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Objetivo: Identificar los factores asociados a la aceptación por parte del paciente de la hospitalización a domicilio directamente desde el servicio de urgencias. Pacientes y métodos: Estudio de cohortes prospectivo observacional de pacientes que, una vez visitados en urgencias, reunían criterios de ingreso en sala convencional, podían responder a una entrevista y disponían de un posible cuidador. Se tomó como variable dependiente la predisposición a aceptar o no un ingreso en hospitalización a domicilio. De cada paciente, como variables independientes se recogieron aspectos demográficos, factores de su estado de salud-comorbilidad y de su enfermedad actual, y percepciones psicosociales relacionadas con la hospitalización a domicilio. La relación entre variables se estableció por análisis de regresión logística múltiple. Resultados: Se realizaron 129 entrevistas. La predisposición a aceptar un ingreso en hospitalización a domicilio fue del 71%. Sólo las percepciones psicosociales del paciente, con independencia de sus aspectos demográficos e incluso de su estado de salud actual y comorbilidad, se relacionaron con la predisposición a aceptar un ingreso en hospitalización a domicilio, en concreto las adecuadas condiciones físicas del domicilio (odds ratio [OR]: 4,31; intervalo de confianza del 95% [IC95%]: 1,18-15,78), la ausencia de miedo por tener que manejar el oxígeno (OR: 5,99; IC95%: 2,05-17,52), la ausencia de miedo a una mala evolución clínica (OR: 6,07; IC95%: 1,94-18,96) y la percepción de una mayor libertad de horarios (OR: 12,61; IC95%: 3,31-48,01). Conclusiones: La hospitalización a domicilio tendría una buena aceptación si se ofreciera directamente en el Servicio de Urgencias como alternativa a la hospitalización convencional. Esta aceptación se asocia a percepciones psicosociales, que deberían tenerse en cuenta al ofrecer esta modalidad asistencial.Aim: To identify the factors associated with patients' acceptance of emergency department discharge directly to hospital-at-home care. Patients and methods: We performed a prospective observational cohort study of patients seen at the emergency department who met the following inclusion criteria: need for hospital admission, ability to be interviewed, and availability of an informal caregiver. The dependent variable was defined as the predisposition to accept or refuse hospital-at-home care. For each patient, the following independent variables were recorded: demographic characteristics, health-related factors, comorbidities, current illness and psychosocial perceptions related to hospital-at-home care. The associations among the variables were tested by means of logistic regression analysis. Results: We included 129 patients. Seventy-one percent would have accepted hospital-at-home care. Acceptance of hospital-at-home care was associated with psychosocial perceptions only, independently of demographic characteristics, current illness severity and comorbidities. These psychosocial perceptions included adequate conditions at home (OR: 4.31; 95% CI: 1.18-15.78), not being afraid of oxygen manipulation (OR: 5.99; 95% CI: 2.05-17.52), lack of fear of a poor outcome (OR: 6.07; 95% CI: 1.94-18.96) and the possibility of enjoying a more flexible schedule (OR: 12.61; 95% CI: 3.31-48.01). Conclusions: Hospital-at-home care would be well accepted by patients if offered in the emergency department as an alternative to conventional hospitalization. Acceptance depends on patients' psychosocial perceptions, which should be assessed before this mode of care is proposed.

This article talks about how in the literature history, many authors had shown a profound interest in describing the phenomenon of football soccer, one of the most popular sports on earth. We can see this aspect in pre-Hispanic texts like: Popol Vuh, also in some modern intellectuals like Eduardo Galeano (Uruguayan), in his book: El footboy a sol y sombra. The document also mentioned other literary texts which prominent figures, narrative atmospheres, sail in the aesthetic description of the football

