Este trabajo intenta explorar la construcción de una de las imágenes que se tiene sobre la Reforma Universitaria a poco tiempo de sus acontecimientos, una imagen que intenta potenciar el carácter ...revolucionario de los sucesos de Córdoba de 1918. Para ello, concentraremos nuestra atención en la producción de Julio V. González, unos de los protagonistas que postularon la necesidad de expandir el desconecto de una nueva generación de universitarios fuera del marco de la Universidad. Hijo de Joaquín V. González, unos de los líderes modernista de la generación del 80, Julio V. González participó desde el inicio en la Reforma Universitaria. En 1919 se convirtió en el presidente más joven de la FUA. Y más tarde escribió trilogía donde teorizo sobre la reforma. Iniciada con La revolución universitaria de 1922, a la cual le siguieron La reforma universitaria de 1927) y La emancipación universitaria de 1929. El objetivo de este trabajo es analizar la narración de Julio V. González de los hechos y principios de las Reforma del 18, en busca de encontrar sus particularidades. De esta forma, focalizaremos nuestro estudio en la interpretación de los antecedentes históricos de la Reforma señalados establecidos por él (advenimiento del radicalismo, I Guerra Mundial y la revolución rusa), como así también, de la valoración del uso de la violencia en su primer obra, La revolución universitaria de 1922.
RESUMEN El contenido total de un nutriente en el suelo es importante para conocer la fertilidad potencial para la nutrición vegetal y constituye una información básica en estudios ambientales y ...edafogenéticos. El objetivo de este trabajo fue determinar el contenido «pseudototal» de Cu, Zn, Fe y Mn en suelos de la llanura chaco-pampeana de Córdoba, Argentina, mediante una extracción multielemental con HNO3 4 M, pudiendo ser utilizado como aproximación del fondo geoquímico y de línea geoquímica de referencia según se analicen los datos de muestras superficiales y subsuperficiales o superficiales respectivamente. Estos datos se relacionaron con atributos edáficos de importancia agronómica: carbono orgánico, acidez, salinidad y carbonatos. Los contenidos promedios obtenidos fueron: 11,3 a 19,2 mg Cu kg-¹; 29,4 a 61,5 mg Zn kg-¹; 285 a 626 mg Mn kg-¹ y 9 a 19,9 g Fe kg-¹ en la profundidad 0-60 cm de los suelos de la llanura chaco-pampeana de Córdoba (Argentina) y están dentro del rango de valores de referencia a escala mundial, con los valores menores en los suelos de textura más gruesa. Para el suelo superficial (0-20 cm), los valores promedio fueron de 15,7 a 17,7 mg Cu kg-¹, 53,5 a 56,5 mg Zn kg-¹, 548 a 564 mg Mn kg-¹ y 15,8 a 16,¹ g Fe kg-¹ en suelos loéssicos y limo-loéssicos y de 11,9 mg Cu kg-¹ (DSt: 2,8); 34,6 mg Zn kg-¹ (DSt: 8); 309 mg Mn kg-¹ (DSt: 98) y 11,9 g Fe kg-¹ (DSt: 3,2) en suelos franco-arenosos. Las diferencias texturales entre las regiones de suelos loéssicos y arenosos se tradujeron en valores de fondo geoquímico diferentes para los cuatro elementos estudiados, con menores contenidos en los suelos de textura más gruesa. El análisis de regresión múltiple incluyó a Fe y Mn como las principales variables explicativas de los cuatro elementos en todas las profundidades, relacionado con la alta afinidad existente entre los metales de transición, con tendencia a coprecipitar como óxidos de baja cristalinidad. El carbono orgánico en superficie como segunda variable en la mayoría de los modelos para los cuatro elementos confirma la importancia de la materia orgánica como fuente de estos microelementos.
Pain management is a critical component of comprehensive postsurgical care, as it influences patient safety and outcomes, and inadequate control has been associated with the development of chronic ...pain syndromes. Despite recent improvements, the management of postoperative pain following total knee arthroplasty (TKA) remains a challenge. The use of opioid-sparing, multimodal analgesic regimens has broad support, but there is a paucity of high-quality evidence regarding optimal postoperative protocols and novel approaches are needed. Dextromethorphan stands out among both well-studied and emerging pharmacological adjuncts for postoperative pain due its robust safety profile and unique pharmacology. The purpose of this study is to evaluate the efficacy of multi-dose dextromethorphan for postoperative pain control following TKA.
This is a single-center, multi-dose, randomized, double-blinded, placebo-controlled trial. A total of 160 participants will be randomized 1:1 to receive either 60 mg oral dextromethorphan hydrobromide preoperatively, as well as 30 mg 8 h and 16 h postoperatively, or matching placebo. Outcome data will be obtained at baseline, during the first 48 h, and the first two follow-up visits. The primary outcome measure will be total opioid consumption at 24 h postoperatively. Secondary outcomes related to pain, function, and quality of life will be evaluated using standard pain scales, the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS, JR) questionnaire, the Patient-Reported Outcomes Measurement Information System (PROMIS-29) questionnaire, and clinical anchors.
