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Thermodynamic analysis and experimental results indicated that the Source reaction produces mainly sulfur Brett Rossi Sabrina Maree en Lengua Profunda and solid calcium sulfate and that the gaseous product from the CaSO 4-H2 reaction is mainly water vapor. The rates of the two reactions are reasonably rapid in the temperature range K, and, importantly, the physical strengths and reactivities of the pellets are maintained largely unchanged up to the tenth cycle, the last cycle tested in this work.

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Sulfur dioxide-containing streams from Brett Rossi Sabrina Maree en Lengua Profunda sources, such as the regenerator off-gas from an integrated gasification combined cycle desulfurization unit and new sulfide smelting plants, contain much higher partial pressures of SO2. In these cases, the rate of the first reaction is expected to be proportionally higher than in the test go here reported in this paper.

Single-crystal EPR spectra of gamma-ray-irradiated gypsum reveal two types of arsenic-associated oxyradicals: [AsO3]2- and an [AsO2] Food insecurity and health status in deprived populations, a multicentre survey in seven of the social and medical healthcare centres CASOs run by Doctors of the World, France.

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To document eating practices and socio-economic profiles of patients seen in the social and medical healthcare centres CASOs in its French acronym run by Doctors of the World Médecins du Monde, MdM in France and evaluate their nutritional and health status.

All the patients attending MdM clinics were given a nutrition and health questionnaire.

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Their anthropometric measurements were taken on site. A total of One third of the patients declared having lost weight over the last two weeks.

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Constrained resources lead people living in very precarious conditions to eat without adequate nutrition, which could have consequences for their health, such as diabetes, obesity and cardiovascular disease.

Published by Elsevier Ltd. Entre essas, o pé diabético PD destaca-se por possuir alta incidência e grande poder mutilador.

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Métodos Estudo descritivo, quantitativo, tipo inquérito por entrevista. Scientific advances and the complexity of human knowledge generate a constant need for creating new tools intended to facilitate learning in an agreeable and lasting form. Simulated patients are one of such tools in medical education.

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Standardized or simulated patients are actors or people vigorously trained to https://pdf-a.microzide.site/topic-2020-05-07.php a medical history or, if possible, specific physical findings with the purpose of using such representations as an educational and evaluating supplement in clinic practice.

The use of simulated patients has been very well received, particularly in the psychiatric field; however, its usefulness in areas such as psychotherapy or evaluation of residents remains questionable.

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Simulated patients are widely used throughout the world in the psychiatry field and their usefulness as an academic tool for pre-graduate students is confirmed in most of the literature reviewed. One of the main benefits of the use of this kind of patients is the acquisition of specific abilities e.

Notwithstanding the controversy, most of the literature reviewed confirms the benefits and acceptance of this methodology in the formation of students and psychiatrists.

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Publicado por Elsevier España. Jaimes; Ortega-García, J.

Sarabanty xxx Watch Mamada de barman en conversaciones de dinero Video Comshot pictures. Sabrina Maree comer Brett Rossis mojado coño. Brett Rossi y Sabrina Maree sexy lesbos. Sammie invitó a dos de sus amigos hermoso sobre para una tarde de tomar el sol y lamidas de coño. Después de unos minutos de bronceado, las chicas decidieron saltar en la piscina. Brett Rossi dando sexo Sabrina Maree. Impulsive excitation of mechanoluminescence in gamma-irradiated CaSO 4:Eu phosphors. ML was excited impulsively by dropping a load onto the sample. Three distinct peaks have been observed in the ML intensity versus time curve. The ML intensity increases with the increasing concentration of the dopant. The effect of temperature on the shape and peak of ML intensity was also recorded. Growth, saturation and broadening in an ML peak were observed. Experimental results suggest that the ML excitation is related to the movement of dislocation with defect centres, the increase in ML with temperature is due to the enhancement in dislocation capture probability, and the reduction is due to the thermal bleaching of defect centres. As the dosimetric procedure involves total integrated counts for dose conversion, the dosimeters are typically read about a week after receiving. However in the event of a suspected over exposure, where urgent processing is expected, this poses limitation. Post irradiation annealing treatment is used in such cases of immediate readout of cards. In this paper we report a new and easier to use technique based on optical bleaching for the urgent processing of TLD cards. On the basis of the differential solubilities of gypsum and anhydrite, a method was developed to remove calcium from the scheelite leaching solution by adding anhydrite as an inoculating crystal. The effects of the reaction time, concentration of the CaSO 4 inoculating crystals, and temperature were investigated. Calcium Sulfate CaSO 4 deposit reduces heat exchange in heat transfer equipment which adversely affects the equipment performance and plant production. In addition, the Scanning Electron Microscopic was used to examine the morphology and distribution of Calcium Sulfate CaSO 4 crystals deposited on titanium metal surfaces. Based on the experimental results, Calcium Sulfate CaSO 4 scale obtained in the present study was almost constant on coated carbon steel in which the rate of scale deposition is equal to the rate of scale removal. However, the deposition of Calcium Sulfate CaSO 4 observed on titanium material was increased as the speed increased. Average particle size is found to be in the range nm with Hexagonal morphology and PL studies showed emission peaks at nm, when samples were excited by nm. However under identical condition it is observed that intensity of emission get enhanced for 0. A phosphor with narrow emission band around nm is desirable, since at this wavelength the transmission of standard glass, polarizing plastic, other coating and LCD material is at acceptable level. Numerical simulation of calcium sulfate CaSO 4 fouling in the plate heat exchanger. Plate heat exchanger is a widely used apparatus in the industrial production processes. Through a numerical simulation method, this paper calculates the deposition rate of CaSO 4 fouling on heat transfer surfaces of the plate heat exchanger under saturation in the bulk. The effects of CaSO 4 concentration in the range 0. The simulation results are compared with the experimental results showing similar trend. The simulation results show that the concentration and the flow velocity affect significantly the fouling characteristics in the plate heat exchanger. The deposition mass rate, removal mass rate, and asymptotic value of fouling resistance all increase with the increase in CaSO 4 concentration and the inlet temperature of the hot fluid, while the asymptotic value of fouling resistance decreases with the increasing of inlet flow velocity. The influence of the inlet temperature of cold fluid may be negligible. With the advent of newer techniques for dose reduction coupled with the development of more sensitive detectors, the radiation doses in radiological medical investigation are decreasing. Nevertheless, keeping the tenet in mind that all radiation doses could entail risk, there is a need to develop more sensitive dosimeters capable of measuring low doses. This paper gives the account of the development of a new and sensitive phosphor CaSO 4:Dy,Mn and its characterization. The standard production procedure based on the recrystallization method was used to prepare CaSO 4:Dy,Mn. Experiments were performed to determine optimum concentration of the dopants Dysprosium Dy and Mangnese Mn in the host CaSO 4 so that maximum sensitivity of the phosphor may be achieved. The optimum dopant concentration turned out to be 0. As there were two dopants Dy and Mn their relative ratio were varied in steps of 0. The TL sensitivity of this phosphor was found to be about 2 and 1. They have high sensitivity, a large dynamic range, thermal stability and ease of preparation. Nevertheless, they can be enhanced by inclusion of lithium and this study reports some effects of lithium co-dopant on the TL and radioluminescence RL emissions of two TL phosphors. Addition of Li as a co-dopant ion was made either during chemical preparation of the phosphors, or as a binder component mixed with the basic phosphors matrix during the process of pressing and sintering the TLD pellets. X-ray absorption spectroscopy and X-ray photoelectron spectroscopy studies of CaSO 4:Dy thermoluminescent phosphors. Measurements were carried out on a set of samples which were subjected to post-preparation annealing at different temperatures and for different cycles. Thermoluminesence of gamma rays irradiated CaSO 4 nanorods doped with different elements. SEM images show that the samples doped with rare earths elements i. Dy, Eu and Tb have thinner nanorods than the other samples, while XRD pattern shows a complete crystalline structures in a monoclinic phase. The TL glow curves of these samples show two components. These glow peaks diver from sample to sample by their TL intensity. The TL results are promising, particularly that of Tb and Eu. The later shows quite linear response in the whole studied exposures i. These results show that Eu or Tb doped CaSO 4 nanorods might be proper candidates as dosimeters for high doses of ionizing radiations used in irradiation of foods and seeds. Electronic excitations and self-trapping of electrons and holes in CaSO 4. A first-principles study of the electronic properties of a CaSO 4 anhydrite structural phase has been performed. The results are consistent with theoretical predictions of a possible low-temperature self-trapping of oxygen p-holes. There is no direct evidence of the self-trapping of heavy d-electrons, however, one can argue that their motion rather differs from that of conduction s-electrons. Estudio descriptivo, prospectivo desde febrero de hasta junio de Después de 12 meses de seguimiento, la salud sexual parece mejorar en los hombres. Descriptive, prospective study from February to June The study of the dissolution kinetics of CaSO 4 is essential for the control of the dissolution and recrystallization behavior of CaSO 4. In this work, the kinetic behavior of CaSO 4 dissolved in NaCl solution was investigated by means of conductivity meter. The results show that with the increase of concentration of NaCl, the temperature rise and the time prolonged, the dissolution rate of dihydrate CaSO 4 gradually increases, and the dissolved apparent activation energy is gradually decreased. When the NaCl concentration is 1. Calcium sulfate CaSO 4 , one of the major sulfate minerals in the Earth's crust, is expected to play a major role in sulfur recycling into the deep mantle. The barite-type phase cannot always be quenched from high temperature and is distorted to metastable AgMnO4-type structure or another modified barite structure depending on pressure. We obtained the pressure-volume data and density of anhydrite, monazite- and barite-type phases and found that their densities are lower than those calculated from the PREM model in the studied P-T conditions. Vibration in many industries commonly generated by the operation mechanical equipment such as extruder, mixer, blower, compressor, turbine, generator etc. Vibration propagates into the floor and attacks the pipe around those mechanical equipment. In this paper, the influence of vibration in a pipe on the CaSO 4 scale formation was investigated to understand the effect of vibration on the kinetics, mass of scale, crystal phases and crystal polymorph. To generate vibration force, mechanical equipment was prepared consisted of electrical motor, crankshaft, connecting rod and a vibration table at where test pipe section mounted. Deposition rate increased significantly when the vibration affected to the system i. The addition Thermoluminescence and photoluminescence of cerium doped CaSO 4 nanosheets. Its TL glow curve contains three overlapping glow peaks at around , and K. Emission spectra band at and nm were observed for the orthorhombic phase of nanosheets. TL kinetic parameters of this nanocrystalline are also presented. The TLD was observed after radiation exposure to Strontium The thermoluminescent response obtained was The sensitivity of the TLD increased in response to the re-annealing temperature rise. In addition to observing the thermoluminescence properties, a comparison was made between the TLD obtained from this experiment with an existing TLD in the market. Finally, also the glow-curve characteristics of the TLD were observed. Carbon ions irradiation on nano- and microcrystalline CaSO 4 : Dy. Nanoparticles of CaSO 4 : Dy phosphor with a particle size of around 30 nm have been prepared by the chemical co-precipitation technique. Thermoluminescence TL glow curves of the irradiated samples were recorded and studied. The microcrystalline form of this sample is also included in the study with the aim of reporting a comparative measurement. These peaks are similar to those induced in the microcrystalline sample with a slight difference in their TL response. The second peak is more prominent in the case of the microcrystalline sample at low fluences, while the first one dominates in the nanostructured sample mainly at higher fluences. Dosimetric properties of the carbon ion beam irradiated materials show that the nanostructure material has excellent features such as a simple glow curve structure and a linear TL response over a wider range than the corresponding microcrystalline sample. These results show that the nanostructure form of CaSO 4 : Dy might be useful for detecting the high doses of carbon ions used in radiotherapy. No phase transitions within this range of heating for both the materials are observed. Insights into water-mediated ion clustering in aqueous CaSO 4 solutions: pre-nucleation cluster characteristics studied by ab initio calculations and molecular dynamics simulations. The molecular structure of growth units building crystals is a fundamental issue in the crystallization processes from aqueous solutions. In this work, a systematic investigation of pre-nucleation clusters and their hydration characteristics in aqueous CaSO 4 solutions was performed using ab initio calculations and molecular dynamics MD simulations. The results of ab initio calculations and MD simulations indicate that the dominant species in aqueous CaSO 4 solutions are monodentate ion-associated structures. Compared with charged ion clusters, neutral clusters are more likely to be present in an aqueous CaSO 4 solution. Neutral CaSO 4 m clusters are probably the growth units involved in the pre-nucleation or crystallization processes. Moreover, the association trend between calcium and sulfate is found to be relatively strong, which hints at the low solubility of calcium sulfate in water. La implantacion del enfoque constructivista en el aula de ciencia: Estudio de caso multiple. Esta investigacion estudia la implantacion del enfoque constructivista en tres aulas de ciencia del contexto puertorriqueno. Se auscultaron las practicas educativas que utilizan maestras consideradas constructivistas y la correspondencia de sus practicas educativas con los elementos esenciales de la didactica que proponen los teoricos de los planteamientos constructivistas. Se ausculto, ademas, a que vision del enfoque constructivista responden las expresiones de las maestras acerca de su practica educativa y como compara con su quehacer, a la luz de los elementos esenciales de las visiones constructivistas piagetiana, social y radical. Se utilizo el diseno de estudio descriptivo de caso multiple. El estudio se baso en entrevistas a profundidad, revision de documentos y observacion no participativa a la sala de clases. El contexto fueron tres escuelas publicas de la Region Educativa de San Juan, una elemental, una intermedia y una superior. Los resultados confirmaron que la transicion hacia el enfoque constructivista es un proceso que toma tiempo, dedicacion y la participacion en adiestramientos y readiestramientos acerca del nuevo enfoque. Las maestras coinciden en la mayoria de las practicas educativas que utilizan para implantar el enfoque constructivista de ensenanza y difieren en algunas debido, probablemente, a que han tenido que adaptarlas a los correspondientes niveles de ensenanza: elemental, intermedio y superior. Dos de las maestras planifican por conceptos generadores, mientras que una de ellas planifica siguiendo la guia que recibe del Departamento de Educacion. Difieren ademas, en el enfasis que confieren al inquirir cientifico. Con relacion a la correspondencia entre la vision manifestada por las maestras a la luz de las visiones piagetiana, social y radical, aparentemente, las preguntas del protocolo de entrevistas no lograron evocar la informacion con suficiente profundidad, por lo que la investigadora tuvo que inferir las visiones de las. This paper presents the characterization and TL properties of dysprosium Dy doped calcium sulfate CaSO 4 TL material produced by co-precipitation technique with 0. The crystallinity of the produced powder was studied using x-ray powder diffraction XRD. The XRD spectra show that the TL material produced is high purity anhydrite CaSO 4 with average crystallite size of 74 nm with orthorhombic crystal system. Calcium sulfate CaSO 4 , an excellent biodegradable bone forming agent that is an ideal choice as additive in gels, however, its disadvantage being poor gel rheology and angiogenesis. Here, we have synthesized chitin-CaSO4-nano-fibrin based injectable gel system which shows improved rheology and angiogenic potential. Rheological studies showed that the composite gel was a shear thinning gel with elastic modulus of These in vitro results highlight the potential of injectable chitin-CaSO4-nFibrin gel for osteo-regeneration via enhanced angiogenesis. All rights reserved. The photon energy response of CaSO 4:Dy teflon disk dosimeters used widely in radiation dosimetry is computed using the energy absorption coefficient values for calcium, sulfur, oxygen, and carbon taken from J. Hubbell's tables. For fluorine, the energy absorption coefficients were obtained from the values given by F. Attix for CaF2 and Ca. The energy response of the radiation-monitoring disk for the range of 10 keV to 10 MeV, relative to air, is computed and plotted. The response is maximum between 20 and 30 keV and then gradually falls to a constant at keV to 10 MeV. This computed response for different energies is compared with the experimental TL response of the dosimeter. The electron energy response of these TLD disks is computed using the stopping-power values for the different component elements. The electron stopping power for sulfur and calcium from 10 keV to 10 MeV is computed using the Bethe-Bloch formula. Those for oxygen and carbon are taken from the tables given by M. Berger and S. For fluorine, the values are computed from those for Li and LiF given in the same tables. This calculated response is compared with the experimental beta response of the TL dosimeter. Further studies on the new high sensitive CaSO 4:Dy thermostimulated luminescence phosphor. N consists of needle shaped crystals while P is mostly quadrilateral. The detection threshold of N The major glow peak s in both the phosphors occur in the K degrees C region. But the low temperature peak near K degrees C is very prominent in P while its presence is insignificant in N. The post-irradiation storage stability of N at approximately 30 degrees C was tested up to a period of 25 d and found to be better than that of P. In P, the nm to nm emission intensity ratio varies slightly with glow peak temperature, unlike that of N. The Dy concentration quenching effect in N is less serious than that in P. The intrinsic UV sensitivity of N is nearly a factor of 20 times lower than that of P. Usually, a small steam generator is not complemented by equipment such as demineralization and chlorination process apparatus since the economic aspect was a precedence. The operation of the small boiler affected the scaling process in its piping system. In a year operation, there was already a large scale of calcium attached to the inner surface of the pipe. Such large scale formed a layer and decreased the overall heat transfer coefficient, prolonged the process time and decreased the production. The aim of the current research was to solve the problem through a laboratory research to inhibit the CaSO 4 scale formation by the addition of trace amounts of zinc ion. This research was conducted through a built in-house experimental rig which consisted of a dosing pump for controlling the flow rate and a thermocouple to control the temperature. The concentration of zinc was set at 0. The data found were characterized by scanning electron microscopy SEM to analyze crystal polymorph as the influence of zinc ion addition. The induction time was also investigated to analyze the nucleation time, and it was found on the 9th, 13th, and 19th minute of the zinc ion addition of 0. After running for a four-hour duration, the scale grow-rate was found to be 5. In the characteristics of spray-dried salt particles, KCl showed the largest particle size with low viscosity in solution. Meanwhile CaSO 4 treatment resulted in the smallest particle size and the highest viscosity p CaSO 4 also manifested harder and less adhesive than control p CaSO 4 treatment was not affected by level of Ca-salt. Eventually, sensorial properties indicated that KCl and CaSO 4 influenced negative effects on pork patties. In contrast, MgSO4 showed better sensorial properties in juiciness intensity, tenderness intensity as well as overall acceptability than control, reflecting that MgSO4 was an effective Na-replacer in meat product formulation. Calcium sulfate CaSO 4 doped with proper activators is a highly sensitive phosphor used in different fields mainly for radiation dosimetry, lighting and display applications. In this work pure and doped nanorods of CaSO 4 were produced by the co-precipitation technique. Color center formation leading to PL emissions were investigated before and after e-beam irradiation. The samples doped with rare earths elements i. Dy, Eu and Tb were observed to have thinner nanorods than the other samples and have higher absorption in the UV region. Quite linear response curves in the whole studied exposures i. These results show that these nanorods might be useful in lighting and display devices development. Thermoluminescence of nanocrystalline CaSO 4: Dy for gamma dosimetry and calculation of trapping parameters using deconvolution method. Nanorods of CaSO 4: Dy having diameter 20 nm and length nm have been synthesized by the chemical coprecipitation method. These samples were irradiated with gamma radiation for the dose varying from 0. TL dose response shows a linear behavior up to 5 kGy and further saturates with increase in the dose. Trapping parameters for various peaks have been calculated by using CGCD program. Resultados pacientes y personal de salud de ambos sistemas coinciden en la importancia del estigma asociado al VIH, la relación médicopaciente, la comunicación entre ambos y la división de responsabilidades en relación al tratamiento como aspectos fundamentales para la adherencia y retención en la cascada de atención. Discusión se resalta la necesidad de intervenciones focalizadas en la díada médico- paciente que considere las particularidades de cada sistema de atención para facilitar el compromiso del paciente en la adherencia. The recent suggestions that the target area for the K-T bolide may have been a sulfate-rich evaporite and that the resulting sulfuric acid-rich aerosol was responsible for the subsequent cooling of the Earth and the resulting biological extinctions has prompted us to experimentally examine the impact-induced devolatization of the sulfate minerals anhydrite CaSO 4 and gypsum CaSO 4 2H2O. Preliminary results for anhydrite are reported. Up to 42 GPa peak shock pressure, little or no devolatilization occurs, consistent with chemical thermodynamic calculations. Calculation of the influence of the partial pressure of the gas species on impact-induced devolatilization suggests that an even greater amount of sulfur than that proposed by Brett could have been released to the atmosphere by an impact into a sulfate-rich layer. Solid recovery, impact-induced devolatilization experiments were performed on the Caltech 20mm gun using vented, stainless steel sample assemblies. Blonde teens Brett Rossi and Lia Lor spend the night in to have sex. Play things. Babes - Alex Grey teaches Brett Rossi the hard lessons. Blondie Brett Rossi has a strong orgasm. Brett Rossi. Subil Arch pleasures Brett Rossi on couch. Poolside Pussy. Smart and cunning lesbians find their way to unexpected sexy things. WeLiveTogether - Play things. Best pornstars Celeste Star and Brett Rossi in crazy blonde, masturbation adult scene. 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Aranda; Marín, J. Delgado; Ascanio, A. López; Jimenez, J.

