Review of electrical impedance tomography in the pediatric patient.

Electrical impedance tomography (EIT) is a new method of monitoring non-invasive mechanical ventilation, at the bedside and useful in critically ill patients. It allows lung monitoring of ventilation and perfusion, obtaining images that provide information on lung function. It is based on the physical principle of impedanciometry or the body's ability to conduct an electrical current. Various studies have shown its usefulness both in adults and in pediatrics in respiratory distress syndrome, pneumonia and atelectasis in addition to pulmonary thromboembolism and pulmonary hypertension by also providing information on pulmonary perfusion, and may be very useful in perioperative medicine; especially in pediatrics avoiding repetitive imaging tests with ionizing radiation.

A new methodology to assess the performance of AOPs in complex samples: Application to the degradation of phenolic compounds by O3 and O3/UV-A-Vis.

A methodology combining experimental design methodology, liquid chromatography, excitation emission matrixes (EEM) and bioassays has been applied to study the performance of O3 and O3/UVA-vis in the treatment of a mixture of eight phenolic pollutants. An experimental design methodology based on Doehlert matrixes was employed to determine the effect of pH (between 3 and 12), ozone dosage (02-1.0 g/h) and initial concentration of the pollutants (1-6 mg/L each). The following conclusions were obtained: a) acidic pH and low O3 dosage resulted in an inefficient process, b) increasing pH and O3 amount produced an enhancement of the reaction, and c) interaction of basic pH and high amounts of ozone decreased the efficiency of the process. The combination of O3/UVA-vis was able to enhance ozonation in those experimental regions were this reagent was less efficient, namely low pH and low ozone dosages. The application of EEM-PARAFAC showed four components, corresponding to the parent pollutants and three different groups of reaction product and its evolution with time. Bioassys indicated important detoxification (from 100% to less than 30% after 1 min of treatment with initial pollutant concentration of 6 mg/L, pH = 9 and ozone dosage of 0.8 g/h) according to the studied methods (D. magna and P. subcapitata). Also estrogenic activity and dioxin-like behavior were significantly decreased.

[Characteristics of the sexual sphere in elderly patients]. / Características de la esfera sexual en pacientes adultos mayores.

OBJECTIVE: Sexuality plays a fundamental role in our lives, but there is little research on this subject with representative samples. This study aims to analyse the knowledge and characteristics of sexual function in people over 60 years of age. MATERIAL AND METHODS: An observational cross-sectional study was carried out. The sample consisted of people over 60 years of age who voluntarily attended health education talks on sexuality held in urban centres for the elderly. Before the talk, they were given a questionnaire to assess their sexual habits and practices. The talk on sexuality was given, and a questionnaire related to the concepts mentioned while the talk was delivered. The data from the questionnaires were collected on spreadsheets in Microsoft Office Excel for Windows, and the statistical analysis was performed with the statistical package SPSS. RESULTS: The results show that sexual activity is important in those over sixty years, with 52.53% of respondents having relationships. More than 70% of adults over 60 refer to being sexually attractive for their age. There were concepts about sexuality that were not clear after the talk. CONCLUSION: Our society is experiencing progressive aging involving the elderly groups in sex education, emphasising the changes at the sexual level implied by age. It is important to start training sessions on health education with content on sexuality and body image reinforcement in the elderly population.

[Tele-medicine consultation as a tool to improve the demand for consultation in Primary Care]. / La consulta no presencial como herramienta de mejora de la consulta a demanda en atención primaria.

OBJECTIVE: Currently, there is a strong healthcare pressure on resources in Primary Care clinics. This significantly compromises the accessibility and the time dedicated to the patient. This paper analyses the implementation of a tele-medicine service using telephone and e-mail consultations. MATERIALS AND METHODS: The telephone and e-mail consultations carried out during one year were reviewed retrospectively. The patient profile, the type of consultation carried out, the need for a face-to-face visit, and the receipt of attached documentation were analysed. RESULTS: A total of 884 distance consultations were received in a 12month period. The distance consultation accounted for 13.56% of consultations on demand. The mean age of the patient was 54 (SD: 17) years old. The large majority (87.7%) of the consultations were made by the patients and the rest by relatives or caregivers. The time spent per patient in the face-to-face consultation was 10.24minutes and the waiting list was less than 48hours on 97% of the days of the year. The patient had to go in person on 24 (2.71%) occasions. CONCLUSIONS: Distance consultation is a useful resource for improving accessibility, as well as leading to more physical consultation time. It has also demonstrated that it is capable of solving problems of different kinds and in different age groups.

