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The European Green Deal states that schools play an important role in engaging with students and the wider community for environmental sustainability and develop the skills needed for a successful transition to a sustainable society. To explore the role of STEM education in sustainability, Scientix, the community for science education in Europe, organised an online Science Topics Networking Seminar (STNS) in collaboration with the projects GreenSCENT and Life Terra. At the event, more than 20 experts representing various stakeholders in STEM education came together to discuss good practices in STEM education in promoting sustainability education and supporting a green future. This observatory paper outlines the key discussion points raised during the seminar, supported by research from the scientific literature. First, there is an abundance of STEM resources and teaching material. There is a need to facilitate the evaluation and exchange of these resources and provide time and support to teachers for implementing them in their classrooms. Second, students could be more involved in sustainability activities that will help them see their impact on their immediate surrounding. This can be achieved with interdisciplinary activities that combine scientific concepts, critical thinking and active citizenship. A whole-school approach and greenifying schools can further engage students in taking action and be more motivated for STEM projects for sustainability. Third, more activities need to adopt the GreenComp and perform STEM in the future 2 assessments based on it to test it as a competence framework. Finally, STEM education for sustainability can be further supported with school visits to nature reserves, science centres and companies involved in sustainability.

Une nouvelle interpretation de l'episcopat a permis aux Eglises qui ne l'ont pas garde de l'apprecier comme signe de la continuite et de l'unite de l'Eglise. Elles le considerent comme un signe preeminent de la succession apostolique de toute l'Eglise pour la foi, la vie et la doctrine. La seule chose qui paraisse une difficulte est l'idee selon laquelle la succession episcopale serait identique a l'apostolicite de toute l'Eglise et la contiendrait. Le present article, dans le but d'eliminer les obstacles sur le chemin de l'unite des Eglises, examine d'abord ce que dit le Nouveau Testament sur l'unite; puis il indique la nuance importante entre le Ministere et le ministere; ensuite il montre l'importance de l'ecclesiologie locale; enfin il parle de l'episcopat comme Ministere universel.

PURPOSE Population-based cancer registries (PBCRs) are critical for national cancer control planning, yet few low- and middle-income countries (LMICs) have quality PBCRs. The Central America Four region represents the principal LMIC region in the Western hemisphere. We describe the establishment of a PBCR in rural Western Honduras with first estimates for the 2013-2017 period. METHODS The Western Honduras PBCR was established through a collaboration of academic institutions and the Honduras Ministry of Health for collection of incident cancer data from public and private health services. Data were recorded using the Research Electronic Data Capture (REDCap) web-based platform with data monitoring and quality checks. Crude and age-standardized rates (ASRs) were calculated at the regional level, following WHO methodology. RESULTS The web-based platform for data collection, available ancillary data services (eg, endoscopy), and technical support from international centers (United States and Colombia) were instrumental for quality control. Crude cancer incidence rates were 112.2, 69.8, and 154.6 per 100,000 habitants overall, males, and females, respectively (excluding nonmelanoma skin cancer). The adjusted ASRs were 84.2, 49.6, and 118.9 per 100,000 overall habitants, males, and females, respectively. The most common sites among men were stomach (ASR 26.0, 52.4%), colorectal (ASR 5.11, 10.15%), and prostate (ASR 2.7, 5.4%). The most common sites in women were cervix (ASR 34.2, 36.7%), breast (ASR 11.2, 12.3%), and stomach (ASR 10.8, 11.7%). CONCLUSION The Copán-PBCR represents a successful model to develop cancer monitoring in rural LMICs. Innovations included the use of the REDCap platform and leverage of Health Ministry resources. This provides the first PBCR data for Honduras and the Central America Four and confirms that infection-driven cancers, such as gastric and cervical, should be priority targets for cancer control initiatives.

En la actualidad el estudio del fenómeno de la superhidrofóbicidad ha tenido avances muy significativos, uno de ellos asido la obtención de recubrimientos superhidrofóbicos a base de materiales compositos; con el fin de mejorar las propiedades de algunos materiales, como: inhibidores de corrosión, la reducción de la adherencia de líquidos en la superficie en estos materiales. Dado que algunos recubrimientos anticorrosivos son realmente costosos, incluyendo la manipulación de la técnica. Con la aplicación de la nanotecnología se ha tenido un mayor avance, esto es debido a los excelentes métodos para la obtención de recubrimiento con propiedades anticorrosivas y superhidrofóbicas. En el presente artículo, se presenta un composito superhidrofóbico a base de nano partículas de caolín–polímeros reciclados, con aplicación innovadora como un recubrimiento, presentando propiedades anticorrosivas y de no-mojabilidad; para aceros de bajo carbón, el composito se depositó con un robot cartesiano con deposición por spray, por ende, se obtuvieron recubrimientos homogéneos con características esperadas. La espectroscopia infrarroja por transformada de Fourier (FTIR), indica la presencia de los grupos funcionales ac. carboxílico (COOH) a 2920 y 2853 cm-1, característico de superficies altamente hidrofóbicas, además se aplicaron métodos de aproximación para efectuar la medición del ángulo de contacto (Reflexión y Aumento de imagen), los cuales demostraron que el ángulo es igual o se aproxima a 150º. Con ello se procedió a hacer ensayos de corrosión mediante cámaras que simulaban atmosferas corrosivas, se obtuvieron resultados favorables, el cual demuestra que el composito nanoestructurado posee las propiedades anticorrosivas y superhidrofóbicas.

Resumen Caso clinico Varon joven con sindrome hemolitico uremico atipico (SHUa) complicado con la presencia de desprendimientos serosos retinianos bilaterales (DSR), multiples exudados algodonosos y una oclusion de rama arterial. El tratamiento con terapia plasmatica, hemodialisis y posteriormente con eculizumab, permitio una rapida normalizacion de los parametros sanguineos y urinarios y la resolucion de las alteraciones retinianas. El analisis genetico mostro 2 mutaciones en el factor H y C3 del sistema complemento. Discusion El sindrome hemolitico uremico (SHU) es una microangiopatia trombotica con anemia hemolitica, trombocitopenia e insuficiencia renal aguda, que se denomina atipico cuando esta causado por una alteracion genetica del sistema complemento. La afectacion ocular es una rara manifestacion de este infrecuente sindrome.

