Estado actual de la cefalea postpunción meníngea en un hospital colombiano / Status of post-dural puncture headache in a Colombian hospital

Introducción: La cefalea postpunción meníngea (CPPM) posterior a la anestesia raquídea es una de las complicaciones más frecuentes asociadas a factores intrínsecos del paciente y de la técnica anestésica. Objetivo: Describir la frecuencia y los factores asociados con el desarrollo de la cefalea postpunción meníngea. Materiales y métodos: Serie retrospectiva de pacientes que ingresaron a un hospital de segundo nivel y se les confirmó el diagnóstico de cefalea secundaria a la anestesia raquídea. Resultados: Serie de 49 casos, 88 % de sexo femenino y 12 % de sexo masculino, con una edad media de 27,7 años. Los procedimientos quirúrgicos con desenlace de CPPM fueron: cirugías de ginecología y obstetricia (63 %), cirugías de urgencias de otras especialidades (28 %) y cirugías electivas (8 %). La técnica anestésica se realizó con agujas biseladas tipo Quincke calibre 25 gauge (G) en 14%, calibre 26 G 33 % y 27 G 53 %. El 51 % se realizó en posición de sedestación y el 49 % en decúbito lateral izquierdo. El 10% de los casos se manejó con parche hemático, en tanto que el antecedente de migraña se presentó en el 8 %. Discusión: En la actualidad, el uso de agujas con diseño de punta cónica es el estándar de oro, ya que permite obtener resultados confiables y disminuye complicaciones como la CPPM. Conclusión: La CPPM luego de una anestesia espinal se relacionó con factores como la edad (joven), el sexo (femenino) y el uso de agujas biseladas. Los otros factores de riesgo identificados fueron poco concluyentes, aunque no se pueden descartar, debido a la naturaleza de este estudio.

Introduction: Post dural puncture headache (PDPH) following spinal anesthesia is one of the most frequent complications associated with intrinsic patient and anesthetic technique factors. Objective: To describe the frequency and associated factors related to the development of PDPH. Materials and methods: Retrospective series of patients admitted to a second level hospital with a confirmed diagnosis of headache secondary to spinal anesthesia. Results: Series of 49 cases, 88 % female and 12 % male, mean age 27.7 years. The surgical procedures resulting in CPPM were gynecology and obstetrics surgeries 63 %, emergency surgeries of other specialties 28 % and elective surgeries 8 %. The anesthetic technique was performed with beveled needles Quincke type 25 gauge (G) in 14 %, 26 G gauge 33% and 27 G 53 %. In the seated position 51 % and in the left lateral decubitus position 49% were performed. A blood patch was used in 10 % of the cases and a history of migraine was present in 8 %. Discussion: The use of needles with conical tip design is currently the gold standard, they give reliable results and reduce complications such as PDPH. Conclusion: PDPH after spinal anesthesia was related to factors such as age (young), sex (female) and the use of traumatic needles. The other risk factors identified were inconclusive, although they cannot be ruled out due to the nature of this study.

An Experimental Method for Bio-Signal Denoising Using Unconventional Sensors.

In bio-signal denoising, current methods reported in the literature consider purely simulated environments, requiring high computational powers and signal processing algorithms that may introduce signal distortion. To achieve an efficient noise reduction, such methods require previous knowledge of the noise signals or to have certain periodicity and stability, making the noise estimation difficult to predict. In this paper, we solve these challenges through the development of an experimental method applied to bio-signal denoising using a combined approach. This is based on the implementation of unconventional electric field sensors used for creating a noise replica required to obtain the ideal Wiener filter transfer function and achieve further noise reduction. This work aims to investigate the suitability of the proposed approach for real-time noise reduction affecting bio-signal recordings. The experimental evaluation presented here considers two scenarios: (a) human bio-signals trials including electrocardiogram, electromyogram and electrooculogram; and (b) bio-signal recordings from the MIT-MIH arrhythmia database. The performance of the proposed method is evaluated using qualitative criteria (i.e., power spectral density) and quantitative criteria (i.e., signal-to-noise ratio and mean square error) followed by a comparison between the proposed methodology and state of the art denoising methods. The results indicate that the combined approach proposed in this paper can be used for noise reduction in electrocardiogram, electromyogram and electrooculogram signals, achieving noise attenuation levels of 26.4 dB, 21.2 dB and 40.8 dB, respectively.

