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1.
Waste Manag Res ; : 734242X231200744, 2023 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-37791483

RESUMO

To evaluate the potential of compost based on municipal solid waste (MSW) and 20% legume pruning under a pyrolysis process, generated products, including solids (biochar), liquids (bio-oil), and gases (non-condensable gases), through experimentation in a pilot plant with a fluidized bed reactor at 450°C and gas chromatography/mass spectrometry have been analysed. In addition, the compost kinetic behaviour by thermogravimetric analysis (TGA), using the Flynn-Wall-Ozawa (FWO) method, has been investigated. Four different reaction zones, associated with lignocellulosic materials (hemicellulose, cellulose, and lignin) with a first step for water evaporation, in TGA curve have been observed. A biochar with low stability and aromaticity, considering high and low O/C and H/C ratios, respectively, has been obtained. The obtained pyrolytic liquids contain a high concentration of phenolic compounds because of a significant presence of lignins and other high molecular weight compounds in the original material. Moreover, the generated non-condensable gases consist mainly of short-chain compounds, such as alcohols, aldehydes, and alkenes produced from hemicellulose, cellulose, and proteins.

2.
Int J Gynecol Cancer ; 33(10): 1564-1571, 2023 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-37726197

RESUMO

OBJECTIVES: The objective of our study was to describe the characteristics of patients with endometrial cancer diagnosed with a first recurrence involving the lung, and to describe the prognostic role of the molecular profile. We also aimed to describe the prognostic outcomes after local treatment of recurrence (resection of lung metastases or stereotactic body radiation therapy) in a group of patients with isolated lung recurrence. METHODS: This was a retrospective, single-center study between June 1995 and July 2021. The study included patients diagnosed with a first recurrence of endometrial cancer involving the lung. We defined two groups of patients: patients with isolated lung recurrence (confined to the lung) and patients with multisystemic recurrence (in the lung and other locations). RESULTS: Among 1413 patients diagnosed with endometrial cancer in stage IA to IVA of the International Federation of Gynecology and Obstetrics (FIGO) 2009, 64 (4.5%) patients had a first recurrence involving the lung. Of these, 15 (39.1%) were of a non-specific molecular profile, 16 (25%) were p53-abnormal, 15 (23.4%) were mismatch-repair deficient, and 0% POLE-mutated. P53-abnormal patients had the shortest 3 year progression-free survival after recurrence and those with mismatch-repair deficient had the longest 3 year progression-free survival (14.3% (range; 1.6-40.3) and 47.6% (range; 9.1-79.5) respectively, p=0.001). We found no differences on overall survival after recurrence by molecular profile. Thirty-one of 64 (48.4%) patients had an isolated recurrence in the lung, and 16 (25%) patients received local treatment. When comparing patients with isolated lung recurrence, locally treated patients had a longer median progression-free survival than patients treated systemically (41.9 (range, 15.4-NA) vs 7.8 (range, 7.2-10.6) months respectively, p=0.029), a complete response rate of 80% for stereotactic body radiation therapy and a complete resection of 90.9% for surgery. CONCLUSION: Although few patients will benefit from local treatment (stereotactic body radiation therapy or resection) after a recurrence involving the lung, local therapies might be considered as an option in oligometastatic lung recurrences as they achieve high local control rates and better oncological outcomes than systemic treatment alone.


Assuntos
Adenocarcinoma , Neoplasias do Endométrio , Feminino , Humanos , Estudos Retrospectivos , Proteína Supressora de Tumor p53 , Recidiva Local de Neoplasia/genética , Recidiva Local de Neoplasia/terapia , Recidiva Local de Neoplasia/patologia , Prognóstico , Neoplasias do Endométrio/genética , Neoplasias do Endométrio/terapia , Neoplasias do Endométrio/patologia , Pulmão/patologia , Adenocarcinoma/patologia , Estadiamento de Neoplasias
3.
Heliyon ; 9(7): e17943, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37539151

