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El uso de la ecocardiografía a pie de cama se ha convertido en una herramienta indispensable en la monitorización hemodinámica y diagnóstico en el paciente crítico. Su conocimiento, manejo e indicaciones requieren por parte de las sociedades científicas una implicación para una formación reglada que capacite al profesional. El grupo de trabajo de Ecografía Clínica en Cuidados Intensivos de la Sociedad Española de Anestesiología y Reanimación (SEDAR) y el grupo de trabajo de Ecografía Clínica de la Sociedad Española de Medicina de Urgencias y Emergencias (SEMES) han desarrollado un documento de consenso en el que se definen los objetivos de aprendizaje y los requisitos necesarios para adquirir las competencias recomendadas en relación con el uso de la Ecocardiografía básica en Cuidados Intensivos y Urgencias, y así poder obtener un diploma acreditativo en Ecocardiografía básica en Cuidados Intensivos y Urgencias. En este documento se definen las competencias y el programa de formación para alcanzar el nivel básico en Ecocardiografía en Cuidados Intensivos y Urgencias, como parte del Diploma Completo en Ecografía en Cuidados Intensivos y Urgencias de la SEDAR y SEMES. La Sociedad Española de Anestesiología y Reanimación (SEDAR), junto con la Sociedad Española de Medicina Interna (SEMI) y la Sociedad Española de Medicina de Urgencias y Emergencias (SEMES), ha desarrollado un documento de consenso determinando las competencias y un programa formativo para la adquisición de un diploma en ecografía (pulmonar, vascular y abdominal) en Cuidados Intensivos y Urgencias. Solo cuando se obtenga el Diploma en Ecocardiografía básica y el Diploma en Ecografía pulmonar, vascular, abdominal de la SEDAR, SEMI y SEMES se podrá adquirir el Diploma Completo de Ecografía en Cuidados Intensivos y Urgencias de la SEDAR y SEMES.(AU)

Cardiac ultrasound has become an essential tool for diagnosis and hemodynamic monitoring in critically ill patients. Scientific societies need to work toward developing a training program that will allow clinicians to acquire competence in performing cardiac ultrasound and understanding its indications. The Clinical Ultrasound for Intensive Care task force of the Spanish Society of Anesthesiology and Critical Care (SEDAR) and the Spanish Society of Emergency Medicine (SEMES) have drawn up this position statement defining the learning objectives and training required to acquire the competencies recommended for basic ultrasound management in the intensive care and emergency setting in order to obtain a diploma in Basic Ultrasound in Intensive Care and Emergency Medicine. This document defines the training program and the competencies needed for basic skills in ultrasound in Intensive Care and Emergency Medicine - part of the Diploma in Ultrasound for Intensive Care and Emergency Medicine awarded by SEDAR/SEMES. The Spanish Society of Anesthesia (SEDAR), Spanish Society of Internal Medicine (SEMI) and Spanish Society of Emergency Medicine (SEMES) have drawn up a position statement determining the competencies and training program for a diploma in ultrasound (lung, abdominal and vascular) in Intensive Care and Emergency Medicine. To obtain the SEDAR/SEMES Diploma in Ultrasound in Intensive Care and Emergency Medicine, clinicians must have completed the SEDAR, SEMI and SEMES Diploma in basic ultrasound and the Diploma in lung, abdominal, and vascular ultrasound.(AU)

