In-silico study of the adsorption of H2, CO and CO2 chemical species on (TiO2)n n=15-20 clusters: The (TiO2)19 case as candidate promising.

In order to obtain an adsorption tendency of H2, CO and CO2 molecules on (TiO2)n n = 15-20 clusters, DFT calculations were carried out to evaluate the interaction among these systems. The (TiO2)19 cluster emerges as the best candidate to storage these chemical species. Then, two adsorption sites were considered to attach these molecules onto (TiO2)19 cluster: through of surface formed by i) titanium and ii) oxygen atoms, respectively. The adsorption energy values are more favored for case 1 than the case 2, due to short distances between titanium atom and these chemical species. In this sense, the larger values of chemisorption are related to great decreasing of values of vibrational modes for gases isolated respect to those bonded to bare cluster. In general, the values of electronic gap do not suffer drastic changes, however the HOMO iso-surfaces are displayed in different way for both cases, and LUMO is located at center of cluster for the whole set of systems analyzed in this study. The electronic transference occurs from chemical species toward atoms at adsorption site, in all systems. These results reveal that this (TiO2)19 cluster is good candidate to storage or sense different kind of gases; thereby, this system can be used as a hydrogen storage device for energy green applications.

Operative safety of orthotopic liver transplant in patients with prior transjugular intrahepatic portosystemic shunts: A 20-year experience.

INTRODUCTION AND AIMS: Orthotopic liver transplant (OLT) is the definitive treatment of most types of liver failure. Transjugular intrahepatic portosystemic shunt (TIPS) and portocaval shunt placement procedures reduce the systemic vascular complications of portal hypertension. TIPS placement remains a "bridge" therapy that enables treatment of refractory symptoms until transplantation becomes available. The aim of the present study was to describe the operative impact of TIPS prior to OLT. MATERIALS AND METHODS: A retrospective review was conducted on patients that underwent liver transplant at the Hospital San José within the timeframe of 1999 and February 2020. RESULTS: We reviewed a total of 92 patients with OLT. Sixty-six patients were male and 26 were female, with a mean age of 52 years. Nine (9.8%) of the 92 patients had a TIPS, before the OLT. Preoperative Child-Pugh class, MELD score, and sodium and platelet levels were similar between groups. We found no difference in the means of intensive care unit stay, operative time, or blood transfusions for liver transplant, with or without previous TIPS. There was no significant difference between groups regarding vascular and biliary complication rates or the need for early intervention. The overall one-year mortality rate in the TIPS group was 11%. CONCLUSIONS: TIPS is an appropriate therapeutic bridge towards liver transplant. We found no greater operative or postoperative complications in patients with TIPS before OLT, when compared with OLT patients without TIPS. The need for transfusion, operative time, and ICU stay were similar in both groups.

Management of Parkinson's disease and other movement disorders in women of childbearing age: Part 2. / Manejo de la enfermedad de Parkinson y otros trastornos del movimiento en mujeres en edad fértil: parte 2.

INTRODUCTION: Many diseases associated with hyperkinetic movement disorders manifest in women of childbearing age. It is important to understand the risks of these diseases during pregnancy, and the potential risks of treatment for the fetus. OBJECTIVES: This study aims to define the clinical characteristics and the factors affecting the lives of women of childbearing age with dystonia, chorea, Tourette syndrome, tremor, and restless legs syndrome, and to establish guidelines for management of pregnancy and breastfeeding in these patients. RESULTS: This consensus document was developed through an exhaustive literature search and a discussion of the content by a group of movement disorder experts from the Spanish Society of Neurology. CONCLUSIONS: We must evaluate the risks and benefits of treatment in all women with hyperkinetic movement disorders, whether pre-existing or with onset during pregnancy, and aim to reduce effective doses as much as possible or to administer drugs only when necessary. In hereditary diseases, families should be offered genetic counselling. It is important to recognise movement disorders triggered during pregnancy, such as certain types of chorea and restless legs syndrome.

Management of Parkinson's disease and other movement disorders in woman of childbearing age: Part 1. / Manejo de la enfermedad de Parkinson y otros trastornos del movimiento en mujeres en edad fértil: Parte 1.