RESUMO

Leucaena leucocephala is a fast-growing leguminous biomass with great energetical and value-added chemical compounds potential (saccharides, biogas, bio-oil, etc.). Using the thermogravimetric and derivative thermogravimetric curves, the different trends followed by L. leucocephala during pyrolysis, 0.25 equivalence ratio (ER) of gasification, 0.50 equivalence ratio of gasification and combustion were analyzed, and the activation energies were obtained by Distributed Activation Energy Model (DAEM) method. Gas samples were collected through adsorption tubes during the gasification at 0.25 ER and 0.50 ER to observe the distribution of the main chemical products in this process by gas chromatography/mass spectrometry and were compared with pyrolysis products. It was found that small amounts of oxygen have changes in the kinetics of the process, leading to significant decreases in the activation energy at the beginning of the degradation of components such as cellulose (from 170 to 135 kJ mol-1 at 0.25 conversion at 0.50 ER gasification). The activation energy of lignin disintegration was also reduced (342 kJ mol-1), assimilating the beginnings of gasification processes such as the Boudouard reaction. 0.50 ER gasification is potentially an interesting process to obtain quality bio-oil, since a large amount of hexane is detected (44.96%), and value-added oxygenated intermediates such as alcohols and glycols. Gasification at 0.25 ER, on the other hand, is much more similar to pyrolysis, obtaining a wide variety of short-chain compounds resulting from the disintegration of the main lignocellulosic components, especially ketones such as 1-hydroxypropan-2-one (19.48%), and notable amount of furans and anhydrosugars like d-allose (5.50%).

4.
Rev Sci Instrum ; 93(10): 103533, 2022 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-36319359

RESUMO

This work presents a novel approach for imaging the visible emissions from plasmas in pulsed power experiments using high-resolution plastic optical fibers. The diagnostic consists of a 2 mm diameter core commercial cable constructed of 13 000 individual acrylic fibers. The fibers are fused together to create a single high-resolution bundle. Different designs were investigated to cover a wide range of resolutions and fields of view (3-700 µm and 0.05-45 mm, respectively). The system was tested on the 1-MA Mykonos accelerator at Sandia National Laboratories and successfully imaged visible emission from a hybrid x-pinch target. Diagnostic development and preliminary results are presented.

5.
Nat Commun ; 13(1): 5568, 2022 10 04.
Artigo em Inglês | MEDLINE | ID: mdl-36195604

RESUMO

Plastic degradation by biological systems with re-utilization of the by-products could be a future solution to the global threat of plastic waste accumulation. Here, we report that the saliva of Galleria mellonella larvae (wax worms) is capable of oxidizing and depolymerizing polyethylene (PE), one of the most produced and sturdy polyolefin-derived plastics. This effect is achieved after a few hours' exposure at room temperature under physiological conditions (neutral pH). The wax worm saliva can overcome the bottleneck step in PE biodegradation, namely the initial oxidation step. Within the saliva, we identify two enzymes, belonging to the phenol oxidase family, that can reproduce the same effect. To the best of our knowledge, these enzymes are the first animal enzymes with this capability, opening the way to potential solutions for plastic waste management through bio-recycling/up-cycling.


Assuntos
Mariposas , Polietileno , Animais , Biodegradação Ambiental , Monofenol Mono-Oxigenase/metabolismo , Mariposas/metabolismo , Plásticos/metabolismo , Polietileno/metabolismo , Saliva/metabolismo
6.
Biomed Phys Eng Express ; 8(6)2022 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-35961284

RESUMO

Objective.The goal of this study was to use Monte Carlo (MC) simulations and measurements to investigate the dosimetric suitability of an interventional radiology (IR) c-arm fluoroscope to deliver low-dose radiotherapy to the lungs.Approach.A previously-validated MC model of an IR fluoroscope was used to calculate the dose distributions in a COVID-19-infected patient, 20 non-infected patients of varying sizes, and a postmortem subject. Dose distributions for PA, AP/PA, 3-field and 4-field treatments irradiating 95% of the lungs to a 0.5 Gy dose were calculated. An algorithm was created to calculate skin entrance dose as a function of patient thickness for treatment planning purposes. Treatments were experimentally validated in a postmortem subject by using implanted dosimeters to capture organ doses.Main results.Mean doses to the left/right lungs for the COVID-19 CT data were 1.2/1.3 Gy, 0.8/0.9 Gy, 0.8/0.8 Gy and 0.6/0.6 Gy for the PA, AP/PA, 3-field, and 4-field configurations, respectively. Skin dose toxicity was the highest probability for the PA and lowest for the 4-field configuration. Dose to the heart slightly exceeded the ICRP tolerance; all other organ doses were below published tolerances. The AP/PA configuration provided the best fit for entrance skin dose as a function of patient thickness (R2 = 0.8). The average dose difference between simulation and measurement in the postmortem subject was 5%.Significance.An IR fluoroscope should be capable of delivering low-dose radiotherapy to the lungs with tolerable collateral dose to nearby organs.