This study has a number of strengths including adequate power, a randomized controlled design, and an evidence-based dosing schedule. As such, it will provide the most robust evidence to date on dextromethorphan utilization for postoperative pain control following TKA. Limitations include not obtaining serum samples for pharmacokinetic analysis and the single-center study design.
This trial has been registered on the National Institute of Health's ClinicalTrials.gov (NCT number: NCT05278494). Registered on March 14, 2022.
To determine the prevalence of children with complex chronic conditions in PICUs in Argentina. To describe the demographic profile, clinical course and outcomes in PICU of children with complex ...chronic condition in comparison to previously healthy children.
Prospective, observational multicenter study.
Nineteen PICUs located in Argentina belonging to public and private institutions.
All children admitted to the participating PICUs between March 1, 2015, and February 28, 2016.
None.
We analyzed 3,483 PICU admissions. The prevalence of complex chronic condition was 48.06% (95% CI, 46.39-49.72). Cardiovascular complex chronic condition was predominant (22.24% 421/1,893), followed by neuromuscular complex chronic condition (18.75% 355/1,893) and malignant disease 17.7% (335/1,893). Technologic dependence was present in 22.22% of the patients (372 of 1,674). Predominant admission diagnosis was postoperative (36.6%) and respiratory disease (28.32%). Children with complex chronic condition had higher mortality than previously healthy patients (odds ratio, 2.74; 95% CI, 2.01-3.73). The risk of prolonged stay (≥ 26 d) was also higher (odds ratio, 1.44; 95% CI, 1.10-1.89). Rate utilization of the following devices was higher in patients with complex chronic condition: mechanical ventilation (odds ratio, 1.35; 95% CI, 1.12-1.63), central venous catheter (odds ratio, 1.24; 95% CI, 1.04-1.48), and arterial monitoring (odds ratio, 1.33; 95% CI, 1.09-1.63).
We observed a high prevalence of patients with complex chronic condition in this sample of argentine PICUs. These patients presented higher mortality and resource use than previously healthy children. This information is valuable to understand the impact that patients with complex chronic condition have on PICU performance and enables proper planning of care.
Este trabajo intenta explorar la construcción de una de las imágenes que se tiene sobre la Reforma Universitaria a poco tiempo de sus acontecimientos, una imagen que intenta potenciar el carácter ...revolucionario de los sucesos de Córdoba de 1918. Para ello, concentraremos nuestra atención en la producción de Julio V. González, unos de los protagonistas que postularon la necesidad de expandir el desconecto de una nueva generación de universitarios fuera del marco de la Universidad. Hijo de Joaquín V. González, unos de los líderes modernista de la generación del 80, Julio V. González participó desde el inicio en la Reforma Universitaria. En 1919 se convirtió en el presidente más joven de la FUA. Y más tarde escribió trilogía donde teorizó sobre la reforma. Iniciada con La revolución universitaria de 1922, a la cual le siguieron La reforma universitaria de 1927 y La emancipación universitaria de 1929. El objetivo de este trabajo es analizar la narración de Julio V. González de los hechos y principios de las Reforma del 18, en busca de encontrar sus particularidades. De esta forma, focalizaremos nuestro estudio en la interpretación de los antecedentes históricos de la Reforma señalados establecidos por él (advenimiento del radicalismo, I Guerra Mundial y la revolución rusa), como así también, de la valoración del uso de la violencia en su primer obra, La revolución universitaria de 1922.
This work tries to explore the construction of one of the images that one has about the University Reform shortly after its events, an image that tries to enhance the revolutionary character of the events of Córdoba in 1918. For this, we will concentrate our attention on the production by Julio V. González, one of the protagonists who postulated the need to expand the disconnection of a new generation of university students outside the framework of the University. Son of Joaquín V. González, one of the modernist leaders of the generation of 80, Julio V. González participated from the beginning in the University Reform. In 1919 he became the youngest president of the FUA. And later he wrote a trilogy where I theorize about the reform. Initiated with the university revolution of 1922, which was followed by the university reform of 1927) and the university emancipation of 1929. The objective of this work is toanalyze the narration of Julio V. González of the facts and principles of the Reformation of 18, in search of finding its particularities. In this way, we will focus our study on the interpretation of the historical background of the Reformation established by him (advent of radicalism, World War I and the Russian Revolution), as well as the evaluation of the use of violence in his first work, The university revolution of 1922.
To assess the performance of the Pediatric Index of Mortality 3 score in a population of children admitted to PICUs in Argentina.
Prospective, national, multicenter study.