Synthesis and characterization of V2O5-Ga2O3 photocatalysts and their application on the photocatalytic reduction of CO2.

The photocatalytic reduction of carbon dioxide (CO2) to produce methanol (CH3OH) is a promising strategy for producing clean energy. The catalyst, the aqueous medium, and the UV light are key parameters for the formation of the most relevant pair (e-/h+) and the specific selectivity towards the desired product (methanol). The use of Ga2O3 and V2O5 in the photocatalytic reduction of CO2 to produce methanol has been little studied. However, the combination of these oxides is important to generate synergies and decrease the band energy, enhancing the photocatalytic activity in CO2 reduction. In this work, V2O5-Ga2O3 combined photocatalysts have been prepared and investigated for the photocatalytic reduction of CO2. These photocatalysts were characterized by spectroscopic and microscopic techniques. The results showed that textural properties such as surface area and morphology do not influence the photocatalytic activity. However, species such as Ga2p3/2 and Ga2p1/2 identified by XPS enhanced the photocatalytic activity, most likely due to the formation of vacancies and the reduction of the bandgap in the combined oxides, as compared to single oxides. The contribution of these factors in pair interactions (e-/h+) with CO2 to generate methanol is demonstrated.

Non-invasive sensor methods used in monitoring newborn babies after birth, a clinical perspective.

BACKGROUND: Reducing the global new-born mortality is a paramount challenge for humanity. There are approximately 786,323 live births in the UK each year according to the office for National Statistics; around 10% of these newborn infants require assistance during this transition after birth. Each year around, globally around 2.5 million newborns die within their first month. The main causes are complications due to prematurity and during delivery. To act in a timely manner and prevent further damage, health professionals should rely on accurate monitoring of the main vital signs heart rate and respiratory rate. AIMS: To present a clinical perspective on innovative, non-invasive methods to monitor heart rate and respiratory rate in babies highlighting their advantages and limitations in comparison with well-established methods. METHODS: Using the data collected in our recently published systematic review we highlight the barriers and facilitators for the novel sensor devices in obtaining reliable heart rate measurements. Details about difficulties related to the application of sensors and interfaces, time to display, and user feedback are explored. We also provide a unique overview of using a non-invasive respiratory rate monitoring method by extracting RR from the pulse oximetry trace of newborn babies. RESULTS: Novel sensors to monitor heart rate offer the advantages of minimally obtrusive technologies but have limitations due to movement artefact, bad sensor coupling, intermittent measurement, and poor-quality recordings compared to gold standard well established methods. Respiratory rate can be derived accurately from pleth recordings in infants. CONCLUSION: Some limitations have been identified in current methods to monitor heart rate and respiratory rate in newborn babies. Novel minimally invasive sensors have advantages that may help clinical practice. Further research studies are needed to assess whether they are sufficiently accurate, practical, and reliable to be suitable for clinical use.

Palmitic and Stearic Acids Inhibit Chaperone-Mediated Autophagy (CMA) in POMC-like Neurons In Vitro.

The intake of food with high levels of saturated fatty acids (SatFAs) is associated with the development of obesity and insulin resistance. SatFAs, such as palmitic (PA) and stearic (SA) acids, have been shown to accumulate in the hypothalamus, causing several pathological consequences. Autophagy is a lysosomal-degrading pathway that can be divided into macroautophagy, microautophagy, and chaperone-mediated autophagy (CMA). Previous studies showed that PA impairs macroautophagy function and insulin response in hypothalamic proopiomelanocortin (POMC) neurons. Here, we show in vitro that the exposure of POMC neurons to PA or SA also inhibits CMA, possibly by decreasing the total and lysosomal LAMP2A protein levels. Proteomics of lysosomes from PA- and SA-treated cells showed that the inhibition of CMA could impact vesicle formation and trafficking, mitochondrial components, and insulin response, among others. Finally, we show that CMA activity is important for regulating the insulin response in POMC hypothalamic neurons. These in vitro results demonstrate that CMA is inhibited by PA and SA in POMC-like neurons, giving an overview of the CMA-dependent cellular pathways that could be affected by such inhibition and opening a door for in vivo studies of CMA in the context of the hypothalamus and obesity.