Assuntos
COVID-19 , Planejamento da Radioterapia Assistida por Computador , COVID-19/radioterapia , Humanos , Pulmão/diagnóstico por imagem , Método de Monte Carlo , Radiologia Intervencionista , Planejamento da Radioterapia Assistida por Computador/métodos
7.
Water Res ; 221: 118727, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35797818

RESUMO

Hypersaline endorheic aquatic systems (H-SEAS) are lakes/shallow playas in arid and semiarid regions that undergo extreme oscillations in salinity and severe drought episodes. Although their geochemical uniqueness and microbiome have been deeply studied, very little is known about the availability and quality of dissolved organic matter (DOM) in the water column.. A H-SEAS from the Monegros Desert (Zaragoza, NE Spain) was studied during a hydrological wetting-drying-rewetting cycle. DOM analysis included: (i) a dissolved organic carbon (DOC) mass balance; (ii) spectroscopy (absorbance and fluorescence) and (iii) a molecular characterization with Fourier-transform ion cyclotron resonance mass spectrometry (FT-ICR-MS). The studied system stored a large amount of DOC and under the highest salinity conditions, salt-saturated waters (i.e., brines with salinity > 30%) accumulated a disproportionate quantity of DOC, indicating a significant in-situ net DOM production. Simultaneously, during the hydrological transition from wet to dry, the DOM pool showed strong alterations of it molecular composition. Spectroscopic methods indicated that aromatic and degraded DOM was rapidly replaced by fresher, relatively small, microbial-derived moieties with a large C/N ratio. FT-ICR-MS highlighted the accumulation of small, saturated and oxidized molecules (molecular O/C > 0.5), with a remarkable increase in the relative contribution of highly oxygenated (molecular O/C>0.9) compounds and a decrease of aliphatic and carboxyl-rich alicyclic moleculesThese results indicated that H-SEAS are extremely active in accumulating and processing DOM, with the notable release of organic solutes probably originated from decaying microplankton under large osmotic stress at extremely high salinities.


Assuntos
Matéria Orgânica Dissolvida , Lagos , Hidrologia , Lagos/química , Espectrometria de Massas , Água
8.
Rev. cir. (Impr.) ; 74(2)abr. 2022.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1449889

RESUMO

Gracias a los grandes avances de la tecnología, los últimos diez años, la impresión en tres dimensiones (3D) se ha convertido en una herramienta accesible, útil e innovadora para distintas áreas de la medicina. Entre ellas planificación quirúrgica, creación de implantes y prótesis, educación médica e incluso comunicación médico-paciente. Con respecto a planificación quirúrgica, la impresión 3D cobra especial relevancia en cirugías de alta complejidad. En el caso del trasplante hepático con donante vivo, donde es prioritario garantizar la máxima seguridad para el donante, al mismo tiempo que la mejor calidad del injerto para el receptor, la planificación quirúrgica es mandatoria. En este aspecto, la impresión 3D de un modelo de hígado, anatómicamente comparable al del donante, entrega al cirujano la posibilidad de obtener una imagen más clara, directa y tangible, desde cualquier ángulo del órgano, que una imagen virtual tradicional. De esta forma, el cirujano tiene a su alcance una herramienta adicional para plantear el mejor abordaje quirúrgico, anticipar variaciones anatómicas e incluso, cuando el material de impresión lo permite, practicar el procedimiento. En Clínica Las Condes, el centro de trasplante junto al Centro de Innovación, trabajaron en conjunto en la impresión 3D de dos modelos de hígado, utilizados para la planificación quirúrgica de los primeros dos trasplantes hepáticos con donante vivo adulto-adulto realizados en Latinoamérica, donde la hepatectomía del donante se realizó de manera totalmente laparoscópica. El objetivo de este trabajo es describir el proceso de impresión 3D y analizar las dificultades y beneficios del proceso y sus resultados.


The last ten years, thanks to the great advances in technology, three-dimensional (3D) printing has become an accessible, useful, and innovative tool for different areas of medicine. These include surgical planning, implant and prosthetic creation, medical education, and even doctor-patient communication. Regarding surgical planning, 3D printing takes on special relevance in highly complex surgeries. In the case of living donor liver transplantation where it is a priority to guarantee maximum safety for the donor, as well as the best quality of the graft for the recipient, surgical planning is mandatory. Regarding this, 3D printing of an anatomically comparable liver model of the donor, gives the surgeon the possibility of obtaining a clearer, more direct, and tangible image, from any angle of the organ, than a traditional virtual image. In this manner, the surgeon has an additional tool to plan the best surgical approach, anticipate anatomical variations and even, when the impression material allows it, to practice the procedure. Transplant center of Clinica las Condes, together with Innovation laboratory worked together on the 3D printing process liver models used for surgical planning of the first two liver transplants with an adult-adult laparoscopic living donor. The objective of this work is to describe the 3D printing process and analyze the difficulties and benefits of the process and its results.

