 2009. The patients were under sevoflurane sedation administered with the AnaConDa placed in the inhalation tube. No exclusion criteria were established before enrollment. The sevoflurane dose was set using the manufacturer's normogram and was later adjusted to give an end-tidal concentration of sevoflurane between 0.5% and 0.7% on the basis of data from a gas analyzer. Remifentanil was administered to all patients; a fast-track extubation protocol was used. The only criterion for excluding a patient's data from analysis was prolonged sedation (> 5 hours). RESULTS: The mean (SD) time patients were under sedation with the AnaConDa in place was 2588 (12.32) minutes. The end-tidal concentration of sevoflurane never exceeded 1%. Scores on the Richmond agitation-sedation scale were -5 at 60 minutes in all cases; there was some score variability at 120 minutes. Deeper sedation was desired for the first 60 minutes to avoid awakening related to rewarming. The mean time until awakening was 6.17 minutes (range, 1-30 minutes). The mean time until extubation was 43 (6.69) minutes. The most common adverse effect was arterial hypotension (12 cases). Hypotension was related to bleeding in 3 patients and to low cardiac output in 4 patients. CONCLUSION: Administering sevoflurane through the AnaConDa can be a safe, valid, and reliable method for sedating patients after cardiac surgery. With this device, it is possible to monitor the concentration administered.

[Evaluation of the effect of hospital clown's performance about anxiety in children subjected to surgical intervention]. / Evaluación del efecto de la actuación de los payasos de hospital sobre la ansiedad, en los niños sometidos a una intervención quirúrgica.

OBJECTIVE: To be hospitalized is a highly distressing event for children. At present, a resort used in Spain and other countries to reduce children's anxiety in the health context are hospital's clown. We studied the effect of the hospital's clowns about the anxiety in children that going to be operated. METHODS: We recruited 60 children aged 6 to 10 years scheduled to undergo elective surgery. 30 children would have clowns before the surgery (case group) and 30 would not have them (control group). In the case group, two clowns performed for children. We measured the anxiety with several scales (STAIC, CCPH, faces scale), after the performance and until 7 days after the surgery. RESULTS: The outcomes show both groups a tendency to increase anxiety but the children of the case group showed less increase at the anxiety's score. In the control group is showed that the children are more alterated at seven days from the discharge. CONCLUSIONS: Children that receive the clown's care, have tendency to be less distressing and with less fear that another ones, measurement by STAIC and faces scale, and these results are maintained seven days after the discharge.

Evaluación del efecto de la actuación de los payasos de hospital sobre la ansiedad, en los niños sometidos a una intervención quirúrgica / Evaluation of the effect of hospital clown´s performance about anxiety in children subjected to surgical intervention

Introducción. Ser hospitalizado es un acontecimiento altamente angustioso para los niños. Actualmente un recurso usado en España y otros países para reducir la ansiedad de los niños en el contexto sanitario son los payasos de hospital. Estudiamos el efecto de los payasos de hospital sobre la ansiedad en los niños que van a ser operados. Método. Reclutamos a 60 niños de entre 6 y 10 años de edad, que iban a ser sometidos a una cirugía electiva. 30 niños tendrían payasos antes de la cirugía (grupo de casos) y 30 no los tendrían (grupo control).En el grupo de casos, 2 payasos actuaron para los niños. Medimos la ansiedad con distintas escalas (STAIC, CCPH, escala de caras), después de la actuación y hasta 7 días después de la cirugía. Resultados. Los resultados muestran que ambos grupos tienen una tendencia a incrementar la ansiedad, pero los niños del grupo de casos mostraron menos incremento en la puntuación de ansiedad. El grupo control mostró que los niños están más alterados a los siete días del alta. Conclusiones. Los niños que reciben la atención de los payasos tienen tendencia a estar menos estresados y con menos miedo que los otros, medido por el STAIC y la escala de caras, y estos resultados se mantienen siete días después del alta (AU)

Objective. To be hospitalized is a highly distressing event for children. At present, a resort used in Spain and other countries to reduce children’s anxiety in the health context are hospital’s clown. We studied the effect of the hospital’s clowns about the anxiety in children that going to be operated. Methods. We recruited 60 children aged 6 to 10 years scheduled to undergo elective surgery. 30 children would have clowns before the surgery (case group) and 30 would not have them (control group).In the case group, two clowns performed for children. We measured the anxiety with several scales (STAIC, CCPH, faces scale), after the performance and until 7 days after the surgery. Results. The outcomes show both groups a tendency to increase anxiety but the children of the case group showed less increase at the anxiety’s score. In the control group is showed that the children are more alterated at seven days from the discharge. Conclusions. Children that receive the clown’s care, have tendency to be less distressing and with less fear that another ones, measurement by STAIC and faces scale, and these results are maintained seven days after the discharge (AU)

[Idiopathic soft palate hemiparalysis]. / Hemiparálisis velopalatina idiopática.