Integrating multiple lines of evidence to assess freshwater ecosystem health in a tropical river basin.

Degradation of freshwater ecosystems by uncontrolled human activities is a growing concern in the tropics. In this regard, we aimed at testing an integrative framework based on the IFEQ index to assess freshwater ecosystem health of river basins impacted by intense livestock and agricultural activities, using the Muchacho River Basin (MRB) as a case study. The IFEQ combine multiple lines of evidence such as riverine hydromorphological analysis (LOE 1), physicochemical characterization using ions and pesticides (LOE 2), aquatic macroinvertebrate monitoring (LOE 3), and phytotoxicological essays with L. sativa (LOE 4). Overall, results showed an important reduction in streamflow and an elevated increase in ion concentrations along the MRB caused by deforestation and erosion linked to agricultural and livestock activities. Impacts of the high ion concentrations were evidenced in macroinvertebrate communities as pollution-tolerant families, associated with high conductivity levels, represented 92 % of the total abundance. Pollution produced by organophosphate pesticides (OPPs) was critical in the whole MRB, showing levels that exceeded 270-fold maximum threshold for malathion and 30-fold for parathion, the latter banned in Ecuador. OPPs concentrations were related to low germination percentages of Lactuca sativa in sediment phytotoxicity tests. The IEFQ index ranged from 44.4 to 25.6, indicating that freshwater ecosystem conditions were "bad" at the headwaters of the MRB and "critical" along the lowest reaches. Our results show strong evidence that intense agricultural and livestock activities generated significant impacts on the aquatic ecosystem of the MRB. This integrative approach better explains the cumulative effects of human impacts, and should be replicated in other basins with similar conditions to help decision-makers and concerned inhabitants generate adequate policies and strategies to mitigate the degradation of freshwater ecosystems.

An Integrative Approach to Assess the Environmental Impacts of Gold Mining Contamination in the Amazon.

As the number of legal and illegal gold mining sites increases in the Andes-Amazonia region, integrative methods to evaluate the effects of mining pollution on freshwater ecosystems are of paramount importance. Here, we sampled water and sediments in 11 sites potentially affected by gold mining activities in the Napo province (Ecuador). The environmental impacts were evaluated using the following lines of evidence (LOEs): water physicochemical parameters, metal exposure concentrations, macroinvertebrate community response (AAMBI), and toxicity by conducting bioassays with Lactuca sativa and Daphnia magna. Dissolved oxygen and total suspended solids were under (<80%) and above (>130 mg/Ls) quality standards 65% of the sites. Ag, Al, As, Cd, Cu, Fe, Mn, Pb, and Zn in water and V, B, and Cr in sediments were detected above quality standards at sampled sites. Nine out of eleven sites were classified as having bad environmental quality based on the AAMBI. L. sativa seed germination in both water (37% to 70%) and sediment (0% to 65%) indicate significant toxicity. In five sites, neonates of D. magna showed a 25% reduction in survival compared to the control. Our integrated LOEs index ranked sites regarding their environmental degradation. We recommend environmental impact monitoring of the mining expansion at the Andes-Amazonia region using multiple LOEs.

Characterisation of Textile Embedded Electrodes for Use in a Neonatal Smart Mattress Electrocardiography System.

Heart rate monitoring is the predominant quantitative health indicator of a newborn in the delivery room. A rapid and accurate heart rate measurement is vital during the first minutes after birth. Clinical recommendations suggest that electrocardiogram (ECG) monitoring should be widely adopted in the neonatal intensive care unit to reduce infant mortality and improve long term health outcomes in births that require intervention. Novel non-contact electrocardiogram sensors can reduce the time from birth to heart rate reading as well as providing unobtrusive and continuous monitoring during intervention. In this work we report the design and development of a solution to provide high resolution, real time electrocardiogram data to the clinicians within the delivery room using non-contact electric potential sensors embedded in a neonatal intensive care unit mattress. A real-time high-resolution electrocardiogram acquisition solution based on a low power embedded system was developed and textile embedded electrodes were fabricated and characterised. Proof of concept tests were carried out on simulated and human cardiac signals, producing electrocardiograms suitable for the calculation of heart rate having an accuracy within ±1 beat per minute using a test ECG signal, ECG recordings from a human volunteer with a correlation coefficient of ~ 87% proved accurate beat to beat morphology reproduction of the waveform without morphological alterations and a time from application to heart rate display below 6 s. This provides evidence that flexible non-contact textile-based electrodes can be embedded in wearable devices for assisting births through heart rate monitoring and serves as a proof of concept for a complete neonate electrocardiogram monitoring system.