9.
Phys Med ; 94: 24-34, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34979431

RESUMO

PURPOSE: To use MC simulations and phantom measurements to investigate the dosimetry of a kilovoltage x-ray beam from an IR fluoroscope to deliver low-dose (0.3-1.0 Gy) radiotherapy to the lungs. MATERIALS AND METHODS: PENELOPE was used to model a 125 kV, 5.94 mm Al HVL x-ray beam produced by a fluoroscope. The model was validated through depth-dose, in-plane/cross-plane profiles and absorbed dose at 2.5-, 5.1-, 10.2- and 15.2-cm depths against the measured beam in an acrylic phantom. CT images of an anthropomorphic phantom thorax/lungs were used to simulate 0.5 Gy dose distributions for PA, AP/PA, 3-field and 4-field treatments. DVHs were generated to assess the dose to the lungs and nearby organs. Gafchromic film was used to measure doses in the phantom exposed to PA and 4-field treatments, and compared to the MC simulations. RESULTS: Depth-dose and profile results were within 3.2% and 7.8% of the MC data uncertainty, respectively, while dose gamma analysis ranged from 0.7 to 1.0. Mean dose to the lungs were 1.1-, 0.8-, 0.9-, and 0.8- Gy for the PA, AP/PA, 3-field, and 4-field after isodose normalization to cover âˆ¼ 95% of each lung volume. Skin dose toxicity was highest for the PA and lowest for the 4-field, and both arrangements successfully delivered the treatment on the phantom. However, the dose distribution for the PA was highly non-uniform and produced skin doses up to 4 Gy. The dose distribution for the 4-field produced a uniform 0.6 Gy dose throughout the lungs, with a maximum dose of 0.73 Gy. The average percent difference between experimental and Monte Carlo values were -0.1% (range -3% to +4%) for the PA treatment and 0.3% (range -10.3% to +15.2%) for the 4-field treatment. CONCLUSION: A 125 kV x-ray beam from an IR fluoroscope delivered through two or more fields can deliver an effective low-dose radiotherapy treatment to the lungs. The 4-field arrangement not only provides an effective treatment, but also significant dose sparing to healthy organs, including skin, compared to the PA treatment. Use of fluoroscopy appears to be a viable alternative to megavoltage radiation therapy equipment for delivering low-dose radiotherapy to the lungs.


Assuntos
Radiologia Intervencionista , Radiometria , Fluoroscopia , Pulmão/diagnóstico por imagem , Método de Monte Carlo , Imagens de Fantasmas , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador
10.
Rev Clin Esp (Barc) ; 221(1): 9-17, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33998484

RESUMO

BACKGROUND AND OBJECTIVES: Osteoporosis is considered a generalised skeletal disorder in which there is impaired bone resistance, which predisposes the individual to a greater risk of fracture. The aim of this cross-sectional study was to collect and present data on the main clinical characteristics of patients who consult medical internists in Spain. Understanding these characteristics can help in implementing action plans to improve these patients' care more effectively and efficiently. MATERIAL AND METHODS: Through an analysis of the Osteoporosis in Internal Medicine (OSTEOMED) registry, this study presents the main clinical characteristics of patients with osteoporosis who attended internal medicine consultations in 23 Spanish hospital centres between 2012 and 2017. We analysed the reasons for the consultations, the densitometric values, the presence of comorbidities, the prescribed treatment and other lifestyle-related factors. RESULTS: In total, 2024 patients with osteoporosis were assessed (89.87% women, 10.13% men). The patients' mean age was 64.1±12.1 years (women, 64.7±11.5 years; men, 61.2±14.2 years). There was no significant difference between the sexes in their history of recent falls (9.1% and 6.7%); however, there were significant differences in the daily intake of calcium from milk products (553.8±332.6mg for women vs. 450.2±303.3mg for men; p<.001) and in the secondary causes of osteoporosis (13% of men vs. 6.5% of women; p<.001). In the sample, there were 404 fractures (20%), with a notable number of confirmed vertebral fractures (17.2%, 35.6% in men vs. 15.2% in women; p<.001). A large portion of the patients did not undergo the indicated treatment and presented low levels of physical activity and sun exposure. A significant percentage of the patients presented associated comorbidities, the most common of which were hypertension (32%) and dyslipidaemia (28%). CONCLUSIONS: These results define the profile of patients with osteoporosis who attend internal medicine consultations in Spain. The results also show the multisystemic character of this condition, which, along with its high prevalence, determine that the specific internal medicine consultations dedicated to managing the condition are the appropriate place for caring for these patients.