Idiopathic soft palate paralysis is an infrequent clinical entity, both in children and adults. We describe the clinical manifestations in two new cases, manifested by fluid dysphagia, rhinolalia, absent gag reflex, and nasal escape of fluids. The remission period is the shortest observed in published cases. Thirty-three reports have been published in the literature to data, 32 in children and adolescents and one in an adult. This paralysis suggests a viral etiology, affects mainly children, and resolves spontaneously.

Hemiparálisis velopalatina idiopática / Idiopathic soft palate hemiparalysis

La parálisis velopalatina idiopática es una entidad muy rara, tanto en niños como en adultos. Se describe la clínica de dos nuevos casos, definida por la aparición de disfagia para líquidos, rinolalia, ausencia de reflejo nauseoso e insuficiencia velopalatina del lado afecto. El plazo de remisión es el más corto observado de todos los casos publicados. Los 33 casos descritos en la literatura médica hasta este momento corresponden a 32 niños y adolescentes y un adulto. Esta parálisis sugiere etiología virásica, afecta sobre todo a la infancia y remite espontáneamente

Idiopathic soft palate paralysis is an infrequent clinical entity, both in children and adults. We describe the clinical manifestations in two new cases, manifested by fluid dysphagia, rhinolalia, absent gag reflex, and nasal escape of fluids. The remission period is the shortest observed in published cases. Thirty-three reports have been published in the literature to data, 32 in children and adolescents and one in an adult. This paralysis suggests a viral etiology, affects mainly children, and resolves spontaneously

Trastorno esquizofreniforme. Estudio prospectivo de 5 años de seguimiento / Schizophreniform disorder. A 5-year prospective follow-up study

Introducción: Estudio prospectivo de 5 años, cuyo objetivo es evaluar la estabilidad temporal del diagnóstico de trastorno esquizofreniforme (TE) provisional y evaluar la validez predictiva de las características de buen pronóstico que define el Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM-IV). Sujetos y métodos: La muestra consta de 38 pacientes (23 varones y 15 mujeres) ingresados en el hospital, entre 1996 y 1998, por un primer episodio psicótico. Se realizaron 4 entrevistas de seguimiento: en el primer, segundo, tercer y quinto años. Los pacientes se evaluaron mediante la Brief Psychiatric Rating Scale (BPRS), la Escala de Evolución de Strauss-Carpenter, la entrevista clínica estructurada del DSM-IV (SCID) y la Escala de Evaluación de la Actividad Global (EEAG). Resultados: Completaron el seguimiento de 5 años 27 pacientes. El 25,9% mantenía el diagnóstico de TE a los 5 años y el 59,2% se clasificaron dentro del espectro esquizofrénico. La presencia en el primer ingreso de características de buen pronóstico se asoció con una mejor evolución a los 5 años, pero no se asoció al mantenimiento del diagnóstico de TE. Los pacientes que mantuvieron el diagnóstico de TE presentaron mejor evolución que los pacientes esquizofrénicos. Conclusiones: Tras 5 años de seguimiento, la mayoría de los pacientes continúan presentando síntomas y cumplen criterios de esquizofrenia o trastorno esquizoafectivo, lo que confirma la baja estabilidad del diagnóstico TE. Los hallazgos sugieren una asociación entre las características de buen pronóstico y una mejor evolución, aunque no se observa asociación con el mantenimiento del diagnóstico TE

Introduction: We performed a 5-year prospective study to evaluate the temporal stability of a provisional diagnosis of schizophreniform disorder (SFD) and evaluate the predictive value of the good prognostic features defined in the DSM-IV. Subjects and Methods: The sample consisted of 38 patients (23 men and 15 women) admitted to our hospital from 1996 to 1998 for a first psychotic episode. Four follow-up interviews were obtained: at the first, second, third and fifth years of follow-up. Patients were evaluated by means of the Brief Psychiatric Rating Scale (BPRS), the Strauss-Carpenter Scale, the Structured Clinical Interview of the DSM-IV (SCID) and the Global Assessment of Functioning Scale (GAF Scale) of the DSM-IV. Results: Twenty-seven patients completed the study. A total of 25.9% retained the diagnosis of SFD and 59.2% were classified as having a disorder of the schizophrenic spectrum. The presence of good prognostic features at the index admission was associated with better outcome, but not with maintenance of the diagnosis of SFD. After 5 years of follow-up, patients with SFD showed significantly better outcomes than did schizophrenic patients. Conclusions: After 5 years of follow-up most of the patients continued to have symptoms and met the criteria for schizophrenia or schizoaffective disorder, confirming the low stability of a provisional diagnosis of SFD. The results of this study suggest an association between good prognostic features and better outcome, but not with maintenance of a diagnosis of SFD

[Infant boy with propionic acidemia: anesthetic implications]. / Implicaciones anestésicas en un niño afecto de acidemia propiónica.

