Acute lumbar paraspinal compartment syndrome after radical cystectomy.

Lumbar paraspinal compartment syndrome (LPCS) is a rare diagnosis, seen in patients chronically after repeated lumbar trauma or acutely in a postoperative setting. Only a dozen cases are documented worldwide, and to date no clinical guidelines exist for the diagnosis nor the treatment.We describe the case of a 44-year-old man with excruciating lower back pain following a radical cystectomy. The postoperative laboratory values were compatible with acute rhabdomyolysis. The lumbar spine MRI showed necrosis of lumbosacral paraspinal muscles, making the diagnosis of acute LPCS. After seeking advice from different specialists, the conservative approach was chosen with combined pain treatment and physiotherapy. The patient is currently still disabled for some tasks and needs chronic pain medication.

Characterization of Orange Peel Waste and Valorization to Obtain Reducing Sugars.

Annually, millions of tons of foods are generated with the purpose to feed the growing world population. One particular eatable is orange, the production of which in 2018 was 75.54 Mt. One way to valorize the orange residue is to produce bioethanol by fermenting the reducing sugars generated from orange peel. Hence, the objective of the present work was to determine the experimental conditions to obtain the maximum yield of reducing sugars from orange peel using a diluted acid hydrolysis process. A proximate and chemical analysis of the orange peel were conducted. For the hydrolysis, two factorial designs were prepared to measure the glucose and fructose concentration with the 3,5-DNS acid method and UV-Visible spectroscopy. The factors were acid concentration, temperature and hydrolysis time. After the hydrolysis, the orange peel samples were subjected to an elemental SEM-EDS analysis. The results for the orange peel were 73.530% of moisture, 99.261% of volatiles, 0.052% of ash, 0.687% of fixed carbon, 19.801% of lignin, 69.096% of cellulose and 9.015% of hemicellulose. The highest concentration of glucose and fructose were 24.585 and 9.709 g/L, respectively. The results highlight that sugar production is increased by decreasing the acid concentration.

Assessment and potential-site determination of a wheat straw power plant by Aspen Plus and multi-criteria GIS model.

Wheat is one of the most important crops worldwide. Mexicali, Baja California, is an important wheat producer in Mexico with an average production of 507,543 t. Wheat straw is generated as a residue which could be used for different purposes such as bioenergy, heat and power generation. In this work, an assessment and potential site determination of a biomass power plant operating with wheat straw as fuel was performed. Aspen Plus was used to evaluate a plant capacity of at least 10 MW considering the physicochemical properties and an higher heating value of 14.86 MJ kg-1 of the wheat straw from the region. The combustion produced 39.76 MW, and the overall plant efficiency was 25.52%. The development of the multi-criteria geographic information system model allowed us to assess and analyse four factors and three restrictions to determine the potential site for the biomass power plant. The factors were raw material, wheat crops, electric transmission lines, paths and roads, water canals and aqueducts, while the restrictions were localities, Ramsar sites and faults. The biomass power plant is technically and geographically feasible. The geographical coordinates of the potential site of the biomass power plant that fulfils all the criteria are 32°29'29.72″N and 115°15'39.45″W.

Development and implementation of virtual instrumentation based on LabView applied to compression ignition engines operated with diesel-biodiesel blends.

This work shows the implementation and development of a set of virtual instruments focused on recording the physical parameters of a compression ignition engine that operates with diesel-biodiesel, 95% diesel and 5% soybean biodiesel. The components of the engine are constituted by several individual virtual instruments (VI) with the objective of registering parameters such as temperature (VITM), revolutions per minute (VIMRPM), fuel consumption (VIMFC), emission of gases such as oxygen (VIMO) and rust nitric (VIMNO). As a result of the research, the software development, hardware of each of the VIs is presented using the virtual programming platform Labview 2015®, the calibration of the O2 sensors, NO and the result of the operation of the engine at 850 rpm constant an ambient temperature of 25 ℃, a relative humidity of 40% and an operating temperature at the engine head of 65 ℃, obtain a fuel consumption of 0.0616 l/min and an average emission of O2 10% and for the NO 540 ppm. •Implementation of virtual instrument focused on evaluate the physical parameters of CI engine operate with diesel-biodiesel.•The engine runs at 850 RPM under controlled conditions of 25 ℃ and a 40% RH with B5 mixture.•Engine emissions are constant and stable at 10% Vol. O2 and 540 ppm of NO.