Plant regeneration by somatic embryogenesis from cell suspensions is considered the most efficient method for mass production of plants. The objective of this work was to achieve the genetic transformation of Coffea arabica cv. Caturra rojo by electroporation of embryogenic cell suspensions. The effect of different electroporation conditions (capacitance and field strength) on the cell suspensions without the application of plasmid DNA, by analysis of cell vitality at 24, 48 and 72 hours after electroporation was evaluated. The effect of electroporation buffer on cell vitality and transient expression of the gene for beta-glucuronidase was also determined. Besides, the transient expression of GUS gene in em bryogenic cell suspensions electroporated with plasmid PDB-GUS-INT was studied. In the electroporated cell suspensions, under different electroporation conditions, electric shocks significantly affect cell vitality compared to the control group. In the Electroporated cell suspensions with buffer of Dekeyser et al. (1990) and applying a discharge time of 500 msec was obtained the highest percentage of vitality, with a value of 32.14, compared to other treatments. While in the electroporated cell aggregates with a capacitance of 100 and 1200 uF there was a higher transient GUS gene activity (59.37 and 61.01%) compared to electroporated treatment with a capacitance of 490 uF, where values obtained were 50.0%. Keywords: somatic embryogenesis, coffee tree

El artí­culo nos habla de cómo a lo largo de la historia de la literatura, distintos autores han mostrado profundo interés por describir el fenómeno del fútbol, uno de los deportes más populares del planeta. Este aspecto lo podemos notar en textos prehispánicos como: Popol Vuh, hasta intelectuales modernos como Eduardo Galeano (uruguayo), en su libro: El futbol a sol y sombra. El documento hace mención de otras obras literarias cuyos personajes, o atmósferas narrativas, navegan en la descripción estética del balompié

It was studied the effect of the kanamicin and sulfadiacin like selection markers in the first phase of the genetic transformation of coffee (Coffea arabica). Embryogenic cell suspensions of coffee of the variety caturra rojo were used. In the differentiation phase of the somatic embryos,the selection in liquids medium was carried out using a density of 0.5 grams of fresh mass for liter (gMF.l-1) and semisolid culture medium, groups of cell aggregates with a fresh mass of 50 mg were placed in Petri dishes.Torpedo somatic embryos were used in the germination phase The agents selective were kanamicin (25, 50 and 100 mg.l-1) and sulfadiacin (10, 20 and 30 mg.l-1). It was evaluated the fresh mass and number of somatic embryos for the differentiation phase and for the germination phase, the number of somatic embryos germinated. In the differentiation process was observed that the treatments with kanamicin in liquid and semisolid culture medium, was presented multiplication of the cell aggregate and the formation of somatic embryos. I did not seize with the use of the sulfadiacin where starting from the concentration minimum of 10 mg.l-1 an inhibitory effect is presented on the embryogenic cell suspension. The survival of the somatic embryos cultivated with kanamicin was 45.7% with a germination among 28.5-34.1% with regard to control treatment who had 71% of survival and 37.1% of germination. In the case of the sulfadiacin, although there was survival in the doses of 10 and 20 mg.l-1 with values between 11.4 and 5.7% respectively, the germination of the somatic embryos was not achieved. There was with 30mg.l-1 of sulfadiacin a total inhibition of the germination. Key words: cell suspension, germination, selective agent, somatic embryos

RESUMO Objetivo: Avaliar quais os preditores de fibrilação atrial de novo em doentes de uma unidade de cuidados intensivos não cardíaca. Métodos: Foram analisados 418 doentes internados entre janeiro e setembro de 2016 em uma unidade de cuidados intensivos não cardíaca. Registaram-se as características clínicas, as intervenções efetuadas e os marcadores bioquímicos durante a internação. Avaliaram-se ainda a mortalidade hospitalar e o tempo de internação hospitalar e na unidade de cuidados intensivos. Resultados: Foram incluídos 310 doentes, com média de idades de 61,0 ± 18,3 anos, 49,4% do sexo masculino, 23,5% com fibrilação atrial de novo. O modelo multivariável identificou acidente vascular cerebral prévio (OR de 10,09; p = 0,016) e valores aumentados de proBNP (OR de 1,28 por cada aumento em 1.000pg/mL; p = 0,004) como preditores independentes de fibrilação atrial de novo. A análise por curva Característica de Operação do Receptor do proBNP para predição de fibrilação atrial de novo revelou área sob a curva de 0,816 (p < 0,001), com sensibilidade de 65,2% e especificidade de 82% para proBNP > 5.666pg/mL. Não se verificaram diferenças na mortalidade (p = 0,370), porém a duração da internação hospitalar (p = 0,002) e na unidade de cuidados intensivos (p = 0,031) foi superior nos doentes com fibrilação atrial de novo. Conclusões: História de acidente vascular cerebral prévio e proBNP elevado em internação constituíram preditores independentes de fibrilação atrial de novo na unidade de cuidados intensivos polivalente. O proBNP pode constituir ferramenta útil, de fácil e rápido acesso na estratificação do risco de fibrilação atrial.