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Cardiac ultrasound has become an essential tool for diagnosis and hemodynamic monitoring in critically ill patients. Scientific societies need to work toward developing a training program that will allow clinicians to acquire competence in performing cardiac ultrasound and understanding its indications. The Clinical Ultrasound for Intensive Care task force of the Spanish Society of Anesthesiology and Critical Care (SEDAR) and the Spanish Society of Emergency Medicine (SEMES) have drawn up this position statement defining the learning objectives and training required to acquire the competencies recommended for basic ultrasound management in the intensive care and emergency setting in order to obtain a diploma in Basic Ultrasound in Intensive Care and Emergency Medicine. This document defines the training program and the competencies needed for basic skills in ultrasound in Intensive Care and Emergency Medicine-part of the Diploma in Ultrasound for Intensive Care and Emergency Medicine awarded by SEDAR/SEMES. The Spanish Society of Anesthesia (SEDAR), Spanish Society of Internal Medicine (SEMI) and Spanish Society of Emergency Medicine (SEMES) have drawn up a position statement determining the competencies and training program for a diploma in ultrasound (lung, abdominal and vascular) in Intensive Care and Emergency Medicine. To obtain the SEDAR/SEMES Diploma in Ultrasound in Intensive Care and Emergency Medicine, clinicians must have completed the SEDAR, SEMI and SEMES Diploma in basic ultrasound and the Diploma in lung, abdominal, and vascular ultrasound.

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El uso de la ecografía como herramienta de diagnóstico clínico y guía de procedimientos a pie de cama se ha convertido en un examen indispensable en los cuidados del paciente agudo. La capacitación de los profesionales en unas competencias mínimas de conocimiento, manejo e indicaciones de uso requieren de una formación reglada definida por las Sociedades Científicas. El grupo de trabajo de Ecografía en Cuidados Intensivos de la Sociedad Española de Anestesiología y Reanimación (SEDAR), de la Sociedad Española de Medicina Interna (SEMI) y la Sociedad Española de Medicina de Urgencias y Emergencias (SEMES) ha desarrollado este documento de consenso en el que se define el programa de formación y las competencias mínimas recomendadas a adquirir con relación al uso de la Ecografía en Cuidados Intensivos, Anestesia, Urgencias y Emergencias. En este documento se definen el programa de formación y las competencias a adquirir para alcanzar el diploma acreditativo en ecografía toraco-pulmonar, ecografía abdominal y ecografía vascular. Este documento puede servir de guía para definir las competencias a adquirir en los programas de formación de médicos internos residentes (MIR) de los especialistas que trabajen en cuidados intensivos, anestesia, urgencias y emergencias.(AU)

The use of ultrasound as a clinical diagnostic tool and guide of bedside procedures has become an indispensable examination in the acute critically ill patient. The training of professionals in minimum skills of knowledge, management and indications of use of ultrasound required to be defined by the Scientific Societies. The Intensive Care Ultrasound Working Group of the Spanish Society of Anesthesiology and Resuscitation (SEDAR), of the Spanish Society of Internal Medicine (SEMI) and the Spanish Society of Emergency Medicine (SEMES) has developed this consensus document in which the recommended training program and the minimum competencies to be achieved with regard to the use of Ultrasound in Intensive Care, Anesthesia and Emergency medicine are defined. This document defines the training program and the skills to acquire in order to achieve the diploma in lung, abdominal and vascular ultrasound. This document can serve as a guide to define the skills to be acquired in the training programs of residents (MIRs) of specialists working in intensive care, anesthesia, and emergency medicine.(AU)

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The use of ultrasound as a clinical diagnostic tool and guide of bedside procedures has become an indispensable examination in the acute critically ill patient. The training of professionals in minimum skills of knowledge, management and indications of use of ultrasound required to be defined by the Scientific Societies. The Intensive Care Ultrasound Working Group of the Spanish Society of Anesthesiology and Resuscitation (SEDAR), of the Spanish Society of Internal Medicine (SEMI) and the Spanish Society of Emergency Medicine (SEMES) has developed this consensus document in which the recommended training program and the minimum competencies to be achieved with regard to the use of Ultrasound in Intensive Care, Anesthesia and Emergency medicine are defined. This document defines the training program and the skills to acquire in order to achieve the diploma in lung, abdominal and vascular ultrasound. This document can serve as a guide to define the skills to be acquired in the training programs of residents (MIRs) of specialists working in intensive care, anesthesia, and emergency medicine.