INTRODUCTION: The main challenge of Parkinson's disease in women of childbearing age is managing symptoms and drugs during pregnancy and breastfeeding. The increase in the age at which women are having children makes it likely that these pregnancies will become more common in future. OBJECTIVES: This study aims to define the clinical characteristics of women of childbearing age with Parkinson's disease and the factors affecting their lives, and to establish a series of guidelines for managing pregnancy in these patients. RESULTS: This consensus document was developed through an exhaustive literature search and a discussion of the available evidence by a group of movement disorder experts from the Spanish Society of Neurology. CONCLUSIONS: Parkinson's disease affects all aspects of sexual and reproductive health in women of childbearing age. Pregnancy should be well planned to minimise teratogenic risk. A multidisciplinary approach should be adopted in the management of these patients in order to take all relevant considerations into account.

Development of food-grade Pickering emulsions stabilized by a biological macromolecule (xanthan gum) and zein.

In this work, food-grade sunflower oil/W Pickering emulsions stabilized by xanthan gum-zein complex were developed. For this purpose, laser diffraction, rheological, multiple light scattering, confocal laser scanning microscopy (CLSM) and field emission scanning electron microscopy (FESEM) measurements were carried out. A response surface methodology was used to determine the optimized zein and oil concentration of the emulsion by using D4,3 and Turbiscan Stability Index (TSI) as objective functions to minimize. Subsequently, the optimized formulation with minimum D4,3 was selected and the biological macromolecule, advanced performance xanthan gum (APXG), was added. CLSM results of emulsions without gum showed the location of zein in the oil-water interface protecting droplets against coalescence as Pickering stabilizer. They also demonstrated that zein did not present important aggregation at the working pH. The addition of APXG changed the flow behaviour from Newtonian to shear thinning which fitted to the Cross model. This fact provoked the occurrence of viscoelastic properties and an increase in stability. FESEM results suggested the formation of a zein-gum complex, which forms a layer covering the droplets, protecting them against oxidation and physical destabilization. Therefore, this research supports the role of zein-APXG complex as a stabilizer of future emulsions.

Color difference thresholds for computer-simulated human Gingiva.

OBJECTIVE: To determine 50:50% perceptibility threshold (PT) and 50:50% acceptability threshold (AT) for computer-simulated samples of human gingiva using CIEDE2000 and CIELAB color difference formulas. MATERIALS AND METHODS: Each of the 60 pairs of simulated human gingiva was displayed on a calibrated monitor, together with three pairs of upper central incisors of different lightness. The color of gingiva left and right from the midline was compared. A total of 30 observers (15 dentists, 15 laypersons) participated in the study. CIEDE2000 and CIELAB formulas were used to calculate the thresholds and a Takagi-Sugeno-Kang Fuzzy Approximation model was used as fitting procedure. Paired t-test (α = 0.05) was used in evaluation of statistical significance of differences. RESULTS: The PT and AT for CIEDE2000 and 95% confidence intervals were 1.1 [0.4, 1.7] and 2.8 [1.8, 4.0], respectively. Corresponding CIELAB values were 1.7 [0.2, 2.6] and 3.7 [2.1, 5.7]. Significant differences (P < .01) were recorded between PT and AT, between the corresponding threshold values in CIEDE2000 and CIELAB formulas as well as between dentists and laypersons. CONCLUSIONS: The difference between the perceptibility and acceptability threshold for gingiva was statistically significant in both CIEDE2000 and CIELAB. The same was true for differences between the corresponding thresholds using two color difference formulas, and between dentists and laypersons. Visual thresholds of human gingiva were not dependent upon lightness of adjacent teeth. Overall, CIEDE2000 color difference formula provided better fit than CIELAB formula in the evaluation of color difference thresholds of human gingiva. CLINICAL SIGNIFICANCE: The data on visual thresholds for healthy human gingiva can be used as quality control tool/guide for selection and evaluation of dental materials, interpretation of color-related findings in clinical dentistry and research, and for standardization in dentistry. It is of particular value that this study was designed based on in-vivo color evaluation of healthy keratinized gingiva of subjects of different ethnicities, age groups, and gender.

