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This paper presents a corpus-based analysis of printed eco-friendly car advertisements in English in line with the growing consumer interest in environmental issues and the development of green advertising. The aim of the research is threefold: 1) to unveil the content cognitive operations (for the purpose of this research, metonymy, metonymic chain, metaphoric amalgam and metaphor) underlying the ads and their modes of representation; 2) to examine the relationship between (i) these conceptual operations and the environmental claims made by advertisers, and (ii) the environmental claims made by advertisers and the text-image interaction. In this light, the paper yields two major findings: a) the cognitive operations underlying our corpus are usually rendered in the visual and verbal modes; b) the environmental claims underlying the ads correlate with the conceptual content and the text-image interplay. The conscious use of these mechanisms by advertisers can help the manner in which messages are interpreted. [ABSTRACT FROM AUTHOR]

Abstract Most studies of long-term air pollution exposure and children's respiratory health have been performed in urban locations with moderate pollution levels. We assessed the effect of outdoor nitrogen dioxide (NO 2), as a proxy for urban air pollution, on current asthma and lung function in Australia, a low-pollution setting. We undertook a national population-based cross-sectional study of children aged 7–11 years living in 12 Australian cities. We collected information on asthma symptoms from parents via questionnaire and measured children's lung function (forced expiratory volume in 1 s [FEV 1 ], forced vital capacity [FVC]) and fractional exhaled nitric oxide [Fe NO ]). We estimated recent NO 2 exposure (last 12 months) using monitors near each child's school, and used a satellite-based land-use regression (LUR) model to estimate NO 2 at each child's school and home. Our analysis comprised 2630 children, among whom the prevalence of current asthma was 14.9%. Mean (±SD) NO 2 exposure was 8.8 ppb (±3.2) and 8.8 ppb (±2.3) for monitor- and LUR-based estimates, respectively. Mean percent predicted post-bronchodilator FEV 1 and FVC were 101.7% (±10.5) and 98.8% (±10.5), respectively. The geometric mean Fe NO concentration was 9.4 ppb (±7.1). An IQR increase in NO 2 (4.0 ppb) was significantly associated with increased odds of having current asthma; odds ratios (ORs) were 1.24 (95% CI: 1.08, 1.43) and 1.54 (95% CI: 1.26, 1.87) for monitor- and LUR-based estimates, respectively. Increased NO 2 exposure was significantly associated with decreased percent predicted FEV 1 (−1.35 percentage points [95% CI: −2.21, −0.49]) and FVC (−1.19 percentage points [95% CI: −2.04, −0.35], and an increase in Fe NO of 71% (95% CI: 38%, 112%). Exposure to outdoor NO 2 was associated with adverse respiratory health effects in this population-based sample of Australian children. The relatively low NO 2 levels at which these effects were observed highlight the potential benefits of continuous exposure reduction. Highlights • We investigated outdoor NO 2 and children's respiratory health in Australia. • We found strong evidence of an association between NO 2 and current asthma. • We found evidence of an association between NO 2 and reduced lung function. • Urban air pollution, estimated by NO 2 , has adverse respiratory effects on children. [ABSTRACT FROM AUTHOR]

Hereditary ichthyosis affects skin keratinization or cornification; It manifested by dry, scaly, thick, hyperpigmented skin, fragile and sometimes blistering, which appears to touch her. "Tightness" of the eyelids and lips; problems with hair growth and psychomotor disturbances. It appears in childhood and remains for life, with mild disease. Signs and symptoms usually disappear during the summer, although there are severe forms. Acquired ichthyosis related to other diseases manifest at any age, either as a systemic disease or paraneoplastic syndrome. Hypothyroid patients suffering from skin disorders: diffuse hyperpigmentation, skin dry and coarse, and chronic urticaria. Generalized myxedema is the most common feature. Demonstrations associated include: weight gain, lethargy, weakness, loss of appetite, intolerance to cold, cold, pale and dry skin. Clinical case: 50 year old with congenital pulmonary stenosis. In June 2014 he referred drowsiness, fatigue, generalized edema, weight gain and weakness. Physical examination: blood pressure 90/60 mmHg, weight 76 kg, heart rate of 55 per minute; dry, hyperpigmented, thick, scaly, conaumento volume of thyroid lobes, skin RS RS CS expulsion lung, generalized hyporeflexia. Laboratory studies: 392.9 total cholesterol, triglycerides 346.7, T 3 Total 0.30 0.40 Free T3, T4 Total 10.7 free T4 1.01. HST over l00. The ultrasound showed changes thyroiditis goiter. The histopathological study reported: hyperkeratosis with reduced or absent, discrete to moderate surface hyperkeratosis, in partnership with a thin layer grained, grainy even absent; follicular involvement without inflammatory response. Treatment was initiated with levothyroxine. In March 2015 the symptoms disappeared; blood pressure of 110/70 mmHg, weight 73 kg, heart rate of 75 identified, and disappeared ichthyosis. Laboratory studies reported: T3 and total and free T4 within normal parameters; TSH only remained high (8.30). [ABSTRACT FROM AUTHOR]