Case report The case is presented of a young man with an atypical haemolytic-uraemic syndrome (aHUS), complicated with bilateral serous retinal detachment, cotton wool spots, and a branch artery occlusion. Treatment with plasmapheresis, haemodialysis and systemic eculizumab led to the blood and urine parameters returning to normal, as well as resolution of the retinal anomalies. Genetic analysis show both mutations in complement factor H and C3. Discussion Haemolytic-uraemic syndrome (HUS) is a thrombotic microangiopathy characterized by microangiopathic haemolytic anemia, thrombocytopenia, and acute renal failure. Atypical HUS is caused by genetic mutation of complement system. Ocular involvement is an unusual manifestation of this rare syndrome.

Low cardiac output syndrome (LCOS) after surgical aortic valve replacement (SAVR) is related to increased mortality and treatment related costs. We aimed to evaluate whether echocardiography-derived left ventricular global longitudinal strain (LV-GLS) relates to the occurrence of postoperative LCOS in patients undergoing SAVR. We prospectively enrolled 75 patients with symptomatic severe aortic stenosis, left ventricular ejection fraction (LVEF) > 40%, NYHA Class

Seven patients (14 eyes) diagnosed with X-linked ichthyosis were studied using the Schirmer test, biomicroscopy, tonometry, endothelial count, optical coherence tomography, Pentacam®, ocular surface analyser, and confocal microscopy. The mean age was 33.83±20.17 years (range: 7-64 years). The most frequent findings in biomicroscopy were Meibomian glands dysfunction (83.3%) and stromal corneal opacities (33%). The tear break-up time was found shortened in 25% of the eyes. Confocal microscopy (both eyes) revealed activated keratocytes with hyper-reflective particles inside them in the anterior stroma and outside them in the posterior stroma. It is believed that the inclusion of the use of confocal microscopy will help in a better understanding of the corneal pathology associated with ichthyosis X, as well as new characteristics of these patients.

Intensive care to facilitate organ donation (ICOD) is defined as the initiation or continuation of life-sustaining measures, such as mechanical ventilation, in patients with a devastating brain injury with high probability of evolving to brain death and in whom curative treatment has been completely dismissed and considered futile. ICOD incorporates the option to organ donation allowing a holistic approach to end-of-life care, consistent with the patients wills and values. Should the patient not evolve to brain death, life-supportive treatment must be withdrawal and controlled asystolia donation could be evaluated. ICOD is a legitimate practice, within the ethical and legal regulations that contributes increasing the accessibility of patients to transplantation, promoting health by increasing deceased donation by 24%, and with a mean of 2.3 organs transplanted per donor, and collaborating with the sustainability of health-care system. This ONT-SEMICYUC recommendations provide a guide to facilitate an ICOD harmonized practice in spanish ICUs.

Resumen Introduccion El esofago de Barrett (EB) es una lesion esofagica ocasionada mayoritariamente por reflujo gastroesofagico acido. El control del reflujo acido es uno de los principales objetivos del tratamiento de esta patologia. Objetivo Evaluar en nuestra area de salud el grado de control del reflujo acido en los pacientes con EB en funcion del tratamiento de mantenimiento recibido, medico o quirurgico. Metodos Estudio retrospectivo de pacientes con diagnostico endoscopico e histologico de EB. Un grupo de pacientes recibio tratamiento medico con inhibidores de la bomba de protones (IBP) y otro grupo fue sometido a intervencion quirurgica (funduplicatura de Nissen). Se compararon datos epidemiologicos y resultados de pHmetria (tiempo de pH 5 min, puntuacion de DeMeester) de cada grupo. La pH-metria se realizo con IBP en el grupo de tratamiento medico y en el grupo de cirugia sin consumo de antisecretores acidos. Se definio fracaso del tratamiento como un pH Resultados Fueron incluidos 128 pacientes con EB (tratamiento medico 75, tratamiento quirurgico 53). Ambas cohortes eran homogeneas respecto a sus caracteristicas demograficas. Las puntuaciones de DeMeester, fraccion de tiempo de pH Conclusiones El grado de control del reflujo acido gastroesofagico es suboptimo en un elevado porcentaje de pacientes con EB. El tratamiento medico ofrece resultados inferiores a la cirugia antirreflujo y se deberia intentar optimizar sus resultados.

Introduction Barrett's oesophagus (BE) is an oesophageal injury caused by gastroesophageal acid reflux. One of the main aims of treatment in BE is to achieve adequate acid reflux control. Objective To assess acid reflux control in patients with BE based on the therapy employed: medical or surgical. Methods A retrospective study was performed in patients with an endoscopic and histological diagnosis of BE. Medical therapy with proton pump inhibitors (PPI) was compared with surgical treatment (Nissen fundoplication). Epidemiological data and the results of pH monitoring (pH time 5 min, DeMeester score) were evaluated in each group. Treatment failure was defined as a pH lower than 4 for more than 5% of the recording time. Results A total of 128 patients with BE were included (75 PPI-treated and 53 surgically-treated patients). Patients included in the two comparison groups were homogeneous in terms of demographic characteristics. DeMeester scores, fraction of time pH p p Conclusions Treatment results were significantly worse with medical treatment than with anti-reflux surgery and should be optimised to improve acid reflux control in BE. Additional evidence is needed to fully elucidate the utility of PPI in this disease.

Clinical cases The cases are presented on 2 patients with bacterial endogenous endophthalmitis. The first one was caused by Streptococcus bovis, developed after colonoscopy, which had a poor outcome and resulted in evisceration. The second case was caused by a methicillin resistant Staphylococcus aureus from an arthrodesis complicated with a para-spinal abscess. It had an excellent visual outcome. Discussion Bacterial endogenous endophthalmitis is a rare, but serious ocular disease that occurs when bacteria reach the eye via the bloodstream. It requires a very early diagnosis based on the clinical symptoms and patient history. A suitable and specific treatment with intravenous and intravitreal antibiotics may prevent a bad visual prognosis in some cases.

Resumen Casos clinicos Presentamos 2 casos clinicos de endoftalmitis endogena bacteriana. El primero causado por Streptococcus bovis tras la realizacion de una colonoscopia, con mala evolucion que acabo en evisceracion. El segundo debido a un Staphylococcus aureus meticilin resistente procedente de un absceso paraespinal que complicaba una artrodesis, con excelente recuperacion visual. Discusion La endoftalmitis endogena bacteriana es una enfermedad poco frecuente y grave en la que bacterias procedentes de un foco primario llegan por via sanguinea hasta el ojo. El diagnostico de sospecha ha de ser lo mas precoz posible, basado en la clinica y los antecedentes del paciente. Un tratamiento adecuado y especifico con antibioticos intravenosos e intravitreos puede evitar el mal pronostico visual en algunos casos.