Correction: Humic-like substances from urban waste as auxiliaries for photo-Fenton treatment: a fluorescence EEM-PARAFAC study.

Correction for 'Humic-like substances from urban waste as auxiliaries for photo-Fenton treatment: a fluorescence EEM-PARAFAC study' by S. García Ballesteros et al., Photochem. Photobiol. Sci., 2017, 16, 38-45.

Cross-validation analysis for genetic evaluation models for ranking in endurance horses.

Ranking trait was used as a selection criterion for competition horses to estimate racing performance. In the literature the most common approaches to estimate breeding values are the linear or threshold statistical models. However, recent studies have shown that a Thurstonian approach was able to fix the race effect (competitive level of the horses that participate in the same race), thus suggesting a better prediction accuracy of breeding values for ranking trait. The aim of this study was to compare the predictability of linear, threshold and Thurstonian approaches for genetic evaluation of ranking in endurance horses. For this purpose, eight genetic models were used for each approach with different combinations of random effects: rider, rider-horse interaction and environmental permanent effect. All genetic models included gender, age and race as systematic effects. The database that was used contained 4065 ranking records from 966 horses and that for the pedigree contained 8733 animals (47% Arabian horses), with an estimated heritability around 0.10 for the ranking trait. The prediction ability of the models for racing performance was evaluated using a cross-validation approach. The average correlation between real and predicted performances across genetic models was around 0.25 for threshold, 0.58 for linear and 0.60 for Thurstonian approaches. Although no significant differences were found between models within approaches, the best genetic model included: the rider and rider-horse random effects for threshold, only rider and environmental permanent effects for linear approach and all random effects for Thurstonian approach. The absolute correlations of predicted breeding values among models were higher between threshold and Thurstonian: 0.90, 0.91 and 0.88 for all animals, top 20% and top 5% best animals. For rank correlations these figures were 0.85, 0.84 and 0.86. The lower values were those between linear and threshold approaches (0.65, 0.62 and 0.51). In conclusion, the Thurstonian approach is recommended for the routine genetic evaluations for ranking in endurance horses.

Really does temperature reduction and norepinephrine have similar effects on the energy metabolism in rat brown adipose tissue?

CONTEXT: Heat generation by brown adipose tissue (BAT) in response to temperature reduction seems to be entirely related to sympathetic nervous stimulation. OBJECTIVE: To analyse if temperature reduction and norepinephrine may differently affect the expression of proteins related to energy metabolism in BAT. MATERIALS AND METHODS: Isolated rats BAT was incubated with/without norepinephrine (10-6 mol/L, 24 h at 32 °C and 37 °C). RESULTS: In BAT, 32 °C increased the protein expression levels of carnitine palmitoyltransferase-I and -II, mitochondrial uncoupling protein-1 (UCP-1) and the expression and activity of lactate dehydrogenase. Mitochondrial F1-ATP synthase α-chain expression was decreased at 32 °C compared to 37 °C. Norepinephrine and at 32 °C exposure, UCP-1 expression was increased but cytochrome-c oxidase and F1-ATP synthase α-chain expression was reduced with respect to 37 °C. DISCUSSION: Sympathetic stimulation seems not to be the only factor associated with heat generation. CONCLUSIONS: Temperature reduction by itself exerts some different effects on the expression of proteins related to the energy metabolism than norepinephrine.

Humic-like substances from urban waste as auxiliaries for photo-Fenton treatment: a fluorescence EEM-PARAFAC study.

In this work, analysis of excitation-emission-matrices (EEM) has been employed to gain further insight into the characterization of humic like substances (HLS) obtained from urban wastes (soluble bio-organic substances, SBOs). In particular, complexation of these substances with iron and changes along a photo-Fenton process have been studied. Recorded EEMs were decomposed by using parallel factor analysis (PARAFAC). Three fluorescent components were identified by PARAFAC modeling of the entire set of SBO solutions studied. The EEM peak locations (λex/λem) of these components were 310-330 nm/400-420 nm (C1), 340-360 nm/450-500 nm (C2), and 285 nm/335-380 nm (C3). Slight variations of the maximum position of each component with the solution pH were observed. The interaction of SBO with Fe(iii) was characterized by determining the stability constants of the components with Fe(iii) at different pH values, which were in the order of magnitude of the ones reported for humic substances and reached their highest values at pH = 5. Photochemical experiments employing SBO and Fe(iii), with and without H2O2, showed pH-dependent trends for the evolution of the modeled components, which exhibited a strong correlation with the efficiency reported for the photo-Fenton processes in the presence of SBO at different pH values.