Abstract Introduction: Foville syndrome (inferior medial pontine syndrome) is a clinical entity that makes part of a subclassification of a broader category of posterior circulation stroke. It is characterized by a blockage of the basilar artery caused by lesions in the pontine tegmentum. This syndrome has a very low incidence worldwide, but its clinical relevance is considerable. Case report: A 41-year-old patient without any medical history was admitted to the emergency department due to signs of focal neurologic deficits. Imaging findings were compatible with an ischemic lesion in the brainstem, and cerebral angiography showed involvement of the basilar artery territory. The patient was diagnosed and followed up in the intensive care unit (ICU) until his recovery. Conclusion: Foville syndrome is a rare disease with high morbidity and mortality. Early recognition and a multidisciplinary approach are decisive to improve the patient's prognosis.

Sugarcane orange rust, caused by Puccinia kuehnii (W. Krüger) EJ Butler, is one of the major diseases impacting sugarcane (Saccharum spp.) production worldwide. The objective of this work was to characterize by histology the development of P. kuehnii in leaves and the response of the cultivars to the disease. Four cultures with different degrees of infection response were inoculated in greenhouse. Microscopy studies were performed in leaf fragments of plants at 5 and 15 days after inoculation. It was shown that the development of fungus structures, prior to foliar tissue penetration, are similar in all cultivars regardless of the type of plant response. It was found that cultivar with grade 1 developed response similar to the hypersensitive response, while grade 2 suggests resistance based on the quantitative contribution of several genes. The results are a contribution towards understanding the genetic basis of orange rust resistance in sugarcane.

La Cruceta es un yacimiento situado en Tauste, en la provincia de Zaragoza. Se trata de un asentamiento rural, que cumplía las funciones de puesto de vigilancia, ocupado entre los siglos XIII y XIV d.C. Durante su excavación, se documentaron estructuras de habitación y de funciones auxiliares, así como cerámica decorada, monedas y elementos metálicos de indumentaria militar. Además, se recuperó una abundante cantidad de restos faunísticos. En este trabajo, se presenta el estudio arqueozoológico de La Cruceta, uno de los primeros para reino de Aragón en época medieval. Los resultados han permitido documentar, además de una funcionalidad estratégica, la existencia de una economía centrada en el ganado ovino y caprino. Los productos explotados son variados (carne, leche, materias primas, etc.), lo que junto a las pautas de procesado parece indicar que La Cruceta, además de puesto de vigilancia, tuvo funciones de producción. ______________________________________________________________________ The Kingdom of Aragon expanded territorially during the 12th and 13th centuries. This expansion was linked to the growth and development of the Aragonese economy, being the agricultural activities the predominant ones. Aragonese husbandry was linked to this territorial and economic expansion of the Kingdom of Aragon, with the increase of the livestock population that took place throughout the 13th century. Studies on this period in the Kingdom of Aragon are practically non-existent, due to the absence of local specialists for this type of study and the scarce interest that has traditionally been given to it. Within this context we find the site of La Cruceta, a Late Medieval settlement located in the municipality of Tauste, in the province of Zaragoza. This settlement was occupied between the beginning of the 13th century and the middle of the 14th century, and it is not clear who promoted this construction. Documentary sources have led to the conclusion that it could have been promoted by the Santa Cristina de Somport Hospital, by the Casa de los Luna or by the municipality of Tauste within a climate of rivalry for the control and exploitation of natural resources. The aims of this work are: 1) to document livestock practices and 2) to show the livestock products exploited by those who occupied La Cruceta, seeking to characterise the economic strategy carried out there. The results have shown how the inhabitants of La Cruceta had a livestock focused on the exploitation of sheep and goats. The dominance of these two species can be observed during most of the Middle Ages in the Iberian Peninsula, but especially from the 13th century onwards, when they formed 50% of the domestic livestock. Furthermore, pigs, cattle, horses and birds also made up the livestock in La Cruceta, although with much lesser quantitative importance. Finally, hunting of species such as red deer also formed part of the economic activities of the site. The results have also shown how the community that occupied La Cruceta exploited a great diversity of animal products (meat, milk, raw materials), highlighting the limited role that wool exploitation could have played. In addition, the presence of perinatal animals led to the conclusion that they were bred at the site. With regard to butchering, the absence of elements such as humerus and femurs from sheep and goats, with a high meat content, stands out. In conclusion, our hypothesis is that in addition to being a strategic settlement for the control of the area, La Cruceta was also a settlement with livestock production for the self-consumption of the community that inhabited the site and perhaps for the supply (mainly of meat) of some settlement near the site. This hypothesis is based on the specialization of production in sheep and goats, the mortality profile of both species and the representation of the anatomical regions, which shows a notable absence of elements with higher meat content in these species.