Transparent films of cellulose nanocrystals (CNC) are prepared by dip-coating on glass substrates from aqueous suspensions of hydrolyzed filter paper. Dragging forces acting during films&rsquo, deposition promote a preferential alignment of the rod-shaped CNC. Films that are 2.8 and 6.0 &micro, m in thickness show retardance effects, as evidenced by placing them between a linearly polarized light source and a linear polarizer sheet in the extinction configuration. Transmission Mueller matrix spectroscopic ellipsometry measurements at normal incidence as a function of sample rotation were used to characterize polarization properties. A differential decomposition of the Mueller matrix reveals linear birefringence as the unique polarization parameter. These results show a promising way for obtaining CNC birefringent films by a simple and controllable method.

To determine the prevalence of ophthalmological emergency visits to two tertiary hospital in all age groups during years 2014 and 2015.All patients who attended Ophthalmological Emergency Department from 1 January 2014 to 31 December 2015 were included in the study. The demographic variables studied were gender, age, place of origin, time of arrival, day of the week, month and year of the visit, the diagnosis, destination on discharge, total time of the visit and priority. Pathologies were categorised using codes from ICD-9, CM.A total of 39,869 visits were made between 2014 and 2015. Emergency consultations were more frequent among women, on Mondays, and from April to June. The mean age of the patients was 46.24years old, and 73.42% of visits were classified as non-emergencies. The most frequent pathology was conjunctivitis (17.28%), followed by keratitis (15.31%), and vitreous detachment (5.37%). The pathology that led to more hospital admissions was orbital cellulitis (23%). The majority of patients (94.85%) were sent to their place of residence after the visit.Given that the great majority of Ophthalmological Emergency visits are categorised as non-emergencies, measures need to be set up in order achieve a more effective care focused on emergency pathology without using unnecessary resources.

The infectious proliferation of phytopathogenic microorganisms depends on a complex sequence of biological events involving host defense, environmental conditions, and chemical and physical interactions between the surface of a plant and microorganisms, which in numerous cases display resistance to conventional microbicides. Among these microorganisms

ECRIS Network integrated in the Spanish AIDS Research Network., Exosome-derived miR-21 was independently associated with CD4 T cell decline in HIV-1-infected elite controllers (OR 0.369, 95% CI 0.137–0.994, p = 0.049). Also, a negative correlation between miR-21 expression and MCP-1 level was found (r = −0.649, p = 0.020), while no correlation between soluble biomarkers or cellular immune activation was found., This work has been partially funded by the Spanish Health Institute Carlos III (ISCIII) and European Regional Development Fund, Spanish AIDS Research Network (RIS) with grant numbers RD16/0025/0001, RD12/0017/0031, RD16/0025/0013, and RD16/0002/0002. Research Grant Project, Spanish Health Research Fund (FIS, ISCIII) number PI14/00011. Miguel Servet Research Program, Spanish Health Institute Carlos III (ISCIII) CP14/00198 to NR. Spanish Health Research Fund (FIS, ISCIII) and IIS-FJD Intramural Research Scholarship co-funded grant number CP14/00198 to MG. Spanish Health Institute Carlos III (ISCIII) grant CD13/00013 to MAJS. Grant Research, Madrid Education, Youth and Sport Counseling number PEJ15/bio/tl-0064 to MJRL.

Resumen: Introducción y objetivos: Los padres con frecuencia solicitan a los pediatras consejo acerca del mejor sistema para el cuidado de sus hijos. En la literatura existen discrepancias al respecto. El objetivo de este estudio es evaluar la influencia de la asistencia a la guardería sobre el riesgo de infecciones agudas y la utilización de recursos sanitarios en los niños menores de 24 meses. Población y métodos: Estudio longitudinal prospectivo de 2 cohortes de niños de 0-24 meses que se diferencian por la asistencia o no a la guardería, nacidos entre el 1 de enero y el 30 de septiembre de 2010 y que acuden habitualmente a las consultas de 33 pediatras del Servicio Público de Salud del Principado de Asturias. Resultados y conclusiones: Se estudiaron 975 niños. A los 24 meses acuden a la guardería el 43,7%. Asistir a guardería incrementa el riesgo de padecer neumonía en un 131%, el de sibilancias recurrentes en un 69%, el de bronquitis un 57% y el de otitis media en un 64%. La exposición temprana a la guardería incrementa el riesgo de neumonías de 2,31 a 2,81 y la media de visitas a urgencias desde 1 a 2,3.La media de ciclos de antibióticos es de 1,7 para los que no van a la guardería, de 3,4 si la inician en los 6 primeros meses y de 2 si comienzan a partir de los 18 meses.La asistencia a guarderías es un factor de riesgo de padecer enfermedades infecciosas que aumenta si asisten desde edades tempranas. Abstract: Introduction and objectives: Parents often ask paediatricians for advice about the best way to care for their children. There are discrepancies in the literature on this subject. The objective of this study is to evaluate the influence of attending kindergartens on the risk of acute infections and the use of health care resources in children less than 24 months. Population and methods: A prospective longitudinal study was conducted on two cohorts of children 0-24 months (born between 1 January and 30 September 2010), who were grouped according to whether they attended kindergarten or not, and were usually seen in 33 pediatric clinics of the Principality of Asturias Public Health Service. Results and conclusions: A total of 975 children were studied, of whom 43.7% attended a kindergarten at 24 months. Attending kindergarten increases the risk of pneumonia by 131%, recurrent wheezing by 69%, bronchitis by 57%, and otitis media by 64%. Early exposure to kindergarten increases the risk of pneumonia from 2.31 to 2.81, and the mean emergency room visits from 1 to 2.3.The mean antibiotic cycle is 1.7 in children who do not go to kindergarten, 3.4 if started within the first 6 months, and 2 if they start at 18 months.Day-care attendance is a risk factor of infectious diseases that increases if attending kindergartens from an early age.