Palpebral edema and eosinophilia

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Metabolic differences between white and brown fat from fasting rabbits at physiological temperature.

It has been suggested that activated brown adipose tissue (BAT) shows increased glucose metabolic activity. However, less is known about metabolic activity of BAT under conditions of fasting and normal temperature. The aim of this study was to compare the possible differences in energetic metabolism between BAT and white adipose tissue (WAT) obtained from rabbits under the conditions of physiological temperature and 24 h after fasting conditions. The study was carried out on New Zealand rabbits (n=10) maintained for a period of 8 weeks at 23±2 °C. Food was removed 24 h before BAT and WAT were obtained. Protein expression levels of the glycolytic-related protein, glyceraldehyde-3-phosphate dehydrogenase, and pyruvate dehydrogenase were higher in WAT than that in BAT. The expression level of carnitine palmitoyltransferase 1 (CPT1) and CPT2, two fatty acid mitochondrial transporters, and the fatty acid ß-oxidation-related enzyme, acyl CoA dehydrogenase, was higher in BAT than in WAT. Cytosolic malate dehydrogenase expression and malate dehydrogenase activity were higher in WAT than in BAT. However, lactate dehydrogenase expression and lactate content were significantly higher in BAT than in WAT. In summary, this study for the first time, to our knowledge, has described how under fasting and normal temperature conditions rabbit BAT seems to use anaerobic metabolism to provide energetic fuel, as opposed to WAT, where the malate-aspartate shuttle and, therefore, the gluconeogenic pathway seem to be potentiated.

Factors involved in rosuvastatin induction of insulin sensitization in rats fed a high fat diet.

BACKGROUND AND AIM: To investigate whether rosuvastatin can improve insulin sensitivity in overweight rats having a high fat diet (HFD). The potential mechanisms involved in this action were evaluated, including SIRT-1, other factors involved in glucose metabolism and stress signaling pathways. METHODS AND RESULTS: Male Wistar rats (n = 30) were divided into three groups: (i) rats fed a standard diet (3.5% fat); (ii) rats fed a HFD (33.5% fat); and (iii) rats fed a HFD and treated with rosuvastatin (15 mg/kg/day). Evolution: 7 weeks. HFD rats showed increased body, epididymal and lumbar adipose tissue weights. Plasma levels of cholesterol, triglycerides, VLDL, glucose and insulin and leptin/adiponectin ratio were higher in HFD rats, and rosuvastatin treatment reduced them. SIRT-1, p53, PGC-1α, PPAR-γ and GLUT-4 protein levels in white adipose tissue (WAT) were lower, and JNK was higher in HFD rats compared to controls. Rosuvastatin treatment normalized expression of these mediators. Endothelium-dependent relaxation was reduced in mesenteric rings from HFD rats compared to controls and rosuvastatin enhanced it in HFD rats. CONCLUSION: Rosuvastatin treatment reduced insulin resistance without affecting body weight or WAT loss in HFD rats. Reduction of leptin and JNK, and enhancement of SIRT-1, p53, PGC-1α, PPAR-γ and GLUT-4 expression in WAT could contribute to insulin sensitization. Normalization of SIRT-1 expression in WAT could be considered a key novel mechanism that aids in explaining the beneficial effects of rosuvastatin on the amelioration of glucose metabolism and the arrangement of multiple signaling pathways participating in insulin resistance in overweight HFD rats.

Relevance of vascular peroxisome proliferator-activated receptor γ coactivator-1α to molecular alterations in atherosclerosis.

Peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) is emerging as a novel factor that plays a critical role in integrating signalling pathways in the control of cellular and systemic metabolism. We investigated the role of vascular expression of PGC-1α and related factors, such as sirtuin 1 (SIRT1), peroxisome proliferator-activated receptor γ (PPARγ) and adiponectin, during the atherosclerotic process. Endothelial function, vascular superoxide anion production and inflammatory mediators were also evaluated. This study was carried out in male New Zealand rabbits fed a diet containing 0.5% cholesterol and 14% coconut oil for 8 weeks. Animals developed mixed dyslipidaemia and atherosclerotic lesions, which were associated with endothelial dysfunction, aortic overproduction of superoxide anions and inflammation. Expression of PGC-1α, SIRT1, PPARγ and adiponectin was reduced (P<0.05) in aorta from atherosclerotic rabbits. Levels of PGC-1α were correlated negatively (P<0.05) with total cholesterol levels, aortic superoxide anion production and tumour necrosis factor-α expression, and positively (P<0.05) with maximal relaxation in response to acetylcholine. The observed results suggest that PGC-1α could be considered to be a link between the main atherosclerotic processes (endothelial dysfunction, oxidation and inflammation) and alterations of other factors involved in vascular wall integrity, such as SIRT1, PPARγ and adiponectin.