Assuntos
Medicina Interna , Osteoporose/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Cálcio da Dieta/administração & dosagem , Comorbidade , Estudos Transversais , Densitometria , Dislipidemias/epidemiologia , Exercício Físico , Feminino , Fraturas Ósseas/epidemiologia , Humanos , Hipertensão/epidemiologia , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Leite , Osteoporose/epidemiologia , Osteoporose/etiologia , Osteoporose/terapia , Sistema de Registros , Distribuição por Sexo , Espanha , Fraturas da Coluna Vertebral/epidemiologia , Luz Solar
11.
Injury ; 52 Suppl 4: S145-S150, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33750586

RESUMO

PURPOSE: Evaluate the Scratch Collapse Test in an objective way, by replacing the subjective evaluation made by the physician with an objective evaluation measure, made with a digital dynamometer. METHODS: Observational study carried out, in 90 patients divided into three groups of 30 patients, taking into account the electromyographic study of the median nerve in the carpal tunnel (no alteration, moderate, severe).The external rotation of the shoulder was measured in four different situations (no scratch, scratch over the carpal tunnel, scratch in the dorsum of the wrist and scratch in the shoulder). RESULTS: There were no statistical differences in the result of the strength in any of the four different situations in patients without carpal tunnel of with moderate carpal tunnel syndrome. However, there were statistical differences between the basal measurement (without scratching) and the measurement after tunnel scratching in patients with severe carpal tunnel syndrome. But this statistical difference was only 0.08 kg in the average measure, and this difference is clinically undetectable and far for producing a real collapse of the external rotation of the shoulder. CONCLUSION: The Scratch Collapse Test is not a valid diagnostic exam for carpal tunnel syndrome if the strength is measured in an objective manner.


Assuntos
Síndrome do Túnel Carpal , Síndrome do Túnel Carpal/diagnóstico , Humanos , Nervo Mediano , Articulação do Punho
12.
Rev Clin Esp ; 2020 Jul 15.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32682689

RESUMO

BACKGROUND AND OBJECTIVES: Osteoporosis is considered a generalised skeletal disorder in which there is impaired bone resistance, which predisposes the individual to a greater risk of fracture. The aim of this cross-sectional study was to collect and present data on the main clinical characteristics of patients who consult medical internists in Spain. Understanding these characteristics can help in implementing action plans to improve these patients' care more effectively and efficiently. MATERIAL AND METHODS: Through an analysis of the Osteoporosis in Internal Medicine (OSTEOMED) registry, this study presents the main clinical characteristics of patients with osteoporosis who attended internal medicine consultations in 23 Spanish hospital centres between 2012 and 2017. We analysed the reasons for the consultations, the densitometric values, the presence of comorbidities, the prescribed treatment and other lifestyle-related factors. RESULTS: In total, 2024 patients with osteoporosis were assessed (89.87% women, 10.13% men). The patients' mean age was 64.1±12.1 years (women, 64.7±11.5 years; men, 61.2±14.2 years). There was no significant difference between the sexes in their history of recent falls (9.1% and 6.7%); however, there were significant differences in the daily intake of calcium from milk products (553.8±332.6mg for women vs. 450.2±303.3mg for men; P<.001) and in the secondary causes of osteoporosis (13% of men vs. 6.5% of women; P<.001). In the sample, there were 404 fractures (20%), with a notable number of confirmed vertebral fractures (17.2%, 35.6% in men vs. 15.2% in women; P<.001). A large portion of the patients did not undergo the indicated treatment and presented low levels of physical activity and sun exposure. A significant percentage of the patients presented associated comorbidities, the most common of which were hypertension (32%) and dyslipidaemia (28%). CONCLUSIONS: These results define the profile of patients with osteoporosis who attend internal medicine consultations in Spain. The results also show the multisystemic character of this condition, which, along with its high prevalence, determine that the specific internal medicine consultations dedicated to managing the condition are the appropriate place for caring for these patients.