Introduction and objectives: Parents often ask paediatricians for advice about the best way to care for their children. There are discrepancies in the literature on this subject. The objective of this study is to evaluate the influence of attending kindergartens at the risk of acute infections and the use of health care resources in children less than 24 months. Population and methods: A prospective longitudinal study was conducted on two cohorts of children aged 0–24 months (born between 1 January and 30 September 2010), who were grouped according to whether they attended kindergarten or not, and were usually seen in 33 paediatric clinics of the Principality of Asturias Public Health Service. Results and conclusions: A total of 975 children were studied, of whom 43.7% attended a kindergarten at 24 months. Attending kindergarten increases the risk of pneumonia by 131%, recurrent wheezing by 69%, bronchitis by 57%, and otitis media by 64%. Early exposure to kindergarten increases the risk of pneumonia from 2.31 to 2.81, and the mean emergency room visits from 1 to 2.3.The mean antibiotic cycle is 1.7 in children who do not go to kindergarten, 3.4 if started within the first 6 months, and 2 if they start at 18 months.Care attendance is a factor of risk of infectious diseases increases if they attend at an early age. Resumen: Introducción y objetivos: Los padres con frecuencia solicitan a los pediatras consejo acerca del mejor sistema para el cuidado de sus hijos. En la literatura existen discrepancias al respecto. El objetivo de este estudio es evaluar la influencia de la asistencia a la guardería sobre el riesgo de infecciones agudas y la utilización de recursos sanitarios en los niños menores de 24 meses. Población y métodos: Estudio longitudinal prospectivo de 2 cohortes de niños de 0–24 meses que se diferencian por la asistencia o no a la guardería, nacidos entre el 1 de enero y el 30 de septiembre de 2010 y que acuden habitualmente a las consultas de 33 pediatras del Servicio Público de Salud del Principado de Asturias. Resultados y conclusiones: Se estudiaron 975 niños. A los 24 meses acuden a la guardería el 43,7%. Asistir a guardería incrementa el riesgo de padecer neumonía en un 131%, el de sibilancias recurrentes en un 69%, el de bronquitis un 57% y el de otitis media en un 64%. La exposición temprana a la guardería incrementa el riesgo de neumonías de 2,31 a 2,81 y la media de visitas a urgencias desde 1 a 2,3.La media de ciclos de antibióticos es de 1,7 para los que no van a la guardería, de 3,4 si la inician en los 6 primeros meses y de 2 si comienzan a partir de los 18 meses.La asistencia a guarderías es un factor de riesgo de padecer enfermedades infecciosas que aumenta si asisten desde edades tempranas.

One-dimensional titanate nanotubes (H

A DNA oligo-microarray enriched in genes and involved in inflammatory and immune responses was used to evaluate the effects of resveratrol on gene expression in turbot head kidney leucocytes. Leucocytes were cultured for 3, 6 and 24 h, in the presence or absence of resveratrol, or were stimulated with the membrane fraction of the parasite Philasterides dicentrarchi or with the membrane plus resveratrol. Gene expression changed considerably in control cells, and several of the regulated genes were related to inflammatory and immune responses and to the cytoskeleton. Similar changes in gene expression occurred in control cells and in cells stimulated with P. dicentrarchi membrane fraction. Treatment with resveratrol induced changes in the expression (mostly down-regulation) of several genes involved in immune responses and inflammation. Thus, the down-regulation of the transcription factor PU.1, pentraxin-multidomain protein, heme oxygenase 1, S100 calcium-binding protein A-16 (S100A16) and the signal transducer and activator of transcription 4 was observed after all three incubation times. The down-regulation of the suppressor of cytokine signalling 3a, LPS-induced tumour necrosis alpha, hepcidin, metallothionein, TLR8 and the calcium dependent lectin A was observed after 3 and 6 h. Resveratrol also decreased the expression of CCL20, IL-8, apolipoprotein E and glutathione S-transferase after incubation for 6 and 24 h, and of TNF-α after incubation for 3 and 24 h. Resveratrol also induced strong regulation of several cytoskeleton-related genes. The use of the turbot oligo-microarray enabled us to discover genes whose expression was not previously suspected of being modulated by this polyphenol.

The cases are presented on 2patients with bacterial endogenous endophthalmitis. The first one was caused by Streptococcus bovis, developed after colonoscopy, which had a poor outcome and resulted in evisceration. The second case was caused by a methicillin resistant Staphylococcus aureus from an arthrodesis complicated with a para-spinal abscess. It had an excellent visual outcome.Bacterial endogenous endophthalmitis is a rare, but serious ocular disease that occurs when bacteria reach the eye via the bloodstream. It requires a very early diagnosis based on the clinical symptoms and patient history. A suitable and specific treatment with intravenous and intravitreal antibiotics may prevent a bad visual prognosis in some cases.

The case is presented of a young man with an atypical haemolytic-uraemic syndrome (aHUS), complicated with bilateral serous retinal detachment, cotton wool spots, and a branch artery occlusion. Treatment with plasmapheresis, haemodialysis and systemic eculizumab led to the blood and urine parameters returning to normal, as well as resolution of the retinal anomalies. Genetic analysis show both mutations in complement factor H and C3.Haemolytic-uraemic syndrome (HUS) is a thrombotic microangiopathy characterised by microangiopathic haemolytic anaemia, thrombocytopenia, and acute renal failure. Atypical HUS is caused by genetic mutation of complement system. Ocular involvement is an unusual manifestation of this rare syndrome.