A 12-month-old boy diagnosed with propionic acidemia underwent gastrostomy. The patient's general state was good and he was alert, but with reduced muscular tone (unstable when seated with support, floppy head) and with dystonic movements in all extremities. An electroencephalogram showed slightly slowed brain activity. The patient was being treated with a low protein diet, phenobarbital, L-carnitine, L-isoleucine, and biotin. Surgery was carried out in satisfactory conditions with general anesthesia without opioids combined with infiltration of the surgical wound with local anesthetic. Recovery from anesthesia was rapid and free of complications. Propionic acidemia is caused by mitochondrial propionyl coenzyme carboxylase deficiency. Most patients have episodes of severe metabolic ketoacidosis as a result of excessive protein intake, delayed development, vomiting, gastroesophageal reflux, lethargy, hypotonia, and convulsions. The anesthetic approach involves avoiding triggers of metabolic acidosis (such as fasting, dehydration, hypoxemia, and hypotension) and preventing airway complications. Agents that metabolize propionic acid (such as succinylcholine, benzylisoquinoline neuromuscular blocking agents, and propofol) are not used, as they can exacerbate acidemia. We also believe that using local or regional anesthesia in combination with general anesthesia without opiates is safe and effective for controlling pain during surgery and postoperative recovery, as that combination avoids respiratory depression in these patients, who are highly sensitive to opiates.

Implicaciones anestésicas en un niño afecto de acidemia propiónica / Infant boy with propionic acidemia: anesthetic implications

Un niño de 12 meses de edad con diagnóstico de acidemia propiónica fue intervenido para gastrostomía. El paciente presentaba buen estado general y sensorio despejado, tono muscular disminuido, sedestación inestable con apoyo, sostén cefálico incompetente y movimientos distónicos de las cuatro extremidades. El EEG mostraba una actividad bioeléctrica cerebral discretamente enlentecida. El paciente estaba siendo tratado con dieta hipoproteica, fenobarbital, L-carnitina, L-isoleucina y biotina. La cirugía fue realizada bajo anestesia general sin opioides combinada con infiltración de la herida quirúrgica con anestésico local, que proporcionó condiciones quirúrgicas satisfactorias y una recuperación de la anestesia rápida y sin complicaciones. La acidemia propiónica se produce como consecuencia de la actividad deficiente de la enzima mitocondrial propionilCo-A carboxilasa. La mayoría de los pacientes presentan episodios de cetoacidosis metabólica severa secundaria a la excesiva ingesta proteica, retraso del desarrollo, vómitos, reflujo gastroesofágico, letargia, hipotonía y crisis convulsivas. La conducta anestésica se dirige a evitar los precipitantes de acidosis metabólica (ayuno, deshidratación, hipoxemia e hipotensión arterial) y las complicaciones de la vía aérea, así como no utilizar agentes anestésicos que se metabolizan a ácido propiónico como la succinilcolina, bloqueantes neuromusculares bencilisoquinoleínicos y el propofol, ya que pueden contribuir a la acidemia. Además, consideramos que el empleo de anestesia locorregional combinada con anestesia general sin opioides es segura y efectiva para el control del dolor durante la intervención y en el postoperatorio, ya que evitaría la depresión respiratoria en estos pacientes con elevada sensibilidad a los opioides

A 12-month-old boy diagnosed with propionic acidemia underwent gastrostomy. The patient's general state was good and he was alert, but with reduced muscular tone (unstable when seated with support, floppy head) and with dystonic movements in all extremities. An electroencephalogram showed slightly slowed brain activity. The patient was being treated with a low protein diet, phenobarbital, L-carnitine, L-isoleucine, and biotin. Surgery was carried out in satisfactory conditions with general anesthesia without opioids combined with infiltration of the surgical wound with local anesthetic. Recovery from anesthesia was rapid and free of complications. Propionic acidemia is caused by mitochondrial propionyl coenzyme carboxylase deficiency. Most patients have episodes of severe metabolic ketoacidosis as a result of excessive protein intake, delayed development, vomiting, gastroesophageal reflux, lethargy, hypotonia, and convulsions. The anesthetic approach involves avoiding triggers of metabolic acidosis (such as fasting, dehydration, hypoxemia, and hypotension) and preventing airway complications. Agents that metabolize propionic acid (such as succinylcholine, benzylisoquinoline neuromuscular blocking agents, and propofol) are not used, as they can exacerbate acidemia. We also believe that using local or regional anesthesia in combination with general anesthesia without opiates is safe and effective for controlling pain during surgery and postoperative recovery, as that combination avoids respiratory depression in these patients, who are highly sensitive to opiates

[Post-surgical paediatric pain: Nursing- PCA vs continuous I.V. infusion of tramadol ]. / Dolor postoperatorio en lactantes y niños pequeños: nursing-PCA vs perfusión i.v. de tramadol.