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In this paper, the structure of a southeastern Spanish population was studied for the first time with respect to its inbreeding patterns and its relationship with demographic and geographic factors. Data on consanguineous marriages (up to second cousins) from 1900 to 1969 were taken from ecclesiastic dispensations. Our results confirm that the patterns and trends of inbreeding in the study area are consistent with those previously observed in most non-Cantabrian Spanish populations. The rate of consanguineous marriages was apparently stable between 1900 and 1935 and then sharply decreased since 1940, which coincides with industrialization in Spain. A marked departure from Hardy-Weinberg expectations (0.25) in the ratio of first cousin (M22) to second cousin (M33) marriages in the study population (0.88) was observed. The high levels of endogamy (>80%) and its significant steadiness throughout the twentieth century is noteworthy. Accordingly, our results show that exogamous marriages were not only poorly represented but also that this reduced mobility (<6 km) suggests that the choice of a mate was preferentially local. We found higher mobility in M22 with respect to M33 cousin mating. The relationships between population size and consanguinity rates and inbreeding fit power-law distributions. A significant positive correlation was observed between inbreeding and elevation. Many Spanish populations have experienced a prolonged and considerable isolation across generations, which has led to high proportions of historical and local endogamy that is associated, in general, with high [Formula: see text] values. Thus, assessing genomic inbreeding using runs of homozygosity (ROH) in current Spanish populations could be an additional pertinent strategy for obtaining a more refined perspective regarding the population history inferred from the extent and frequency of ROH regions.

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Several works studied the elicitation of emotions through the exposure of individuals to relevant stimuli, using spectral analysis of Heart Rate Variability (HRV) when people are subject to emotional elicitation. If correlation exists between HRV and emotional responses, spectral analysis can be used to study emotion regulation under external stimuli. In this work, we studied the relationship between visual elicitation and emotion regulation, employing HRV. Images (with pleasant, unpleasant and neutral emotional content) were selected from the IAPS (International Affective Picture System) dataset. Ninety-eight participants were enrolled, and subject to view all images, displayed in random order for each participant. Heart rate was recorded during the experiment, and HRV analysis was performed. Spectral values were studied for the different images. The presentation order of images was relevant, mainly when unpleasant images were viewed in first place; this significantly affects HRV values. Spectral values were higher for men, being this difference stronger when pleasant pictures were displayed. Age and gender dependences of spectral indexes were found. The influence of visual elicitation, with different emotional contents, over HRV, was assessed. Results indicate that HRV parameters are affected when individuals are subject to external, emotional-based stimuli.

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Adolescence is a period of ongoing brain maturation characterized by hierarchical changes in the functional and structural networks. For this reason, the young brain is particularly vulnerable to the toxic effects of alcohol. Nowadays, binge drinking is a pattern of alcohol consumption increasingly prevalent among adolescents. The aim of the present study is to evaluate the evolution of the functional and anatomical connectivity of the Default Mode Network (DMN) in young binge drinkers along two years. Magnetoencephalography signal during eyes closed resting state as well as Diffusion Tensor Imaging (DTI) were acquired twice within a 2-year interval from 39 undergraduate students (22 controls, 17 binge drinkers) with neither personal nor family history of alcoholism. The group comparison showed that, after maintaining a binge drinking pattern along at least two years, binge drinkers displayed an increased brain connectivity of the DMN in comparison with the control group. On the other hand, the structural connectivity did not show significant differences neither between groups nor over the time. These findings point out that a continued pattern of binge drinking leads to functional alterations in the normal brain maturation process, even before anatomical changes can be detected.

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BACKGROUND AND OBJECTIVE: At present, tools capable of acquiring heart rate data can be found both in commercial and research fields. However, these tools do not allow users to manage experiments comprising sequences of activities or to store the information needed to perform heart rate variability analysis across different activities. One exception is VARVI, a simple software tool developed previously in our research group that does not have a graphical user interface and it works only with visual stimuli. In this paper, we present gVARVI, a software tool aimed at obtaining heart rate data signals while the user is either receiving a sequence of external stimuli or performing a sequence of actions (an activity). METHODS: gVARVI is an open source application developed in Python programming language. It can acquire heart rate data by means of a wireless chest strap using either Bluetooth or ANT+ protocols. Users can define activities of different types (video, sounds, pictures or keyboard controlled actions) which will associate contextual information to the heart rate data. gVARVI allows users to preview this data or to store it to be used for heart rate variability studies. Our tool was validated by 15 researchers, who worked with the application and filled in a usability questionnaire. RESULTS: The outcome of the usability test was satisfactory, giving a mean score of 4.75 in a 1-5 scale (1 - strongly disagree, 5 - strongly agree). Participants also contributed with valuable comments, which we used to include new features in the last version of our tool. CONCLUSIONS: gVARVI is an open source tool that offers new possibilities to both physicians and clinicians to perform heart rate variability studies. It allows users to acquire heart rate data including information on the activity performed by subjects while recording. In this paper, we describe all the functionalities included in gVARVI, and a complete example of use is provided.