13.
Nat Commun ; 11(1): 2126, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32358532

RESUMO

Many inland waters exhibit complete or partial desiccation, or have vanished due to global change, exposing sediments to the atmosphere. Yet, data on carbon dioxide (CO2) emissions from these sediments are too scarce to upscale emissions for global estimates or to understand their fundamental drivers. Here, we present the results of a global survey covering 196 dry inland waters across diverse ecosystem types and climate zones. We show that their CO2 emissions share fundamental drivers and constitute a substantial fraction of the carbon cycled by inland waters. CO2 emissions were consistent across ecosystem types and climate zones, with local characteristics explaining much of the variability. Accounting for such emissions increases global estimates of carbon emissions from inland waters by 6% (~0.12 Pg C y-1). Our results indicate that emissions from dry inland waters represent a significant and likely increasing component of the inland waters carbon cycle.

14.
Arch Osteoporos ; 15(1): 63, 2020 04 25.
Artigo em Inglês | MEDLINE | ID: mdl-32335759

RESUMO

The coordination of Fracture Liaison Services (FLS) with Primary Care (PC) is necessary for the continuity of care of patients with fragility fractures. This study proposes a Best Practice Framework (BPF) and performance indicators for the implementation and follow-up of FLS-PC coordination in clinical practice in Spain. PURPOSE: To develop a BPF for the coordination of FLS with PC in Spain and to improve the continuity of care for patients with fragility fractures. METHODS: A Steering Committee selected experts from seven Spanish FLS and related PC doctors and nurses to participate in a best practice workshop. Selection criteria were an active FLS with an identified champion and prior contact with PC centres linked to the hospital. The main aim of the workshop was to review current FLS practices in Spain and their integration with PC. A BPF document with processes, tools, roles, and metrics was then generated. RESULTS: Spanish FLS consists of a multidisciplinary team of physicians/nurses but with low participation of other professionals and PC staff. Evaluation and treatment strategies are widely variable. Four desired standards were agreed upon: (1) Effective channels for FLS-PC communication; (2) minimum contents of an FLS clinical report and its delivery to PC; (3) adherence monitoring 3 months after FLS baseline visit; and (4) follow-up by PC. Proposed key performance indicators are (a) number of FLS-PC communications, including consensus protocols; (b) confirmation FLS report received by PC; (c) medical/nursing PC appointment after FLS report received; and (d) number of training sessions in PC. CONCLUSIONS: The BPF provides a comprehensive approach for FLS-PC coordination in Spain, to promote the continuity of care in patients with fragility fractures and improve secondary prevention. The implementation of BPF recommendations and performance indicator tracking will benchmark best FLS practices in the future.


Assuntos
Benchmarking , Continuidade da Assistência ao Paciente/normas , Fraturas por Osteoporose/terapia , Guias de Prática Clínica como Assunto , Atenção Primária à Saúde/normas , Feminino , Implementação de Plano de Saúde , Humanos , Masculino , Espanha
15.
Thromb Res ; 182: 20-26, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31442694

RESUMO

BACKGROUND: Prescription of compression stockings to prevent post-thrombotic syndrome (PTS) in adults is controversial. We sought to estimate the efficacy of compression stockings vs. placebo/no intervention (control) in preventing PTS, and to estimate the probability of observing a benefit when prescribing compression stockings to prevent PTS. METHODS: We conducted a systematic review of the literature in MEDLINE, EMBASE, and the Cochrane Central Register of Randomized Trials, searching for randomized controlled trials that compared compression stockings, applied in the acute setting of deep vein thrombosis, vs. control to prevent PTS. We used a Bayesian approach for data analysis. RESULTS: Four studies met our inclusion criteria. When comparing intervention vs. control, the estimated odds ratio (OR) was 0.57 (95% Credible Interval (CrI): 0.21 to 1.20) for PTS vs. no PTS and 0.79 (95% CrI 0.31 to 1.67) for severe vs. no/mild/moderate PTS. The probabilities of observing treatment benefits in the population if prescribing compression stockings ranged between 47% (large benefit, OR < 0.50) and 95% (small benefit, OR < 1.00) for any PTS and between 16% and 82% (from large to small benefit) for severe PTS. The probabilities of observing benefit of compression stockings in a future study ranged 44%-76% and 25%-72% (from large to small benefit) for any PTS and severe PTS, respectively. CONCLUSION: Despite heterogeneity, data show that it is still probable to observe some degree of treatment benefit when prescribing compression stockings and to observe some degree of treatment benefit in a future study.