Magnetic Field Triggerable Macroporous PDMS Sponge Loaded with an Anticancer Drug, 5-Fluorouracil.

This study aims to prepare, optimize, and characterize magnetic-field-sensitive sugar-templated polydimethylsiloxane (PDMS) sponges for localized delivery of an anticancer drug, 5-fluorouracil (FLU). For this purpose, different concentrations of carbonyl iron (CI) and magnetite Fe3O4 nanopowders were embedded as magnetosensitive materials in PDMS resins for the fabrication of macroporous sponges via a sugar-template process. The process is environmentally friendly and simple. The fabricated interconnected macroporous magnetic particles loaded PDMS sponges possess flexible skeletons and good recyclability because of their recoverability after compression (deformation) without any breakdown. The prepared magnetic PDMS sponges were evaluated for their morphology (SEM and EDS), porosity (absorbency), elastic modulus, deformation under a magnetic field, thermostability, and in vitro cell studies. All physicochemical and magnetomechanical analysis confirmed that the optimized magnetic-field-sensitive PDMS sponge can provide an efficient method for delivering an on-demand dose of anticancer drug solutions at a specific location and timing with the aid of controlled magnetic fields.

Assessing the Quality of Amazon Aquatic Ecosystems with Multiple Lines of Evidence: The Case of the Northeast Andean Foothills of Ecuador.

We assessed the quality of Andes-Amazonia streams in Ecuador impacted by gold mining (GM), discharges from inefficient sewage network in urban areas (UA), wastes from fish farming (FF) and from non-functional landfill (LF) and other few threats (FT). We selected three lines of evidence (LOE) that were used separately and integrated into a index: water quality (WQI) and macroinvertebrate community (AAMBI) indices and phytotoxicity tests. Streams affected by UA and LF had the lowest scores to WQI and phytotoxicity, and by GM had the lowest scores to AAMBI. Macroinvertebrate absence in GM should be considered as a warning signal of long-term mining impacts in the area. The integrated LOE index showed that sites with identified threats had 30%-53% stream quality decline compared to FT sites. The use of the selected LOE seems to be a useful tools for long-term monitoring and evaluation of this sensitive aquatic ecosystem.

Novel 3D printed device with integrated macroscale magnetic field triggerable anti-cancer drug delivery system.

With the growing demand for personalized medicine and medical devices, the impact of on-demand triggerable (e.g., via magnetic fields) drug delivery systems increased significantly in recent years. The three-dimensional (3D) printing technology has already been applied in the development of personalized dosage forms because of its high-precision and accurate manufacturing ability. In this study, a novel magnetically triggerable drug delivery device composed of a magnetic polydimethylsiloxane (PDMS) sponge cylinder and a 3D printed reservoir was designed, fabricated and characterized. This system can realize a switch between "on" and "off" state easily through the application of different magnetic fields and from different directions. Active and repeatable control of the localized drug release could be achieved by the utilization of magnetic fields to this device due to the shrinking extent of the macro-porous magnetic sponge inside. The switching "on" state of drug-releasing could be realized by the magnetic bar contacted with the side part of the device because the times at which 50%, 80% and 90% (w/w) of the drug were dissolved are observed to be 20, 55 and 140 min, respectively. In contrast, the switching "off" state of drug-releasing could be realized by the magnetic bar placed at the bottom of the device as only 10% (w/w) of the drug could be released within 12 h. An anti-cancer substance, 5-fluorouracil (FLU), was used as the model drug to illustrate the drug release behaviour of the device under different strengths of magnetic fields applied. In vitro cell culture studies also demonstrated that the stronger the magnetic field applied, the higher the drug release from the deformed PDMS sponge cylinder and thus more obvious inhibition effects on Trex cell growth. All results confirmed that the device can provide a safe, long-term, triggerable and reutilizable way for localized disease treatment such as cancer.