Introduccion: la estructura actual de la sociedad espanola favorece la asistencia de los ninos a guarderias infantiles a edades cada vez mas tempranas. Esto es un factor de riesgo por si solo para el padecimiento de infecciones del tracto respiratorio superior e inferior, otitis media aguda, infecciones gastrointestinales y otras infecciones. Objetivo: evaluar la influencia de la asistencia a la guarderia sobre el riesgo de padecer infecciones en los ninos menores de 12 meses de edad. Poblacion y metodos: estudio longitudinal prospectivo. Se incluyeron en el estudio los ninos nacidos entre el 1 de enero y el 30 de septiembre de 2010 que acuden a consulta de Pediatria de Atencion Primaria. Se excluyeron los ninos que presentaban patologia respiratoria o cardiaca grave o inmunodeficiencias graves. Los datos se obtuvieron de la historia clinica informatizada y de las entrevistas en visitas programadas a los padres a los 6 y a los 12 meses. Para el analisis estadistico de los datos se utilizo el programa estadistico R® (R Development Core Team, 2011). Resultados: los ninos que acuden a la guarderia presentan mas episodios infecciosos que los que no lo hacen, siendo estadisticamente significativas (p-valor

Actualmente la raza Ovella Galega se encuentra en peligro de extinción, por lo que está sometida a un Programa de Conservación y Recuperación donde prima la preservación de la variabilidad genética. En este trabajo se estudió el crecimiento y la canal en corderos de la raza, para profundizar en su caracterización. Se han utilizado 10 corderos machos de parto simple inscritos en el Libro Genealógico de la raza, criados sólo con leche materna hasta la edad de sacrificio de 45 días. El crecimiento y las GMD son acordes con los resultados publicados en otros estudios sobre la raza, y a pesar de que ésta presenta un pequeño formato, entre los resultados obtenidos cabe destacar su alto rendimiento comercial (59%) así como un adecuado porcentaje en piezas de 1ª y 2ª categoría.

Resumen: Introducción: Desde 2007 y de forma obligatoria, los médicos especialistas en formación de Pediatría (MIR) deben rotar por centros de salud durante 3 meses. Al discrepar de la forma de rotación propuesta, el grupo de docencia MIR de la Asociación Española de Pediatría de Atención Primaria (AEPap) se planteó conocer las opiniones de pediatras hospitalarios (PH), pediatras de Atención Primaria (PAP) y MIR en cuanto a necesidad, duración, período de realización y expectativas de la rotación. Metodología: Estudio transversal con encuesta validada de 13 preguntas, cuya distribución a las distintas asociaciones de la AEPap y su cumplimentación se realizó a través de su página web. Los datos se procesaron con el paquete estadístico SPSS 12.0, utilizándose en su análisis el test de χ2. Resultados: Se analizaron 323 encuestas de 13 comunidades, contestadas por el 56% de PAP, el 38,7% de MIR y el 5,3% de PH, siendo mujeres el 67,5%; predominan 2 tramos de edad: menores de 30 años y entre 41 y 50 años. De los encuestados, el 99% cree necesaria la rotación, con una duración para el 73,3% de los PAP de 6 meses con respecto a una duración de uno o 2 meses para el 56,9% de los MIR (p

Chest pain is the most common symptom of patients who present with ischemic heart disease. Morphine has traditionally been the drug of choice for managing chest pain in acute coronary syndrome (ACS) due to its high analgesic potency, though its physiological effects are poorly understood. Routinely used for managing chest pain, morphine is recommended in the 2002 guidelines of the American College of Cardiology/American Heart Association. This recommendation, however, is not based on a high level of scientific evidence but on expert opinion. Studies have found both for and against the use of morphine in ACS, suggesting that its benefits are perhaps not altogether clear. This review examines the pathophysiological effects of morphine and their cardiac implications, with special attention to a possible negative effect on ACS. We reviewed articles in the MEDLINE database from 1982 to 2006.

To describe end-of-life care practices relevant to organ donation in patients with devastating brain injury in Spain.A multicenter prospective study of a retrospective cohort.1 November 2014 to 30 April 2015.Sixty-eight hospitals authorized for organ procurement.Patients dying from devastating brain injury (possible donors). Age: 1 month-85 years.Type of care, donation after brain death, donation after circulatory death, intubation/ventilation, referral to the donor coordinator.A total of 1,970 possible donors were identified, of which half received active treatment in an Intensive Care Unit (ICU) until brain death (27%), cardiac arrest (5%) or the withdrawal of life-sustaining therapy (19%). Of the rest, 10% were admitted to the ICU to facilitate organ donation, while 39% were not admitted to the ICU. Of those patients who evolved to a brain death condition (n=695), most transitioned to actual donation (n=446; 64%). Of those who died following the withdrawal of life-sustaining therapy (n=537), 45 (8%) were converted into actual donation after circulatory death donors. The lack of a dedicated donation after circulatory death program was the main reason for non-donation. Thirty-seven percent of the possible donors were not intubated/ventilated at death, mainly because the professional in charge did not consider donation alter discarding therapeutic intubation. Thirty-six percent of the possible donors were never referred to the donor coordinator.Although deceased donation is optimized in Spain, there are still opportunities for improvement in the identification of possible donors outside the ICU and in the consideration of donation after circulatory death in patients who die following the withdrawal of life-sustaining therapy.

Barrett's oesophagus (BE) is an oesophageal injury caused by gastroesophageal acid reflux. One of the main aims of treatment in BE is to achieve adequate acid reflux control.To assess acid reflux control in patients with BE based on the therapy employed: medical or surgical.A retrospective study was performed in patients with an endoscopic and histological diagnosis of BE. Medical therapy with proton pump inhibitors (PPI) was compared with surgical treatment (Nissen fundoplication). Epidemiological data and the results of pH monitoring (pH time4, prolonged reflux5min, DeMeester score) were evaluated in each group. Treatment failure was defined as a pH lower than 4 for more than 5% of the recording time.A total of 128 patients with BE were included (75 PPI-treated and 53 surgically-treated patients). Patients included in the two comparison groups were homogeneous in terms of demographic characteristics. DeMeester scores, fraction of time pH4 and the number of prolonged refluxes were significantly lower in patients with fundoplication versus those receiving PPIs (P.001). Treatment failure occurred in 29% of patients and was significantly higher in those receiving medical therapy (40% vs 13%; P.001).Treatment results were significantly worse with medical treatment than with anti-reflux surgery and should be optimized to improve acid reflux control in BE. Additional evidence is needed to fully elucidate the utility of PPI in this disease.