Assuntos
Síndrome Pós-Trombótica/prevenção & controle , Meias de Compressão , Teorema de Bayes , Humanos , Razão de Chances , Síndrome Pós-Trombótica/etiologia , Probabilidade , Ensaios Clínicos Controlados Aleatórios como Assunto , Trombose Venosa/complicações , Trombose Venosa/terapia
16.
J Environ Manage ; 238: 153-158, 2019 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-30851553

RESUMO

MSW compost valorization under combustion, at two different composting process conditions, have been studied by thermogravimetric analysis (TGA). The composting operating parameters such as aeration and moisture affect the biodegradability of compost and results of the combustion (different gross heating values for each reactors). The obtained TGA showed that maximum weight loss for 10-12% (245-247 °C), 32-34% (407-411 °C) and 44-46% (760-769 °C) in correspondence to hemicellulose, cellulose and lignin-humic-fulvic acids decomposition for each reactor are observed. Obtained valued in kinetic study (Flynn-Wall-Ozawa method) results in suitable coefficients of determination. In that form, to establish the assumption that combustion of compost under a first-order reaction may be appropriate. Moreover, in both reactors, the conversion rate increased and the activation energy decreased with composting time is found. The maximum gross heating value versus minimum activation energy (for α = 0.25 and α = 0.5) corresponds to final composts and under aeration of 0.050 and 0.175 Lair kg-1 d-1 and moisture of 40% and 55% for R1 and R2 reactors respectively. For MSW, under proper conditions, composting could be used as a suitable biodrying process, stabilizing and concentrating the heating value.


Assuntos
Compostagem , Celulose , Substâncias Húmicas , Lignina , Solo
17.
Probiotics Antimicrob Proteins ; 11(2): 470-477, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-29862461

RESUMO

It has been recognized that lactic acid bacteria exhibit antioxidant properties, which have been mainly endorsed to the intact viable bacteria. However, recent studies have shown that intracellular content (IC) may also be good sources of antioxidative metabolites, which may potentially contribute to oxidative homeostasis in vivo. Hence, the modulatory effect of the intracellular content of Lactobacillus casei CRL 431 (IC431) on aflatoxin B1 (AFB1)-induced oxidative stress in rats was evaluated on the basis of its influence on hepatic lipid peroxidation (LPO), antioxidant status-antioxidant capacity (TAC), catalase (CAT), and glutathione peroxidase (GPx) activities; and on the oxidative stress index (OSi). Results demonstrated that CAT and GPx activities, and TAC, determined in plasma samples, were significantly (P < 0.05) higher in rats treated with AFB1 plus IC431 (3.98 µM/min/mg protein, 1.88 µM/min/mg protein, and 238.7 µM Trolox equivalent, respectively) than AFB1-treated rats (3.47 µM/min/mg protein, 1.46 µM/min/mg protein, and 179.7 µM Trolox equivalent, respectively). Furthermore, plasma and liver tissue samples from rats treated with AFB1 plus IC431 showed significantly (P < 0.05) lower LPO values (52 and 51%, respectively) and OSi (59 and 51%, respectively) than AFB1-treated rats. Hence, our results proved that the intracellular content of Lact. casei CRL 431 contains metabolites that are capable to modulate the antioxidant defense systems in living organism, which may help to ameliorate the damage associated to AFB1-induced oxidative stress.


Assuntos
Aflatoxina B1/toxicidade , Lacticaseibacillus casei , Estresse Oxidativo/efeitos dos fármacos , Animais , Catalase/metabolismo , Glutationa Peroxidase/metabolismo , Lacticaseibacillus casei/metabolismo , Peroxidação de Lipídeos/efeitos dos fármacos , Masculino , Ratos , Ratos Wistar
18.
Vet J ; 233: 41-48, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29486878

RESUMO

African swine fever (ASF) recently has spread beyond sub-Saharan Africa to the Trans-Caucasus region, parts of the Russian Federation and Eastern Europe. In this new epidemiological scenario, the disease has similarities, but also important differences, compared to the situation in Africa, including the substantial involvement of wild boar. A better understanding of this new situation will enable better control and prevent further spread of disease. In this article, these different scenarios are compared, and recent information on the pathogenesis of ASF virus strains, the immune response to infection and prospects for developing vaccines is presented. Knowledge gaps and the prospects for future control are discussed.