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A total of twenty-four Yorkshire gilt pigs of 6-7 weeks of age were used in a 2×2 factorial experiment to determine the individual and combined effects of the inclusion of two dietary factors (cholesterol rich, 3% ß-cyclodextrin (BCD) and Lactobacillus acidophilus cultures) on total cholesterol and LDL-cholesterol levels in blood serum. Pigs were assigned randomly to treatment groups (n 6). Total serum cholesterol concentrations decreased after 3 weeks in all the experimental treatment groups, including diets with BCD, L. acidophilus or both. Similar trends were observed for serum LDL-cholesterol concentrations among the experimental treatments. No statistically significant differences from the control group were observed in either total serum cholesterol or LDL-cholesterol concentrations (P<0·05) for each of the individual treatment groups: BCD or L. acidophilus. However, significant differences in total serum cholesterol concentrations were observed when comparing the combined treatment group (BCD and L. acidophilus) with the control group, which consisted of a basal diet and sterile milk. The combined treatment group exhibited 17·9% lower total serum cholesterol concentration after 3 weeks. Similar significant differences were observed when comparing the combined effect experimental group with the control group after 3 weeks. The combined treatment group exhibited 27·9% lower serum LDL-cholesterol concentrations.

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Binge Drinking (BD) is a pattern of intermittent intensive alcohol intake which has spread among young adults over the last decades. Adolescence constitutes a critical neuromaturation period in which the brain is particularly sensitive to the effects of alcohol. However, little is known about how BD affects the brain activity. This study aimed to characterize the brain's functional organization in BD and non-BD young population by means of analyzing functional connectivity (FC) and relative power spectra (PS) profiles measured with magnetoencephalography (MEG) during eyes-closed resting state. Our sample composed 73 first-year university students (35 BDs and 38 controls). Results showed that the BD subjects displayed a decreased alpha FC in frontal-parietal regions, and conversely, an enhanced FC in the delta, theta and beta bands in fronto-temporal networks. Besides the FC differences, the BD group showed a decreased PS within alpha range and an increased PS within theta range in the brain's occipital region. These differences in FC and PS measurements provide new evidence of the neurophysiological alterations related to the alcohol neurotoxicity and could represent an initial sign of an anomalous neural activity caused by a BD pattern of alcohol consumption during youth.

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The development and life performance of 404 high-producing Holstein dairy cows was studied from birth onwards and during two lactations. The management, environment and parental genetics of the cows were known in detail. Cluster analysis identified four performance 'types': high-yielding (HY) cows and persistently high-yielding (PHY) cows, which accounted for 33% of the animals; medium-yielding (MY) cows, 41%; and low-yielding (LY) cows, 26%. Prenatal determinants of the life performance of the progeny were analyzed. Developmental and environmental factors were excluded as determinants of performance (including birth weight, level of passive immunity transfer, growth rate, age at first parturition and reproductive efficiency). Life performance did show minor seasonal effects, with more HY cows but less PHY being born during the cold season (90.1% in HY; 58.3% in PHY v. 81.5%). Instead, the single most important factor influencing life performance of daughters was maternal age. HY cows were born from the youngest mothers (1.89±1.14 parturitions, 3.12±1.42-year old), whereas LY cows were born from the oldest (2.72±1.80 parturitions, 3.97±2.01-year old; P<0.001). Life performance of the dams did not differ among clusters. In addition, metabolic parameters (fat and protein yield) were found to correlate significantly with yields between the first and second lactations (milk yield: r=0.357; fat yield: r=0.211; protein yield: r=0.277; P<0.0001), suggesting the influence of the individual. These results suggest that under optimal health, nutritional and environmental conditions, maternal aging is an important determinant of the life performance of progeny and argue for the need to identify conditions that contribute to health and disease in progeny according to the Developmental Origin of Health and Disease or DOHaD concept. Our findings may help the development of novel management guidelines for dairy farms.

