Search

Current teaching and training methods for surgical techniques in the pediatric population involve artificial models (manikins), animals or adult human cadavers embalmed using various techniques. We found no references in the literature concerning the use of the Thiel method in the pediatric population. The aim of this study, therefore, was to assess the viability of using pediatric human cadavers embalmed through Thiel's technique and to compare them with standard pediatric manikins. After donation of a 24-week stillborn, the Thiel technique was carried out for fixation following the usual protocol. A video recording with eye-tracking glasses was used to perform an examination, and techniques. The same procedures were conducted on a pediatric manikin. Medical students, medical residents and physicians were asked to respond to questions in an online survey after being shown the video. A total of 92 responses were obtained. The Thiel-embalmed stillborn was assessed as superior to the manikin in all items. Our study confirmed that this technique is feasible even with extremely small donors. The value of this form of preservation for medical training is not widely known though it is receiving increasing interest. Our results show that Thiel fixation in pediatrics is clearly more highly valued than a manikin and offers great potential. This innovative application of the Thiel method in the pediatric population is technically possible. It poses no additional difficulties and is very positively assessed for undergraduate and postgraduate teaching.

Introduction. Multiple sclerosis is a chronic autoimmune, inflammatory and neurodegenerative disease of the central nervous system and the most common non-traumatic disabling neurological disease in young adults. In the latest decades, multiple sclerosis is increasing worldwide, especially in women. The latitudinal distribution has been progressively attenuated. Aim. To review the epidemiological studies of multiple sclerosis in Spain to verify if this worldwide trend also occurs in Spain. Development. We searched PubMed and Teseo databases using the search terms 'epidemiology', 'prevalence', 'incidence', 'multiple sclerosis' and 'Spain'. We selected articles published in Spanish and English between 1968 and 2018. Conclusions. Recent epidemiological studies confirm that Spain is a medium-high risk area for MS. The prevalence of MS has increased significantly throughout Spain in the latest years, especially in women, and recent studies show prevalence as high as 80-180 cases per 100,000.

OBJECTIVE: Tobii glasses can record corneal infrared light reflection to track pupil position and to map gaze focusing in the video recording. Eye tracking has been proposed for use in training and coaching as a visually guided control interface. The aim of our study was to test the potential use of these glasses in various situations: explanations of anatomical structures on tablet-type electronic devices, explanations of anatomical models and dissected cadavers, and during the prosection thereof. An additional aim of the study was to test the use of the glasses during laparoscopies performed on Thiel-embalmed cadavers (that allows pneumoinsufflation and exact reproduction of the laparoscopic surgical technique). The device was also tried out in actual surgery (both laparoscopy and open surgery). DESIGN: We performed a pilot study using the Tobii glasses. SETTING: Dissection room at our School of Medicine and in the operating room at our Hospital. PARTICIPANTS: To evaluate usefulness, a survey was designed for use among students, instructors, and practicing physicians. RESULTS: The results were satisfactory, with the usefulness of this tool supported by more than 80% positive responses to most questions. There was no inconvenience for surgeons and that patient safety was ensured in the real laparoscopy. CONCLUSION: To our knowledge, this is the first publication to demonstrate the usefulness of eye tracking in practical instruction of human anatomy, as well as in teaching clinical anatomy and surgical techniques in the dissection and operating rooms. (C) 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

[ES] Se describe un proyecto experimental en neuroantropología que combina el trabajo de campo etnográfico con la Resonancia Magnético funcional (RMf) a un grupo de 10 ecuatorianos (grupo experimental α) y a 10 individuos españoles (grupo control β). El objetivo es investigar las relaciones entre los contextos socioculturales de producción de sentido y significado –significación– que son el fundamento de la identidad, y los procesos neurobiológicos subyacentes, para entender mejor la interrelación cerebro cultura. El artículo explica primero la relación entre el sustrato neuronal (cerebro) y el entorno sociocultural (cultura) en el proceso de significación considerando el contexto de producción y la intencionalidad; después detalla los pasos seguidos explicando los retos y obstáculos de orden metodológico; y, finalmente, se presentan indicios que sugieren nuevas líneas de investigación. La propuesta subraya el valor de técnicas cualitativas como la observación participante, la entrevista individual en profundidad y las estructuradas en grupo, en combinación con la estadística de frecuencias, los cuestionarios, la potencia analítica de los programas de análisis de datos cualitativos asistido por ordenador (CAQDAS), los test neuropsicológicos y las neuroimágenes. Los resultados provisionales indican que se producen activaciones cerebrales distintivas en los grupos experimental y de control dependiendo del contenido de los estímulos visuales presentados., [EN] The article describes a neuroanthropological experiment that combines ethnographic fieldwork along with functional Magnetic Resonance Imaging (fMRI) among 10 Ecuadorian (experimental group α) and 10 Spanish (control group β) individuals. The objective of the research is to study the relationship between the sociocultural contexts of sense and meaning production, as the base of identity, and the underlying neurobiological processes, in order to understand better the interrelation brainculture. First, the article approaches the relationships between the neural basis (brain) and the sociocultural environment (culture) during the process of meaning production, while considering the role of the context of production and intentionality. Then it details the methodological phases and steps, and explains the challenges faced. Finally, it presents the provisional results that suggest new research lines in the field. The methodology highlights the value of qualitative techniques such as participant observation, in-depth individual interviews and focus group, combined with statistics, questionnaires, the analytical strength of computer assisted qualitative data analysis software (CAQDAS), neuropsychological tests and neuroimaging. The provisional results hint at different neural activations between the groups depending on the content of the stimuli displayed., El proyecto de investigación ha sido financiado mediante un convenio de colaboración Universitas Miguel Hernández-Bancaixa en 2011.