Diversity patterns of aquatic macroinvertebrates in a tropical high-Andean catchment

Introduction: Glacierised catchments are remote and hostile environments, in which streams from different water sources (e.g., glacier melt, rain/snowmelt, groundwater) converge, creating a complex mosaic of stream sites with varying levels of glacial influence and environmental conditions. This environmental heterogeneity, in turn, influences the assemblage and composition of aquatic communities and produces complex patterns of species diversity at the catchment scale. Objectives: In this contribution, we assessed biodiversity and community composition of aquatic macroinvertebrate communities from 51 stream site types in a glacierised catchment in the tropical Andes. The aim of our study was to: (1) determine diversity, rarity, commonness and spatial distribution patterns of aquatic macroinvertebrate communities from sites with different water sources, and (2) identify which environmental variables influence the density and presence of macroinvertebrate taxa and, in particular, of the subfamilies of the ubiquitous chironomids. Methods: Our study sites were grouped according to their water source and to their percentage of glacier coverage in the catchment (GCC). At each site we sampled aquatic macroinvertebrates, measured environmental variables and assessed community differences and environmental influence with ordination analyses and generalized linear models. Results: Kryal and mixed sites had an important proportion of rare taxa. Mean richness was highest in the mixed sites and lowest in the sites with the highest glacier cover; while sites with an intermediate percentage of glacier cover, had the highest values of α and β diversity. We found that 13 taxa (15.9%) were common to all stream site types. SIMPER analysis showed that Orthocladiinae, Hyalella sp. and Andesiops sp. contributed the most to the dissimilarity between site types (˃ 45% of cumulative contribution). RDA showed that kryal sites were associated with high turbidity and density of Podonomids, and with low temperature, amount of CPOM and densities of both Anomalocosmoecus sp. and Andesiops sp. Orthocladinae was associated with high current velocity and chlorophyll a concentration, whereas Hyalella sp. had a positive relationship with higher pH and streambed stability. Generalized linear models showed that GCC was the main variable explaining all faunal metrics. Current velocity explained macroinvertebrate abundance, water temperature was related to chironomid density and chlorophyll a influenced Orthocladiinae presence-absence. Conclusions: Our results suggest that by favoring the presence of rare taxa and taxa turnover, glacier influence may increase biodiversity in glacierised catchments. In terms of biodiversity conservation, this study confirms an urgent need to increase knowledge of high-Andean stream biodiversity, especially in highly heterogenous glacierised catchments, to better describe regional biodiversity patterns and community composition of these highly vulnerable freshwater ecosystems. Detailed analyses of benthic communities and development of databases are key for conservation strategies. Water management municipalities and/or enterprises should consider water quality and stream types for more sustainable management of these important ecosystems.