La pornografía puede definirse como el material audiovisual que presenta de forma explícita actividades sexuales y genitales de manera inocultable, con el objetivo de excitar al espectador. El objetivo de este trabajo es identificar las principales causas y consecuencias de la adicción a la pornografía en hombres y mujeres. Se empleó la metodología de la revisión sistemática de literatura (RSL), tomando como referencia investigaciones previas publicadas en bases de datos científicas y publicaciones web especializadas. Este trabajo concluye que la adicción a la pornografía puede generar problemas físicos, mentales, psicológicos y sociales, que son equiparables con los que genera la adicción al consumo de sustancias psicoactivas. Establecer estrategias de autocontrol, incrementar la actividad física y la participación en actividades sociales son algunas de las alternativas que pueden ayudar a combatir y prevenir la adicción.

This work was carried out to evaluate morph agronomic parameters on field conditions plant populations of grain sorghum [Sorghum bicolor (L.) Moench] variety CIAP 132R-05 regenerated via somatic embryogenesis. Plants regenerated from somatic embryos use as plant material in the present work were compared with plants grown from botanical seeds. Quantitative characteristics of the two populations correspond to those listed in the National Register of Commercial Varieties of Cuba. However the population of plants derived from somatic embryos showed significantly higher values in terms of: plant height, stem diameter, length and width of limbo and panicle, fresh and dry weight of panicle length assertion, grain length, number of spikelets per panicle, number of grains per spike and panicle, fresh and dry mass of 1000 grains and agricultural yields. These assessments allowed determining the phenotypic stability of the regenerated plants via somatic embryogenesis, by assessing morphological characters in field conditions.

Orange rust [Puccinia kuehnii (W. Kruger) E. J. Butler] from sugarcane (Saccharum spp.) is a disease of potential importance for Cuban sugarcane farming. However, under natural conditions, the presence of symptoms has not maintained stability in the foci of infection, which makes it difficult to evaluate the phenotypic resistance response of the cultivars to this disease. The present work was carried out with the objective of establishing a protocol to select sugarcane cultivars for their resistance to orange rust in the greenhouse. Includes, reference cultivars, source of inoculum, morphological and molecular characterization of P. kuehnii uredospores, inoculation conditions and inoculation method, variables to evaluate the response of the inoculated plants and their classification according to the degree of resistance to P. kuehnii. Keywords: inoculation, Puccinia kuehnii, resistance, Saccharum spp.