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Ruiz; de Paco Matallana, C. Métodos Estudio de casos -control. Estudio descriptivo y regresión logística multivariable.

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Se presenta caso de paciente obesa a quien se le realiza endoscopía digestiva alta por disfagia tras ingesta accidental de hueso de pollo. Se constata leve esofagitis de reflujo y atrofia duodenal.

La biopsia intestinal informa atrofia intestinal con infiltrado inflamatorio.

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Los autoanticuerpos para enfermedad celiaca resultan positivos. La paciente nunca presentó síntomas digestivos. Se confirma enfermedad celiaca silente e inicia dieta sin gluten.

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Report of a case]. Métodos Foram tratados 20 membros em 20 pacientestodos com ulcerações relacionadas a refluxo de veias safenas.

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Los modelos de eensenanza y aprendizaje constructivistas conceptualizan el aprendizaje como un proceso activo. El modelo de Aprendizaje Basado en Proyectos ABPr se distingue por una serie de componentes, entre los cuales se destaca el aspecto colaborativo y cooperativo como un reto al momento de su implantacion.

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Son pocas las investigaciones que se concentran en este aspecto del modelo. En este estudio, se analizaron las diversas interacciones que surgen durante la implantacion de una unidad curricular sobre el tema de Geologia de Puerto Rico, la cual se diseno con el modelo ABPr cuyo enfoque es orientacion a proyectos.

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Particularmente, se examinaron las interacciones sociales que surgen entre los pares y entre pares y docente durante el proceso de planificacion y desarrollo de los productos finales, al igual que las interacciones entre los estudiantes y el material didactico en estas etapas del modelo. La investigacion here de tipo cualitativo e incorpora como diseno el estudio de caso.

Las diversas interacciones constituyen la unidad de analisis.

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En el estudio participaron 19 estudiantes de 9no grado, a quienes se organizaron en 5 grupos colaborativos por temas de interes Pangea, Placas tectonicas, Volcanes, Tsunamis y Terremotos. Las tecnicas que se https://blog-2.microzide.site/doc-9380.php para recopilar los datos fueron: observaciones participativas, grupos focales y analisis de documentos cuadernos reflexivos y respuestas de los estudiantes a la pregunta central del proyecto.

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Para el analisis Brett Rossi Sabrina Maree en Lengua Profunda los datos se aplico la teoria de actividad CHAT que concentra la unidad de analisis en la actividad humana en un contexto particular. Los resultados del estudio senalan que las interacciones entre pares, entre pares y docente, asi como entre estudiantes y material didactico son fundamentales en el proceso de aprendizaje.

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Cl-CO3-scapolite [ Na,Ca 4[Al3 Al,Si 3 Si3 O24] Cl, CO3SO4 ] occurs as a common partial to total alteration of plagioclase in deep-crustal xenoliths, skarns, marbles, gabbros, metabasites, calc-silicate gneisses, as well as in quartzofeldspathic granulite-facies rocks in general Moecher and Essene,J Petrol 31, Natural plagioclase and scapolite, along with synthetic calcite and Brett Rossi Sabrina Maree en Lengua Profunda, were lightly ground together in equi-molar amounts in ethanol.

A series of duplicate experiments for the same mineral mix, at the same P-T conditions, were done utilizing pure H2O as the flux. In contrast.

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Based on this model validated from experimental data, it can be seen that temperature, pressure and salinity all have significant effects on pH, alkalinity and speciations of aqueous solutions and on the solubility of calcite, halite, anhydrite Brett Rossi Sabrina Maree en Lengua Profunda gypsum. The solubility of anhydrite and gypsum will decrease as temperature increases e.

The increase of pressure may increase the solubility of sulphate minerals e.

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Addition of NaCl to the solution may increase mineral solubility up to about 3 molality of NaCl, adding more NaCl beyond that may slightly decrease its solubility. Dissolved CO 2 in solution may decrease the solubility of minerals.

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The influence of dissolved calcite on the solubility of gypsum and anhydrite can be ignored, but dissolved gypsum or anhydrite has a big influence on the calcite solubility. Online calculation is made available on www.

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Con este objetivo, presentamos nuestra experiencia con el software Osirix. Descripción de la técnica: Se presentan 3 casos ejemplificadores de 40 realizados.

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En el Caso 1 se pudo analizar las relaciones del tumor con las estructuras adyacentes para minimizar el abordaje. En el Caso 2 permitió comprender la anatomía post-operatoria previa del pacientepara determinar la trayectoria del abordaje transnasal endoscópico y la necesidad de ampliar su exposición, logrando la resección tumoral completa.

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Remisión de aneurisma luego de exéresis de MAV con aparición de síndrome del acento extranjero. La conducta frente a los aneurismas asociados es dicotómica en la literatura, mientras existen reportes de la desaparición de los mismos luego de la exéresis de la MAV, otros artículos enfatizan su tratamiento precoz.

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Estimating the incidence rate of pressure ulcers and verifying factors associated with this occurrence in a cohort of hospitalized patients. This is a cohort study in which the considered outcome was the time until pressure ulcer occurrence. Estimated effect of the variables on the cumulative incidence ratio of the outcome was performed using the Cox proportional hazards model. Variable selection occurred via the Logrank hypothesis test. The sample consisted of adults, with 25 incidents of pressure ulcers. Patients with high scores on the Braden scale presented a higher risk of pressure ulcer incidence when compared to those classified into the low score category. These results reinforce the importance of using the Braden Scale to assist in identifying patients more likely to develop pressure ulcers. Pleuroparenchymal fibroelastosis: report of two cases in Brazil. Pleuroparenchymal fibroelastosis PPFE is a rare lung disease. It can be idiopathic or associated with any one of various conditions. Our first patient presented with pleural and subpleural fibrosis in the upper lobes; a spiculated nodule in the left upper lobe; and a mild reticular pattern in the lower lobes. Surgical lung biopsy revealed PPFE in the upper lobes, including the nodule, and unclassified interstitial pneumonia in the left lower lobe. Our second patient had a history of exposure to domestic birds, indicating a risk of hypersensitivity pneumonitis, and presented with advanced lung disease, predominantly in the upper lobes, together with subpleural fibrosis. That patient underwent lung transplantation. In the explant specimen, PPFE and granulomas were identified, suggesting hypersensitivity pneumonitis as an associated cause. Esse paciente foi submetido a transplante pulmonar. No espécime do explante, FEPP e granulomas foram identificados, sugerindo pneumonite de hipersensibilidade como causa associada. Terapia fibrinolítica sistêmica no tromboembolismo pulmonar. Ependimoma myxopapilar sacro gigante con osteolisis. Objetivo: la presentación de un caso de una paciente con un ependimoma sacro con extensa infiltración y destrucción ósea local. Descripción del caso : una mujer de 53 años acudió a la consulta por dolor lumbosacro y alteraciones sensitivas perineales y esfinterianas. Se realizó una exéresis tumoral completa con mejoría del estatus funcional. La anatomía patológica informó ependimoma mixopapilar. El tratamiento radiante se reserva como opción adyuvante para las resecciones incompletas y recidiva tumoral. La quimioterapia sólo debería utilizarse en casos en que la cirugía y la radioterapia estén contraindicadas. Conclusión: Los ependimomas mixopapilares sacros con destrucción ósea y presentación intra y extradural son muy infrecuentes y deben ser tenidos en cuenta entre los diagnósticos diferenciales preoperatorios. Su resección total, siempre que sea posible, es la mejor alternativa terapéutica. Profile of thoracic trauma victims submitted to chest drainage. O tempo médio de internamento foi 15 dias e de drenagem, 8,1 dias, sem diferença estatística entre trauma aberto e fechado. O desfecho clínico envolveu alta na maioria dos casos. Resultados: Se realizaron controles prenatales sólo en 27 mujeres La edad de ingreso del MMC en su mayoría fue después de las 24 horas De ellos, De los 70 casos , tres 4. La mortalidad general y postoperatoria fue de 7. Bacterial genus is a risk factor for major amputation in patients with diabetic foot. The bacteriological evaluation was performed in deep tissue cultures from the lesions and amputation was considered major when performed above the foot'smiddle tarsus. The cultures were positive in In patients with major amputation, Acinetobacter spp. The most commonly isolated species were Acinetobacter baumannii, Morganella morganii, Pseudomonas aeruginosa and Proteus mirabilis. As predictors of major amputation, we identified the isolation of the generaAcinetobacter spp. Although Bond Bell Sys. Métodos: Foram incluídos cem pacientes adultos sem doenças cardíacas ou pulmonares conhecidas que procuraram atendimento de urgência com queixas cardiológicas. Foram excluídos pacientes com alterações isquêmicas no eletrocardiograma ou febre. Em 28 pacientes a ecocardiografia direcionada confirmou a hipótese diagnóstica inicial: 19 pacientes com insuficiência cardíaca, cinco com síndrome coronariana aguda, dois com tromboembolismo pulmonar e dois com tamponamento cardíaco. Two crystal faces showed atom-resolved images just after cleavage, and , of which the former was roughened by the dissolution, while step structures were developed on the latter. After dissolution, steplines ran along the a- and c-axes on the face, while they ran in directions inclined to these axes before. It was revealed that the arrangement of dipoles is a key factor in determining stabilities of step structures on crystal faces. On the terraces, the arrangement of oxygen atoms of the sulfate groups and calcium ions were clearly observed. Searching for an economical and effective sand-fixing material and technology is of great importance in Northwest China. Its morphology and composition were characterized by SEM, and its water resistance, freezing-thawing resistance and wind erosion resistance were tested in the field. Its strength is maintained at 1. Its compressive strength starts to decrease after nine months of field tests with no change in appearance, but it still satisfies the requirements of fixation technology. This sand-fixing material should have wide application owing to its good weather resistance. Este artículo contribuye a la literatura al analizar las características económicas y laborales de los ninis, explora la situación laboral de sus parejas y provee proyecciones al año Las experiencias clinicas de los estudiantes de enfermeria: Estudio de caso hacia la integracion de la mentoria. Clinical experiences are an essential part of the training of future nursing professionals. The period of clinical experience aims to develop in the student the necessary skills to practice as a nursing professional, when the academic program ends. This case study aimed to understand the opinion and explore the perception of faculty, clinical instructors, and nursing students on the meaning, contributions and challenges presented during clinical experiences. Among the themes explored in the focus groups were the meaning and importance to learning about the profession of clinical experiences, teaching strategies used during the practice scenarios, didactic relationships developed among students, clinical instructors, and teachers. The goal was to learn from all participants about what they do, their expectations, and the challenges presented during the clinical experiences. A qualitative, descriptive and contextual research design was followed, which required conducting six focus groups to collect the information from the perspective of all the participants. Faculty, clinical instructors, and nursing students participated each in two focus groups. Collected data were transcribed, coded and analyzed in order to organize it under themes related to the research framework. The qualitative analysis of the focus groups revealed that nursing faculty and clinical instructors perceived clinical experiences as a very important element in the training of nursing students, but that coordination between the academy and practice scenarios is disconnected and needs improvement. They also expressed that they use various learning strategies during the clinical experiences, however, they recognize it needs more structure and suggested mentoring as a strategy to consider. They affirmed that mentoring could contribute positively to enhance the teaching-learning process. Clinical instructors understand they perform mentoring roles, but they would like to have a more defined role and structured process. Nursing students, also, recognized the importance of clinical experiences in their professional training. They expressed the need to improve the communication between the academy and the practice scenarios in order to reduce the levels of anxiety they experience when entering the clinical experiences. Nursing students also expressed the need to consider the use of different teaching strategies, such as mentoring, to improve clinical experiences. The use of a metronome during cardiopulmonary resuscitation in the emergency room of a university hospital. Data were collected using In-hospital Utstein Style. ROSC occurred in Os dados foram coletados por meio do In-hospital Utstein Style. Para comparar. Prevalencia de síntomas de enfermedad de la superficie ocular en pacientes que acuden a consulta oftalmológica. To determine the prevalence of symptoms of ocular surface disease OSDI surface disease and its relationship with associated risk factors in patients of ophthalmic practices using OSDI questionnaire. The OSDI average value was Women had OSDI symptoms more frequently than men odds ratio: 1. Patients without disease were younger than the patients with severe disease Ophthalmological patients have a prevalence of Female and older age was associated with ocular surface disease. Asociación de la hemorragia prerretiniana con la presencia y la gravedad de la retinopatía del prematuro en pacientes de alto riesgo. To assess whether preretinal hemorrhage PRH is associated with the presence and severity of retinopathy of prematurity ROP in high-risk patients. Prospective cohort study, patients referred to the Department of Ophthalmology for ROP screening during October-November were evaluated weekly on 4 occasions to assess the relationship with PRH and the development of ROP as well as degree of severity associated. Stage I severity occurred more frequently. HPR is a risk factor for the development of ROP during the first weeks of life and is associated with stages of mild severity. Risk factors for mortality in ventilator-associated tracheobronchitis: a case-control study. To describe the microbiological characteristics and to assess the risk factors for mortality of ventilator-associated tracheobronchitis in a case-control study of intensive care patients. Case patients were identified using the Nosocomial Infection Control Committee database. For the analysis of risk factors, matched control subjects were selected from the same institution at a A total of 40 episodes of ventilator-associated tracheobronchitis were evaluated in 40 patients in the intensive care unit, and intensive care patients who did not experience tracheobronchitis were included as the Control Group. Using a logistic regression model, we found the following independent risk factors for mortality in ventilator-associated tracheobronchitis patients: Acute Physiology and Chronic Health Evaluation I score odds ratio 1. Our study provided insight into the risk factors for mortality and microbiological characteristics of ventilator-associated tracheobronchitis. Brachial insertion of fully implantable venous catheters for chemotherapy: complications and quality of life assessment in 35 patients. Os pacientes estudados apresentaram-se satisfeitos com o dispositivo e recomendariam o procedimento para outras pessoas. Surgical correction of ectopic penis and scrotum associated with bilateral orchidopexy. Ectopic penis is usually associated with penoscrotal transposition, and it is rarely observed in isolation. We report a surgical approach for an extremely rare case. A year-old male patient with bilateral cryptorchidism and ectopic penis and scrotum in perineal area, with no penoscrotal transposition, representing an association not yet described in literature. A previous orchiopexy failed due to ectopic scrotum. By means of an inverted Y incision, the penis was mobilized and a perineal skin flap in form of a testicular sac was prepared. Finally orchiopexy was performed. The surgery was essential to treat cryptorchidism and to improve the self-image of the patient. Orquidopexia prévia sem sucesso, devido à ectopia do escroto. Por fim, realizou-se a orquidopexia. A cirurgia foi fundamental para tratar a criptorquidia e promover ganho na autoimagem do paciente. Splenic artery aneurysm. Splenic artery aneurysms - the most common visceral artery aneurysms - are found most often in multiparous women and in patients with portal hypertension. Indications for treatment of splenic artery aneurysm or pseudoaneurysm include specific symptoms, female gender and childbearing age, presence of portal hypertension, planned liver transplantation, a pseudoaneurysm of any size, and an aneurysm with a diameter of more than 2. Historically, the treatment of splenic artery aneurysm has been surgical ligation of the splenic artery, ligation of the aneurysm, or aneurysmectomy with or without splenectomy, depending on the aneurysm location. There are other percutaneous interventional techniques. The authors present a case of a splenic artery aneurysm in a year-old woman, detected incidentally. Existem outras técnicas intervencionistas percutâneas. Os autores apresentam o caso de um aneurisma de artéria esplênica em uma mulher de 51 anos de idade, diagnosticado incidentalmente. Caring for Alzheimer's Patients. This manual is intended for caregivers of homebound patients with Alzheimer's disease and others who are mentally impaired. It deals with the nature of Alzheimer's, the decline in a patient's abilities, information about available services, and legal and financial issues. The manual provides guidance and suggestions to lessen the daily stress…. Nursing diagnosis in older adults with chronic kidney disease on hemodialysis. To identify the main nursing diagnoses NSs in older adult patients under hemodialysis treatment. Exploratory research using case studies in data collection performed by interview and physical examination of older adults, in the first semester of Were included twenty-eight older adults undergoing chronic hemodialysis treatment who met the selection criteria. The total of NSs was , averaging 3. Such results can help systematize the care of older people who are undergoing hemodialysis treatment. Identificar os principais diagnósticos de enfermagem DEs em pacientes idosos em tratamento hemodialítico. Pesquisa exploratória utilizando estudos de casos na coleta de dados realizada por entrevista e exame físico dos idosos, no primeiro semestre de O total de DEs foi de , com média de 3,9 por paciente. Ovarian hyperstimulation syndrome in a spontaneous singleton pregnancy. The ovarian hyperstimulation syndrome is the combination of increased ovarian volume, due to the presence of multiple cysts and vascular hyperpermeability, with subsequent hypovolemia and hemoconcentration. We report a case of spontaneous syndrome in a singleton pregnancy. This was a spontaneous pregnancy with 12 weeks of gestational age. The pregnancy was uneventful until 11 weeks of gestational age. After that, the pregnant woman complained of progressive abdominal distention associated with abdominal discomfort. She did not report other symptoms. In the first trimester, a routine ultrasonography showed enlarged ovaries, multiples cysts and ascites. All results were within normal parameters. During hospitalization, she received albumin, furosemide and prophylactic dose of enoxaparin. The patient was discharged on the sixth hospital day. Trata-se de gravidez espontânea com 12 semanas de idade gestacional. A gravidez ocorreu sem intercorrências até 11 semanas de idade gestacional. Impact of neoadjuvant therapy in downstaging of lower rectal adenocarcinoma and the role of pelvic magnetic resonance in staging. Use of cuff tear arthroplasty head prosthesis for rotator cuff arthropathy treatment in elderly patients with comorbidities. Self-image and perception of mother and father in psychotic and borderline patients. Des patients psychotiques et Borderline ont évalué leur image d'eux-mêmes et leur perception de leur mère et père à l'aide du modèle de l'Analyse Structural du Comportement Social SASB. Les patients Borderline avaient des imagess plus négatives d'eux-mêmes et de leurs parents, surtout de leur père, que les patients psychotiques et les sujets normaux, alors que les patients psychotiques se jugeaient à peine différemment des sujets normaux. L'image de soi était en relation avec les images des deux parents pour les patients Borderline et pour les sujets normaux, alors que pour les patients psychotiques, seulement l'image de la mère jouait un rôle pour leur image. En plus, les patients psychotiques ne différenciaient pas entre les pôles de contrôle et d'autonomie dans l'image de soi introjectée. Nous en avons conclu que les patients Borderline se caractérisent par un attachement négatif, et les patients psychotiques par une faible séparation de la mère ainsi qu'une différenciation modeste entre autonomie et contrôle. L'influence de ceci sur les relations des patients avec les autrs est discutée dans cet article. La autoimagen tuvo relación con la imagen de ambos progenitores tanto en el caso de los pacientes limítrofes como de los sujetos normales. El primero presenta síntomas motores en la mano, mientras que el segundo sólo síntomas sensitivos en el miembro superior. El objetivo de este trabajo es analizar los resultados obtenidos en una serie de 31 cirugías. Resultados: Se incluyeron 31 cirugías realizadas en 30 pacientes , 9 OTV 8 mujeres de Por el contrario, Estos hallazgos coinciden con otros reportes recientes de esta patología. Describir los costos y el impacto económico de la atención de pacientes diagnosticados con hipercolesterolemia en México en el año Los costos de los recursos médicos utilizados son obtenidos de los costos unitarios por nivel de atención del Instituto Mexicano del Seguro Social IMSS así como de las licitaciones publicadas en el portal de compras del IMSS. El resto de los grupos de hipercolesterolemia representan una carga económica menor. Published by Elsevier Inc. Actitudes Éticas de los estudiantes y egresados en carrera de medicina con metodologías activas. El presente estudio tiene por objeto desarrollar un diagnostico de la inserción integrada de la ética en la carrera de medicina brasileña con una metodología de aprendizaje basada en problemas y describir las percepciones de actitudes éticas de los estudiantes y egresados. El diseño metodológico es un estudio de caso , descriptivo y documental, con abordaje cualitativo y cuantitativo. La muestra de esta investigación ha sido constituida por estudiantes y 40 egresados de dos promociones del Curso de Medicina de la ESCS. Los estudiantes y egresados de la ESCS demostraron un buen manejo en el abordaje de los conflictos éticos y respeto a los pacientes. Desgarros del epitelio pigmentario de la retina: factores de riesgo, mecanismo y control terapéutico. 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Objetivo: Presentar un paciente que desarrolla el síndrome del acento extranjero posterior a la exéresis de una MAV y la evolución de un aneurisma asociado. Retrospective analysis of a case series https://page-f.microzide.site/pub-2020-02-29.php patients with traumatic injuries to the craniocervical junction.