Antecedentes: Se presenta la fase III del estudio ISAAC (International Study of Asthma and other Allergies in Childhood) en escolares de 6-7 años de ocho áreas españolas para estimar la tendencia temporal y variaciones geográficas de los síntomas de rinitis alérgica. Material y método: Se comparan las prevalencias de síntomas de rinitis alérgica entre la fase I y fase III, efectuadas entre los años 1993-1994 y 2001-2002, mediante un cuestionario estandarizado y validado según metodología ISAAC, cumplimentado por los padres de los escolares. Participaron ocho centros de Asturias, Barcelona, Bilbao, Cartagena, Castellón, Madrid, Pamplona y Valencia. Se empleó la regresión de Poisson en el análisis. Resultados: La población estudiada fue de 25.113 escolares con una mediana de participación del 81,7 %. En todos los centros se observó una tendencia creciente en síntomas de rinitis alérgica, destacando la razón de prevalencia de rinoconjuntivitis en los últimos 12 meses de 1,61 (intervalos de confianza del 95 %: 1,48-1,76) al comparar ambas fases, y después de ajustar por sexo, centro y variación estacional. La prevalencia de síntomas de rinitis alérgica fue mayor en los niños que en las niñas. Se apreciaron amplias variaciones entre centros con elevadas prevalencias en Asturias, Madrid, Cartagena y Bilbao. Las menores prevalencias se produjeron en Barcelona, Castellón y Pamplona. Conclusiones: El incremento de los síntomas de rinitis alérgica parece ser general y existen amplias variaciones entre centros que sugieren la diferente magnitud de factores de riesgo a escala local y cuya investigación más exhaustiva potenciaría actuaciones preventivas más adecuadas. : Background: Phase III of the International Study of Asthma and other Allergies in Childhood (ISAAC) was carried out in schoolchildren aged 6-7 years from eight areas of Spain to estimate time trends and geographic variations in the prevalence of symptoms of allergic rhinitis (AR). Material and method: A standard and validated questionnaire was used following ISAAC methodology and was completed by the schoolchildren's parents. The prevalence of symptoms of AR in Phase I (1993-1994) and Phase III (2001-2002) was compared. Eight centers participated: Asturias, Barcelona, Bilbao, Cartagena, Castellón, Madrid, Pamplona and Valencia. Poisson regression was used in the analysis. Results: A total of 25,113 schoolchildren were studied with a median participation of 81.7 %. In all centers, AR symptoms tended to increase, with a prevalence ratio of rhinoconjunctivitis in the previous year of 1.61 (95 % confidence interval: 1.48-1.76) when both phases, adjusted by gender, center, and seasonal variation, were compared. The prevalence of AR symptoms was higher in boys than in girls. Wide variations in the prevalence of AR were observed across centers with a higher prevalence in Asturias, Madrid, Cartagena and Bilbao. Lower prevalences were reported in Barcelona, Castellón and Pamplona. Conclusions: There seems to have been a general increase in AR symptoms. Substantial variations between centers suggested that there may be local differences in risk factors. Intense research will be required for satisfactory preventive actions.

Objetivos: valorar el estado de nutricion de los ninos menores de quince anos del Principado de Asturias, identificando los que tienen parametros alterados, por exceso o defecto, y devolver la informacion obtenida a pediatras y gestores. Metodos: estudio descriptivo transversal retrospectivo. Poblacion diana: menores de 15 anos de Asturias nacidos entre 1995 y 2012. Fuente de datos: historia clinica informatizada de Atencion Primaria. Variables: ultimo peso y talla registrados, fecha de medida y de nacimiento, sexo, y codigos de area, zona basica y pediatra del nino. Indicadores calculados: peso/edad; talla/edad; indice de masa corporal (IMC)/edad y peso/longitud (< cinco anos). Patrones de comparacion utilizados: estandares de la Organizacion Mundial de la Salud (OMS) y se han utilizado los softwares ANTHRO y ANTHRO PLUS. Se calcularon para cada nino la desviacion estandar (DE) segun edad y sexo para el IMC/edad, talla/edad y peso/edad; (Z-standard) y las prevalencias de cada variable ajustadas por edad y sexo. Resultados y conclusiones: se obtuvo una base neta con 89 989 registros: el 50,98% ninos y el 49,02% ninas. Presentaron baja talla el 1,8%, normopeso el 66,56%, sobrepeso el 22,5%, obesidad el 10,9%, obesidad grave el 1,9% y delgadez el 1,1%. Por sexos, la tasa de obesidad es mayor en ninos (12,4) que en ninas (9,2). Por edades, la tasa de exceso de peso fue mayor en los ninos de entre 10 y 14 anos (41,9). Los ninos de entre cinco y nueve anos presentaron las mayores tasas de obesidad (15,1) y obesidad grave (3,7). Las diferencias de prevalencia de exceso de peso entre las 68 zonas basicas estudiadas llegan hasta 20 puntos; su conocimiento permitira establecer las zonas prioritarias de intervencion.

La hipertension arterial (HTA) es extremadamente frecuente despues del trasplante renal y presenta una clara relacion con la nefropatia cronica del injerto y la morbimortalidad cardiovascular, ambas circunstancias principales responsables de la perdida de los injertos renales a partir del primer ano postrasplante. En su etiopatogenia participan numerosos factores, dentro de los cuales la propia medicacion inmunosupresora, en concreto, los inhibidores de la calcineurina, desempenan un papel fundamental. La HTA postrasplante ha de ser tratada energicamente con medidas higienico-dieteticas y farmacologicas. La eleccion del farmaco antihipertensivo ha de realizarse de manera individualizada. Probablemente los calcioantagonistas sean los farmacos de primera linea, salvo en aquellos pacientes con proteinuria, en los que seria preferible utilizar un inhibidor de la enzima convertidora de angiotensina o un antagonista de los receptores de angiotensina II. El advenimiento de nuevos farmacos inmunosupresores sin capacidad nefrotoxica ni prohipertensiva facilitara en un futuro el desarrollo de nuevos protocolos de inmunosupresion que permitiran minimizar la nefrotoxicidad, con el consiguiente impacto en la HTA postrasplante.

Parents often ask paediatricians for advice about the best way to care for their children. There are discrepancies in the literature on this subject. The objective of this study is to evaluate the influence of attending kindergartens on the risk of acute infections and the use of health care resources in children less than 24 months.A prospective longitudinal study was conducted on two cohorts of children 0-24 months (born between 1 January and 30 September 2010), who were grouped according to whether they attended kindergarten or not, and were usually seen in 33 pediatric clinics of the Principality of Asturias Public Health Service.A total of 975 children were studied, of whom 43.7% attended a kindergarten at 24 months. Attending kindergarten increases the risk of pneumonia by 131%, recurrent wheezing by 69%, bronchitis by 57%, and otitis media by 64%. Early exposure to kindergarten increases the risk of pneumonia from 2.31 to 2.81, and the mean emergency room visits from 1 to 2.3. The mean antibiotic cycle is 1.7 in children who do not go to kindergarten, 3.4 if started within the first 6 months, and 2 if they start at 18 months. Day-care attendance is a risk factor of infectious diseases that increases if attending kindergartens from an early age.