BackgroundHypertrophic cardiomyopathy (HCM) is characterized by inappropriate hypertrophy, myocyte disarray and increased interstitial fibrosis. The tumour necrosis factor-like weak inducer of apoptosis (TWEAK) is a cell surface cytokine with biological activities including stimulation of cell growth, induction of inflammatory cytokines and stimulation of apoptosis. There are controversial data about the potential role of TWEAK in different cardiovascular pathologies. NT-proBNP is an established biomarker of myocardial wall stress, associated with poor functional class in HCM. We hypothesized that effort capacity in patients with HCM could be related to serum levels of these biomarkers. Materials and methodsWe included 40 haemodynamic stable HCM patients and 53 healthy controls with similar sex and age. We studied exercise capacity by maximal oxygen consumption in a limited treadmill exercise test. TWEAK and NT-proBNP were assayed by ELISA method and automated Elecsys (R) platform, respectively. We obtained 46 samples of myocardial tissues by septal myectomy in patients with HCM and evaluated myocardial fibrosis, immunoreaction with TWEAK antibody and apoptosis with TUNEL assay. ResultsWe found raised TWEAK and NT-proBNP serum levels in patients when compared with control levels (both P

In the last decades, several studies have demonstrated and given a valuable insight about the existence of a global climate change. Even though the existence of a high regional heterogeneity about the level and temporality of climate change impacts, the trends of the potential future changes on the temperature and precipitation patterns are better known and consequently the potential impacts on the Biosphere and the Cryosphere. In this context, mountain regions have been identified as highly vulnerable areas to the effects of climate change and especially interesting areas for the detection and assessment of the potential changes and impacts. Moreover, in the last few decades, winter tourism, highly dependent on weather and snow availability, has become one of the main economic activities and source of local development in many mountain regions around the world. The Pyrenees, one of the most important winter tourism areas in Europe after the Alps, is a clear example of this pattern. The aim of the NIVO PYR project, an international research project in the framework of the Working Community of the Pyrenees (CTP), is to analyze the effects of the climate change on the winter tourism, and especially alpine ski tourism, in the Pyrenees. In order to achieve this objective the project intended to joint the current knowledge about the effects of climate change on temperatures, precipitations, snow cover and skiers behavior in the Pyrenees and develop for first time objective and accurate results for this area. To achieve this goal several methods have been used including, historical analysis of climatical series evolution, assessment of different future climate change scenarios for the Pyrenees, modeling future snowpack based on surface energy balance models and agent based modeling for coupling physical and socioeconomic parameters. One of the main results of this project was the identification of different ski resorts profiles depending on their vulnerability to climate change. Three different groups were identified. The first group includes the high vulnerable ski resorts, effected both by a mid and a high-climate change scenario. The second group, includes the low vulnerable ski resorts, affected by a high-climate change scenario but able to be viable with technical adaptation measures in a mid-climate change scenario. Finally, the group of resilient ski resorts includes the geographically and socioeconomically privileged compared to the rest of Pyrenean ski resorts. These ski resorts would be viable both in a mid and a high-climate change scenario just applying technical adaptation strategies., En los últimos años multitud de estudios han evidenciado y corroborado la existencia de un cambio climático global. A pesar de la existencia de una gran heterogeneidad regional en el grado y la temporalidad de los posibles impactos del cambio climático, cada vez se conocen mejor cuales pueden ser las tendencias futuras sobre posibles cambios en regímenes de temperatura y precipitaciones y, por lo tanto, en otros impactos indirectos sobre la Biosfera o la Criosfera. En este contexto, las áreas de montaña han sido identificadas como regiones especialmente vulnerables a los efectos del cambio climático y como zonas de gran interés para la detección y evaluación de los posibles impactos. Por otro lado, en las últimas décadas, el turismo de invierno, altamente sensible a los cambios en la meteorología y la disponibilidad de nieve, se ha convertido en una de las principales actividades económicas en muchas zonas de montaña y ha jugado un papel clave y fundamental como fuente de ingresos y desarrollo local. Un claro ejemplo es el caso de los Pirineos, una de las regiones europeas más importantes en lo que se refiere a turismo de invierno después de los Alpes. La motivación principal del proyecto NIVOPYR, proyecto de investigación multinacional en el marco de la Comunidad de Trabajo de los Pirineos (CTP), es evaluar la posible influencia del cambio climático en la evolución del turismo de nieve, y más específicamente el esquí alpino, en esta región. Así, se han realizado diferentes tareas orientadas a integrar el conocimiento ya existente en los patrones presentes y futuros de las temperaturas, precipitaciones, cubierta de nieve y comportamiento de los esquiadores, desarrollar metodologías de análisis y obtener por primera vez datos objetivos para la región Pirenaica. De este modo, se ha obtenido tres perfiles diferentes de estaciones de esquí dependiendo de su vulnerabilidad frente al cambio climático. Un primer grupo de estaciones, identificado como altamente vulnerables, se vería afectado tanto por un escenario de cambio climático medio como por uno más intensivo y, por lo tanto, deberían contemplar la aplicación de medidas de adaptación estructurales, como una mayor desestacionalización y diversificación de su actividad turística. Las estaciones del segundo grupo, consideradas de climábaja vulnerabilidad, podrían seguir operando con medidas de adaptación técnicas bajo un escenario de cambio climático medio, pero no bajo un escenario de cambio climático más intenso. Finalmente, el tercer grupo, engloba las estaciones consideradas como resilientes. Estas estaciones, debido a una situación geográfica y socioeconómica privilegiada frente al resto de estaciones del Pirineo, se verían poco afectadas tanto por un escenario medio de cambio climático como por uno más intenso.