The impact of treatment on quality of life of patients with head and neck cancer and its association with prognosis.

BACKGROUND: Information is scarce regarding the impact of treatment on Health-Related Quality of Life (HRQL) of patients with Head and Neck (H&N) cancers. We assessed the effect of treatment on HRQL and its association with prognosis in H&N cancer. PATIENTS AND METHODS: Patients with H&N cancer in whom HRQL was assessed before and after treatment. The European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-H&N35 instruments were used. Association of changes in patients' HRQL after treatment with Loco-Regional Recurrence (LRR) and Overall Survival (OS) was investigated. RESULTS: One hundred sixty patients were included; scales of the baseline assessment of HRQL were moderately associated with LRR and OS, but the impact of treatment on most HRQL scales was strongly associated with OS. By multivariate analysis, baseline assessment of Global Health, Physical, HN Teeth, HN Dry mouth, and HN Cough scales, and impact of treatment on the Physical and Pain scales comprised independent variables associated with LRR. Male gender, positive lymph nodes, baseline assessment of Role, HN Pain, HN Cough, and impact of treatment on Emotion, Pain, Financial, HN Swallowing, HN Social contact, and the interaction of HN Pain-change in Pain scales were associated with OS. Both multivariate models were adjusted by the neoplasm's site of origin. CONCLUSION: Aside from well-known clinical-pathologic prognostic factors in H&N cancers, HRQL assessment, both prior to and after treatment, provides significant prognostic information and should be measured. Design of therapeutic clinical trials in patients with H&N cancers should consider these novel prognostic factors.

Survey of hemostasis management and transfusion in liver transplantation.

OBJECTIVE: To determine the management of haemostasis and transfusion practice in the field of liver transplantation in Spain. METHODS: A questionnaire was developed for physicians in anaesthesiology of all centres performing liver transplantation in Spain. The information required made reference to the 12 months prior to its distribution, from January 1 to December 31, 2011. RESULTS: Data were collected from 24 centres in which liver transplantation is performed in Spain. Only 46% reported that they had protocols or practice guidelines for the management of haemostasis, and 83% of hospitals responded that they knew the percentage of transfused patients, but only 57% knew the mean transfusion. Regarding the degree of satisfaction with the management of haemostasis/coagulation, 50% said they were not satisfied. Thromboelastometry was used as an additional method of preoperative monitoring in only 8% of the centres and intra-operatively in one-third. Less than half (46%) of the centres performed preoperative correction of coagulation deficits based on conventional tests. The mean number of packed red cells used was ≤4 in 57% of centres. Consumption of fresh frozen plasma was highly variable, while 100% of centres consumed less than 4 pools of platelets per patient. CONCLUSIONS: There is a wide variability in the management of haemostasis and transfusion practice among Spanish centres. There are no guidelines or they are not widely used. The mean use of transfused blood products remain high. There was a decrease in centres using new methods of monitoring.

Machine learning models for the differential diagnosis of vascular parkinsonism and Parkinson's disease using [(123)I]FP-CIT SPECT.

PURPOSE: The study's objective was to develop diagnostic predictive models using data from two commonly used [(123)I]FP-CIT SPECT assessment methods: region-of-interest (ROI) analysis and whole-brain voxel-based analysis. METHODS: We included retrospectively 80 patients with vascular parkinsonism (VP) and 164 patients with Parkinson's disease (PD) who underwent [(123)I]FP-CIT SPECT. Nuclear-medicine specialists evaluated the scans and calculated bilateral caudate and putamen [(123)I]FP-CIT uptake and asymmetry indices using BRASS software. Statistical parametric mapping (SPM) was used to compare the radioligand uptake between the two diseases at the voxel level. Quantitative data from these two methods, together with potential confounding factors for dopamine transporter availability (sex, age, disease duration and severity), were used to build predictive models following a tenfold cross-validation scheme. The performance of logistic regression (LR), linear discriminant analysis and support vector machine (SVM) algorithms for ROI data, and their penalized versions for SPM data (penalized LR, penalized discriminant analysis and SVM), were assessed. RESULTS: Significant differences were found in the ROI analysis after covariate correction between VP and PD patients in [(123)I]FP-CIT uptake in the more affected side of the putamen and the ipsilateral caudate. Age, disease duration and severity were also found to be informative in feeding the statistical model. SPM localized significant reductions in [(123)I]FP-CIT uptake in PD with respect to VP in two specular clusters comprising areas corresponding to the left and right striatum. The diagnostic predictive accuracy of the LR model using ROI data was 90.3 % and of the SVM model using SPM data was 90.4 %. CONCLUSION: The predictive models built with ROI data and SPM data from [(123)I]FP-CIT SPECT provide great discrimination accuracy between VP and PD. External validation of these methods is necessary to confirm their applicability across centres.