Pericarditis can be of infectious, neoplastic and immunological origin or secondary to hypoparathyroidism, uremia and dialysis. The tamponade are common in neoplastic, tuberculous and uremic pericarditis and in myxedema and parasitic diseases. Most organisms causing purulent pericarditis are grampositive and few gramnegative. It is uncommon in adults, but when it occurs it has a high mortality, 40% in treated patients fatal if left untreated due to cardiac tamponade, toxicity and constriction. Klebsiella pneumoniae is an emerging pathogen with high nosocomial spread. Its risk factors for appearance are: prolonged hospitalizations, prior administration of antimicrobials, immunosuppression, chronic diseases, excessive alcohol consumption, rheumatoid arthritis, heart surgery and chest trauma. Purulent pericarditis is usually a complication from infection of contiguous tissue or hematogenous spread. The picture is of an acute and fulminant infection. Pericardiocentesis should be performed promptly with a mortality of 8%, preferable pericardial window. This paper reports the case of a 52-year-old female patient, with mother and grandmother with breast cancer, nubile, with breast cancer, left radical mastectomy five years ago, followed by radiotherapy and chemotherapy, one month before last scheme, with bony, liver, axillary and neck metastases. Patient assisted with gastroenteritis, dyspnea, orthopnea, edema of lower limbs, cough, myalgia, arthralgia, and malaise. Multinodular tele-ray shows diffuse bilateral infiltrates and pleural effusion with cardiac silhouette image of "bottle". By bilateral transthoracic echocardiogram pleural effusion and tamponade were detected, pericardial window was performed draining 1,100 cc of serosanguineous fluid. Pathology study did not showed tumor cells but did Klebsiella, which was also found in uro and blood culture. Patient showed clinical improvement with treatment and was discharged. [ABSTRACT FROM AUTHOR]

Objective: To observe the safety of the new oral anticoagulants compared with vitamin K inhibitors. Patients and method: An observational and prospective study was done with selected patients with non-valvular atrial fibrillation attended at Zacatecas General Hospital from April 2012 to May 2013. To choose antithrombotic or anticoagulant patients were evaluated with CHA2DS2- VASc: Score l aspirin, score 2 or more: dabigatran, rivaroxaban or warfarin, by systematic selection. EHRA classification was employed. Atrial fibrillation was classified in: paroxysmal, persistent, persistent, prolonged or permanent. Endpoints were: stroke, systemic embolism and mortality. A safety criterion was severe bleeding. Results: Thirty-seven patients with non-valvular atrial fibrillation were included, 23 women and 14 men; 97.2% over 50 years; 33 with permanent atrial fibrillation. Two had CHA2DS2-VASc score of 1 and were treated with acetylsalicylic acid, 35 with a score of 2 or more were given vitamin K inhibitors (n=24), dabigatran (n=6) and rivaroxaban (n=5). Conclusions: Complications were: stroke in 10, hemorrhagic diathesis in 9 and mortality in 2 (5.1%). The incidence of stroke (27%) and bleeding diathesis (24%) is high compared with other reports (1.6% and 3.3%, respectively) and are caused by an inadequate anticoagulation. Based on the evaluation criteria and safety criteria, the new oral anticoagulants showed better results than vitamin K inhibitors, in absolute numbers but without statistical significance; these results allow the introduction of a new treatment. [ABSTRACT FROM AUTHOR]