Creosote Bush (Larrea tridentata) Extract Assessment as a Green Antioxidant for Biodiesel.

In this work, the antioxidant properties of methanolic extract of Larrea tridentata were assessed through the free radical scavenging method, ferric reducing antioxidant power and oxygen radical absorbance capacity. The phenolic acids content in the extract was quantified by high-performance liquid chromatography (HPLC) and the total phenol content by the Folin-Ciocalteu method. The extract was used as an antioxidant in biodiesel from canola oil composed mostly by fatty acid methyl esters identified and quantified by gas chromatography-mass spectrophotometry (GC-MS). The performance of the extract as an antioxidant was assessed by the oxidative stability index (OSI) with a Rancimat equipment at 100, 110, 120 and 130 °C. Additionally, the change of the peroxide value (PV) and the higher heating value under conditions of oxidative stress at 100 °C and air injection were measured. The antioxidant capacity of the extract reached 50,000 TAEC (micromole of Trolox antioxidant equivalent capacity per gram). The biodiesel was constituted by more than 70% of unsaturated fatty acid methyl esters (FAME), mainly methyl oleate. The time needed to reach a PV of 100 meqO2/kg was almost four times longer with an antioxidant concentration of 250 mg/L than the blank. The biodiesel showed an OSI time of 1.25 h at 110 °C, while it increased to 8.8, 15.89 and 32.27 h with the antioxidant at concentrations of 250, 500 and 1000 mg/L, respectively. The methanolic Larrea tridentata extract proved to have an antioxidant capacity and it is a green antioxidant in biodiesel to increase its oxidative stability. According to the results obtained, the L. tridentata methanolic extract is an alternative to the commercial synthetic antioxidants used in biodiesel nowadays.

Virtual Instrument for Emissions Measurement of Internal Combustion Engines.

The gases emissions measurement systems in internal combustion engines are strict and expensive nowadays. For this reason, a virtual instrument was developed to measure the combustion emissions from an internal combustion diesel engine, running with diesel-biodiesel mixtures. This software is called virtual instrument for emissions measurement (VIEM), and it was developed in the platform of LabVIEW 2010® virtual programming. VIEM works with sensors connected to a signal conditioning system, and a data acquisition system is used as interface for a computer in order to measure and monitor in real time the emissions of O2, NO, CO, SO2, and CO2 gases. This paper shows the results of the VIEM programming, the integrated circuits diagrams used for the signal conditioning of sensors, and the sensors characterization of O2, NO, CO, SO2, and CO2. VIEM is a low-cost instrument and is simple and easy to use. Besides, it is scalable, making it flexible and defined by the user.

A 3-step therapeutic strategy for severe alveolar proteinosis.

Pulmonary alveolar proteinosis (PAP) is characterized by accumulation of lipoproteinaceous material in the terminal airways. Whole lung lavage (WLL) remains the gold standard treatment but may be particularly challenging in cases of severe hypoxemia. We present a 3-step strategy that was used in a patient with PAP-associated refractory hypoxemia and that combined venovenous extracorporeal membrane oxygenation (vvECMO), double-lumen orotracheal intubation, and bilateral multisegmental sequential lavage (MSL). The procedure was well tolerated and permitted weaning from the ventilator.

Clinical pharmacist's role in implementing a smoking cessation intervention in a Swiss regional hospital: an exploratory study.