Um paciente apresentava déficit neurológico, melhorando após o tratamento. No grupo conservador, predominaram as fraturas do odontóide oito e dos elementos posteriores de C2 cinco.

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Em dois casoshavia também fraturas em outros segmentos da coluna. Diagnóstico diferencial en la encefalitis por anticuerpos contra el receptor NMDA.

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Pacientes Presentamos a 2 pacientes diagnosticadas de encefalitis por anticuerpos NMDAR con un cuadro clínico típico, pero que inicialmente señaló otras etiologías. La caracterización clínica e inmunológica de esta enfermedad ha llevado a la identificación de nuevos anticuerpos que afectan a procesos de memoria, aprendizaje, conducta y psicosis.

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Surgical site infection in patients submitted to heart transplantation. The correlation between variables was evaluated by using Fisher's exact test and Mann-Whitney-Wilcoxon test.

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Signs of surgical site infection were observed in 9. There was no statistically significant association between the variables related to the patient and the surgery.

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Programmed home visits by nursing professionals to older adults: prevention or treatment? Muestreo aleatorio.

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Variables principales morbilidad, mortalidad; descriptivas: visitas de la enfermera, filiación, datos clínicos y socio sanitarios.

CONCLUSIÓN: la visita domiciliaria del profesional en enfermería no repercute en la morbimortalidad; visita a los pacientes cuando ya ha aparecido el problema de salud, no hay datos de prevención. La rotura traqueal tras una contusión es rara, aunque potencialmente mortal.

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El objetivo de este estudio es informar sobre un caso de rotura traqueal tras una contusión en el cuello producto de un accidente de bicicleta que se trató de manera conservadora. Sociedad Argentina de Pediatría.

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La deficiencia de vitamina A es infrecuente en los países desarrollados. Health literacy in patients attending a University Hospital. Low level of health literacy is associated with poor communication between patients and clinicians and with increased hospitalization rates, less frequent screening for cancer, poor control of diabetes, and disproportionately high rates of disease and mortality.

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Brett Rossi Sabrina Maree en Lengua Profunda the importance of health literacy in medicine, there is no information about its prevalence in Latin America. The aim of this study was to assess the prevalence of inadequate health literacy in a random sample of patients, at a University Hospital where a descriptive study was performed during Participants were randomly selected from the ambulatory clinic and from the medical inpatient link during The respondents had a median age of 56 years.

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The prevalence of inadequate health literacy was We found a high prevalence of inadequate health literacy, being strongly associated with the level of formal education. It is important that health care providers know the implications of health literacy and its consequences.

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Oral health and risk of pneumonia in asthmatic pacients with inhaled treatment. Asthma is a chronic disease requiring inhaled treatment and in addition it is a risk factor RF of pneumonia. In the oropharyngeal cavity there are numerous species of bacteria that could be dragged to the bronco-alveolar level.

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Case-control study in asthmatic population with inhaled treatment. We recruited asthmatic patients diagnosed with pneumonia by clinical and radiological criteria cases and asthmatics not diagnosed with pneumonia during the last year controlsmatched by age. The multivariated analysis shows an independent association of performing 6 or more inhalations per day OR 2.

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Síndrome de Susac en un paciente con colitis ulcerosa. The Susac's syndrome is a rare disorder that was first described in and is characterized by a classic triad consisting in encephalopathy, visual impairment and sensorineural hearing loss.

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However, the etiology of the disease is still unclear. We report the case of a year-old with ulcerative colitis treated with mercaptopurine, six months before to her admission started with personality changes attributed to symptoms of depression who subsequently present neurological symptoms characteristic of Susac's Syndrome.

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In the literature there is no clear association between inflammatory bowel disease and Susac's -syndrome, but this case is presented in order to emphasize the simultaneous presentation of these two diseases with a tendency to vasospasm and an autoimmune pathogenesis. A incidência anual de ruptura do AAA é de oito casos por Métodos Estudo descritivo, retrospectivo e randomizado.

Resultados Foram analisados 1.

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Nesse ínterim, apresentou deiscência das suturas e fístula purulenta inguinal esquerda em contato com a prótese vascular. Essa pode se constituir em ferramenta importante em casos similares.

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Trombose venosa profunda e vírus chicungunha. Los defectos craneales secundarios a traumatismos son frecuentes.

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Históricamente se han utilizado diversos materiales para la reconstrucción. Las localizaciones afectaron el frontal, el borde orbitario superior y el techo orbitario en cuatro casosy la porción lateral del frontal, la zona temporoparietal y el borde del occipital en un caso.

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La reconstrucción en cuatro pacientes fue entre 6 y 12 meses después de la lesión, y en un caso después de 25 años. En dos casos se requirió expansión tisular antes de colocar el implante. Cuatro pacientes evolucionaron favorablemente, con mejoría de los síntomas neurológicos, forma y contorno adecuados, así como un proceso de cicatrización adecuada de los colgajos de piel cabelluda.

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Un paciente presentó infección por Staphylococcus aureus, atribuida a la presencia de un mucocele y una fístula de la vía aérea a la cavidad craneal, lo que hizo necesario retirar el implante.

Brindan resultados satisfactorios desde el punto de vista funcional y cosmético.