Forty-nine PICUs located in ...Argentina belonging to public and private institutions.
All children between 1 month and 16 years old admitted to the participating PICUs between May 15, 2016, and February 15, 2017.
None.
A total of 6,602 patients were enrolled in the study. The observed mortality was 8% (531/6,602), whereas mortality predicted by Pediatric Index of Mortality 3 was 6.16% (407 deaths). The standardized mortality rate was 1.3 (95% CI, 1.20-1.42). The area under the receiver operating characteristic curve was 0.83 (95% CI, 0.82-0.85). The Hosmer-Lemeshow test showed that the difference between the mortality observed and the mortality predicted by Pediatric Index of Mortality 3 was statistically significant (χ, 135.63; p < 0.001).
The Pediatric Index of Mortality 3 score adequately discriminated patients who died from those who survived in our population. However, the observed mortality was higher than predicted by the score. The use of an updated instrument such as Pediatric Index of Mortality 3 will allow an actual comparison between pediatric intensive care provided in the country and care provided internationally. This might also allow future planning of pediatric intensive care services in Argentina.
Abstract Purpose The purpose of this study is to asses the performance of the Pediatric Index of Mortality 2 (PIM2) score in pediatric intensive care units (PICUs) in Latin America. Materials and ...methods This is a prospective, observational, multicenter study. We included patients aged 1 month to 16 years old admitted consecutively during 1 year to 34 PICUs in 9 Latin American countries. Discrimination and calibration tests were performed to validate the performance of PIM2 in the entire sample and in different subgroups. Results A total of 7391 patients were analyzed. Pediatric Index of Mortality 2 predicted 573 deaths, whereas the observed deaths were 663 ( P < .001). The area under the receiver operating characteristic curve for the entire population was 0.817 (95% confidence interval, 0.808-0.825). The score showed good discrimination. Instead, calibration was inadequate. The difference between observed and predicted deaths for the entire population and across different risk intervals was statistically significant ( χ2 = 121.87; df = 8; P < .001). Pediatric Index of Mortality 2 did not predict mortality correctly in different diagnostic categories (injury, postoperative, and miscellaneous), in children younger than 12 months, adolescents, and patients with chronic complex conditions. Conclusions Pediatric Index of Mortality 2 showed good discrimination, but calibration was inadequate. To use PIM2 for monitoring PICU performance in Latin America, it might be necessary to recalibrate the score locally.
Introduction
In inguinal hernia repair, many complications are due to mesh fixation technique. Therefore, new types of atraumatic methods of fixation have been proposed. In this article, we present ...the results of a prospective multicentric parallel randomized controlled trial aiming to compare two mesh fixation techniques: fibrin sealant (QUIXIL
®
, Omrix Biopharmaceuticals S.A., Belgium) and Lichtenstein technique.
Method
Adult patients with primary uncomplicated inguinal hernia were randomized in two groups: fibrin sealant group (FSG) and Lichtenstein group (LTG). The two groups underwent a follow-up of 15 months. Operative time is the primary outcome. Intraoperative and postoperative outcomes were analyzed. Moreover, a differential cost analysis was performed. Patients and evaluators (with exception of the surgeon who treated the patient) were blinded.
Results
A total of 102 patients, 50 in FSG and 52 in LTG, were enrolled from January 2009 to June 2010, and two patients were lost to follow-up at the twelfth month. No significant differences in baseline and clinical characteristics were observed in the two groups. Operative time was longer in LTG (median/ interquartile range: 35 min/30–42.5 min vs. 31 min/28–35 min; effect size: 0.65/95 % CI 0.50–0.91;
p
< 0.05). No differences in intraoperative complications were observed. No significant differences were observed in early complication rate (RR = 0.62;
p
> 0.05). Numbness rate was lower in the FSG at 1 week (RR = 0.43;
p
< 0.01) and at 1 month (RR = 0.17;
p
< 0.05). No significant differences were observed after 6 months. Postoperative pain was lower in the FSG at 1 week (0/0–1 vs. 1/0–2;
p
< 0.05) and at 1 month (0/0–0 vs. 0/0–1;
p
< 0.05). Pain disappeared in all patients after 6 months. Analgesic assumption rate was lower in the FSG (RR = 0.42;
p
< 0.05). Twenty per cent of FSG and 9.62 % of LTG patients were discharged within 12 h; 78 % of FSG and 90.38 % of LTG patients were discharged within 24 h. The only one recurrence we observed was in FSG group. About costs, although fibrin sealant needed for one mesh fixation is about 10 times more costly than the needed sutures, the total costs of the two procedures did not change significantly. This was mainly due to reduction in operative time.
Conclusions
The use of fibrin sealant determined a significant reduction in short-term numbness rate and postoperative pain. There was no relevant difference in total costs per patient between the two procedures.
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