Introducción: Las cuencas glaciares son entornos remotos y hostiles, en los que los arroyos de diferentes fuentes de agua (p.ej., deshielo de glaciares, lluvia/deshielo, agua subterránea) convergen, creando un mosaico complejo de tramos con diferentes niveles de influencia glacial y condiciones ambientales. Esta heterogeneidad ambiental influye, a su vez, en el ensamblaje y composición de las comunidades acuáticas y produce complejos patrones de diversidad a la escala de la cuenca. Objetivos: En esta contribución, evaluamos la biodiversidad y composición de comunidades de macroinvertebrados acuáticos en 51 sitios de una cuenca glaciar en los Andes tropicales. Los objetivos de nuestro estudio fueron: (1) determinar la diversidad, la contribución de taxones raros y comunes y los patrones de distribución espacial de las comunidades de macroinvertebrados acuáticos en sitios con diferentes fuentes de agua, y (2) identificar qué variables ambientales influyen en la densidad y presencia de taxones de macroinvertebrados y, en particular, de las subfamilias de los omnipresentes quironómidos. Métodos: Agrupamos a nuestros sitios de estudio según su fuente de agua y su porcentaje de cobertura de glaciar en la cuenca (GCC). En cada sitio donde muestreamos macroinvertebrados acuáticos, medimos variables ambientales y evaluamos las diferencias entre comunidades y la influencia ambiental con análisis de ordenación y modelos lineales generalizados. Resultados: Los sitios kryal y mixtos tuvieron una proporción importante de taxones raros. La riqueza media fue más alta en los sitios mixtos y más baja en los sitios con mayor cobertura glaciar; mientras que los sitios con un porcentaje intermedio de cobertura glaciar tuvieron los valores más altos de diversidad α y β. Encontramos que 13 taxones (15,9%) fueron comunes a todos los tipos de sitios de estudio. El análisis SIMPER mostró que Orthocladiinae, Hyalella sp. y Andesiops sp. contribuyeron más a la disimilitud entre tipos de sitios (˃ 45% de la contribución acumulada). El RDA mostró que los sitios kryal estaban asociados con alta turbidez y densidad de podonómidos, y con baja temperatura, cantidad de CPOM y densidad de Anomalocosmoecus sp. y Andesiops sp. Orthocladinae se asoció con una alta velocidad de corriente y concentración de clorofila a, mientras que Hyalella sp. tuvo una relación positiva con pH más alto y estabilidad del lecho del río. Los modelos lineales generalizados mostraron que GCC fue la variable principal para explicar todas las métricas de fauna. La velocidad de corriente explicó la abundancia de macroinvertebrados, la temperatura del agua estuvo relacionada con la densidad de los quironómidos y la clorofila influenció la presencia-ausencia de Orthocladiinae. Conclusiones: Nuestros resultados sugieren que, al favorecer la presencia de taxones raros y la rotación de taxones, la influencia de los glaciares puede aumentar la biodiversidad en cuencas con influencia glaciar. En términos de conservación de la biodiversidad, este estudio confirma la necesidad urgente de incrementar el conocimiento de la biodiversidad en arroyos de la región altoandina, especialmente en cuencas glaciares altamente heterogéneas, para describir mejor los patrones de biodiversidad regional y la composición de las comunidades en estos ecosistemas altamente vulnerables. Análisis detallados de las comunidades bentónicas y el desarrollo de bases de datos son claves para diseñar estrategias de conservación. Los municipios y/o empresas administradoras de agua deben considerar la calidad del agua y los tipos de arroyos para una gestión más sostenible de estos importantes ecosistemas.

Heart Rate Monitoring in Newborn Babies: A Systematic Review.

BACKGROUND: Around 10% of newborn infants require assistance during transition after birth. Heart rate (HR) is the most important clinical indicator to evaluate the clinical status of a newborn. AIM: Our study aimed to review all established and novel methods to detect HR in babies giving special consideration to non-invasive techniques. METHODS: We performed a systematic literature search on the following databases: MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL. The inclusion criteria were studies on methods to detect HR in both term and preterm infants in comparison to one of the current gold standards: pulse oximetry (PO) or electrocardiography (ECG) published in the last 15 years. Two independent reviewers screened titles and abstracts for eligibility. Data extracted in an Excel table were analysed to produce a narrative review structured around the type of monitoring, identified obstacles in use, as well as methods to overcome these limitations. RESULTS: The search revealed 649 studies after duplicates were removed. Full article analysis was performed on 26 studies of which 25 met the inclusion criteria. Well established methods such as auscultation and palpation, although rapid and easily available, have been shown to be inaccurate. ECG and PO were both more precise but the delay in obtaining a reliable HR signal from birth often exceeded 1-2 min. Novel sensors offered the advantages of minimally obtrusive technologies but have limitations mainly due to movement artefact, bad sensor coupling, intermittent measurement, and poor-quality recordings. CONCLUSIONS: The limitations of existing methods have a potential impact on short- and long-term morbidity and mortality outcomes. The development of a technological solution to determine HR accurately and quickly in babies at birth has immense implications for further research and can guide interventions, such as placental transfusion and resuscitation.

Global patterns and drivers of ecosystem functioning in rivers and riparian zones.

River ecosystems receive and process vast quantities of terrestrial organic carbon, the fate of which depends strongly on microbial activity. Variation in and controls of processing rates, however, are poorly characterized at the global scale. In response, we used a peer-sourced research network and a highly standardized carbon processing assay to conduct a global-scale field experiment in greater than 1000 river and riparian sites. We found that Earth's biomes have distinct carbon processing signatures. Slow processing is evident across latitudes, whereas rapid rates are restricted to lower latitudes. Both the mean rate and variability decline with latitude, suggesting temperature constraints toward the poles and greater roles for other environmental drivers (e.g., nutrient loading) toward the equator. These results and data set the stage for unprecedented "next-generation biomonitoring" by establishing baselines to help quantify environmental impacts to the functioning of ecosystems at a global scale.