Contaminación acústica en el transporte sanitario urgente por carretera / Acoustic contamination in urgent medical transportation by road

Fundamento. Determinar los niveles de exposición a ruido durante el transporte sanitario urgente por carretera y describirla percepción de deterioro de la función auditiva en los trabajadores del sector y el empleo de mecanismos de protección acústica. Metodología. Estudio observacional realizado en Bizkaia (España). Mediante dosimetrías sonométricas se registraron los valores instantáneos máximos de nivel sonoro (Lpico) y niveles continuos equivalentes (Leq) medidos en una ambulancia tipo de la red de emergencias. Paralelamente, se realizó una encuesta sobre una muestra representativa compuesta por 127 trabajadores en la que se exploró la percepción subjetiva de pérdida de audición y posibles factores asociados, además de otras cuestiones de interés desde la perspectiva de la prevención de riesgos laborales. Resultados. Se registraron Lpico oscilantes entre 80 y 109 dBA en función de la ubicación. Los niveles Leq medios evaluados durante 10 asistencias, desde la activación hasta la llegada al incidente y durante el traslado al hospital fueron de 79,5 dBA y 74,3 dBA (p<0,001) respectivamente. El 36,2% de los trabajadores encuestados refirió deterioro de la audición en los últimos años. Las variables independientes asociadas a un mayor riesgo fueron la edad mayor a 45 años, antigüedad profesional superior a 15 años y sexo masculino. Las estrategias más empleadas para mitigar el ruido de las sirenas durante la emergencia fueron cerrar las ventanillas de la ambulancia y el uso del atenuador durante la noche. Conclusiones. Los valores de las dosimetrías no exceden los valores críticos estipulados, pero se observa una alta prevalencia referida por los trabajadores de deterioro auditivo. Debe incidirse en la adopción de estrategias orientadas a disminuir el ruido y sus efectos en el transporte sanitario(AU)

Background. To determine levels of exposure to noise during urgent medical transportation by road and to describe the perception of hearing function impairment in workers and the use of hearing protection devices. Material and methods. An observational study was performed in Bizkaia (Spain). The instantaneous maximum noise levels (Lpeak) and its continuous equivalents (Leq) were recorded through sonometric dosimetries, measured in a "sample ambulance" of the emergency network. In parallel, a survey was conducted on a representative sample of 127 workers in which self-reported hearing loss and associated factors were explored, in addition to other issues of concern from the perspective of prevention of occupational hazards. Results. Lpeak oscillating between 80 and 109 dBA were recorded depending on the location. The average Leq levels measured over 10 emergency calls, from activation until arrival at the incident and during transport to the hospital, were of 79.5 dBA and 74.3 dBA (p <0.001) respectively. Thirty-six point two percent of the surveyed workers spoke of hearing impairment in recent years. The independent variables associated with increased risk were: age over 45years, professional seniority over 15 years and male gender. The strategies used to mitigate the siren's noise during the emergency were closing the windows of the ambulance and using the dimmer at night. Conclusions. The values of the dosimetries do not exceed the critical values provided, but there is a high prevalence of hearing-impaired problems reported by the workers. Emphasis should be placed on the adoption of strategies to reduce noise and its effects on the ambulance service(AU)

Replica del autor. Unidades de soporte vital básico y avanzado en España: análisis de la situación actual / Author's replay. Basic and advanced life support units in Spain: analysis and current situations

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[Basic and advanced life support units in Spain: analysis of the current situation]. / Unidades de soporte vital básico y avanzado en España: análisis de la situación actual.

BACKGROUND: To describe the type and number of emergency care ambulances integrated in the Emergency Medical System in the Spanish autonomous communities and to calculate their relationship with the assigned population. MATERIAL AND METHODS: The official literature of the autonomous communities was reviewed, and the type and number of terrestrial care resources integrated in the Emergency Medical System and population data for 2011 were extracted. Secondary or specialized resources were excluded, and part-time units were computed in proportion to operational time. RESULTS: A total of 319 Advanced Life Support Units (ALSU) and 1,109.05 Basic Life Support Units (BLSU) were identified, of which 31.9 are provided with nursing staff. The national rate of ambulances by absolute population was 0.86 ALSU (range 0.32 to 1.44) and 2.35 BLSU (range 0.07 to 5.30) per 100,000 inhabitants. The state rate by relative population was estimated at 0.29 (range 1.06 to 30.22) and 0.08 (range 0.94 to 16.03) inhabitants/km2 for ALSU and BLSU respectively, and the national rate by surface was 1,586.2 (range 140.8 to 4204.5) and 456.2 km2 (range 44.1 to 14599.6) for ALSU and BLSU respectively. CONCLUSIONS: There are significant differences in the calculated rates of emergency care resources of autonomous regions over their population and area. No relation was found with the geodemographic idiosyncrasies of each territory. These differences could be caused by heterogeneity in the management of EMS or other factors not considered in this work.