Effects of dietary antioxidant of tomato extract and lycopene on Carassius auratus and Xiphophorus maculatus / Efecto antioxidante de un extracto de jitomate y licopeno en Carassius auratus y Xiphophorus maculatus

Objective. Evaluate the effect on tegument pigmentation, survival, growth and antioxidant capacity in diets supplemented with tomato extract and lycopene as additives in experimental feed for Carassius auratus and Xiphophorus maculatus. Materials and methods. The additives were added in different concentrations to a basic diet. We performed beginning and an ending biometrics for 100% of the population in each bioassay. The growth and survival of organisms were evaluated. The antioxidant capacity was analyzed by ABTS assay, both in the tomato extract sample as well as in foods used in different bioassays. The concentration of lycopene was determined in food and liver and muscle samples of fish fed with it. Acquired pigmentation of fish was assessed through photographs analyzed with Adobe Photoshop®. The results were evaluated by analysis of variance, and when differences were found (p<0.05) the means were compared by the Tukey test. Results. No significant effect (p>0.05) on pigmentation and growth of the organisms under the established experimental conditions was obtained. Significant differences in antioxidant capacity (p<0.05) were obtained in foods with added lycopene. Conclusions. The inclusion of lycopene or tomato extract in food for the organisms used is not recommended to improve pigmentation, but further studies are needed to demonstrate antioxidant effect.

Objetivo. Evaluar el efecto sobre la coloración de la piel, la sobrevivencia, el crecimiento y la capacidad antioxidante por dietas suplementadas con extracto de jitomate y licopeno como aditivos en la alimentación de Carassius auratus y de Xiphophorus maculatus. Materiales y métodos. Los aditivos se añadieron en diferentes concentraciones a una dieta base. Se realizó una biometría inicial y una final del 100% de la población en cada bioensayo. Se evaluó el crecimiento y supervivencia de los organismos. La capacidad antioxidante se analizó a través del ensayo ABTS, tanto a la muestra de extracto de jitomate como a los alimentos utilizados en diferentes bioensayos. Se determinó la concentración de licopeno a los alimentos y en muestras de hígado y músculo de peces alimentados con ellos. La pigmentación adquirida por los peces se evaluó a través de fotografías analizadas con el programa de Adobe Photoshop®. Los resultados fueron evaluados con análisis de varianza, cuando se encontraron diferencias (p<0.05) las medias fueron comparadas mediante la prueba de Tukey. Resultados. No se obtuvo un efecto significativo (p>0.05) sobre la pigmentación y el crecimiento de los organismos en estudio bajo las condiciones experimentales establecidas. Se obtuvieron diferencias significativas (p<0.05) en la capacidad antioxidante en los alimentos adicionados con licopeno. Conclusiones. La inclusión de licopeno o de extracto de jitomate en alimentos para los organismos utilizados no es recomendable con el fin de mejorar la pigmentación, aunque se requieren otros estudios para demostrar su efecto antioxidante.

Anesthesia for bariatric surgery: 8-year retrospective study: are our patients now easier to manage?