50shades Sex Watch La chica mas sexy desnuda Video Fucking Butak. Cachonda pelirroja Heather pone un reconfo. Tetona rubia y pelirroja coño lamiendo, lesbianas de bombshell hermosa Sabrina Maree y Heather Summers se sientan en la intimidad del dormitorio. Cachonda pelirroja Heather pone un recon. Sammie invitó a dos de sus amigos hermoso sobre para una tarde de tomar el sol y lamidas de coño. Después de unos minutos de bronceado, las chicas decidieron saltar en la piscina. Brett Rossi y Sabrina Maree sexy lesbos. Brett Rossi y Sabrina Maree sexy lesbos que aman coño. Constrained resources lead people living in very precarious conditions to eat without adequate nutrition, which could have consequences for their health, such as diabetes, obesity and cardiovascular disease. Published by Elsevier Ltd. Entre essas, o pé diabético PD destaca-se por possuir alta incidência e grande poder mutilador. Métodos Estudo descritivo, quantitativo, tipo inquérito por entrevista. Scientific advances and the complexity of human knowledge generate a constant need for creating new tools intended to facilitate learning in an agreeable and lasting form. Simulated patients are one of such tools in medical education. Standardized or simulated patients are actors or people vigorously trained to represent a medical history or, if possible, specific physical findings with the purpose of using such representations as an educational and evaluating supplement in clinic practice. The use of simulated patients has been very well received, particularly in the psychiatric field; however, its usefulness in areas such as psychotherapy or evaluation of residents remains questionable. Simulated patients are widely used throughout the world in the psychiatry field and their usefulness as an academic tool for pre-graduate students is confirmed in most of the literature reviewed. One of the main benefits of the use of this kind of patients is the acquisition of specific abilities e. Notwithstanding the controversy, most of the literature reviewed confirms the benefits and acceptance of this methodology in the formation of students and psychiatrists. Publicado por Elsevier España. Jaimes; Ortega-García, J. Aranda; Marín, J. Delgado; Ascanio, A. López; Jimenez, J. Ruiz; de Paco Matallana, C. Métodos Estudio de casos -control. Estudio descriptivo y regresión logística multivariable. Se presenta caso de paciente obesa a quien se le realiza endoscopía digestiva alta por disfagia tras ingesta accidental de hueso de pollo. Se constata leve esofagitis de reflujo y atrofia duodenal. La biopsia intestinal informa atrofia intestinal con infiltrado inflamatorio. Los autoanticuerpos para enfermedad celiaca resultan positivos. La paciente nunca presentó síntomas digestivos. Se confirma enfermedad celiaca silente e inicia dieta sin gluten. Report of a case]. Métodos Foram tratados 20 membros em 20 pacientes , todos com ulcerações relacionadas a refluxo de veias safenas. Los modelos de eensenanza y aprendizaje constructivistas conceptualizan el aprendizaje como un proceso activo. El modelo de Aprendizaje Basado en Proyectos ABPr se distingue por una serie de componentes, entre los cuales se destaca el aspecto colaborativo y cooperativo como un reto al momento de su implantacion. Son pocas las investigaciones que se concentran en este aspecto del modelo. En este estudio, se analizaron las diversas interacciones que surgen durante la implantacion de una unidad curricular sobre el tema de Geologia de Puerto Rico, la cual se diseno con el modelo ABPr cuyo enfoque es orientacion a proyectos. Particularmente, se examinaron las interacciones sociales que surgen entre los pares y entre pares y docente durante el proceso de planificacion y desarrollo de los productos finales, al igual que las interacciones entre los estudiantes y el material didactico en estas etapas del modelo. La investigacion es de tipo cualitativo e incorpora como diseno el estudio de caso. Las diversas interacciones constituyen la unidad de analisis. En el estudio participaron 19 estudiantes de 9no grado, a quienes se organizaron en 5 grupos colaborativos por temas de interes Pangea, Placas tectonicas, Volcanes, Tsunamis y Terremotos. Las tecnicas que se utilizaron para recopilar los datos fueron: observaciones participativas, grupos focales y analisis de documentos cuadernos reflexivos y respuestas de los estudiantes a la pregunta central del proyecto. Para el analisis de los datos se aplico la teoria de actividad CHAT que concentra la unidad de analisis en la actividad humana en un contexto particular. Los resultados del estudio senalan que las interacciones entre pares, entre pares y docente, asi como entre estudiantes y material didactico son fundamentales en el proceso de aprendizaje. Una mayor interaccion entre pares durante las etapas de planificar y desarrollar los productos finales de la unidad, promueve una mejor comprension de los conceptos de la. Cl-CO3-scapolite [ Na,Ca 4[Al3 Al,Si 3 Si3 O24] Cl, CO3 , SO4 ] occurs as a common partial to total alteration of plagioclase in deep-crustal xenoliths, skarns, marbles, gabbros, metabasites, calc-silicate gneisses, as well as in quartzofeldspathic granulite-facies rocks in general Moecher and Essene, , J Petrol 31, Natural plagioclase and scapolite, along with synthetic calcite and anhydrite, were lightly ground together in equi-molar amounts in ethanol. A series of duplicate experiments for the same mineral mix, at the same P-T conditions, were done utilizing pure H2O as the flux. In contrast. Based on this model validated from experimental data, it can be seen that temperature, pressure and salinity all have significant effects on pH, alkalinity and speciations of aqueous solutions and on the solubility of calcite, halite, anhydrite and gypsum. The solubility of anhydrite and gypsum will decrease as temperature increases e. The increase of pressure may increase the solubility of sulphate minerals e. Addition of NaCl to the solution may increase mineral solubility up to about 3 molality of NaCl, adding more NaCl beyond that may slightly decrease its solubility. Dissolved CO 2 in solution may decrease the solubility of minerals. The influence of dissolved calcite on the solubility of gypsum and anhydrite can be ignored, but dissolved gypsum or anhydrite has a big influence on the calcite solubility. Online calculation is made available on www. Con este objetivo, presentamos nuestra experiencia con el software Osirix. Descripción de la técnica: Se presentan 3 casos ejemplificadores de 40 realizados. En el Caso 1 se pudo analizar las relaciones del tumor con las estructuras adyacentes para minimizar el abordaje. En el Caso 2 permitió comprender la anatomía post-operatoria previa del paciente , para determinar la trayectoria del abordaje transnasal endoscópico y la necesidad de ampliar su exposición, logrando la resección tumoral completa. Remisión de aneurisma luego de exéresis de MAV con aparición de síndrome del acento extranjero. La conducta frente a los aneurismas asociados es dicotómica en la literatura, mientras existen reportes de la desaparición de los mismos luego de la exéresis de la MAV, otros artículos enfatizan su tratamiento precoz. Objetivo: Presentar un paciente que desarrolla el síndrome del acento extranjero posterior a la exéresis de una MAV y la evolución de un aneurisma asociado. Retrospective analysis of a case series of patients with traumatic injuries to the craniocervical junction. Um paciente apresentava déficit neurológico, melhorando após o tratamento. No grupo conservador, predominaram as fraturas do odontóide oito e dos elementos posteriores de C2 cinco. Em dois casos , havia também fraturas em outros segmentos da coluna. Diagnóstico diferencial en la encefalitis por anticuerpos contra el receptor NMDA. Pacientes Presentamos a 2 pacientes diagnosticadas de encefalitis por anticuerpos NMDAR con un cuadro clínico típico, pero que inicialmente señaló otras etiologías. La caracterización clínica e inmunológica de esta enfermedad ha llevado a la identificación de nuevos anticuerpos que afectan a procesos de memoria, aprendizaje, conducta y psicosis. Surgical site infection in patients submitted to heart transplantation. The correlation between variables was evaluated by using Fisher's exact test and Mann-Whitney-Wilcoxon test. Signs of surgical site infection were observed in 9. There was no statistically significant association between the variables related to the patient and the surgery. Programmed home visits by nursing professionals to older adults: prevention or treatment? Muestreo aleatorio. Variables principales morbilidad, mortalidad; descriptivas: visitas de la enfermera, filiación, datos clínicos y socio sanitarios. CONCLUSIÓN: la visita domiciliaria del profesional en enfermería no repercute en la morbimortalidad; visita a los pacientes cuando ya ha aparecido el problema de salud, no hay datos de prevención. La rotura traqueal tras una contusión es rara, aunque potencialmente mortal. El objetivo de este estudio es informar sobre un caso de rotura traqueal tras una contusión en el cuello producto de un accidente de bicicleta que se trató de manera conservadora. Sociedad Argentina de Pediatría. La deficiencia de vitamina A es infrecuente en los países desarrollados. Health literacy in patients attending a University Hospital. Low level of health literacy is associated with poor communication between patients and clinicians and with increased hospitalization rates, less frequent screening for cancer, poor control of diabetes, and disproportionately high rates of disease and mortality. Despite the importance of health literacy in medicine, there is no information about its prevalence in Latin America. The aim of this study was to assess the prevalence of inadequate health literacy in a random sample of patients, at a University Hospital where a descriptive study was performed during Participants were randomly selected from the ambulatory clinic and from the medical inpatient ward during The respondents had a median age of 56 years. The prevalence of inadequate health literacy was We found a high prevalence of inadequate health literacy, being strongly associated with the level of formal education. It is important that health care providers know the implications of health literacy and its consequences. Oral health and risk of pneumonia in asthmatic pacients with inhaled treatment. Asthma is a chronic disease requiring inhaled treatment and in addition it is a risk factor RF of pneumonia. In the oropharyngeal cavity there are numerous species of bacteria that could be dragged to the bronco-alveolar level. Case-control study in asthmatic population with inhaled treatment. We recruited asthmatic patients diagnosed with pneumonia by clinical and radiological criteria cases and asthmatics not diagnosed with pneumonia during the last year controls , matched by age. The multivariated analysis shows an independent association of performing 6 or more inhalations per day OR 2. Síndrome de Susac en un paciente con colitis ulcerosa. The Susac's syndrome is a rare disorder that was first described in and is characterized by a classic triad consisting in encephalopathy, visual impairment and sensorineural hearing loss. However, the etiology of the disease is still unclear. We report the case of a year-old with ulcerative colitis treated with mercaptopurine, six months before to her admission started with personality changes attributed to symptoms of depression who subsequently present neurological symptoms characteristic of Susac's Syndrome. In the literature there is no clear association between inflammatory bowel disease and Susac's -syndrome, but this case is presented in order to emphasize the simultaneous presentation of these two diseases with a tendency to vasospasm and an autoimmune pathogenesis. A incidência anual de ruptura do AAA é de oito casos por Métodos Estudo descritivo, retrospectivo e randomizado. Resultados Foram analisados 1. Nesse ínterim, apresentou deiscência das suturas e fístula purulenta inguinal esquerda em contato com a prótese vascular. Essa pode se constituir em ferramenta importante em casos similares. Trombose venosa profunda e vírus chicungunha. Los defectos craneales secundarios a traumatismos son frecuentes. Históricamente se han utilizado diversos materiales para la reconstrucción. Las localizaciones afectaron el frontal, el borde orbitario superior y el techo orbitario en cuatro casos , y la porción lateral del frontal, la zona temporoparietal y el borde del occipital en un caso. La reconstrucción en cuatro pacientes fue entre 6 y 12 meses después de la lesión, y en un caso después de 25 años. En dos casos se requirió expansión tisular antes de colocar el implante. Cuatro pacientes evolucionaron favorablemente, con mejoría de los síntomas neurológicos, forma y contorno adecuados, así como un proceso de cicatrización adecuada de los colgajos de piel cabelluda. Un paciente presentó infección por Staphylococcus aureus, atribuida a la presencia de un mucocele y una fístula de la vía aérea a la cavidad craneal, lo que hizo necesario retirar el implante. Brindan resultados satisfactorios desde el punto de vista funcional y cosmético. Deben tomarse precauciones respecto al tratamiento de las lesiones que afecten el seno frontal, para evitar la comunicación entre la vía aérea y la cavidad craneal. Cranial defects due to trauma are frequent. They are usually repaired in a secondary fashion due to features such as syndrome of the trephined, for brain protection and for cosmetic purposes. Historically, various materials have been used for reconstruction. Defects involved. Foraminotomia cervical posterior en el tratamiento de conflictos foraminales. En este trabajo evaluamos nuestra serie de pacientes tratados por esta via. Método: Desde enero de a diciembre de , 17 pacientes 18 foraminotomías fueron operados por presentar cervicobraquialgia a causa de un conflicto foraminal, realizando un foraminotomía cervical posterior. Los pacientes fueron evaluados en el postoperatorio inmediato, al mes y a los 3 meses de la cirugía. Resultados: El dolor radicular por conflicto foraminal secundario a hernia de disco cervical fue el síntoma y la patología predominante. La resolución completa del dolor radicular se observó en casi todos los pacientes. La VAS preoperatoria en promedio fue de 8. La media en la Neck Disability Index al inicio fue de Los Criterios de Odom para la evaluación de pacientes operados de columna cervical fueron satisfactorios con un promedio de 1. Conclusión: La foraminotomía cervical posterior es un procedimiento efectivo para el tratamiento del dolor radicular en los conflictos foraminales PMID Uno de los principales problemas de los pacientes oncohematológicos es la desnutrición, que suele tener causas multifactoriales de la propia enfermedad, de los pacientes y de los diferentes tratamientos administrados. Para minimizar el impacto de la desnutrición es necesaria una intervención nutricional, ya sea adaptando la dieta o mediante la instauración de soporte nutricional artificial, en función de la gravedad de cada caso. En cualquier paciente que esté recibiendo un tratamiento oncológico hay que evaluar las posibles interacciones que pueden existir con el soporte nutricional instaurado, ya sea dieta oral, suplementación oral o nutrición enteral. Estas interacciones pueden disminuir la eficacia, aumentar la toxicidad de los tratamientos o producir déficits nutricionales. Se detallan las principales interacciones que se pueden producir, las interacciones entre los tratamientos oncológicos y el soporte nutricional. Material y métodos: Estudio descriptivo retrospectivo que incluye a 53 pacientes en los que se utilizó la hemilaminectomía como abordaje a tumores intradurales-extramedulares durante el periodo junio de a diciembre de El periodo de seguimiento promedio fue de Resultados: Cincuenta y tres pacientes con tumores intradurales-extramedulares fueron intervenidos mediante hemilaminectomía. La serie incluyó 5 tumores cervicales, 24 dorsales y 24 lumbares. No se evidenció recidiva en ninguno de los casos durante el periodo de seguimiento. Conclusión: La hemilaminectomía constituye una vía efectiva para la resección de tumores intradurales-extramedulares lateralizados a nivel cervicodorsal. Analysis of the discrepancies identified during medication reconciliation on patient admission in cardiology units: a descriptive study. Of the discrepancies found, Of these, These results reveal the number of drugs that are not reincorporated into the treatment of patients, which can have important clinical consequences. Differences in the clinical-epidemiological profile between new cases of tuberculosis and retreatment cases after default. To identify the socioeconomic and clinical-epidemiological factors related to tuberculosis in new cases and retreatment cases. Comparative study with patients, of which 42 were retreatment cases after default attended in a reference center, and 84 were new cases completing the first treatment and treated in Basic Health Units. The collection of primary data was through interview, and of secondary data by records of the Notifiable Diseases Information System. Comparative analysis between the two groups. The new cases differ from retreatment cases regarding educational level. The clinical-epidemiological profile shows a significant difference in relation to performance of the tuberculin skin test, and the HIV test result positive in favor of new cases. In relation to performance of sputum culture and the result positive of the first sputum smear of the first and second samples, in favor of retreatment cases. The two groups are significantly different in clinical and epidemiological characteristics that show the access to exams. Identificar fatores socioeconômicos e clínico-epidemiológicos associados à tuberculose em casos novos e em casos em retratamento. Os casos novos diferem dos em retratamento quanto à escolaridade. Os dois grupos. Inguinodynia in patients submitted to conventional inguinal hernioplasty. We questioned patients about the presence of chronic inguinal pain and, if confirmed, invited them to a consultation in which we assessed the pain and its impact on quality of life. El objetivo del trabajo es conocer las disyuntivas entre los principios de beneficencia y autonomía, que se presentan en la relación médico- paciente , durante la terapéutica del intento de suicidio. La información se obtuvo previo consentimiento informado en entrevistas individuales. Las discordancias entre la beneficencia y la autonomía estuvieron relacionadas con el beneficio del tratamiento, el respeto por los valores y las creencias de los pacientes , entre otros. We present results of the study of the glolular cluster system of NGC The number of members of the system is calculated; and compared with other elliptical galaxies from literature. Influencias socioculturales en conceptos astronómicos: el caso del horizonte en la reforma copernicana. I analyze the meaning given by Ptolemy to the concept of horizon; especially how it allowed him to prove, through astronomical observations, the central position of the Earth in the Universe. I review the ways in which Copernicus and Galileo gave heliocentric answers to the Ptolemaic proof. I show that Galilean solution entailed a radical conceptual change, which brought with it a new sense to the concept of horizon. I state that this change was the product of sociocultural influences of the period. The injection of calcium-based sorbents into coal-fired boilers for reaction with, and reduction in the levels of, sulfur dioxide SO2 in the flue gas has undergone considerable research and development. Significant effort has also been made in developing models for the overall Etologia aplicada al manejo de especies amenazadas: el caso del turon de patas negras Mustela nigripes. Black-footed ferrets are considered one of the world's most endangered mammals. The last wild population was discovered in in Meteetsee, Wyoming, and, in it collapsed due to an epizootic of canine distemper in combination with sylvatic plague. 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Deben tomarse precauciones respecto al tratamiento de las lesiones que afecten el seno frontal, para evitar la comunicación entre la vía aérea y la cavidad craneal. Cranial defects due to trauma are frequent. They are usually repaired in a secondary fashion due to features such as syndrome of the trephined, for brain protection and for cosmetic purposes.

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Historically, various materials have been used for reconstruction. Defects involved. Foraminotomia cervical posterior en el tratamiento de conflictos foraminales.

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En este trabajo evaluamos nuestra serie de pacientes tratados por esta via. Método: Desde enero de a diciembre de17 pacientes 18 foraminotomías fueron operados por presentar cervicobraquialgia a causa de un conflicto foraminal, realizando un foraminotomía cervical posterior.

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Los pacientes fueron evaluados en el postoperatorio inmediato, al mes y a los 3 meses de la cirugía. Resultados: El dolor radicular por conflicto foraminal secundario a hernia de disco cervical fue el síntoma y la patología predominante.

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La resolución completa del dolor radicular se observó en casi todos los pacientes. La VAS preoperatoria en promedio fue de 8. La media en la Neck Disability Index al inicio fue de Los Criterios de Odom para la evaluación de pacientes operados de columna cervical fueron satisfactorios con un promedio de 1.

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Conclusión: La foraminotomía cervical posterior es un procedimiento efectivo para el tratamiento del dolor radicular en los conflictos foraminales PMID Uno de los principales problemas de los pacientes oncohematológicos es la desnutrición, que suele tener causas multifactoriales de la propia enfermedad, de los pacientes y de los diferentes tratamientos administrados. Para minimizar el impacto de la desnutrición es necesaria una intervención nutricional, ya sea Brett Rossi Sabrina Maree en Lengua Profunda la dieta o mediante la instauración de soporte nutricional artificial, en función de la gravedad de cada caso.

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En cualquier paciente que esté recibiendo un tratamiento oncológico hay que evaluar las posibles interacciones que pueden existir con el soporte nutricional instaurado, ya sea dieta oral, suplementación oral o nutrición enteral.

Estas interacciones pueden Brett Rossi Sabrina Maree en Lengua Profunda la eficacia, aumentar la toxicidad de los tratamientos o producir déficits nutricionales. Se detallan las principales interacciones que se pueden producir, las interacciones entre los tratamientos oncológicos y el soporte nutricional.

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Material y métodos: Estudio descriptivo retrospectivo que incluye a 53 pacientes en los que se utilizó la hemilaminectomía como abordaje a tumores intradurales-extramedulares durante el Brett Rossi Sabrina Maree en Lengua Profunda junio de a diciembre de El periodo de seguimiento promedio fue de Resultados: Cincuenta y tres pacientes con tumores intradurales-extramedulares fueron intervenidos mediante hemilaminectomía.

La serie incluyó 5 tumores cervicales, 24 dorsales y 24 lumbares.