Sugarcane orange rust, caused by Puccinia kuehnii (Krüguer) Butler, is considered one of the most important diseases, due to losses in agricultural yields in susceptible commercial plantations. The objective of this work was to characterize the response of sugarcane cultivars to orange rust in green house conditions. Sugarcane plants of two months old were inoculated with spore suspension obtained from pustules on sugarcane leaves (‘C01-227’) with orange rust symptoms. Previously to inoculum preparation, P. kuehnii occurrence were confirmed by optical microscopy and polymerase chain reaction techniques. The experimental conditions used allow identify differential response between sugarcane cultivars to P. kuehnii infection. Some cultivars showed to be resistant to the fungus through interactions incompatible with a typical hypersensitive response. In other cultivars, different grades of susceptibility with significant differences in latency period of the disease was observed. Key words: Puccinia kuehnii, resistance, Saccharum spp.

Introducción: en nuestro país, como en el resto del mundo, los sistemas de salud están sometidos a procesos de modernización y reforma con el objetivo de adecuar sus capacidades a las necesidades de la población. En este contexto la estructura y gestión del sistema de salud son vehículos importantes para cumplir el objetivo. A fin de hacer buen uso de esta red, resulta crucial asegurar una buena coordinación entre los diferentes niveles de atención. Un sistema de referencia-contrarreferencia (SRC) constituye una herramienta que pone, a disposición de los médicos, criterios y procedimientos homogéneos que permiten canalizar la demanda para servicios de salud y hacer uso eficiente del sistema de atención. Objetivos: analizar las derivaciones de pacientes al Hospital Pediátrico del Centro Hospitalario Pereira Rossell (HP-CHPR) a través del Departamento de Emergencia (DEP) y de la Policlínica Pediátrica General de Referencia (PPGR). Material y método: se realizó un estudio descriptivo a partir de los registros correspondientes del triage de las interconsultas de las policlínicas de atención primaria a los servicios de neuropediatría, neumología y gastroenterología realizados en la PPGR desde agosto del año 2005 a diciembre de 2006. Se analizaron además los pases realizados al DEP del CHPR desde septiembre a diciembre del año 2006. Se realizaron fichas codificadas tanto para evaluar la interconsula a especialista, así como para evaluar el pase al DEP. Se calcularon porcentajes. Los datos se procesaron mediante Epi Info 6.04. Resultados: evaluación de los niños derivados a especialistas. El 69% de los casos procedía de Montevideo. Luego del triage, 69% del total de interconsultas fueron derivadas a la policlínica de referencia. Neuropediatría fue la especialidad más solicitada en 60% de los pases. Luego de realizado el triage del total de niños con pase a neuropediatría, 30% fue derivado a esta especialidad, a gastroenterología 0,05% y a neumología 0,03%. La calidad de los datos fue buena en 30% de los casos. La derivación fue oportuna en 89% de los casos. Evaluación de los pases al DEP. Del total de consultas en ese período, 24% concurrieron con pase. Se analizó 7,6%. El 73,2% provenía de Montevideo, 20% de Canelones. Los pacientes fueron derivados desde sistemas de emergencia móvil en 39% de casos. El 26% de los pases fue realizado por pediatra y el resto por médico general o de familia. El motivo de la derivación más frecuente fue por requerimiento de especialista, 29,6%. La calidad del pase fue buena en 64%. El 57% de los pacientes fue trasladado en ambulancia con médico; de éstos, 58,5% no requería tercer nivel de atención. Conclusiones: los resultados hallados muestran una ineficiente utilización de los recursos. Se deben establecer medidas para racionalizar el sistema de atención y promover su eficacia. Se proponen medidas para mejorar el funcionamiento del SRC y la derivación oportuna y adecuada a especialista en el HP-CHPR.