Unidades de soporte vital básico y avanzado en España: análisis de la situación actual / Basic and advanced life support units in Spain: analysis of the current situation

Fundamento. Describir el tipo y número de ambulancias asistenciales de urgencia integradas en el Sistema de Emergencias Médicas de cada comunidad autónoma en España y calcular su relación con la población a la que asisten. Metodología. Se ha revisando la bibliografía oficial de cada Comunidad Autónoma y se han extraído los datos referentes al tipo y número de recursos asistenciales terrestres con capacidad de realizar traslado de pacientes integradas en el Sistema de Emergencias Médicas y datos poblacionales, correspondientes a 2011. Se excluyeron los recursos destinados al transporte secundario o especializado y aquellos activos a tiempo parcial computaron de manera proporcional al tiempo de operatividad. Resultados. Se han identificado un total de 319 Unidades de Soporte Vital Avanzado (USVA) y 1.109,05 Unidades de Soporte Vital Básico (USVB), de las que 31,9 están provistas con personal de enfermería. La tasa estatal de ambulancias por población absoluta ha resultado de 0,86 USVA (rango 0,32-1,44) y 2,35 USVB (rango 0,07-5,30) por cada100.000 habitantes. La tasa estatal por población relativa se ha estimado en 0,29 (rango 1,06-30,22) y 0,08 (rango 0,94-16,03) habitantes/km2 por USVA y USVB respectivamente y la tasa nacional por superficie en 1586,2 (rango140,8-4204,5) y 456,2 (rango 44,1-14599,6) km2 por USVA y USVB respectivamente. Conclusiones. Existen grandes diferencias en cuanto a los índices calculados de los recursos asistenciales de emergencias de las comunidades autónomas sobre su población y extensión, no estableciéndose, además, relación con la idiosincrasia geodemográfica de cada territorio. Estas diferencias podrían ser causadas por una heterogeneidad en la gestión de los SEM u otros factores no contemplados en este trabajo(AU)

Background. To describe the type and number of emergency care ambulances integrated in the Emergency Medical System in the Spanish autonomous communities and to calculate their relationship with the assigned population. Material and methods. The official literature of the autonomous communities was reviewed, and the type and number of terrestrial care resources integrated in the Emergency Medical System and population data for 2011were extracted. Secondary or specialized resources were excluded, and part-time units were computed in proportion to operational time. Results. A total of 319 Advanced Life Support Units(ALSU) and 1,109.05 Basic Life Support Units (BLSU) were identified, of which 31.9 are provided with nursing staff. The national rate of ambulances by absolute population was 0.86 ALSU (range 0.32 to 1.44) and 2.35 BLSU (range0.07 to 5.30) per 100,000 inhabitants. The state rate by relative population was estimated at 0.29 (range 1.06to 30.22) and 0.08 (range 0.94 to 16.03) inhabitants/km2for ALSU and BLSU respectively, and the national rate by surface was 1,586.2 (range 140.8 to 4204.5) and 456.2 km2 (range 44.1 to 14599.6) for ALSU and BLSU respectively. Conclusions. There are significant differences in the calculated rates of emergency care resources of autonomous regions over their population and area. No relation was found with the geodemographic idiosyncrasies of each territory. These differences could be caused by heterogeneity in the management of EMS or other factors not considered in this work(AU)

Stroop interference and negative priming (NP) suppression in normal aging.

Age-related differences in the reduction of Stroop interference were explored by comparing the performance of 18 younger (of mean age: 30.0±3.9 years) and 18 older healthy adults (of mean age: 75±7.2 years) in a color-word Stroop task. The aim of this study was to determine whether a decrease in the efficiency of inhibitory mechanisms associated with aging could account for age-related differences in the ability to suppress a pre-potent response. Participants performed a Stroop task to assess Stroop interference and NP suppression concurrently. Results showed a greater Stroop interference in older than in young adults. On the other hand, the NP effect was only reliable in the younger group, the older group not showing NP suppression. These findings suggest that the slowing hypothesis alone cannot explain this pattern of results and that the age-related differences must also involve an inhibitory breakdown during aging.