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In this paper, the gHRV software tool is presented. It is a simple, free and portable tool developed in python for analysing heart rate variability. It includes a graphical user interface and it can import files in multiple formats, analyse time intervals in the signal, test statistical significance and export the results. This paper also contains, as an example of use, a clinical analysis performed with the gHRV tool, namely to determine whether the heart rate variability indexes change across different stages of sleep. Results from tests completed by researchers who have tried gHRV are also explained: in general the application was positively valued and results reflect a high level of satisfaction. gHRV is in continuous development and new versions will include suggestions made by testers.

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Mild cognitive impairment (MCI) has been described as an intermediate stage between normal aging and dementia. Previous studies characterized the alterations of brain oscillatory activity at this stage, but little is known about the differences between single and multidomain amnestic MCI patients. In order to study the patterns of oscillatory magnetic activity in amnestic MCI subtypes, a total of 105 subjects underwent an eyes-closed resting-state magnetoencephalographic recording: 36 healthy controls, 33 amnestic single domain MCIs (a-sd-MCI), and 36 amnestic multidomain MCIs (a-md-MCI). Relative power values were calculated and compared among groups. Subsequently, relative power values were correlated with neuropsychological tests scores and hippocampal volumes. Both MCI groups showed an increase in relative power in lower frequency bands (delta and theta frequency ranges) and a decrease in power values in higher frequency bands (alpha and beta frequency ranges), as compared with the control group. More importantly, clear differences emerged from the comparison between the two amnestic MCI subtypes. The a-md-MCI group showed a significant power increase within delta and theta ranges and reduced relative power within alpha and beta ranges. Such pattern correlated with the neuropsychological performance, indicating that the a-md-MCI subtype is associated not only with a "slowing" of the spectrum but also with a poorer cognitive status. These results suggest that a-md-MCI patients are characterized by a brain activity profile that is closer to that observed in Alzheimer disease. Therefore, it might be hypothesized that the likelihood of conversion to dementia would be higher within this subtype.

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In this prospective study, a canine-adapted histological grading method was compared with histopathological and clinical characteristics and was evaluated as a prognostic indicator in canine mammary carcinomas (CMCs). Recruited dogs with at least 1 malignant mammary tumor (n = 65) were clinically evaluated, surgically treated, and followed up (minimum follow-up 28 months, maximum 38 months). Histopathological diagnoses were performed according to Goldschmidt et al (2011). Tumors were graded as grade I (29/65), grade II (19/65), and grade III (17/65). The tumor size, clinical stage, histological diagnosis, presence/absence of myoepithelial proliferation, and regional lymph node metastases at diagnosis were significantly associated with histological grade. The histological grade, age, clinical stage, tumor subtype group, and lymph node metastases at time of diagnosis were significantly associated with the development of recurrences and/or metastases, cancer-associated death, and survival times (disease-free survival and overall survival) in univariate analyses. A subdivision of clinical stage I (T1N0M0) into stages IA and IB was proposed in terms of prognosis. The clinical stage, histological grade, and spay status were selected as independent prognostic variables (multivariate analyses) with disease-free survival as the dependent variable. When overall survival was evaluated as a dependent variable, clinical stage and histological grade were selected as the independent covariates. This grading system is a useful prognostic tool, facilitates histological interpretation, and offers uniform criteria for veterinary pathologists. Comparative studies on CMCs performed in different countries should take into account possible changes in the prognoses due to different proportions of spayed females among the selected dog population.