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However, the planned interval test and XRD results showed the corrosion activity of the copper cable in the studied solution was a relatively slow process and considered not to be corroded as a partially protective scale of copper oxide formed on the surface. Nonferrous smelters and coal gasification processes generate environmentally harmful sulfur dioxide streams, most of which are treated to produce sulfuric acid with the accompanying problems of market shortage and transportation difficulties. Some sulfur dioxide streams are scrubbed with an alkali solution or a solid substance such as limestone or dolomite, which in turn generates wastes that pose other pollution problems. While the conversion of sulfur dioxide to elemental sulfur has many environmental advantages, no processes exist that are environmentally acceptable and economically viable. A new method for converting sulfur dioxide to elemental sulfur by a cyclic process involving calcium sulfide and calcium sulfate without generating solid wastes has been developed. In this process, calcium sulfate pellets as the starting raw material are reduced by a suitable reducing agent such as hydrogen to produce calcium sulfide pellets, which are used to reduce sulfur dioxide producing elemental sulfur vapor and calcium sulfate. The latter is then reduced to regenerate calcium sulfide. Thermodynamic analysis and experimental results indicated that the CaS-SO2 reaction produces mainly sulfur vapor and solid calcium sulfate and that the gaseous product from the CaSO 4-H2 reaction is mainly water vapor. The rates of the two reactions are reasonably rapid in the temperature range K, and, importantly, the physical strengths and reactivities of the pellets are maintained largely unchanged up to the tenth cycle, the last cycle tested in this work. Sulfur dioxide-containing streams from certain sources, such as the regenerator off-gas from an integrated gasification combined cycle desulfurization unit and new sulfide smelting plants, contain much higher partial pressures of SO2. In these cases, the rate of the first reaction is expected to be proportionally higher than in the test conditions reported in this paper. Single-crystal EPR spectra of gamma-ray-irradiated gypsum reveal two types of arsenic-associated oxyradicals: [AsO3]2- and an [AsO2] Food insecurity and health status in deprived populations, a multicentre survey in seven of the social and medical healthcare centres CASOs run by Doctors of the World, France. To document eating practices and socio-economic profiles of patients seen in the social and medical healthcare centres CASOs in its French acronym run by Doctors of the World Médecins du Monde, MdM in France and evaluate their nutritional and health status. All the patients attending MdM clinics were given a nutrition and health questionnaire. Their anthropometric measurements were taken on site. A total of One third of the patients declared having lost weight over the last two weeks. Constrained resources lead people living in very precarious conditions to eat without adequate nutrition, which could have consequences for their health, such as diabetes, obesity and cardiovascular disease. Published by Elsevier Ltd. Entre essas, o pé diabético PD destaca-se por possuir alta incidência e grande poder mutilador. Métodos Estudo descritivo, quantitativo, tipo inquérito por entrevista. Scientific advances and the complexity of human knowledge generate a constant need for creating new tools intended to facilitate learning in an agreeable and lasting form. Simulated patients are one of such tools in medical education. Standardized or simulated patients are actors or people vigorously trained to represent a medical history or, if possible, specific physical findings with the purpose of using such representations as an educational and evaluating supplement in clinic practice. The use of simulated patients has been very well received, particularly in the psychiatric field; however, its usefulness in areas such as psychotherapy or evaluation of residents remains questionable. Simulated patients are widely used throughout the world in the psychiatry field and their usefulness as an academic tool for pre-graduate students is confirmed in most of the literature reviewed. One of the main benefits of the use of this kind of patients is the acquisition of specific abilities e. Notwithstanding the controversy, most of the literature reviewed confirms the benefits and acceptance of this methodology in the formation of students and psychiatrists. Publicado por Elsevier España. Jaimes; Ortega-García, J. Aranda; Marín, J. Delgado; Ascanio, A. López; Jimenez, J. Ruiz; de Paco Matallana, C. Métodos Estudio de casos -control. Estudio descriptivo y regresión logística multivariable. Se presenta caso de paciente obesa a quien se le realiza endoscopía digestiva alta por disfagia tras ingesta accidental de hueso de pollo. Se constata leve esofagitis de reflujo y atrofia duodenal. La biopsia intestinal informa atrofia intestinal con infiltrado inflamatorio. Los autoanticuerpos para enfermedad celiaca resultan positivos. La paciente nunca presentó síntomas digestivos. Se confirma enfermedad celiaca silente e inicia dieta sin gluten. Report of a case]. Métodos Foram tratados 20 membros em 20 pacientes , todos com ulcerações relacionadas a refluxo de veias safenas. Los modelos de eensenanza y aprendizaje constructivistas conceptualizan el aprendizaje como un proceso activo. El modelo de Aprendizaje Basado en Proyectos ABPr se distingue por una serie de componentes, entre los cuales se destaca el aspecto colaborativo y cooperativo como un reto al momento de su implantacion. Son pocas las investigaciones que se concentran en este aspecto del modelo. En este estudio, se analizaron las diversas interacciones que surgen durante la implantacion de una unidad curricular sobre el tema de Geologia de Puerto Rico, la cual se diseno con el modelo ABPr cuyo enfoque es orientacion a proyectos. Particularmente, se examinaron las interacciones sociales que surgen entre los pares y entre pares y docente durante el proceso de planificacion y desarrollo de los productos finales, al igual que las interacciones entre los estudiantes y el material didactico en estas etapas del modelo. La investigacion es de tipo cualitativo e incorpora como diseno el estudio de caso. Las diversas interacciones constituyen la unidad de analisis. En el estudio participaron 19 estudiantes de 9no grado, a quienes se organizaron en 5 grupos colaborativos por temas de interes Pangea, Placas tectonicas, Volcanes, Tsunamis y Terremotos. Las tecnicas que se utilizaron para recopilar los datos fueron: observaciones participativas, grupos focales y analisis de documentos cuadernos reflexivos y respuestas de los estudiantes a la pregunta central del proyecto. Para el analisis de los datos se aplico la teoria de actividad CHAT que concentra la unidad de analisis en la actividad humana en un contexto particular. Los resultados del estudio senalan que las interacciones entre pares, entre pares y docente, asi como entre estudiantes y material didactico son fundamentales en el proceso de aprendizaje. Una mayor interaccion entre pares durante las etapas de planificar y desarrollar los productos finales de la unidad, promueve una mejor comprension de los conceptos de la. Cl-CO3-scapolite [ Na,Ca 4[Al3 Al,Si 3 Si3 O24] Cl, CO3 , SO4 ] occurs as a common partial to total alteration of plagioclase in deep-crustal xenoliths, skarns, marbles, gabbros, metabasites, calc-silicate gneisses, as well as in quartzofeldspathic granulite-facies rocks in general Moecher and Essene, , J Petrol 31, Natural plagioclase and scapolite, along with synthetic calcite and anhydrite, were lightly ground together in equi-molar amounts in ethanol. A series of duplicate experiments for the same mineral mix, at the same P-T conditions, were done utilizing pure H2O as the flux. In contrast. Based on this model validated from experimental data, it can be seen that temperature, pressure and salinity all have significant effects on pH, alkalinity and speciations of aqueous solutions and on the solubility of calcite, halite, anhydrite and gypsum. The solubility of anhydrite and gypsum will decrease as temperature increases e. The increase of pressure may increase the solubility of sulphate minerals e. Addition of NaCl to the solution may increase mineral solubility up to about 3 molality of NaCl, adding more NaCl beyond that may slightly decrease its solubility. Dissolved CO 2 in solution may decrease the solubility of minerals. The influence of dissolved calcite on the solubility of gypsum and anhydrite can be ignored, but dissolved gypsum or anhydrite has a big influence on the calcite solubility. Online calculation is made available on www. Con este objetivo, presentamos nuestra experiencia con el software Osirix. Descripción de la técnica: Se presentan 3 casos ejemplificadores de 40 realizados. En el Caso 1 se pudo analizar las relaciones del tumor con las estructuras adyacentes para minimizar el abordaje. En el Caso 2 permitió comprender la anatomía post-operatoria previa del paciente , para determinar la trayectoria del abordaje transnasal endoscópico y la necesidad de ampliar su exposición, logrando la resección tumoral completa. Remisión de aneurisma luego de exéresis de MAV con aparición de síndrome del acento extranjero. La conducta frente a los aneurismas asociados es dicotómica en la literatura, mientras existen reportes de la desaparición de los mismos luego de la exéresis de la MAV, otros artículos enfatizan su tratamiento precoz. Objetivo: Presentar un paciente que desarrolla el síndrome del acento extranjero posterior a la exéresis de una MAV y la evolución de un aneurisma asociado. Retrospective analysis of a case series of patients with traumatic injuries to the craniocervical junction. Um paciente apresentava déficit neurológico, melhorando após o tratamento. No grupo conservador, predominaram as fraturas do odontóide oito e dos elementos posteriores de C2 cinco. Em dois casos , havia também fraturas em outros segmentos da coluna. Diagnóstico diferencial en la encefalitis por anticuerpos contra el receptor NMDA. Pacientes Presentamos a 2 pacientes diagnosticadas de encefalitis por anticuerpos NMDAR con un cuadro clínico típico, pero que inicialmente señaló otras etiologías. La caracterización clínica e inmunológica de esta enfermedad ha llevado a la identificación de nuevos anticuerpos que afectan a procesos de memoria, aprendizaje, conducta y psicosis. Surgical site infection in patients submitted to heart transplantation. The correlation between variables was evaluated by using Fisher's exact test and Mann-Whitney-Wilcoxon test. Signs of surgical site infection were observed in 9. There was no statistically significant association between the variables related to the patient and the surgery. Programmed home visits by nursing professionals to older adults: prevention or treatment? Muestreo aleatorio. Variables principales morbilidad, mortalidad; descriptivas: visitas de la enfermera, filiación, datos clínicos y socio sanitarios. CONCLUSIÓN: la visita domiciliaria del profesional en enfermería no repercute en la morbimortalidad; visita a los pacientes cuando ya ha aparecido el problema de salud, no hay datos de prevención. La rotura traqueal tras una contusión es rara, aunque potencialmente mortal. El objetivo de este estudio es informar sobre un caso de rotura traqueal tras una contusión en el cuello producto de un accidente de bicicleta que se trató de manera conservadora. Sociedad Argentina de Pediatría. La deficiencia de vitamina A es infrecuente en los países desarrollados. Health literacy in patients attending a University Hospital. Low level of health literacy is associated with poor communication between patients and clinicians and with increased hospitalization rates, less frequent screening for cancer, poor control of diabetes, and disproportionately high rates of disease and mortality. Despite the importance of health literacy in medicine, there is no information about its prevalence in Latin America. The aim of this study was to assess the prevalence of inadequate health literacy in a random sample of patients, at a University Hospital where a descriptive study was performed during Participants were randomly selected from the ambulatory clinic and from the medical inpatient ward during The respondents had a median age of 56 years. The prevalence of inadequate health literacy was We found a high prevalence of inadequate health literacy, being strongly associated with the level of formal education. It is important that health care providers know the implications of health literacy and its consequences. Oral health and risk of pneumonia in asthmatic pacients with inhaled treatment. Asthma is a chronic disease requiring inhaled treatment and in addition it is a risk factor RF of pneumonia. In the oropharyngeal cavity there are numerous species of bacteria that could be dragged to the bronco-alveolar level. Case-control study in asthmatic population with inhaled treatment. We recruited asthmatic patients diagnosed with pneumonia by clinical and radiological criteria cases and asthmatics not diagnosed with pneumonia during the last year controls , matched by age. The multivariated analysis shows an independent association of performing 6 or more inhalations per day OR 2. Síndrome de Susac en un paciente con colitis ulcerosa. The Susac's syndrome is a rare disorder that was first described in and is characterized by a classic triad consisting in encephalopathy, visual impairment and sensorineural hearing loss. However, the etiology of the disease is still unclear. We report the case of a year-old with ulcerative colitis treated with mercaptopurine, six months before to her admission started with personality changes attributed to symptoms of depression who subsequently present neurological symptoms characteristic of Susac's Syndrome. In the literature there is no clear association between inflammatory bowel disease and Susac's -syndrome, but this case is presented in order to emphasize the simultaneous presentation of these two diseases with a tendency to vasospasm and an autoimmune pathogenesis. A incidência anual de ruptura do AAA é de oito casos por Métodos Estudo descritivo, retrospectivo e randomizado. Resultados Foram analisados 1. Nesse ínterim, apresentou deiscência das suturas e fístula purulenta inguinal esquerda em contato com a prótese vascular. Essa pode se constituir em ferramenta importante em casos similares. Trombose venosa profunda e vírus chicungunha. Los defectos craneales secundarios a traumatismos son frecuentes. Históricamente se han utilizado diversos materiales para la reconstrucción. Las localizaciones afectaron el frontal, el borde orbitario superior y el techo orbitario en cuatro casos , y la porción lateral del frontal, la zona temporoparietal y el borde del occipital en un caso. La reconstrucción en cuatro pacientes fue entre 6 y 12 meses después de la lesión, y en un caso después de 25 años. En dos casos se requirió expansión tisular antes de colocar el implante. Cuatro pacientes evolucionaron favorablemente, con mejoría de los síntomas neurológicos, forma y contorno adecuados, así como un proceso de cicatrización adecuada de los colgajos de piel cabelluda. Un paciente presentó infección por Staphylococcus aureus, atribuida a la presencia de un mucocele y una fístula de la vía aérea a la cavidad craneal, lo que hizo necesario retirar el implante. Brindan resultados satisfactorios desde el punto de vista funcional y cosmético. Deben tomarse precauciones respecto al tratamiento de las lesiones que afecten el seno frontal, para evitar la comunicación entre la vía aérea y la cavidad craneal. Cranial defects due to trauma are frequent. They are usually repaired in a secondary fashion due to features such as syndrome of the trephined, for brain protection and for cosmetic purposes. Historically, various materials have been used for reconstruction. Defects involved. Foraminotomia cervical posterior en el tratamiento de conflictos foraminales. En este trabajo evaluamos nuestra serie de pacientes tratados por esta via. Método: Desde enero de a diciembre de , 17 pacientes 18 foraminotomías fueron operados por presentar cervicobraquialgia a causa de un conflicto foraminal, realizando un foraminotomía cervical posterior. Los pacientes fueron evaluados en el postoperatorio inmediato, al mes y a los 3 meses de la cirugía. Resultados: El dolor radicular por conflicto foraminal secundario a hernia de disco cervical fue el síntoma y la patología predominante. La resolución completa del dolor radicular se observó en casi todos los pacientes. La VAS preoperatoria en promedio fue de 8. La media en la Neck Disability Index al inicio fue de Los Criterios de Odom para la evaluación de pacientes operados de columna cervical fueron satisfactorios con un promedio de 1. Conclusión: La foraminotomía cervical posterior es un procedimiento efectivo para el tratamiento del dolor radicular en los conflictos foraminales PMID Uno de los principales problemas de los pacientes oncohematológicos es la desnutrición, que suele tener causas multifactoriales de la propia enfermedad, de los pacientes y de los diferentes tratamientos administrados. Para minimizar el impacto de la desnutrición es necesaria una intervención nutricional, ya sea adaptando la dieta o mediante la instauración de soporte nutricional artificial, en función de la gravedad de cada caso. En cualquier paciente que esté recibiendo un tratamiento oncológico hay que evaluar las posibles interacciones que pueden existir con el soporte nutricional instaurado, ya sea dieta oral, suplementación oral o nutrición enteral. Estas interacciones pueden disminuir la eficacia, aumentar la toxicidad de los tratamientos o producir déficits nutricionales. Se detallan las principales interacciones que se pueden producir, las interacciones entre los tratamientos oncológicos y el soporte nutricional. Material y métodos: Estudio descriptivo retrospectivo que incluye a 53 pacientes en los que se utilizó la hemilaminectomía como abordaje a tumores intradurales-extramedulares durante el periodo junio de a diciembre de El periodo de seguimiento promedio fue de Resultados: Cincuenta y tres pacientes con tumores intradurales-extramedulares fueron intervenidos mediante hemilaminectomía. La serie incluyó 5 tumores cervicales, 24 dorsales y 24 lumbares. No se evidenció recidiva en ninguno de los casos durante el periodo de seguimiento. Conclusión: La hemilaminectomía constituye una vía efectiva para la resección de tumores intradurales-extramedulares lateralizados a nivel cervicodorsal. Analysis of the discrepancies identified during medication reconciliation on patient admission in cardiology units: a descriptive study. Of the discrepancies found, Of these, These results reveal the number of drugs that are not reincorporated into the treatment of patients, which can have important clinical consequences. Differences in the clinical-epidemiological profile between new cases of tuberculosis and retreatment cases after default. To identify the socioeconomic and clinical-epidemiological factors related to tuberculosis in new cases and retreatment cases. Comparative study with patients, of which 42 were retreatment cases after default attended in a reference center, and 84 were new cases completing the first treatment and treated in Basic Health Units. The collection of primary data was through interview, and of secondary data by records of the Notifiable Diseases Information System. Comparative analysis between the two groups. The new cases differ from retreatment cases regarding educational level. The clinical-epidemiological profile shows a significant difference in relation to performance of the tuberculin skin test, and the HIV test result positive in favor of new cases. In relation to performance of sputum culture and the result positive of the first sputum smear of the first and second samples, in favor of retreatment cases. The two groups are significantly different in clinical and epidemiological characteristics that show the access to exams. Identificar fatores socioeconômicos e clínico-epidemiológicos associados à tuberculose em casos novos e em casos em retratamento. Sabrina Maree comer Brett Rossis mojado coño. Brett Rossi y Sabrina Maree sexy lesbos. Sammie invitó a dos de sus amigos hermoso sobre para una tarde de tomar el sol y lamidas de coño. Después de unos minutos de bronceado, las chicas decidieron saltar en la piscina. Brett Rossi dando sexo Sabrina Maree..

No se evidenció recidiva en ninguno de los casos durante el periodo de seguimiento. Conclusión: La hemilaminectomía constituye una vía efectiva para la resección de tumores intradurales-extramedulares lateralizados a nivel cervicodorsal.

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Analysis of the discrepancies identified during medication reconciliation on patient admission in cardiology units: a descriptive study.

Of the discrepancies found, Of these, These results reveal the number of drugs that are not reincorporated into the treatment of patients, which can have important clinical consequences.

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Differences in the clinical-epidemiological profile between new cases of tuberculosis and retreatment cases after default.

To identify the socioeconomic and clinical-epidemiological factors related to tuberculosis in new cases and retreatment cases.

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Comparative study with patients, of which 42 were retreatment cases after default attended in a reference center, and 84 were new cases completing the first treatment and treated in Basic Health Units. The collection of primary data was through interview, and of secondary data by records of the Notifiable Diseases Information System.

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Comparative analysis between the two groups. The new cases differ from retreatment cases regarding educational level.

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The clinical-epidemiological profile shows a significant difference in relation to performance of the tuberculin skin test, and the HIV test result positive in favor of new cases. In relation to performance of sputum culture and the result positive of the first sputum smear of the first and second samples, in favor of retreatment cases.

The two groups are significantly different in clinical and epidemiological characteristics that show the access to exams.

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Identificar fatores socioeconômicos e clínico-epidemiológicos associados à tuberculose em casos novos e em casos em retratamento. Os casos novos diferem dos em retratamento quanto à escolaridade.