Myelosuppression secondary to chemotherapy remains a serious adverse effect of cancer therapy that causes high morbidity and mortality. Several current European and American guidelines recommend consideration of primary prophylaxis with colony-stimulating factors (CSFs) when the risk of febrile neutropenia is higher than 20 %. The main factors associated with a high risk of febrile neutropenia include the chemotherapy regimen, tumor type, and patient-related factors such as old age and/or comorbidities. The purpose of this paper is to summarize the most relevant clinical trials and updated recommendations of the main guidelines on the role of granulocyte colony-stimulating factors (G-CSFs) in febrile neutropenia, examining whether the combination of G-CSF with chemotherapy improves overall survival. Future directions for G-CSF use are also discussed. [ABSTRACT FROM AUTHOR]

The atrioventricular block is a delay or interruption of the electrical impulse from the sinusal node, to level of the auricle-ventricular nodule. This is a congenital disease affecting 1 of every 20,000-25,000 born alive. It is secondary to an abnormal embryonic development of the node AV, and proximal branches of the bundle of His, associated with structural cardiac abnormalities or without structural malformations, for maternal isoimmunization with antibodies that cause immunological irreversible damage in the fetal heart tissue, by inflammation and subsequent fibrosis. Detected by fetal Doppler or echocardiography, between 16 and 30 weeks of gestation for persistent fetal bradycardia, with congestive heart failure or fetal dropsy with mortality of 20%. Factors of worst prognosis are: Coexistence with cardiovascular malformations, heart failure, ventricular frequency below 50 per minute during sleep, bradycardia less than 30 per minute, pacemaker under or changing and long QT. Medical treatment or pacemaker in newborns and breastfed infants is indicated with cardiac insufficiency and ventricular frequency below 50 per minute. In children and asymptomatic teenagers, follow-up with monitoring and echocardiography is recommended. Because our patient did not have them, we decided only to follow him with monthly echocardiogram and Holter every six months, unless there were data of low cardiac output. [ABSTRACT FROM AUTHOR]

Investigators have the responsibility to ensure that prospective participants are fully informed about a research protocol prior to consenting to participate, yet many researchers face challenges when obtaining consent, since the majority of the general population has limited or no familiarity with research studies. These challenges are further magnified when obtaining consent from individuals with low literacy levels and who speak languages other than English. In this article we present findings from a qualitative study conducted with Spanish-speaking individuals with low-literacy designed to refine the Agency for Healthcare Research and Quality's Informed Consent and Authorization Toolkit for Minimal Risk Research. Findings from this study indicate that familiarity with providing informed consent and authorization for research or the experience of being a research participant appear to play key roles in an individual's ability to understand the consent and authorization process. While the text of the consent and authorization documents can be simplified using plain language principles, comprehension of several fundamental ideas such as risk and privacy need to be safeguarded with a consent process that confirms comprehension. Recommendations are provided to address the informational needs of individuals with low literacy levels and limited or no experience with research participation. [ABSTRACT FROM AUTHOR]

The aim of chemotherapy is the destruction of tumor cells, is classified as adjuvant, neoadjuvant or induction, concomitant with radiation therapy, palliative monotherapy, chemotherapy, combined and sequential. The main drugs: alkylating agents, platinum agents, antimetabolites, topoisomerase inhibitors, microtubule inhibitors, and miscellaneous. Secondary effects on the heart are cardiomyopathies chemotherapy induce, acute cardiotoxicity, and chronic cardiotoxicity. Late cardiotoxicity. Cardiac arrhythmias, ischemic heart disease and second neoplasic, particularly hematologic (leukemia, lymphomas) and solid tumors that evolve with increased morbility and mortality. CASE REPORT: Female of 36 years old. Right breast Cancer in 2005 received neoadjuvant chemotherapy of 4 cycles and other 4 adjuvant cycles. Radical Mastectomy and Axillary Radical Dissection, Radiotherapy, complete breast cycle. Subsequently, hormone therapy until October 2009. In December 2009 tumor exeresis in feb.2010 left buttock, with reports of malignancy. Removal of buttock was on August 2010, with a diagnosis of pleomorphic rhabdomyosarcoma, with treatment adjuvant radiotherapy (51.5 Gy) and adjuvant chemotherapy with cisplatin and doxorubicin, 3 cycles. In March, 2011 goes to the fourth cycle, dyspnoea 4 days of evolution of small efforts, and paroxysmal nocturnal chest pain, oppressive, 6 hours, after walking home and a productive cough. E.F: ta 60/30, fc 130 L x min, did not tolerate lying, pale, diaphoretic, thready pulse, yugular plethora, fc 150 x min gallop. Electrocardiogram: qs in v1, embryonic r in v2- v3. ECOTT: FEVI 28%, generalized hypokinesia LV septal wall thinning. Was diagnosed heart insufficiency (according to Framingham criteria) and septal infarct. This is due to the increased survival of cancer and side effects of treatment, which should apply in these patients Routine ECG, ECOTT and so we can start early management and prevent or postpone these late stages. [ABSTRACT FROM AUTHOR]