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Although the intensive production system of Lacaune dairy sheep is the only profitable method for producers outside of the French Roquefort area, little is known about this type of systems. This study evaluated yield records of 3677 Lacaune sheep under intensive management between 2005 and 2010 in order to describe the lactation curve of this breed and to investigate the suitability of different mathematical functions for modeling this curve. A total of 7873 complete lactations during a 40-week lactation period corresponding to 201 281 pieces of weekly yield data were used. First, five mathematical functions were evaluated on the basis of the residual mean square, determination coefficient, Durbin Watson and Runs Test values. The two better models were found to be Pollott Additive and fractional polynomial (FP). In the second part of the study, the milk yield, peak of milk yield, day of peak and persistency of the lactations were calculated with Pollot Additive and FP models and compared with the real data. The results indicate that both models gave an extremely accurate fit to Lacaune lactation curves in order to predict milk yields (P = 0.871), with the FP model being the best choice to provide a good fit to an extensive amount of real data and applicable on farm without specific statistical software. On the other hand, the interpretation of the parameters of the Pollott Additive function helps to understand the biology of the udder of the Lacaune sheep. The characteristics of the Lacaune lactation curve and milk yield are affected by lactation number and length. The lactation curves obtained in the present study allow the early identification of ewes with low milk yield potential, which will help to optimize farm profitability.

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Introducción. A pesar de los avances en cuidados neonatales entre el 20 y 63% de los niños con enterocolitis necrotizante (ECN) necesitan cirugía. El objeto fue buscar una correlación y factores de riesgo de los neonatos con ECN “IIB/IIIA/IIIB” de Bell y los hallazgos clínicos, quirúrgicos y de anatomía patológica. Material y métodos. Se analizaron neonatos con diagnóstico de ECN que recibieron cirugía y se analizó las variables: clínico- quirúrgicas y de anatomía patológica. Estudiamos dos grupos: control (n= 5)y grupo ECN (n= 12). Se realizaron comparaciones entre los grupos mediante la U-Mann-Whitney y el coeficiente de Sperman (r). Para valorar el riesgo de morbilidad/mortalidad asociada a la extensión de (..) (AU)

Introduction. Despite advances in neonatal care between 20% and63% of children with necrotizing enterocolitis (NEC) require surgery. The aim was correlation the risk factors of infants with NEC “IIB / IIIA/ IIIB” Bell and the clinical, surgical and pathological findings. Method. In the children with diagnosis of NEC surgically treated, were analyzed of variables: clinical, surgical and pathological findings. We studied two groups: control (n= 5) and NEC group (n= 12). Comparisons were made between groups using the Mann-Whitney U- and the Spearman coefficient (r). To assess the risk of morbidity / mortality associated with the extent of intestinal resection we applied the Cox (..) (AU)

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INTRODUCTION: Despite advances in neonatal care between 20% and 63% of children with necrotizing enterocolitis (NEC) require surgery. The aim was correlation the risk factors of infants with NEC "IIB / IIIA / IIIB" Bell and the clinical, surgical and pathological findings. METHOD: In the children with diagnosis of NEC surgically treated, were analyzed of variables: clinical, surgical and pathological findings. We studied two groups: control (n=5) and NEC group (n=12). Comparisons were made between groups using the Mann-Whitney U- and the Spearman coefficient (r). To assess the risk of morbidity / mortality associated with the extent of intestinal resection we applied the Cox regression. RESULT: We found differences (p < 0.05) between control group and the NEC group regarding Bell, the mean height of villi, Chiu and the number of goblet cells. In the NEC group we find correlations (p < 0.05) from Bell, regarding Chiu (r = 0.761), resection of the colon (r = 0.687), pneumatosis / perforation (r = 1) and the mean height of villi (r = -0.878). The gut reseccion was at 26 cm (3-107). We observed a risk of 1.04 in the neonatal period (p > 0.05) of mortality or consequence post-enterocolitis associated with the extent of bowel resection. CONCLUSION: The decrease in the average height of villi, the highest level of microscopic intestinal injury and reduced goblet cell population contributes to a greater extent of intestinal resection, which favors the risk of death or developing consequence post-enterocolitis.

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