OBJECTIVES: To review the perioperative management of patients who had undergone bariatric surgery in our institution during an 8-year period, with the aim of identifying variables that correlated with improved clinical outcomes and changes in perioperative practice. METHODS: This was a retrospective observational study of 437 patients who had undergone bariatric surgery from January 2005 to June 2013. Of these patients, 163 had undergone open or laparoscopic biliopancreatic diversion (Group 1), and 274 had been managed according to a Tailored Laparoscopic Approach Program (TLAP) (Group 2). We analyzed major cardiocirculatory, pulmonary, and surgery-related complications, mortality rate, intensive care unit (ICU) admissions, post-anesthetic care unit (PACU) length of stay, and perioperative management standards, throughout the study period. RESULTS: Changes were observed in anesthetic patterns and perioperative care standards during the study period: 25% of patients had combined epidural anesthesia in 2005, compared with none at present; ICU admissions decreased from 28.6% in 2005 to 3.1% at present; and time in PACU declined from a median of 23 h in 2005 to 5.12h at present. Duration of postoperative opioid therapy was also significantly reduced (from 48 h to 6h). Group 2 had a significantly lower mortality rate than Group 1 (0.37% versus 4.3%, respectively, P=0.004). CONCLUSIONS: In our institution, adoption of a TLAP for bariatric surgery has led to changes in perioperative care standards that have been followed by clear improvements according to morbidity, mortality and management indicators.

[Perioperative treatment for the urgent orbital decompression surgery in a 30-weeks pregnant woman with Graves' orbitopathy]. / Tratamiento perioperatorio para la cirugía urgente de descompresión orbitaria en una paciente gestante de 30 semanas con orbitopatía de Graves.

Thyroid ophthalmopathy is a rare extra-thyroid complication usually associated with Graves' disease. This disease can occur in the euthyroid pregnant patient. Graves' orbitopathy is characterized by eyelid retraction, proptosis, extraocular muscle dysfunction, and periorbital edema. In some cases an emergency surgical repair may be required to avoid irreversible vision loss. We present the case of a 35-year-old woman in her 30th gestational week, who suffered from Graves' ophthalmopathy, severe exophthalmia, and visual acuity decrease. Following consultations among anesthesiologists, ophthalmologists, maxillofacial surgeons, endocrinologists, obstetricians and the patient, it was decided to perform a surgical orbital wall decompression. The anesthetic and perioperative implications associated with gestational age and the considerations for this surgical procedure, and how to avoid increasing intraocular pressure are discussed.

[Advanced Parkinson's disease: clinical characteristics and treatment (part 1)]. / Enfermedad de Parkinson avanzada. Características clínicas y tratamiento (parte I).

INTRODUCTION: A large percentage of patients with Parkinson's disease (PD) develop motor fluctuations, dyskinesias, and severe non-motor symptoms within 3 to 5 years of starting dopaminergic therapy, and these motor complications are refractory to treatment. Several authors refer to this stage of the disease as advanced Parkinson's disease. OBJECTIVE: To define the clinical manifestations of advanced PD and the risk factors for reaching this stage of the disease. DEVELOPMENT: This consensus document has been prepared by using an exhaustive literature search and by discussion of the contents by an expert group on movement disorders of the Sociedad Española de Neurología (Spanish Neurology Society), coordinated by two of the authors (JK and MRL). CONCLUSIONS: Severe motor fluctuations and dyskinesias, axial motor symptoms resistant to levodopa, and cognitive decline are the main signs in the clinical phenotype of advanced PD.

Advanced Parkinson's disease: clinical characteristics and treatment. Part II.

INTRODUCTION: Many patients who have had Parkinson's disease (PD) for several years will present severe motor fluctuations and dyskinesias which require more aggressive therapies. The different approaches which are now available include deep brain stimulation of the subthalamic nucleus or medial globus pallidus, subcutaneous infusion of apomorphine, and intestinal infusion of levodopa-carbidopa. OBJECTIVE: To define the indications and results for the 3 available therapies for advanced PD. DEVELOPMENT: Exhaustive review of the literature concerning the indications and results of deep brain stimulation, subcutaneous apomorphine infusion and duodenal infusion of levodopa/carbidopa gel to treat patients with advanced Parkinson disease. CONCLUSIONS: Although numerous studies have confirmed the efficacy of the 3 different therapies in advanced PD, there are no comparative studies that would allow us to define the best candidate for each technique.

[Elaboration of the SPM template for the standardization of SPECT images with 123I-Ioflupane]. / Elaboración de una plantilla de SPM para la normalización de imágenes de SPECT con 123I-Ioflupano.