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Os dois grupos. Inguinodynia in patients submitted to conventional inguinal hernioplasty. We questioned patients about the presence of chronic inguinal pain and, if confirmed, invited them to a consultation in which we assessed the pain and its impact on quality of life.

Pumpingfuck Milf Watch Video de sexo de gemelos olson Video Fuckswipe scam. Conclusiones En nuestra serie de pacientes con encefalitis por anticuerpos contra el receptor de NMDA, ninguno se asoció a tumores. Todos los casos recibieron metotrexato por lo menos durante un año, no observamos eventos adversos clínicos ni por laboratorio, ni hubo secuelas neurológicas ni recaídas durante el tratamiento. Resumo Os autores relatam o caso de uma paciente jovem previamente submetida a nefrectomia direita por apresentar angiomiolipomas renais AMLRs e portadora de dois volumosos angiomiolipomas no rim esquerdo remanescente. A paciente foi encaminhada pelo urologista para tratamento endovascular. Hemangioblastomas de fosa posterior: Reporte de 16 casos y revisión de la literatura. Se evaluó: sexo, edad, tipo de lesión quística con nódulo, quística sin nódulo, sólida y sólida-quística , sintomatología y resultados postoperatorios. Resultados: De los 16 pacientes intervenidos, 11 fueron varones y 5 mujeres. La edad promedio fue de 44 años. En todos los casos la resección fue completa, siendo necesario en un caso una embolización previa. Como complicaciones postoperatorias, 2 pacientes presentaron ataxia mejoró al cabo de 3 meses , y 1 paciente presentó una fístula de LCR se solucionó con un drenaje espinal externo. Se registró un óbito por complicaciones postoperatorias. Pacientes y Métodos: se llevó a cabo una revisión de las historias clínicas de 47 pacientes con meningiomas primarios intraorbitarios. Se realizaron 52 cirugías en los pacientes con MF. Se empleó una craneotomía fronto-orbitaria, seguida de una descompresión extradural del canal óptico, resección del componente intraorbitario y exploración intradural del nervio óptico. Resultados: de los 12 pacientes con MF que presentaban la visión conservada, la agudeza visual fue preservada en 7 casos , mejoró en 2, y empeoró en 3. En 18 pacientes , el principal síntoma fue exoftalmos y en 35 pacientes ceguera unilateral. Cinco de ellos fueron reoperados. Se indicó radioterapia después de la recurrencia en 3 pacientes. Integrando la historia clínica ambiental en el consejo prenatal y cuidado de 2 casos de gastrosquisis. García, J. Ortega; Martín, M. Brea; De Paco-Matallana, C. Ruiz; Soldin, O. Introducción La gastroquisis es una malformación de etiología desconocida en la que se han implicado factores de riesgo FR genéticos y medioambientales. Un caso estuvo expuesto a cocaína, humo de cannabis y se realizó una ortopantografía durante el embarazo. Towards this primary objective, we created the Phoenix Pilot as a crucible from which systemization of the new discipline could emerge. Hiperplasia angiolinfoide com eosinofilia: um caso raro em cavidade oral. Tem como principal diagnóstico diferencial a doença de Kimura. Descompresión microvascular en neuralgia del trigémino: Reporte de 36 casos y revisión de la literatura. Objetivo: El propósito del presente trabajo es presentar los resultados de 36 pacientes con diagnóstico de neuralgia del trigémino NT , en los cuales se realizó una descompresión microvascular DMV. Resultados: De los 36 pacientes operados, 25 fueron mujeres y 11 varones. El promedio de edad fue de 48 años. El seguimiento postoperatorio fue en promedio de 38 meses. De los 4 casos con recurrencia de dolor, en dos pacientes se observó como hallazgo intraoperatorio un conflicto venoso. Genes del receptor variable beta de células T en células circulantes de pacientes con lupus eritematoso generalizado y sus familiares sanos. Descompresión microvascular en espasmo hemifacial: Reporte de 13 casos y revisión de la literatura. Objetivo: El propósito del presente trabajo es presentar los resultados de 13 pacientes con diagnóstico de espasmo hemifacial EHF , en los cuales se realizó una descompresión microvascular DMV. Se evaluó: edad, sexo, tiempo de evolución de la sintomatología, hallazgos intraoperatorios y resultados postoperatorios. Resultados: De los 13 pacientes intervenidos, 7 fueron mujeres y 6 varones. La media de edad fue de 53 años. Por orden decreciente de frecuencia la causa de la compresión fue arteria cerebelosa anteroinferior, arteria cerebelosa posteroinferior, arteria dolicomega basilar y arteria dolicomega vertebral. El seguimiento postoperatorio fue en promedio de 24 meses. En cuanto a las complicaciones postoperatorias: 3 pacientes presentaron paresia facial II-III en la escala de House-Brackman se recuperaron en un período de 6 meses , y 1 paciente presentó fístula de líquido cefalorraquídeo. Ninguno de los pacientes de la serie presentaron hipoacusia transitorio o permanente. Conclusión: La DMV como tratamiento del EHF es un procedimiento efectivo y seguro, que permite la resolución completa de la patología en la mayoría de los casos. Sabemos prescrever profilaxia de tromboembolismo venoso nos pacientes internados? Resumo Contexto Embora preconizada, a profilaxia de tromboembolismo venoso TEV deixa de ser realizada sistematicamente em pacientes internados. Excluíram-se os pacientes em uso de anticoagulantes ou com sangramento ativo. Objetivo Identificar os casos de TEP incidental em pacientes oncológicos submetidos a tomografia computadorizada TC de tórax, correlacionando aspectos clínicos e fatores de risco associados. Resultados Foram avaliados pacientes com TEP no período citado. Sintomas sugestivos de TEP estavam presentes em pacientes sem suspeita clínica ao realizarem a TC de tórax. Doença cística adventicial da artéria poplítea: relato de caso. Discutimos alternativas diagnósticas e terapêuticas. Resumen Los quistes neuroentéricos QNE son lesiones raras, congénitas y benignas, causadas por la comunicación persistente o anormal entre el neuroectodermo, la notocorda y el endodermo. Son lesiones intradurales extramedulares, siendo excepcional su presentación intramedular. El objetivo del presente artículo es reportar un caso de QNE intramedular cervical en un adulto joven, sin malformaciones concomitantes. El seguimiento con RMN es recomendado en resecciones subtotales. O presente estudo relata o caso de um paciente de 52 anos, etilista crônico, internado com dor abdominal difusa, cuja propedêutica revelou se tratar de um pseudoaneurisma em aorta infrarrenal. Debido a su rareza, no se han llevado a cabo ensayos aleatorizados específicamente en ENKL nasal; sin embargo, los informes de caso y las series de caso pequeñas ofrecen un conocimiento importante sobre nuevos tratamientos potenciales. Aspergilosis cervical con diseminación al sistema nervioso central. Presentación de un caso y revisión de bibliografía. Puede presentarse con cuadros de meningitis, aneurismas micóticos, infartos o abscesos. Es una infección con pronóstico reservado y puede afectar el SNC de forma primaria o secundaria a partir de un foco que se disemina por vía hematógena. Presentamos el caso de un paciente con AI con invasión primaria a nivel óseo y diseminación posterior al cerebro. Posteriormente agregó cervicalgia y con el diagnóstico de osteomielitis cervical se realiza punción bajo tomografía computada TC sin aislarse gérmenes. Se colocó Halo Vest e inició tratamiento antibiótico empírico. Posteriormente presentó afasia de expresión secundaria a lesión frontal izquierda. Se realizó evacuación de absceso cerebral aislando A. El tratamiento antibiótico específico posterior permitió una buena respuesta clínica y radiológica. Conclusión: La presencia de lesiones en el SNC de pacientes inmunocomprometidos debe incluir a las micosis como diagnóstico diferencial. Para evaluar la respuesta terapéutica y posibles recaídas se debe realizar un seguimiento periódico clínico radiológico. Palabras clave: Aspergilosis cerebral; Aspergilosis cervical; Aspergilosis invasiva; Voriconazol. Resumo A doença de Behçet é uma doença sistêmica, multifatorial e autoimune com diversas manifestações clínicas, entre elas o acometimento vascular. The polycrystalline samples of undoped and doped CaSO 4 are prepared by the melting method. The formation of CaSO 4 compound is confirmed by X-ray diffraction and Fourier transform infrared studies. Scanning electron microscopic studies of CaSO 4 are also carried out. The TL-dose dependence of all three samples was studied and was observed to be almost linear in the studied range of irradiation time. The trap parameters, namely order of kinetics b , activation energy E and frequency factor s associated with the most intensive glow peaks of CaSO 4:Mn, CaSO 4:Cu and CaSO 4 phosphors were determined using the glow curve shape Chen's method. This study was carried out to investigate the properties of the OSL signal from Eu-doped calcium sulfate CaSO 4:Eu phosphor and study on its thermal behavior as a function of temperature under a series of luminescence experiments. The suitability of its usage as an optically stimulated luminescence OSL dosimeter was also checked. CaSO 4:Eu was synthesized using the precipitation method and prepared in pellet form. The dopant concentration value was performed as 0. To have an idea about the crystallography and microstructure morphology of the material, scanning electron microscope SEM analysis were carried out. The excitation spectrum of CaSO 4:Eu showed different peaks in the region nm with the highest one at nm. The dosimetric properties such as dose response, minimum detectable dose, energy response, reusability, fading properties, thermal stability and effect of reading temperatures on OSL signals were examined. Seguridad del paciente en Radioterapia Intraoperatoria: Impacto de los elementos controlados por el Radiofisico. Por ultimo, al precisarse el uso en RIO de la simulacion virtual y del calculo de la dosis absorbida en el paciente virtual, se ha ilustrado este apartado con la aceptacion y el estado de referencia inicial del planificador de tratamientos modulados con calculo de Monte Carlo Elekta Monaco. No se experimentaron sucesos relativos a una administracion inadecuada de la dosis absorbida. Se identificaron las revisiones dobles y por un par como claves para reducir los riesgos asociados al equipo de profesionales involucrado en la RIO. Se identificaron tambien oportunidades de mejora con el uso de la automatizacion y el enclavamiento. Las camaras de ionizacion Farmer derivaron en direcciones opuestas en un periodo de 6 anos; aunque ello no se aprecio en los informes de calibracion del laboratorio acreditado. No derivo la camara PPC Los valores centrales de las dosis absorbidas quedaron entre la dosis absorbida prescrita y la maxima, con lo que indicaron un tratamiento correcto del lecho tumoral. Las verificaciones de. Resumen IntroducciÓn: El papiloma invertido es una neoplasia benigna de los senos paranasales localmente agresiva con alto potencial de recurrencia y de malignización. Caso clínico: Presentamos el caso de una paciente de 32 años que consultó por lesión exofítica en fosa nasal derecha y exoftalmos, asociada a cefalea, anosmia y disgeusia. La paciente evolucionó de forma favorable y sin complicaciones, con permeabilidad de vía aérea superior, sin signos de recidiva lesional luego de 4 años de seguimiento. Conclusión: La invasión intracraneal de esta patología es sumamente infrecuente. Cuando existe, es indicador de agresividad y potencial recidiva, por lo que la exéresis completa de la misma define el pronóstico de la enfermedad. Doença cística da adventícia na veia basílica: relato de caso. Resumo A doença cística da adventícia é uma entidade rara que acomete principalmente a artéria poplítea. A ocorrência em veias é muito rara, e sua etiologia é desconhecida. Clinicamente, apresenta-se como isquemia, trombose ou dor a depender do território acometido. Apresentamos o caso de um paciente masculino jovem referindo nódulo no braço esquerdo. O estudo anatomopatológico foi sugestivo de cisto de adventícia de veia basílica. The binary system K2SO4 CaSO 4 was studied by means of heating-cooling curves, differential thermal analysis, high-temperature quenching technique and by means of a heating stage mounted on an X-ray diffractometer. Compositions and quench products were identified optically and by X-ray. There is a eutectic at ?? C and 34 wt. Calcium langbeinite melts incongruently at ?? The melting-point of CaSO 4 ?? C was determined by the quenching technique using sealed platinum tubes. The only intermediate crystalline phase found in the system is K2SO4?? Existen prejuicios en relación con la vejez, incluso entre los profesionales que se dedican a la gerontología. Melting and subsolidus relations in the system K2SO4MgSO4 CaSO 4 were studied using heating-cooling curves, differential thermal analysis, optics, X-ray diffraction at room and high temperatures and by quenching techniques. This problem was partly overcome by a novel sealed-tube quenching method, by hydrothermal synthesis, and by long-time heating in the solidus. As a result of this study, we found: 1 a new compound, CaSO 4?? C with a field extending into the ternary system; 2 a high temperature form of MgSO4 with a sluggishly reversible inversion. An X-ray diffraction pattern for this polymorphic form is given; 3 the inversion of?? C, in agreement with grahmann; 1 4 the melting point of MgSO4 is ?? C and that of CaSO 4 is ?? C using sealed tube methods to prevent decomposition of the sulphates ; 5 calcium langbeinite K2SO4?? This resolved discrepancies in the results of previous investigators; 6 a continuous solid solution series between congruently melting K2SOP4?? The CaSO 4 field extends over a large portion of the system. Previously reported fields for the compounds K2SO4?? CaSO 4 were not found; 8 a minimum in the ternary system at: ?? Junot, Danilo O. The crystals used in this work were grown using a production route based on the Yamashita method Yamashita et al. TL analyses have been performed and characteristics such as sensitivity, reproducibility, linearity, and fading have been studied. In all the samples the TL response was proportional to the absorbed dose. Odontoidectomía endoscópica transnasal y fijación occípito-cervical. Reporte de caso y revisión de literatura. La inestabilidad atlanto-axial de origen inflamatorio Síndrome de Grisel es una rara entidad de la que solo se han reportado 16 casos adultos en la literatura. Esta patología se caracteriza por el desarrollo de una lesión osteolítica a nivel de la articulación atlanto-axoidea posterior a un evento infeccioso, generalmente de las vías aéreas superiores. La sintomatología comenzó posteriormente a un proceso infeccioso respiratorio. Se realizó una fijación occípito-cervical posterior y una Odontoidectomía con descompresión anterior por vía endoscópica transnasal. La paciente evolucionó con resolución completa de los síntomas. Los cultivos fueron negativos y el estudio de anatomía patológica concluyó cambios inflamatorios inespecíficos. Impulsive excitation of mechanoluminescence in gamma-irradiated CaSO 4:Eu phosphors. ML was excited impulsively by dropping a load onto the sample. Three distinct peaks have been observed in the ML intensity versus time curve. The ML intensity increases with the increasing concentration of the dopant. The effect of temperature on the shape and peak of ML intensity was also recorded. Growth, saturation and broadening in an ML peak were observed. Experimental results suggest that the ML excitation is related to the movement of dislocation with defect centres, the increase in ML with temperature is due to the enhancement in dislocation capture probability, and the reduction is due to the thermal bleaching of defect centres. As the dosimetric procedure involves total integrated counts for dose conversion, the dosimeters are typically read about a week after receiving. However in the event of a suspected over exposure, where urgent processing is expected, this poses limitation. Post irradiation annealing treatment is used in such cases of immediate readout of cards. In this paper we report a new and easier to use technique based on optical bleaching for the urgent processing of TLD cards. On the basis of the differential solubilities of gypsum and anhydrite, a method was developed to remove calcium from the scheelite leaching solution by adding anhydrite as an inoculating crystal. The effects of the reaction time, concentration of the CaSO 4 inoculating crystals, and temperature were investigated. Calcium Sulfate CaSO 4 deposit reduces heat exchange in heat transfer equipment which adversely affects the equipment performance and plant production. In addition, the Scanning Electron Microscopic was used to examine the morphology and distribution of Calcium Sulfate CaSO 4 crystals deposited on titanium metal surfaces. Based on the experimental results, Calcium Sulfate CaSO 4 scale obtained in the present study was almost constant on coated carbon steel in which the rate of scale deposition is equal to the rate of scale removal. However, the deposition of Calcium Sulfate CaSO 4 observed on titanium material was increased as the speed increased. Average particle size is found to be in the range nm with Hexagonal morphology and PL studies showed emission peaks at nm, when samples were excited by nm. However under identical condition it is observed that intensity of emission get enhanced for 0. A phosphor with narrow emission band around nm is desirable, since at this wavelength the transmission of standard glass, polarizing plastic, other coating and LCD material is at acceptable level. Numerical simulation of calcium sulfate CaSO 4 fouling in the plate heat exchanger. Plate heat exchanger is a widely used apparatus in the industrial production processes. Through a numerical simulation method, this paper calculates the deposition rate of CaSO 4 fouling on heat transfer surfaces of the plate heat exchanger under saturation in the bulk. The effects of CaSO 4 concentration in the range 0. The simulation results are compared with the experimental results showing similar trend. The simulation results show that the concentration and the flow velocity affect significantly the fouling characteristics in the plate heat exchanger. The deposition mass rate, removal mass rate, and asymptotic value of fouling resistance all increase with the increase in CaSO 4 concentration and the inlet temperature of the hot fluid, while the asymptotic value of fouling resistance decreases with the increasing of inlet flow velocity. The influence of the inlet temperature of cold fluid may be negligible. With the advent of newer techniques for dose reduction coupled with the development of more sensitive detectors, the radiation doses in radiological medical investigation are decreasing. Nevertheless, keeping the tenet in mind that all radiation doses could entail risk, there is a need to develop more sensitive dosimeters capable of measuring low doses. This paper gives the account of the development of a new and sensitive phosphor CaSO 4:Dy,Mn and its characterization. 