AIM: To evaluate the efficiency in the control of the post-surgical paediatric pain of the combination of a weak opioid [tramadol (T)] and an NSAID (paracetamol), comparing its administration through "Nursing-PCA" (NCA) techniques or through continuous i.v. infusion. METHODS: The investigation has been carried out in 30 patients (mean 9.5 months) selected according to their foreseeable degree of moderate-hard pain. All of them consumed in the postoperative period: rectal paracetamol (20 mg/Kg) every 8 hours and tramadol in two groups. Group I: PCA pump with tramadol that was handled by the nurse. Initial dose: 0.5 mg/Kg NCA, bolus injection 0.3 mg/Kg with an interval of 10 minutes for security and a highest dose of 1.2 mg/Kg/4 h every 4 hours. Group II: continuous infusion i.v. of tramadol (6 mg/Kg/24 h). The pain was evaluated, as well as the sedative action, saturation oxygen, respiratory and hemodynamics parameters, adverse effects, and efficiency during the first 24 hours, as well as the number of total dose of drugs asked in the Nursing PCA group. RESULTS: Pain decreased in both groups. There were more sedative effects in group II and the total dose of tramadol was higher. There were no cases of respiratory depression. CONCLUSIONS: The combination of tramadol and paracetamol through "Nursing PCA" has turned out to be an efficient method in the treatment of the post-surgical pain in little children and those whose are in their lacteal period. It is a possible alternative of the continuous infusion of Morphine in these patients.

Dolor postoperatorio en lactantes y niños pequeños: Nursing-PCA vs perfusión I.V. de tramadol / Post-surgical paediatric pain: Nursing-pca vs continuous i.v. infusion oftramadol

Objetivos. Evaluar la eficacia en el control del dolor postoperatorio pediátrico de la asociación de un opiáceo menor [tramadol(T) ] y un AINE (paracetamol), comparando su administración mediante técnicas de «Nursing-PCA» (NCA) o mediante infusión I.V. continua. Material y métodos. Se han estudiado 30 pacientes ASA I, de edad media 9,5 meses, seleccionados según el grado previsible de dolor moderado-severo. Todos reciben en el postoperatorio: Paracetamol 20mg/Kg rectal cada 8 horas y Tramadol en dos grupos. Grupo I: Bomba PCA con Tramadol (dosis de inicio: 0,5 mg/Kg-NCA bolo 0,3 mg/Kg con un intervalo de seguridad 10 minutos y dosis máxima cada 4 horas de 1,2 mg/Kg/4h), que se accionó por enfermería. Grupo II: Perfusión IV de Tramadol (6 mg/Kg/24h). Se evaluó dolor, sedación, saturación de O2, frecuencia respiratoria, parámetros hemodinámicos, efectos (..) (AU)

The putative role of botrydial and related metabolites in the infection mechanism of Botrytis cinerea.

Phytotoxic assays, performed both in vitro and in vivo on leaves of Phaseolus vulgaris, with metabolites excreted by the fungus B. cinerea are evaluated. Exogenous application of the phytotoxin botrydial has been found to produce severe chlorosis and cell collapse and facilitated fungal penetration and colonization of plant tissue. The results also show a light-dependent action mechanism for the phytotoxin and seem to indicate that botrydial is a non-host-specific toxin involved in fungal infection of B. cinerea.

Novel rearrangements of sesquiterpenoid panasinsane derivatives under acidic conditions.

The sesquiterpenoid panasinsane derivatives 11 and 14-16 have been prepared from caryophyllene oxide (7). The novel rearrangement reactions of compounds 11 and 14 under TCNE-catalyzed solvolysis conditions and the reactions of compounds 15 and 16 under superacid conditions (HSO3F/Et2O, -63 degrees C) have been investigated. The ginsenol derivative 17 is obtained from compounds 11 and 14 under TCNE-catalyzed conditions. The rearrangement of compounds 15 and 16 under superacid conditions leads to the novel sesquiterpene derivatives (1S,4S,7S,10S,11S)-3,3,10,11-tetramethyltricyclo[5.3.1.0(4,10)]undecan-1,11-yl sulfate (19) and (1S,4S,5S,8S)-2,2,4,8-tetramethyl tricyclo[3.3.2.1(4,8)]undecan-11-one (20). The influence of the secondary hydroxyl group at C-5 of the panasinsane derivatives on the course of these rearrangements is discussed.