PURPOSE: Statistical parametric mapping (SPM) is a widely used produced for normalization of functional images. This study has aimed to develop a normalization template of (123)I-Ioflupane SPECT-imaging DaTSCAN(®), GE Healthcare), not available in SPM5, and to validate it compared to other quantification methods. MATERIAL AND METHODS: In order to write the template we retrospectively selected 26 subjects who had no evidence of nigrostriatal degeneration and whose age distribution was similar to that of the patients in the usual practice of our Department: 2 subjects (7.6%) were < 35 years, 9 between 35-65 years (34.6%) and 15 > 65 years (57.7%). All the studies were normalized with the T1-template available in SPM5 and an average image of the value was obtained for each voxel. For validation we analyzed 60 patients: 30 with idiopathic Parkinson's disease patients (iPD) with right involvement (66.83±12.20 years) and 30 with essential tremor patients (ET) (67.27±8.33 years). Specific uptake rates (SUR) of different striatal regions were compared after image normalization with our template and the application of a semiautomated VOIs-map created with Analyze v9.0 ((©)BIR, Mayo Clinic), against two quantification methods: a) manual adjustment of a ROIs-map drawn in Analyze, and b) semi-automated method (HERMES-BRASS) with normalization and implementation of VOIs-map. RESULTS: No statistically significant differences in the iPD/ET discriminatory capacity between the three methods analyzed were observed (p<0,001). The correlation of SUR after normalization with our «template¼ was higher than that obtained by method b) (R>0,871, p<0,001). This difference was greater in patients with PD. CONCLUSIONS: Our study demonstrates the efficacy of our SPM «template¼ for (123)I-Ioflupane SPECT-imaging, obtained from normalization with «T1-template¼.

Low serum uric acid concentration in Parkinson's disease in southern Spain.

BACKGROUND AND PURPOSE: Uric acid (UA) is thought to have an antioxidant effect on the central nervous system and may also prevent cerebral damage induced by oxidative stress. Our study aimed to investigate whether patients with Parkinson's disease (PD) had lower serum UA concentrations than controls and whether UA concentration was related to clinical parameters of the disease. METHODS: We included 161 patients with PD and 178 controls from southern Spain. UA concentration was compared between these two groups. Clinical parameters including severity of the disease were related to serum UA. RESULTS: Patients with PD showed statistically significant lower serum UA concentrations than controls. Serum UA concentration was lower in patients with PD in severe stages (4 and 5) than in those in moderate stage (2) according to the modified Hoehn and Yahr scale. Other clinical parameters were not related to serum UA concentration, except for levodopa equivalent daily dose that was associated with lower serum UA concentration in men. CONCLUSIONS: Our study produced consistent findings that UA might have a protective effect against PD and could influence its clinical progression.

Usefulness of biodegradable polydioxanone stents in the treatment of postsurgical colorectal strictures and fistulas.

Benign colonic strictures and fistulas are a growing problem presenting most commonly after bowel resection. Standard treatment is with endoscopic bougies or, more usually, balloon dilation. When these approaches are not successful, other solutions are available and different endoscopic and surgical approaches have been used to treat fistulas. We present an additional option--biodegradable stents--for the treatment of colonic strictures and fistulas that have proven refractory to other endoscopic interventions. We analyzed the results from 10 patients with either a postsurgical colorectal stricture (n =7) or rectocutaneous fistula (n =3) treated with the biodegradable SX-ELLA esophageal stent (covered or uncovered). Stents were successfully placed in nine patients, although early migration subsequently occurred in one. Placement was impossible in one patient due to deformity of the area and the fact that the stricture was approximately 30cm from the anus. The fistulas were successfully closed in all patients, although symptoms reappeared in one patient. In the six patients who received stents for strictures, symptoms resolved in five; in the remaining patient, the stent migrated shortly after the endoscopy. Treatment of colonic strictures and rectocutaneous fistulas with biodegradable stents is an effective alternative in the short-to-medium term. The stent does not have to be removed and is subject to very few complications. The drawbacks of this approach are the need to repeat the procedure in some patients and the lack of published series on efficacy.