BACKGROUND: Smoking cessation represents one of the best means of preventing smoking-related complications. In recent years, a majority of hospitals have implemented smoke-free policies, making support for smoker patients a necessary and indispensable task. The clinical pharmacist is well-positioned to provide this kind of support, given a good understanding of the medical condition and pharmacotherapy of hospitalized patients and the possibility to acquire specific smoking cessation training. OBJECTIVES: This study aimed to evaluate the impact of a smoking cessation intervention for hospitalized patients by a clinical pharmacist previously trained for smoking cessation counselling. SETTING: Internal medicine department of a Swiss regional hospital. METHOD: Smoker patients hospitalized in this department were included in the study from mid-September 2012 to mid-January 2013, according to the inclusion criteria. Moderate-intensity smoking cessation interventions based on smoking counselling and motivational interviewing techniques were used, and a follow-up telephone call at least 1 month after discharge was made. Patients' pharmacotherapy was analysed with regards to interactions with tobacco smoke. MAIN OUTCOME MEASURES: Motivational stage, abstinence at follow-up, change of readiness to quit between hospital visit and follow-up, patients' evaluation of the programme, pharmacotherapy interventions. RESULTS: One hundred smoker patients were screened, of whom 41 received the intervention and 40 received a follow-up contact. At least 1 month after discharge, the readiness to quit of 53 % of patients improved and 33 % of patients declared themselves abstinent. Even though 35 % of patients declared having mild to moderate withdrawal symptoms in hospital, only 15 % were interested in receiving nicotine replacement therapy. Study participants evaluated the intervention positively. CONCLUSION: A moderate-intensity smoking cessation intervention in hospitalized patients was associated with a higher quit rate than in control groups from other studies, and their readiness to quit generally improved at least 1 month after hospital discharge. A clinical pharmacist trained for smoking cessation counselling can play a key role in providing such interventions, including the assessment of pharmacotherapy interactions with tobacco smoke.

[Exertional heatstroke]. / Le coup de chaleur d'exercice.

Exertional heatstroke is defined by an increase of core body temperature above 40 degrees C and neurological symptoms in association with exercise. It is related to excessive heat production, which overwhelms the endogenous mechanisms of thermoregulation. It is observed during intense physical activity in a hot and humid environment, most commonly in untrained subjects poorly adapted to such conditions. Clinical manifestations of exertional heatstroke are related to the induction of a systemic inflammatory response and a disseminated intravascular coagulation triggered by heat stress, which may lead to multiorgan dysfunction and death. Early management through rapid cooling is mandatory to prevent the devastating consequences of exertional heatstroke.

[Extrapulmonary effects of chronic obstructive pulmonary disease]. / Effets extrapulmonaires de la bronchopneumopathie chronique obstructive.

Patients suffering from advanced COPD not only present respiratory symptoms but extrapulmonary manifestations as well: muscle dysfunction, weight loss, osteoporosis, sexual dysfunction, cardiovascular diseases. A chronic inflammation is likely to play a role in the occurrence of these associated disorders. These different aspects contribute to a poor quality of life, and to added morbidity and mortality. The presence of systemic effects in COPD means that the patient suffering from this pulmonary disease needs a comprehensive care.

Walking activity measured by accelerometry during respiratory rehabilitation.

PURPOSE: Activity monitoring is considered a highly relevant outcome measure of respiratory rehabilitation. This study aimed to assess the usefulness of a new accelerometric method for characterization of walking activity during a 3-week inpatient rehabilitation program. METHODS: After individual calibration of the accelerometer at different walking speeds, whole-day physical activity was recorded for 15 patients with chronic obstructive pulmonary disease on the first and the last days of the program, and for 10 healthy subjects. Data were expressed as percentage of time spent in inactivity, low level activity, and medium level activity, with the latter corresponding to usual walking speed. RESULTS: The patients spent more time being inactive and less time walking than healthy subjects. At the end of the rehabilitation program, medium level activity had increased from 4% to 7% of total recording time. However, the change was not significant after periods of imposed exercise training were excluded. Walking activity increased to a greater degree among the patients with preserved limb muscle strength at entry to the program. Although health status scores improved, the changes did not correlate with the changes in walking activity. CONCLUSION: The findings lead to the conclusion that this new accelerometric method provides detailed analysis of walking activity during respiratory rehabilitation and may represent an additional useful measure of outcome.