Objective: Many children with asthma do not take medications as prescribed. We studied parents of children with asthma to define patterns of non-concordance between families' use of asthma controller medications and clinicians' recommendations, examine parents' explanatory models (EMs) of asthma, and describe relationships between patterns of non-concordance and EM.Methods: Qualitative study using semi-structured interviews with parents of children with persistent asthma. Grounded theory analysis identified recurrent themes and relationships between reported medication use, EMs, and other factors.Results: Twelve of the 37 parents reported non-concordance with providers' recommendations. Three types of non-concordance were identified: unintentional--parents believed they were following recommendations; unplanned--parents reported intending to give controller medications but could not; and intentional--parents stated giving medication was the wrong course of action. Analysis revealed two EMs of asthma: chronic--parents believed their child always has asthma; and intermittent--parents believed asthma was a problem their child sometimes developed.Conclusions: Concordance or non-concordance with recommended use of medications were related to EM's and family context and took on three different patterns associated with medication underuse.Practice Implications: Efforts to reduce medication underuse in children with asthma may be optimized by identifying different types of non-concordance and tailoring interventions accordingly. [ABSTRACT FROM AUTHOR]

To assess mental health status among Latinos, culturally and linguistically appropriate instruments are needed. The purpose of this study was to assess psychometric properties and sensitivity of the Spanish revised Behavior and Symptom Identification Scale (BASIS-24), a self-report mental health assessment instrument first developed and validated in English. The Spanish translation was field tested among Spanish-speaking recipients of inpatient (N = 283) or outpatient (N = 311) mental health services in Massachusetts, Puerto Rico, and California. BASIS-24 was completed within 72 h of admission and up to 48 h before discharge (for inpatients) or at intake and 30-60 days later for outpatients. Confirmatory factor analysis indicated adequate fit for the model obtained from the English instrument. Internal consistency reliability exceeded 0.70 for five of the six factors. Concurrent and discriminant validity were partially supported. Improvement following treatment was statistically significant, with small to moderate effect sizes. [ABSTRACT FROM AUTHOR]

Mosquito-borne viruses are emerging or re-emerging globally, afflicting millions of people around the world. Aedes aegypti, the yellow fever mosquito, is the principal vector of dengue, Zika, and chikungunya viruses, and has well-established populations across tropical and subtropical urban areas of the Americas, including the southern United States. While intense arboviral epidemics have occurred in Mexico and further south in the Americas, local transmission in the United States has been minimal. Here, we study Ae. aegypti and Culex quinquefasciatus host feeding patterns and vertebrate host communities in residential environments of South Texas to identify host-utilization relative to availability. Only 31% of Ae. aegypti blood meals were derived from humans, while 50% were from dogs and 19% from other wild and domestic animals. In Cx. quinquefasciatus, 67% of blood meals were derived from chicken, 22% came from dogs, 9% from various wild avian species, and 2% from other mammals including one human, one cat, and one pig. We developed a model for the reproductive number, R0, for Zika virus (ZIKV) in South Texas relative to northern Mexico using human disease data from Tamaulipas, Mexico. We show that ZIKV R0 in South Texas communities could be greater than one if the risk of human exposure to Ae. aegypti bites in these communities is at least 60% that of Northern Mexico communities. The high utilization of non-human vertebrates and low risk of human exposure in South Texas diminishes the outbreak potential for human-amplified urban arboviruses transmitted by Ae. aegypti. [ABSTRACT FROM AUTHOR]