Responsabilidad penal médica: consideraciones en la aplicación del principio del doble efecto / Medical Criminal Liability: considerations in the application of the principle of double effect

La responsabilidad médica en Chile contempla un espacio de discrecionalidad, en situaciones de peligro para la mujer durante el embarazo y en el tratamiento paliativo de pacientes terminales. En estos casos se presentan conceptos jurídicos indeterminados, en el ordenamiento jurídico chileno, que requieren de una propuesta interpretativa en consonancia con la protección del derecho a la vida, en actividades médicas que tengan por efecto colateral la muerte de personas inocentes (AU).

The chilean medical liability leaves a room of discretion in cases when a hazardous condition exists during the pregnancy or palliative care for those dying from a terminal disease. In such cases, the Chilean legal system presents undefined legal concepts. This concepts need to be in accordance with the promotion of the constitutional right to life, in medical cases where innocent people could die by side effect (AU).

Responsabilidad penal médica: consideraciones en la aplicación del principio del doble efecto / Medical Criminal Liability: considerations in the application of the principle of double effect

La responsabilidad médica en Chile contempla un espacio de discrecionalidad, en situaciones de peligro para la mujer durante el embarazo y en el tratamiento paliativo de pacientes terminales. En estos casos se presentan conceptos jurídicos indeterminados, en el ordenamiento jurídico chileno, que requieren de una propuesta interpretativa en consonancia con la protección del derecho a la vida, en actividades médicas que tengan por efecto colateral la muerte de personas inocentes (AU).

The chilean medical liability leaves a room of discretion in cases when a hazardous condition exists during the pregnancy or palliative care for those dying from a terminal disease. In such cases, the Chilean legal system presents undefined legal concepts. This concepts need to be in accordance with the promotion of the constitutional right to life, in medical cases where innocent people could die by side effect (AU).

Study of dynamic of chicken infectious anaemia virus infection: which sample is more reliable for viral detection?

Chicken infectious anaemia virus (CIAV) is a widely distributed immunosuppressive agent. SPF flocks and eggs used for vaccine production and diagnostics must be CIAV-free. Detection of CIAV infection in SPF flocks involves primarily serology or other invasive methods. In order to evaluate different types of samples for rapid detection of CIAV infection, a trial was conducted in serologically negative broiler breeder pullets vaccinated with a commercial live-attenuated CIAV vaccine. Controls and vaccinated groups were sampled before and after vaccination. Invasive and non-invasive samples were used for CIAV DNA detection by real-time PCR. Seroconversion occurred at 14 days post-inoculation (DPI) in the vaccinated group, whereas CIAV genome was detected by qPCR at 7 DPI in both invasive and non-invasive samples. Only invasive samples remained qPCR positive for CIAV DNA by 21 DPI despite seroconversion of the chickens.

Aproximación analítica a la imputación en el ámbito de la responsabilidad extracontractual chilena / Analytical approach to imputation in the field of Chilean extracontractual liability / Abordagem analítica da imputação no campo da responsabilidade extracontractual chilena

Resumen La imputación es una operación que se utiliza para la atribución de responsabilidad en materia extracontractual. La dogmática civilista generalmente realiza un tratamiento de la misma que, tanto en los manuales de responsabilidad extracontractual, como en sus artículos doctrinarios, desconoce las virtudes del modelo analítico de imputación. La dogmática chilena reconoce el modelo de la teoría de la causa adecuada o de la equivalencia de las condiciones en el campo de la causalidad, pero omite establecer una diferenciación apropiada de estos modelos con la imputación. Por ello, pueden darse supuestos de responsabilidad en que se desconozca dicha diferenciación. En el presente trabajo se sistematiza y analiza el criterio de imputación, dentro del sistema de responsabilidad extracontractual en Chile, así como el régimen jurídico que corresponde a este concepto, centrándose primero en el tratamiento dogmático reconocido en dos fallos recientes de la Corte Suprema, y después, se analiza el modelo de razonamiento utilizado por esta desde los parámetros del modelo kantiano, para finalizar con el examen de este criterio, con especial énfasis en el modelo de imputación analítico.