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Cl-CO3-scapolite [ Na,Ca 4[Al3 Al,Si 3 Si3 O24] Cl, CO3 , SO4 ] occurs as a common partial to total alteration of plagioclase in deep-crustal xenoliths, skarns, marbles, gabbros, metabasites, calc-silicate gneisses, as well as in quartzofeldspathic granulite-facies rocks in general Moecher and Essene, , J Petrol 31, Natural plagioclase and scapolite, along with synthetic calcite and anhydrite, were lightly ground together in equi-molar amounts in ethanol. A series of duplicate experiments for the same mineral mix, at the same P-T conditions, were done utilizing pure H2O as the flux. In contrast. Based on this model validated from experimental data, it can be seen that temperature, pressure and salinity all have significant effects on pH, alkalinity and speciations of aqueous solutions and on the solubility of calcite, halite, anhydrite and gypsum. The solubility of anhydrite and gypsum will decrease as temperature increases e. The increase of pressure may increase the solubility of sulphate minerals e. Addition of NaCl to the solution may increase mineral solubility up to about 3 molality of NaCl, adding more NaCl beyond that may slightly decrease its solubility. Dissolved CO 2 in solution may decrease the solubility of minerals. The influence of dissolved calcite on the solubility of gypsum and anhydrite can be ignored, but dissolved gypsum or anhydrite has a big influence on the calcite solubility. Online calculation is made available on www. Con este objetivo, presentamos nuestra experiencia con el software Osirix. Descripción de la técnica: Se presentan 3 casos ejemplificadores de 40 realizados. En el Caso 1 se pudo analizar las relaciones del tumor con las estructuras adyacentes para minimizar el abordaje. En el Caso 2 permitió comprender la anatomía post-operatoria previa del paciente , para determinar la trayectoria del abordaje transnasal endoscópico y la necesidad de ampliar su exposición, logrando la resección tumoral completa. Remisión de aneurisma luego de exéresis de MAV con aparición de síndrome del acento extranjero. La conducta frente a los aneurismas asociados es dicotómica en la literatura, mientras existen reportes de la desaparición de los mismos luego de la exéresis de la MAV, otros artículos enfatizan su tratamiento precoz. Objetivo: Presentar un paciente que desarrolla el síndrome del acento extranjero posterior a la exéresis de una MAV y la evolución de un aneurisma asociado. Retrospective analysis of a case series of patients with traumatic injuries to the craniocervical junction. Um paciente apresentava déficit neurológico, melhorando após o tratamento. No grupo conservador, predominaram as fraturas do odontóide oito e dos elementos posteriores de C2 cinco. Em dois casos , havia também fraturas em outros segmentos da coluna. Diagnóstico diferencial en la encefalitis por anticuerpos contra el receptor NMDA. Pacientes Presentamos a 2 pacientes diagnosticadas de encefalitis por anticuerpos NMDAR con un cuadro clínico típico, pero que inicialmente señaló otras etiologías. La caracterización clínica e inmunológica de esta enfermedad ha llevado a la identificación de nuevos anticuerpos que afectan a procesos de memoria, aprendizaje, conducta y psicosis. Surgical site infection in patients submitted to heart transplantation. The correlation between variables was evaluated by using Fisher's exact test and Mann-Whitney-Wilcoxon test. Signs of surgical site infection were observed in 9. There was no statistically significant association between the variables related to the patient and the surgery. Programmed home visits by nursing professionals to older adults: prevention or treatment? Muestreo aleatorio. Variables principales morbilidad, mortalidad; descriptivas: visitas de la enfermera, filiación, datos clínicos y socio sanitarios. CONCLUSIÓN: la visita domiciliaria del profesional en enfermería no repercute en la morbimortalidad; visita a los pacientes cuando ya ha aparecido el problema de salud, no hay datos de prevención. La rotura traqueal tras una contusión es rara, aunque potencialmente mortal. El objetivo de este estudio es informar sobre un caso de rotura traqueal tras una contusión en el cuello producto de un accidente de bicicleta que se trató de manera conservadora. Sociedad Argentina de Pediatría. La deficiencia de vitamina A es infrecuente en los países desarrollados. Health literacy in patients attending a University Hospital. Low level of health literacy is associated with poor communication between patients and clinicians and with increased hospitalization rates, less frequent screening for cancer, poor control of diabetes, and disproportionately high rates of disease and mortality. Despite the importance of health literacy in medicine, there is no information about its prevalence in Latin America. The aim of this study was to assess the prevalence of inadequate health literacy in a random sample of patients, at a University Hospital where a descriptive study was performed during Participants were randomly selected from the ambulatory clinic and from the medical inpatient ward during The respondents had a median age of 56 years. The prevalence of inadequate health literacy was We found a high prevalence of inadequate health literacy, being strongly associated with the level of formal education. It is important that health care providers know the implications of health literacy and its consequences. Oral health and risk of pneumonia in asthmatic pacients with inhaled treatment. Asthma is a chronic disease requiring inhaled treatment and in addition it is a risk factor RF of pneumonia. In the oropharyngeal cavity there are numerous species of bacteria that could be dragged to the bronco-alveolar level. Case-control study in asthmatic population with inhaled treatment. We recruited asthmatic patients diagnosed with pneumonia by clinical and radiological criteria cases and asthmatics not diagnosed with pneumonia during the last year controls , matched by age. The multivariated analysis shows an independent association of performing 6 or more inhalations per day OR 2. Síndrome de Susac en un paciente con colitis ulcerosa. The Susac's syndrome is a rare disorder that was first described in and is characterized by a classic triad consisting in encephalopathy, visual impairment and sensorineural hearing loss. However, the etiology of the disease is still unclear. We report the case of a year-old with ulcerative colitis treated with mercaptopurine, six months before to her admission started with personality changes attributed to symptoms of depression who subsequently present neurological symptoms characteristic of Susac's Syndrome. In the literature there is no clear association between inflammatory bowel disease and Susac's -syndrome, but this case is presented in order to emphasize the simultaneous presentation of these two diseases with a tendency to vasospasm and an autoimmune pathogenesis. A incidência anual de ruptura do AAA é de oito casos por Métodos Estudo descritivo, retrospectivo e randomizado. Resultados Foram analisados 1. Nesse ínterim, apresentou deiscência das suturas e fístula purulenta inguinal esquerda em contato com a prótese vascular. Essa pode se constituir em ferramenta importante em casos similares. Trombose venosa profunda e vírus chicungunha. Los defectos craneales secundarios a traumatismos son frecuentes. Históricamente se han utilizado diversos materiales para la reconstrucción. Las localizaciones afectaron el frontal, el borde orbitario superior y el techo orbitario en cuatro casos , y la porción lateral del frontal, la zona temporoparietal y el borde del occipital en un caso. La reconstrucción en cuatro pacientes fue entre 6 y 12 meses después de la lesión, y en un caso después de 25 años. En dos casos se requirió expansión tisular antes de colocar el implante. Cuatro pacientes evolucionaron favorablemente, con mejoría de los síntomas neurológicos, forma y contorno adecuados, así como un proceso de cicatrización adecuada de los colgajos de piel cabelluda. Un paciente presentó infección por Staphylococcus aureus, atribuida a la presencia de un mucocele y una fístula de la vía aérea a la cavidad craneal, lo que hizo necesario retirar el implante. Brindan resultados satisfactorios desde el punto de vista funcional y cosmético. Deben tomarse precauciones respecto al tratamiento de las lesiones que afecten el seno frontal, para evitar la comunicación entre la vía aérea y la cavidad craneal. Cranial defects due to trauma are frequent. They are usually repaired in a secondary fashion due to features such as syndrome of the trephined, for brain protection and for cosmetic purposes. Historically, various materials have been used for reconstruction. Defects involved. Foraminotomia cervical posterior en el tratamiento de conflictos foraminales. En este trabajo evaluamos nuestra serie de pacientes tratados por esta via. Método: Desde enero de a diciembre de , 17 pacientes 18 foraminotomías fueron operados por presentar cervicobraquialgia a causa de un conflicto foraminal, realizando un foraminotomía cervical posterior. Los pacientes fueron evaluados en el postoperatorio inmediato, al mes y a los 3 meses de la cirugía. Resultados: El dolor radicular por conflicto foraminal secundario a hernia de disco cervical fue el síntoma y la patología predominante. La resolución completa del dolor radicular se observó en casi todos los pacientes. La VAS preoperatoria en promedio fue de 8. La media en la Neck Disability Index al inicio fue de Los Criterios de Odom para la evaluación de pacientes operados de columna cervical fueron satisfactorios con un promedio de 1. Conclusión: La foraminotomía cervical posterior es un procedimiento efectivo para el tratamiento del dolor radicular en los conflictos foraminales PMID Uno de los principales problemas de los pacientes oncohematológicos es la desnutrición, que suele tener causas multifactoriales de la propia enfermedad, de los pacientes y de los diferentes tratamientos administrados. Para minimizar el impacto de la desnutrición es necesaria una intervención nutricional, ya sea adaptando la dieta o mediante la instauración de soporte nutricional artificial, en función de la gravedad de cada caso. En cualquier paciente que esté recibiendo un tratamiento oncológico hay que evaluar las posibles interacciones que pueden existir con el soporte nutricional instaurado, ya sea dieta oral, suplementación oral o nutrición enteral. Estas interacciones pueden disminuir la eficacia, aumentar la toxicidad de los tratamientos o producir déficits nutricionales. Se detallan las principales interacciones que se pueden producir, las interacciones entre los tratamientos oncológicos y el soporte nutricional. Material y métodos: Estudio descriptivo retrospectivo que incluye a 53 pacientes en los que se utilizó la hemilaminectomía como abordaje a tumores intradurales-extramedulares durante el periodo junio de a diciembre de El periodo de seguimiento promedio fue de Resultados: Cincuenta y tres pacientes con tumores intradurales-extramedulares fueron intervenidos mediante hemilaminectomía. La serie incluyó 5 tumores cervicales, 24 dorsales y 24 lumbares. No se evidenció recidiva en ninguno de los casos durante el periodo de seguimiento. Conclusión: La hemilaminectomía constituye una vía efectiva para la resección de tumores intradurales-extramedulares lateralizados a nivel cervicodorsal. Analysis of the discrepancies identified during medication reconciliation on patient admission in cardiology units: a descriptive study. Of the discrepancies found, Of these, These results reveal the number of drugs that are not reincorporated into the treatment of patients, which can have important clinical consequences. Differences in the clinical-epidemiological profile between new cases of tuberculosis and retreatment cases after default. To identify the socioeconomic and clinical-epidemiological factors related to tuberculosis in new cases and retreatment cases. Comparative study with patients, of which 42 were retreatment cases after default attended in a reference center, and 84 were new cases completing the first treatment and treated in Basic Health Units. The collection of primary data was through interview, and of secondary data by records of the Notifiable Diseases Information System. Comparative analysis between the two groups. The new cases differ from retreatment cases regarding educational level. The clinical-epidemiological profile shows a significant difference in relation to performance of the tuberculin skin test, and the HIV test result positive in favor of new cases. In relation to performance of sputum culture and the result positive of the first sputum smear of the first and second samples, in favor of retreatment cases. The two groups are significantly different in clinical and epidemiological characteristics that show the access to exams. Identificar fatores socioeconômicos e clínico-epidemiológicos associados à tuberculose em casos novos e em casos em retratamento. Os casos novos diferem dos em retratamento quanto à escolaridade. Os dois grupos. Inguinodynia in patients submitted to conventional inguinal hernioplasty. We questioned patients about the presence of chronic inguinal pain and, if confirmed, invited them to a consultation in which we assessed the pain and its impact on quality of life. El objetivo del trabajo es conocer las disyuntivas entre los principios de beneficencia y autonomía, que se presentan en la relación médico- paciente , durante la terapéutica del intento de suicidio. La información se obtuvo previo consentimiento informado en entrevistas individuales. Las discordancias entre la beneficencia y la autonomía estuvieron relacionadas con el beneficio del tratamiento, el respeto por los valores y las creencias de los pacientes , entre otros. We present results of the study of the glolular cluster system of NGC The number of members of the system is calculated; and compared with other elliptical galaxies from literature. Influencias socioculturales en conceptos astronómicos: el caso del horizonte en la reforma copernicana. I analyze the meaning given by Ptolemy to the concept of horizon; especially how it allowed him to prove, through astronomical observations, the central position of the Earth in the Universe. I review the ways in which Copernicus and Galileo gave heliocentric answers to the Ptolemaic proof. I show that Galilean solution entailed a radical conceptual change, which brought with it a new sense to the concept of horizon. I state that this change was the product of sociocultural influences of the period. The injection of calcium-based sorbents into coal-fired boilers for reaction with, and reduction in the levels of, sulfur dioxide SO2 in the flue gas has undergone considerable research and development. Significant effort has also been made in developing models for the overall Etologia aplicada al manejo de especies amenazadas: el caso del turon de patas negras Mustela nigripes. Black-footed ferrets are considered one of the world's most endangered mammals. The last wild population was discovered in in Meteetsee, Wyoming, and, in it collapsed due to an epizootic of canine distemper in combination with sylvatic plague. Prior to the extinction of the last remnant population, 18 wild black-footed ferrets were captured to initiate captive propagation efforts. Captive breeding has been successful and, during the last 11 years, more than black-footed ferrets have been born in captive breeding centers. Since , approximately ferrets have been reintroduced in 5 areas located within the ferret's original geographic distribution, including sites in Wyoming, Montana, South Dakota, and Arizona. Scientific research has been, and continues to be, a critical tool to direct recovery efforts. Studies in applied ethology conducted on captive and reintroduced ferret populations have demonstrated that a naturalistic captive environment, particularly during early developmental periods, enhances the expression of behaviors necessary for survival in nature. Ferrets raised in a naturalistic environment develop better predatory skills, are able to recognize prairie dog burrows as a home and shelter from predators, and are more physically fit. Results from these studies have been adapted into management strategies to help implement a more cost-effective road to black-footed ferret recovery. Métodos Estudo prospectivo realizado em com amostra de 1. Por sua vez, os casos de obesidade mórbida ocorreram 9,1 vezes mais no mesmo grupo. Extended-release ER paliperidone is an innovative atypical antipsychotic that allows minimal peak-to-through fluctuations with once-daily dosing. The authors conducted a 6-month, open-label, prospective and multicentric study. Other measures of effectiveness, safety and tolerability, were also conducted. A média de idade foi de 38,7 anos , nove pacientes eram homens e quatro mulheres. Durante o seguimento, nenhum apresentou sintomas durante os primeiros nove meses. Diagnosis and medical treatment of neuropathic pain in leprosy. Se aplicó el cuestionario test Douleur Neuropathic 4, y se hizo un minucioso examen neurológico a través del cual se excluyeron 42 pacientes por no haberse comprobado dolor. Recent transmission of drug-resistant Mycobacterium tuberculosis in a prison population in southern Brazil. We conducted a cross-sectional, retrospective study, characterized by classical and molecular epidemiology, involving M. Between January of and August of , prisoners underwent sputum smear microscopy and culture; 53 Of those, 8 Strain genotyping was carried out by locus mycobacterial interspersed repetitive unit-variable-number tandem-repeat analysis; The frequency of drug-resistant tuberculosis cases and the rate of recent transmission were high. Our data suggest the need to implement an effective tuberculosis control program within the prison system. En el grupo con DPNC se realizó "maniobras de liberación - expansión". La edad promedio fue de 62,64 años. La mayoría de pacientes se reinsertó a sus tareas diarias, con buena tolerancia a la disnea luego del procedimiento. La pleurodesis química temprana mejora la calidad de vida de los pacientes portadores de un DPN. Los costos de la atención médica pueden alcanzar niveles tales que marginen a algunos pacientes de los beneficios del avance científico y tecnológico. En este escrito se proponen algunas acciones que los médicos podemos realizar para disminuir los costos de la atención médica. La magnitud del ahorro que se puede alcanzar con estas medidas es modesta, puesto que la mayor parte de los costos no dependen de los médicos, pero se trata de ofrecer nuestra contribución. Results after implementation of a protocol on the incidence of urinary tract infection in an intensive care unit. La muestra estuvo constituida por 47 pacientes , siendo 28 notificados antes y 19 después. Factors associated with the incidence of pressure ulcer during hospital stay. Estimating the incidence rate of pressure ulcers and verifying factors associated with this occurrence in a cohort of hospitalized patients. This is a cohort study in which the considered outcome was the time until pressure ulcer occurrence. Estimated effect of the variables on the cumulative incidence ratio of the outcome was performed using the Cox proportional hazards model. Variable selection occurred via the Logrank hypothesis test. The sample consisted of adults, with 25 incidents of pressure ulcers. Patients with high scores on the Braden scale presented a higher risk of pressure ulcer incidence when compared to those classified into the low score category. Sammie Rhodes, Karlie Montana, Sabrina Maree en atractivo asunto Video, Sammie invitó a dos de sus amigos hermoso sobre para una tarde de tomar el sol y lamidas de coño. 