El presente trabajo tuvo como objetivo caracterizar las relaciones familiares del anciano a partir de su percepción, en el área de salud del Policlínico Docente "Reina" del municipio de Centro Habana. Se caracterizaron 144 ancianos que viven en familias multigeneracionales utilizando la prueba de relaciones familiares, la escala de depresión geriátrica de Yesavage, la escala de actividades instrumentadas de la vida diaria y un cuestionario confeccionado al efecto. Se obtuvo como resultado el predominio de las relaciones poco armónicas y disarmónicas, dificultades en la definición de los límites intergeneracionales, rigidez en la estructura jerárquica familiar y actitudes intolerantes hacia las características y comportamiento de los ancianos por parte de su familia. Igualmente se encontró una importante asociación entre el tipo de relaciones familiares percibidas por el anciano y las variables edad, estado emocional y capacidad físicaThe present paper is aimed at characterizing the elderly person’s family relations on the basis of his/her perception and is carried out in the health area of "Reina" teaching polyclinics in Centro Habana municipality. One-hundred and forty-four elderly persons who live in multi-generation families were characterized by using the family relation test, Yesavage´s geriatric depression scale, the daily life instrumented activities scale and a questionnaire. The results were the predominance of little harmonic or non-harmonic relations, difficulties in defining the inter-generation limits, rigid family hierarchical structure and intolerant attitudes toward the characteristics and behaviours of the elderly people on the part of their families. Likewise, there was a substantial linking of the type of family relations perceived by the elderly and the age, emotional condition and physical capability variables

Nowadays, continuous monitoring is a mandatory issue for almost all industries worldwide. For example, as a part of the quality control process, a large amount of samples is tested in food and beverage industries. Also, as a result of public concern about environmental pollution an accurate and faster monitoring is demanded by current legislations (Rodriguez-Mozaz, Marco et al. 2004). Traditional monitoring has been carried out by chromatographic techniques, which offer high accuracy, sensitivity and selectivity even in complex samples. But, even the outstanding characteristics of chromatographic techniques a faster, cheaper and reliable monitoring is highly desirable for applications where chromatographic techniques are not well suited (i.e. field monitoring, testing large amount of samples) (Rodriguez-Mozaz, Lopez de Alda et al. 2007) (Salvador, Adrian et al. 2007) Some years ago, biosensors emerged as alternative tools for several monitoring applications involving the determination of a single analyte (i.e. toxin, biocide, metals) (Thevenot, Toth et al. 2001). However, as the number of analytes to monitor increase a multianalyte approach is now required. Usually, biosensors are designed to expose a high selectivity to a single analyte which makes difficult a multianalyte determination with a single device. Sensor arrays (i.e. sensors with different sensitivities and selectivities) have been proposed as an alternative to determinate several analytes with a single step (del Valle 2010). In the case of biosensors, arrays with different bioreceptors are integrated to achieve different selectivity and sensitivity to several analytes. But, since the higher order information provided by the biosensor array cannot be processed with the classical univariate approach a robust mathematical model is needed (Hierlemann and Gutierrez-Osuna 2008). In this sense, artificial neural networks have been successfully applied as multivariate calibration tool for such high order data to achieve a multianalyte determination(Bachmann, Leca et al. 2000) (Covaci, Sassolas et al. 2012) (Alonso, Istamboulie et al. 2012). In addition, artificial neural networks are able to model the nonlinearities found in sensor array providing a wider range of operation, even if the single devices do not provide conclusive information by themselves. For faster training, some authors have incorporated automatic flow injection systems to handle liquid samples(Gutes, Cespedes et al. 2007). The incorporation of flow systems, biosensor array and artificial neural networks to provide information has lead to new dedicated devices for automatic monitoring of pollutants (Valdes-Ramirez, Gutierrez et al. 2009, Crew, Lonsdale et al. 2011). These devices can be potentially used as monitoring tools in field applications providing continuous information of the analyzed samples. This chapter attention is focus on the use of biosensor array for pollutant detection, emphasizing the use of artificial neural network as a multivariate calibration tool for multianalyte determination. In the first part, a brief description of biosensors as a single analytical tool is presented. Then, a complete review of monitoring of pollutants with biosensor arrays and the corresponding neural network modeling is covered. Finally, some fully integrated devices are presented and their potential applications as monitoring tools are discussed.

Introducción: en el sistema público de salud, la población debería ser el centro del sistema y el profesional sanitario su principal activo; garantizar que el encuentro asistencial se realice bajo unas condiciones de calidad es fundamental en la organización y diseño de los sistemas sanitarios. Conocer la realidad de los Equipos de Atención Primaria (EAP) y las condiciones de trabajo de los pediatras de Atención Primaria (PAP) resulta imprescindible para poder ofrecer una mejor asistencia a nuestros pacientes. El objetivo es conocer las condiciones del lugar de trabajo y los medios y recursos disponibles, las cargas de trabajo, la autonomía de gestión y la conciliación de la vida familiar y laboral. Material y métodos: estudio observacional descriptivo mediante encuesta realizada on-line a PAP en España a través de la lista de distribución PEDIAP y de la lista de correo de la Asociación Española de Pediatría de Atención Primaria (AEPap) en diciembre de 2012. Resultados: recogidas 809 respuestas de todas las comunidades autónomas (CC. AA.) de un total de 6258 plazas de PAP. Un 40,6% opina que las condiciones de la consulta no permiten una correcta realización de su trabajo. El 50% no tiene acceso a las pruebas complementarias que considera necesarias. Ocho de cada diez dedican más del 75% de su jornada a labores exclusivamente asistenciales. Hasta un tercio de los pediatras tiene que asumir la consulta completa del compañero durante periodos prolongados por falta de cobertura con suplentes. Casi el 80% considera que existen condiciones que facilitan la conciliación de la vida familiar y laboral. Solo el 28% de los equipos tiene capacidad para autogestionar el presupuesto asignado a suplencias. Existen diferencias importantes para todos los ítems estudiados entre las distintas CC. AA. Conclusiones: las condiciones laborales de los PAP distan de cumplir unos requisitos que aseguren una correcta atención clínica. La escasa capacidad de participación en la gestión sitúa las posibilidades de mejora fuera de los PAP e incluso de los propios EAP.