Phthalic acid and phthalate esters are of growing interest due to their significant usage and potential toxicity. Polyethylene terephthalate (PET) and glass are both widely used materials for bottled drinking water. In this study, phthalic acid (PhA), bis(2-ethylhexyl) phthalate (DEHP), dimethyl phthalate (DMP), diethyl phthalate (DEP), diisobutyl phthalate (DiisoBP) and dibutyl phthalate (DBP) were analysed in a large number of Italian bottled water samples. These samples showed different concentrations of phthalates are nearly 20 times higher in samples bottled in PET than those from glass bottles with total levels of phthalates of 3.52 and 0.19 microg l(-1), respectively. However, the observed levels do not represent a significant exposure pathway when considering the US Environmental Protection Agency (USEPA) reference dose (an estimate of a daily oral exposure to the human population, including sensitive subgroups, that is likely to be without an appreciable risk of deleterious effects during a lifetime). In addition, no significant correlation was found between the phthalate concentrations and the physicochemical properties of the different water samples, apart from the still/sparkling water parameter for the PET samples. In this instance, slightly higher concentrations were observed for the PET bottled still water samples than for the sparkling water samples, although no explanation has been found yet.

In this work, a methodology for the determination of total mercury in human hair is presented. This methodology is an improvement of a previous technique which has been reported by Chen et al. in 2002. This previous work was based on an acid digestion, C, cartridge clean-up, a 2,3-dimercaptopropane-1-sulfonate complexing agent, solid phase extraction and a graphite furnace atomic absorption spectrophotometric determination. In the present study, the complexing agent has been replaced by the ammonium pyrrolidine dithiocarbamate followed by a liquid-liquid extraction and the clean-up has been avoided in order to obtain a less expensive and less time consuming methodology.

International audience

In this work, a methodology for the determination of total mercury in human hair is presented. This methodology is an improvement of a previous technique which has been reported by Chen et al. in 2002. This previous work was based on an acid digestion, C, cartridge clean-up, a 2,3-dimercaptopropane-1-sulfonate complexing agent, solid phase extraction and a graphite furnace atomic absorption spectrophotometric determination. In the present study, the complexing agent has been replaced by the ammonium pyrrolidine dithiocarbamate followed by a liquid-liquid extraction and the clean-up has been avoided in order to obtain a less expensive and less time consuming methodology., Journal of Preventive Medicine and Hygiene, Vol 48, No 2 (2007)