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Mummyefaa Porn Watch Castigo de video porno gratis Video Experiente39 (Sexlog)31. The corrosion behaviour of higher power feeding was studied by the immersion and the planned interval test to determine the corrosion rate as well as the effect of voltage magnitudes and the current scheme i. It was then reduced at about - volts which may due to the passive and transpassive mechanism. The corrosion rate was slowly reduced further from to volts. Visually, the positively charged of Cu cable was seems susceptible to severe corrosion, while AC scheme exhibited a slight corrosion reaction on the surface. However, the planned interval test and XRD results showed the corrosion activity of the copper cable in the studied solution was a relatively slow process and considered not to be corroded as a partially protective scale of copper oxide formed on the surface. Nonferrous smelters and coal gasification processes generate environmentally harmful sulfur dioxide streams, most of which are treated to produce sulfuric acid with the accompanying problems of market shortage and transportation difficulties. Some sulfur dioxide streams are scrubbed with an alkali solution or a solid substance such as limestone or dolomite, which in turn generates wastes that pose other pollution problems. While the conversion of sulfur dioxide to elemental sulfur has many environmental advantages, no processes exist that are environmentally acceptable and economically viable. A new method for converting sulfur dioxide to elemental sulfur by a cyclic process involving calcium sulfide and calcium sulfate without generating solid wastes has been developed. In this process, calcium sulfate pellets as the starting raw material are reduced by a suitable reducing agent such as hydrogen to produce calcium sulfide pellets, which are used to reduce sulfur dioxide producing elemental sulfur vapor and calcium sulfate. The latter is then reduced to regenerate calcium sulfide. Thermodynamic analysis and experimental results indicated that the CaS-SO2 reaction produces mainly sulfur vapor and solid calcium sulfate and that the gaseous product from the CaSO 4-H2 reaction is mainly water vapor. The rates of the two reactions are reasonably rapid in the temperature range K, and, importantly, the physical strengths and reactivities of the pellets are maintained largely unchanged up to the tenth cycle, the last cycle tested in this work. Sulfur dioxide-containing streams from certain sources, such as the regenerator off-gas from an integrated gasification combined cycle desulfurization unit and new sulfide smelting plants, contain much higher partial pressures of SO2. In these cases, the rate of the first reaction is expected to be proportionally higher than in the test conditions reported in this paper. Single-crystal EPR spectra of gamma-ray-irradiated gypsum reveal two types of arsenic-associated oxyradicals: [AsO3]2- and an [AsO2] Food insecurity and health status in deprived populations, a multicentre survey in seven of the social and medical healthcare centres CASOs run by Doctors of the World, France. To document eating practices and socio-economic profiles of patients seen in the social and medical healthcare centres CASOs in its French acronym run by Doctors of the World Médecins du Monde, MdM in France and evaluate their nutritional and health status. All the patients attending MdM clinics were given a nutrition and health questionnaire. Their anthropometric measurements were taken on site. A total of One third of the patients declared having lost weight over the last two weeks. Constrained resources lead people living in very precarious conditions to eat without adequate nutrition, which could have consequences for their health, such as diabetes, obesity and cardiovascular disease. Published by Elsevier Ltd. Entre essas, o pé diabético PD destaca-se por possuir alta incidência e grande poder mutilador. Métodos Estudo descritivo, quantitativo, tipo inquérito por entrevista. Scientific advances and the complexity of human knowledge generate a constant need for creating new tools intended to facilitate learning in an agreeable and lasting form. Simulated patients are one of such tools in medical education. Standardized or simulated patients are actors or people vigorously trained to represent a medical history or, if possible, specific physical findings with the purpose of using such representations as an educational and evaluating supplement in clinic practice. The use of simulated patients has been very well received, particularly in the psychiatric field; however, its usefulness in areas such as psychotherapy or evaluation of residents remains questionable. Simulated patients are widely used throughout the world in the psychiatry field and their usefulness as an academic tool for pre-graduate students is confirmed in most of the literature reviewed. One of the main benefits of the use of this kind of patients is the acquisition of specific abilities e. Notwithstanding the controversy, most of the literature reviewed confirms the benefits and acceptance of this methodology in the formation of students and psychiatrists. Publicado por Elsevier España. Jaimes; Ortega-García, J. Aranda; Marín, J. Delgado; Ascanio, A. López; Jimenez, J. Ruiz; de Paco Matallana, C. Métodos Estudio de casos -control. Estudio descriptivo y regresión logística multivariable. Se presenta caso de paciente obesa a quien se le realiza endoscopía digestiva alta por disfagia tras ingesta accidental de hueso de pollo. Se constata leve esofagitis de reflujo y atrofia duodenal. La biopsia intestinal informa atrofia intestinal con infiltrado inflamatorio. Los autoanticuerpos para enfermedad celiaca resultan positivos. La paciente nunca presentó síntomas digestivos. Se confirma enfermedad celiaca silente e inicia dieta sin gluten. Report of a case]. Métodos Foram tratados 20 membros em 20 pacientes , todos com ulcerações relacionadas a refluxo de veias safenas. Los modelos de eensenanza y aprendizaje constructivistas conceptualizan el aprendizaje como un proceso activo. El modelo de Aprendizaje Basado en Proyectos ABPr se distingue por una serie de componentes, entre los cuales se destaca el aspecto colaborativo y cooperativo como un reto al momento de su implantacion. Son pocas las investigaciones que se concentran en este aspecto del modelo. En este estudio, se analizaron las diversas interacciones que surgen durante la implantacion de una unidad curricular sobre el tema de Geologia de Puerto Rico, la cual se diseno con el modelo ABPr cuyo enfoque es orientacion a proyectos. Particularmente, se examinaron las interacciones sociales que surgen entre los pares y entre pares y docente durante el proceso de planificacion y desarrollo de los productos finales, al igual que las interacciones entre los estudiantes y el material didactico en estas etapas del modelo. La investigacion es de tipo cualitativo e incorpora como diseno el estudio de caso. Las diversas interacciones constituyen la unidad de analisis. En el estudio participaron 19 estudiantes de 9no grado, a quienes se organizaron en 5 grupos colaborativos por temas de interes Pangea, Placas tectonicas, Volcanes, Tsunamis y Terremotos. Las tecnicas que se utilizaron para recopilar los datos fueron: observaciones participativas, grupos focales y analisis de documentos cuadernos reflexivos y respuestas de los estudiantes a la pregunta central del proyecto. Para el analisis de los datos se aplico la teoria de actividad CHAT que concentra la unidad de analisis en la actividad humana en un contexto particular. Los resultados del estudio senalan que las interacciones entre pares, entre pares y docente, asi como entre estudiantes y material didactico son fundamentales en el proceso de aprendizaje. Una mayor interaccion entre pares durante las etapas de planificar y desarrollar los productos finales de la unidad, promueve una mejor comprension de los conceptos de la. Cl-CO3-scapolite [ Na,Ca 4[Al3 Al,Si 3 Si3 O24] Cl, CO3 , SO4 ] occurs as a common partial to total alteration of plagioclase in deep-crustal xenoliths, skarns, marbles, gabbros, metabasites, calc-silicate gneisses, as well as in quartzofeldspathic granulite-facies rocks in general Moecher and Essene, , J Petrol 31, Natural plagioclase and scapolite, along with synthetic calcite and anhydrite, were lightly ground together in equi-molar amounts in ethanol. A series of duplicate experiments for the same mineral mix, at the same P-T conditions, were done utilizing pure H2O as the flux. In contrast. Based on this model validated from experimental data, it can be seen that temperature, pressure and salinity all have significant effects on pH, alkalinity and speciations of aqueous solutions and on the solubility of calcite, halite, anhydrite and gypsum. The solubility of anhydrite and gypsum will decrease as temperature increases e. The increase of pressure may increase the solubility of sulphate minerals e. Addition of NaCl to the solution may increase mineral solubility up to about 3 molality of NaCl, adding more NaCl beyond that may slightly decrease its solubility. Dissolved CO 2 in solution may decrease the solubility of minerals. The influence of dissolved calcite on the solubility of gypsum and anhydrite can be ignored, but dissolved gypsum or anhydrite has a big influence on the calcite solubility. Online calculation is made available on www. Con este objetivo, presentamos nuestra experiencia con el software Osirix. Descripción de la técnica: Se presentan 3 casos ejemplificadores de 40 realizados. En el Caso 1 se pudo analizar las relaciones del tumor con las estructuras adyacentes para minimizar el abordaje. En el Caso 2 permitió comprender la anatomía post-operatoria previa del paciente , para determinar la trayectoria del abordaje transnasal endoscópico y la necesidad de ampliar su exposición, logrando la resección tumoral completa. Remisión de aneurisma luego de exéresis de MAV con aparición de síndrome del acento extranjero. La conducta frente a los aneurismas asociados es dicotómica en la literatura, mientras existen reportes de la desaparición de los mismos luego de la exéresis de la MAV, otros artículos enfatizan su tratamiento precoz. Objetivo: Presentar un paciente que desarrolla el síndrome del acento extranjero posterior a la exéresis de una MAV y la evolución de un aneurisma asociado. Retrospective analysis of a case series of patients with traumatic injuries to the craniocervical junction. Um paciente apresentava déficit neurológico, melhorando após o tratamento. No grupo conservador, predominaram as fraturas do odontóide oito e dos elementos posteriores de C2 cinco. Em dois casos , havia também fraturas em outros segmentos da coluna. Diagnóstico diferencial en la encefalitis por anticuerpos contra el receptor NMDA. Pacientes Presentamos a 2 pacientes diagnosticadas de encefalitis por anticuerpos NMDAR con un cuadro clínico típico, pero que inicialmente señaló otras etiologías. La caracterización clínica e inmunológica de esta enfermedad ha llevado a la identificación de nuevos anticuerpos que afectan a procesos de memoria, aprendizaje, conducta y psicosis. Surgical site infection in patients submitted to heart transplantation. The correlation between variables was evaluated by using Fisher's exact test and Mann-Whitney-Wilcoxon test. Signs of surgical site infection were observed in 9. There was no statistically significant association between the variables related to the patient and the surgery. Programmed home visits by nursing professionals to older adults: prevention or treatment? Muestreo aleatorio. Variables principales morbilidad, mortalidad; descriptivas: visitas de la enfermera, filiación, datos clínicos y socio sanitarios. CONCLUSIÓN: la visita domiciliaria del profesional en enfermería no repercute en la morbimortalidad; visita a los pacientes cuando ya ha aparecido el problema de salud, no hay datos de prevención. La rotura traqueal tras una contusión es rara, aunque potencialmente mortal. El objetivo de este estudio es informar sobre un caso de rotura traqueal tras una contusión en el cuello producto de un accidente de bicicleta que se trató de manera conservadora. Sociedad Argentina de Pediatría. La deficiencia de vitamina A es infrecuente en los países desarrollados. Health literacy in patients attending a University Hospital. Low level of health literacy is associated with poor communication between patients and clinicians and with increased hospitalization rates, less frequent screening for cancer, poor control of diabetes, and disproportionately high rates of disease and mortality. Despite the importance of health literacy in medicine, there is no information about its prevalence in Latin America. The aim of this study was to assess the prevalence of inadequate health literacy in a random sample of patients, at a University Hospital where a descriptive study was performed during Participants were randomly selected from the ambulatory clinic and from the medical inpatient ward during The respondents had a median age of 56 years. The prevalence of inadequate health literacy was We found a high prevalence of inadequate health literacy, being strongly associated with the level of formal education. It is important that health care providers know the implications of health literacy and its consequences. Oral health and risk of pneumonia in asthmatic pacients with inhaled treatment. Asthma is a chronic disease requiring inhaled treatment and in addition it is a risk factor RF of pneumonia. In the oropharyngeal cavity there are numerous species of bacteria that could be dragged to the bronco-alveolar level. Case-control study in asthmatic population with inhaled treatment. We recruited asthmatic patients diagnosed with pneumonia by clinical and radiological criteria cases and asthmatics not diagnosed with pneumonia during the last year controls , matched by age. The multivariated analysis shows an independent association of performing 6 or more inhalations per day OR 2. Síndrome de Susac en un paciente con colitis ulcerosa. The Susac's syndrome is a rare disorder that was first described in and is characterized by a classic triad consisting in encephalopathy, visual impairment and sensorineural hearing loss. However, the etiology of the disease is still unclear. We report the case of a year-old with ulcerative colitis treated with mercaptopurine, six months before to her admission started with personality changes attributed to symptoms of depression who subsequently present neurological symptoms characteristic of Susac's Syndrome. In the literature there is no clear association between inflammatory bowel disease and Susac's -syndrome, but this case is presented in order to emphasize the simultaneous presentation of these two diseases with a tendency to vasospasm and an autoimmune pathogenesis. A incidência anual de ruptura do AAA é de oito casos por Métodos Estudo descritivo, retrospectivo e randomizado. Resultados Foram analisados 1. Nesse ínterim, apresentou deiscência das suturas e fístula purulenta inguinal esquerda em contato com a prótese vascular. Essa pode se constituir em ferramenta importante em casos similares. Trombose venosa profunda e vírus chicungunha. Los defectos craneales secundarios a traumatismos son frecuentes. Históricamente se han utilizado diversos materiales para la reconstrucción. Las localizaciones afectaron el frontal, el borde orbitario superior y el techo orbitario en cuatro casos , y la porción lateral del frontal, la zona temporoparietal y el borde del occipital en un caso. La reconstrucción en cuatro pacientes fue entre 6 y 12 meses después de la lesión, y en un caso después de 25 años. En dos casos se requirió expansión tisular antes de colocar el implante. Cuatro pacientes evolucionaron favorablemente, con mejoría de los síntomas neurológicos, forma y contorno adecuados, así como un proceso de cicatrización adecuada de los colgajos de piel cabelluda. Un paciente presentó infección por Staphylococcus aureus, atribuida a la presencia de un mucocele y una fístula de la vía aérea a la cavidad craneal, lo que hizo necesario retirar el implante. Brindan resultados satisfactorios desde el punto de vista funcional y cosmético. Deben tomarse precauciones respecto al tratamiento de las lesiones que afecten el seno frontal, para evitar la comunicación entre la vía aérea y la cavidad craneal. Cranial defects due to trauma are frequent. They are usually repaired in a secondary fashion due to features such as syndrome of the trephined, for brain protection and for cosmetic purposes. Historically, various materials have been used for reconstruction. Defects involved. Foraminotomia cervical posterior en el tratamiento de conflictos foraminales. En este trabajo evaluamos nuestra serie de pacientes tratados por esta via. Método: Desde enero de a diciembre de , 17 pacientes 18 foraminotomías fueron operados por presentar cervicobraquialgia a causa de un conflicto foraminal, realizando un foraminotomía cervical posterior. Los pacientes fueron evaluados en el postoperatorio inmediato, al mes y a los 3 meses de la cirugía. Resultados: El dolor radicular por conflicto foraminal secundario a hernia de disco cervical fue el síntoma y la patología predominante. La resolución completa del dolor radicular se observó en casi todos los pacientes. La VAS preoperatoria en promedio fue de 8. La media en la Neck Disability Index al inicio fue de Los Criterios de Odom para la evaluación de pacientes operados de columna cervical fueron satisfactorios con un promedio de 1. Conclusión: La foraminotomía cervical posterior es un procedimiento efectivo para el tratamiento del dolor radicular en los conflictos foraminales PMID Uno de los principales problemas de los pacientes oncohematológicos es la desnutrición, que suele tener causas multifactoriales de la propia enfermedad, de los pacientes y de los diferentes tratamientos administrados. Para minimizar el impacto de la desnutrición es necesaria una intervención nutricional, ya sea adaptando la dieta o mediante la instauración de soporte nutricional artificial, en función de la gravedad de cada caso. En cualquier paciente que esté recibiendo un tratamiento oncológico hay que evaluar las posibles interacciones que pueden existir con el soporte nutricional instaurado, ya sea dieta oral, suplementación oral o nutrición enteral. Estas interacciones pueden disminuir la eficacia, aumentar la toxicidad de los tratamientos o producir déficits nutricionales. Se detallan las principales interacciones que se pueden producir, las interacciones entre los tratamientos oncológicos y el soporte nutricional. Material y métodos: Estudio descriptivo retrospectivo que incluye a 53 pacientes en los que se utilizó la hemilaminectomía como abordaje a tumores intradurales-extramedulares durante el periodo junio de a diciembre de El periodo de seguimiento promedio fue de Resultados: Cincuenta y tres pacientes con tumores intradurales-extramedulares fueron intervenidos mediante hemilaminectomía. La serie incluyó 5 tumores cervicales, 24 dorsales y 24 lumbares. No se evidenció recidiva en ninguno de los casos durante el periodo de seguimiento. Conclusión: La hemilaminectomía constituye una vía efectiva para la resección de tumores intradurales-extramedulares lateralizados a nivel cervicodorsal. Analysis of the discrepancies identified during medication reconciliation on patient admission in cardiology units: a descriptive study. Of the discrepancies found, Of these, These results reveal the number of drugs that are not reincorporated into the treatment of patients, which can have important clinical consequences. Differences in the clinical-epidemiological profile between new cases of tuberculosis and retreatment cases after default. To identify the socioeconomic and clinical-epidemiological factors related to tuberculosis in new cases and retreatment cases. Comparative study with patients, of which 42 were retreatment cases after default attended in a reference center, and 84 were new cases completing the first treatment and treated in Basic Health Units. The collection of primary data was through interview, and of secondary data by records of the Notifiable Diseases Information System. Comparative analysis between the two groups. The new cases differ from retreatment cases regarding educational level. 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