Assuntos
Febre Suína Africana/epidemiologia , Sus scrofa , Febre Suína Africana/imunologia , Febre Suína Africana/prevenção & controle , Vírus da Febre Suína Africana/genética , Vírus da Febre Suína Africana/patogenicidade , Animais , Europa Oriental/epidemiologia , Genótipo , Federação Russa/epidemiologia , Suínos , Vacinas Virais
19.
Rev. chil. radiol ; 23(2): 66-76, 2017. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-900108

RESUMO

Disc herniation is a frequent pathology in the radiologist's daily practice. There are different pathologies that can simulate a herniated disc from the clinical and especially the imaging point of view that we should consider whenever we report a herniated disc. These lesions may originate from the vertebral body (osteophytes and metastases), the intervertebral disc (discal cyst), the intervertebral foramina (neurinomas), the interapophyseal joints (synovial cyst) and from the epidural space (hematoma and epidural abscess).


La hernia discal es una patología frecuente en la práctica diaria del radiólogo. Hay distintas patologías que pueden simular una hernia discal desde el punto de vista clínico y especialmente imagenológico que debemos considerar cada vez que informamos una hernia discal. Estas lesiones pueden provenir del cuerpo vertebral (osteofitos y metástasis), del disco intervertebral (quiste discal), de los forámenes intervertebrales (neurinomas), de las articulaciones interapofisiarias (quiste sinovial) y desde el espacio epidural (hematoma y absceso epidural).


Assuntos
Humanos , Espectroscopia de Ressonância Magnética/estatística & dados numéricos , Deslocamento do Disco Intervertebral/diagnóstico , Cisto Sinovial/diagnóstico por imagem , Abscesso Epidural/diagnóstico , Deslocamento do Disco Intervertebral/diagnóstico por imagem
20.
Rev. chil. radiol ; 23(2): 80-89, 2017. ilus
Artigo em Espanhol | LILACS | ID: biblio-900110

RESUMO

The expression "there is an elephant in the room" refers to an obvious problem that goes unnoticed. Often we wonder how it was possible that we have not reported a major lesion ("the size of an elephant") in the report that comes into our hands for review. Unlike clinical findings such as the anamnesis and the physical examination, evidence from the radiological examination remains available for subsequent reviews. The error and its consequences are a phenomenon that vertically and horizontally traverse all the medical specialties and those who perform within them. Radiologists are not exempt from this. During each stage of the reporting process, the radiologist may make mistakes. In this article we will concentrate on those errors in which the radiologist participates directly, with graphical representations that illustrate the nature of the error in each case. We will review the phases of the imaging diagnosis and the different types of errors such as Perceptual Errors (error by under-reading, search satisfaction errors, and error due to alterations outside the study area), Cognitive errors (complacency error, error of reasoning, alliterative error, error due to lack of knowledge, error due to lack of clinical records and error due to lack of consultation of previous examinations), Communication error and study type error. Because we cannot completely eliminate the diagnostic errors in our daily practice, we cannot guarantee the outcome; but we can demonstrate that we have done our best, with duly justified technical quality examinations, in the adequate time and with the necessary security.


La expresión "hay un elefante en la habitación", se refiere a que existe un problema obvio que pasa inadvertido. Muchas veces nos preguntamos cómo fue posible que no hayamos reportado una gran lesión ("del tamaño de un elefante") en el informe que llega a nuestras manos para revisión. A diferencia de los hallazgos clínicos como la anamnesis y el examen físico, la evidencia del examen radiológico permanece disponible para revisiones subsecuentes. El error y sus consecuencias son un fenómeno que cruza vertical y horizontalmente todas las especialidades médicas y a quienes en ellas se desempeñan. Los radiólogos no estamos exentos de ello. Durante cada etapa del proceso de informe, el médico radiólogo puede cometer errores. En este artículo nos concentraremos en aquellos errores en los que el radiólogo participa directamente, con representaciones gráficas que ilustran la naturaleza del error en cada caso. Revisaremos las fases del diagnóstico por imágenes y los diferentes tipos de errores como los Errores de percepción (error por sub-lectura, error por satisfacción de la búsqueda y error debido a alteraciones fuera del área de estudio), Errores cognitivos (error de complacencia, error de razonamiento, error aliterativo, error por falta de conocimientos, error por falta de antecedentes clínicos y error por falta de consulta de exámenes previos), Error de comunicación y Error de tipo de estudio. Debido a que no podemos eliminar completamente los errores diagnósticos en nuestra práctica diaria, no podemos garantizar el resultado; pero podemos demostrar que hicimos lo mejor posible, con exámenes de calidad técnica, debidamente justificados, en el tiempo adecuado y con la seguridad necesaria.


Assuntos
Humanos , Sistemas de Informação em Radiologia/estatística & dados numéricos , Erros de Diagnóstico/estatística & dados numéricos , Sistemas de Informação em Radiologia , Erros de Diagnóstico/tendências
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