Induction of mutations is an alternative for genetic improvement of sugarcane (Saccharum spp. hybrid). It has been used to obtain mutants with resistance to rust (Puccinia melanocephala). Characteristics of pathogen infection process were identified through histopathological studies in a mutant (IBP 8518) of the B4362 variety, with resistance to this disease. Fragments of leaves were inoculated with P. melanocephala . Then, these were stained with lactophenol tripan blue to observe, in the optical microscope, the autofluorescence of the dead cell as hypersensitive response. The essay demonstrated fist that resistance of mutant involves a hypersensitive response at the place of interaction with the fungus. The it does not depend on possible structural changes of the leaf surface. Histological characterization of this incompatible interaction could contribute to the study of molecular processes of resistance to P. melanocephala in sugarcane. Keywords: histology, hypersensitive response, mutant

Partial sequences of sugarcane genes, obtained by means of a subtractive library were identified by BLAST alignment against all sequences available in the databases. During the homology search, five genes were identified as chloroplast or citosol ribosomal proteins. The biggest homology obtained among the identified sequences as ribosomal proteins of sugarcane was with the corn genome. Key words: consensus domain, Saccharum spp., subtractive library

AFLPs (amplified fragment length polymorphism) was carried out from genomic DNA of five rust resistant sugar cane somaclons and their susceptible donor, Saccharum officinarum var B 4362, using three combinations of primers (EcoRI/aca: MseI/acc; EcoRI/aca: MseI/atg and EcoRI/aca: MseI/agg). Six polymorphic bands were obtained, two of these only appeared in the resistant genotypes, which are probably DNA sequences, related to rust resistance locus. These fragments have been cloned to study their nucleotide sequence and to investigate their roll in resistance mechanism develop by these mutants during Puccinia melanocephala infection. Key words: molecular markers, Puccinia. melanocephala, Saccharum

The hypersensitive response is one of the most powerful mechanisms for which the plants resist pathogen attack. Mutations carried out previously on the variety B4362, of sugarcane, originated five mutants that express this mechanism towards the attack of rust (Puccinia melanocephala Syd.). By means of a subtractive hybridization among the cDNA obtained starting from the resistant clone inoculated with rust and a pool of cDNA of the susceptible variety (B4362) inoculated and of the resistant clone not inoculated, it was possible to reduce the number of genes expressed during the infection with the fungus. A subtractive library was carried out where we hope that most of the genes are involved in the hypersensitive response that present these mutants towards the infection of the pathogen. Key words: Subtractive hybridization, hypersensitive response, Puccinia melanocephala Syd.

Septic shock comprise a cascade of metabolic, hemodynamic and clinical changes provoked from the release of toxic bacterial products. Recent advances in understanding the pathophysiology of septic shock have suggested modalities of interrupting the earliest stages in the pathogenic mechanism and afford sorne hope of diminishing high mortality. However, at this time, early diagnosis and institution of appropriate medical and, surgical therapy seem to he the way to manage it.

The enteric nervous system (ENS) is responsible for the genesis of motor patterns ensuring an appropriate intestinal transit. Enteric motor neurons are classified into afferent neurons, interneurons and motorneurons. Motorneurons are excitatory or inhibitory causing smooth muscle contraction and relaxation respectively. Muscle relaxation mechanisms are key for the understanding of physiological processes such as sphincter relaxation, gastric accommodation, or the descending phase of the peristaltic reflex. Nitric oxide (NO) and ATP or a related purine are the primary inhibitory neurotransmitters. Nitrergic neurons synthesize NO through nNOS enzyme activity. NO diffuses across the cell membrane to bind guanylyl cyclase, and then activates a number of intracellular mechanisms that ultimately result in muscle relaxation. ATP is an inhibitory neurotransmitter together with NO. The P2Y1 receptor has been identified as a the purine receptor responsible for smooth muscle relaxation. Although, probably, no clinician doubts about the significance of NO in the pathophysiology of gastrointestinal motility, the relevance of purinergic neurotransmission is apparently much lower, as ATP has not been associated with any specific motor dysfunction yet. The goal of this review is to discuss the function of both relaxation mechanisms in order to establish the physiological grounds of potential motor dysfunctions arising from impaired intestinal relaxation.