Several of the adjuvants used in fish vaccines cause adhesions in internal organs when they are injected intraperitoneally. We describe the damage caused by vaccines containing different adjuvants in the turbot Scophthalmus maximus and show that internal adhesions can be greatly reduced by injecting the fish in a specific way. Injection of fish with the needle directed towards the anterior part of the peritoneal cavity induced formation of a single cell-vaccine mass (CVM) that became attached to the parietal peritoneum. However, injection of the fish with the needle pointing in the opposite direction generated many small CVM that became attached to the visceral and parietal peritoneum and in some cases caused internal adhesions. We describe the structural and cellular changes in the adjuvant-induced CVMs. The CVMs mainly comprised neutrophils and macrophages, although most of the former underwent apoptosis, which was particularly evident from day 3 post-injection. The apoptotic cells were phagocytosed by macrophages, which were the dominant cell type from the first days onwards. All of the vaccines induced angiogenesis in the area of contact between the CVM and the mesothelium. Vaccines containing oil-based adjuvants or microspheres induced the formation of granulomas in the CVM; however, no granulomas were observed in the CVM induced by vaccines containing aluminium hydroxide or Matrix-Q(®) as adjuvants. All of the vaccines induced strong migration of cells to the peritoneal cavity. Although some of these cells remained unattached in the peritoneal cavity, most of them formed part of the CVM. We also observed migration of the cells from the peritoneal cavity to lymphoid organs, indicating bidirectional traffic of cells between the inflamed areas and these organs.

Activation of the growth hormone (GH) secretagogue receptor (GHS-R) by synthetic GH releasing peptides (GHRP) or its endogenous ligand (Ghrelin) stimulates GH release. Though much is known about the signal transduction underlying short-term regulation, there is far less information on the mechanisms that produce long-term effects. In the current report, using an enzyme-linked immunosorbent assay for GH detection and whole-cell patch-clamp recordings, we assessed the long-term actions of such regulatory factors on voltage-activated Ca2+currents in bovine somatotropes (BS) separated on a Percoll gradient and detected by immunohistochemistry. After 24 h of treatment with Ghrelin (10 nM) or GHRP-6 (100 nM) enhanced BS secretory activity; GH secretion stimulated by GHS through the activation of GHS-R because treatment with the antagonist of GHS-R (D-Lys3-GHRP-6, 10 μM) blocked the GH secretion, and the effect was dose and time dependent (24, 48, and 72 h). GH secretion stimulated by GHRP-6 was abolished by nifedipine (0.5 μM), a blocker of L-type HVA Ca2+channels, and KN-62 (10 μM), an inhibitor of Ca2+/CaM-KII. After 72 h in culture, all recorded BS exhibited two main Ca2+currents: a low voltage-activated (LVA; T-type) and a high voltage-activated (HVA; mostly dihydropyridine-sensitive L-type) current. Interestingly, HVA and LVA channels were differentially upregulated by Ghrelin. Chronic treatment with the GHS induced a significant selective increase on the Ba2+current through HVA Ca2+channels, and caused only a small increase of currents through LVA channels. The stimulatory effect on HVA current density was accompanied by an augment in maximal conductance with no apparent changes in the kinetics and the voltage dependence of the Ca2+currents, suggesting an increase in the number of functional channels in the cell membrane. Lastly, in consistency with the functional data, quantitative real-time RT-PCR revealed transcripts encoding for the Cav1.2 and Cav1.3 pore-forming subunits of L-type channels. The treatment with Ghrelin significantly increased the Cav1.3 subunit expression, suggeting that the chronic stimulation of the GHS receptor with Ghrelin or GHRP-6 increases the number of voltage-gated Ca2+channels at the cell surface of BS.

The social historians of ends of the 20th century placed in the center of his worries new topics and approaches, between them, the problems linked with the social question called. It is defined as the set of social problems arisen as consequence of the industrialization, the urbanization, the immigration between those who were the conflicts of the work, the poverty, the marginality, the disease, that they returned the protagonism of subjects forgotten as the patients, the madmen, the delinquents between others. The diseases in the society, raise a new historical object of reflection that provides a window to the social reality. To analyze the trilogy disease - health- service of an integrated way is to know an aspect that explains the social problematics. The response to the social problems came from the civil society and from the State, arising institutions of social assistance that were acting in a combined way. The present article approaches the topic of the disease- health- service and the response to this problematics for the State during the period 1900-1940 in Córdoba, seeking to reconstruct how the disease allows us to show the conditions of material and cultural life where they emerged and the social process of constitution of the Social State and the social citizenship, from the continuities, changes and transformations that were demonstrating in the sanitary field.

article i nfo Microsporidia are a large diverse group of intracellular parasites now considered as fungi. They are particu- larly prevalent in fish and are recognized as important opportunistic parasites in humans. Although the mode of transmission of microsporidia has not been fully clarified, the consumption and manipulation of infected fish may be a risk factor for humans. Comparative analysis of rDNA sequence revealed that the microsporidians used in the present study had 99-100% identity with anglerfish microsporidians of the genus Spraguea and very low identity with microsporidians that infect humans. Microsporidian spores were exposed to different physical and chemical treatments: freezing at �20 °C for 24-78 h, heating at 60 °C for 5-15 min, microwaving at 700 W, 2.45 GHz for 15-60 s, and treatment with ethanol at concentra- tions of between 1 and 70% for 15 min. The viability of the spores after each treatment was evaluated by two methods: a) haemocytometer counts, measuring the extrusion of the polar filament in control and trea- ted spores, and b) a fluorometric method, testing the membrane integrity by propidium iodide exclusion. The results of both methods were concordant. Spores were inactivated by freezing at �20 °C for more than 48 h, by heating to 60 °C for 10 min and by microwaving at 750 W, for 20 s. Exposure to 70% ethanol for 15 min also inactivated microsporidian spores. The results suggest that both freezing and heating are effective treat- ments for destroying microsporidian spores in European white anglerfish, and that 70% ethanol could be used by fish processors to disinfect their hands and the utensils used in processing fish. The fluorometric method can be used as an alternative to haemocytometer counts in disinfection studies aimed at establishing strate- gies for inactivating and reducing the viability and the potential infectivity of microsporidians present in fish or in the environment.