Abstract The imputation is an operation that is used for the attribution of responsibility in non-contractual matters. Civilian dogmatics generally carry out a treatment of it, which, in the manuals of non-contractual liability, as well as in its doctrinal articles, ignores the virtues of the analytical model of imputation. Chilean dogmatics recognize the model of the theory of the right cause or the equivalence of conditions in the field of causality, but fails to establish an adequate differentiation of these models with imputation. Therefore, there may be assumptions of responsibility in which such differentiation is unknown. In the present work the concept of imputation is systematized and analyzed, within the system of noncontractual liability in Chile, as well as the legal regime that corresponds to this concept, focusing first on the dogmatic treatment recognized in two recent rulings of the Supreme Court, And then analyze the model of reasoning used by Kant from the parameters of the Kantian model and conclude with the examination of this criterion, with special emphasis on the analytical imputation model.

Resumo A imputação é uma operação que é usada para a atribuição de responsabilidade em assuntos extracontractuais. O dogmatismo civilista geralmente faz um tratamento do mesmo que, tanto nos manuais de responsabilidade extracontractual como em seus artigos doutrinários, não conhece as virtudes do modelo analítico de imputação. A dogmática chilena reconhece o modelo da teoria da causa apropriada ou a equivalência de condições no campo da causalidade, mas não consegue estabelecer uma diferenciação apropriada desses modelos com a imputação. Portanto, podem surgir hipóteses de responsabilidade em que tal diferenciação é desconhecida. No presente trabalho, o critério de imputação é sistematizado e analisado dentro do sistema de responsabilidade extracontratual no Chile, bem como o regime jurídico que corresponde a esse conceito, enfocando primeiro o tratamento dogmático reconhecido em duas recentes decisões do Supremo Tribunal, e então, o modelo de raciocínio usado por ele é analisado a partir dos parâmetros do modelo kantiano, para terminar com o exame deste critério, com ênfase especial no modelo de imputação analítica.

Ecological responses to experimental glacier-runoff reduction in alpine rivers.

Glacier retreat is a worldwide phenomenon with important consequences for the hydrological cycle and downstream ecosystem structure and functioning. To determine the effects of glacier retreat on aquatic communities, we conducted a 4-year flow manipulation in a tropical glacier-fed stream. Compared with an adjacent reference stream, meltwater flow reduction induces significant changes in benthic fauna community composition in less than 2 weeks. Also, both algal and herbivore biomass significantly increase in the manipulated stream as a response to flow reduction. After the flow reduction ceased, the system requires 14-16 months to return to its pre-perturbation state. These results are supported by a multi-stream survey of sites varying in glacial influence, showing an abrupt increase in algal and herbivore biomass below 11% glacier cover in the catchment. This study shows that flow reduction strongly affects glacier-fed stream biota, prefiguring profound ecological effects of ongoing glacier retreat on aquatic systems.

Albendazole induces oxidative stress and DNA damage in the parasitic protozoan Giardia duodenalis.

The control of Giardia duodenalis infections is carried out mainly by drugs, among these albendazole (ABZ) is commonly used. Although the cytotoxic effect of ABZ usually involves binding to ß-tubulin, it has been suggested that oxidative stress may also play a role in its parasiticidal mechanism. In this work the effect of ABZ in Giardia clones that are susceptible or resistant to different concentrations (1.35, 8, and 250 µM) of this drug was analyzed. Reactive oxygen species (ROS) were induced by ABZ in susceptible clones and this was associated with a decrease in growth that was alleviated by cysteine supplementation. Remarkably, ABZ-resistant clones exhibited partial cross-resistance to H2O2, whereas a Giardia H2O2-resistant strain can grow in the presence of ABZ. Lipid oxidation and protein carbonylation in ABZ-treated parasites did not show significant differences as compared to untreated parasites; however, ABZ induced the formation of 8OHdG adducts and DNA degradation, indicating nucleic acid oxidative damage. This was supported by observations of histone H2AX phosphorylation in ABZ-susceptible trophozoites treated with 250 µM ABZ. Flow cytometry analysis showed that ABZ partially arrested cell cycle in drug-susceptible clones at G2/M phase at the expense of cells in G1 phase. Also, ABZ treatment resulted in phosphatidylserine exposure on the parasite surface, an event related to apoptosis. All together these data suggest that ROS induced by ABZ affect Giardia genetic material through oxidative stress mechanisms and subsequent induction of apoptotic-like events.