RESUMO
Fast environmental changes and high coastal human pressures and impacts threaten the Mediterranean Sea. Over the last decade, recurrent blooms of the harmful dinoflagellate Ostreopsis cf. ovata have been recorded in many Mediterranean beaches. These microalgae produce toxins that affect marine organisms and human health. Understanding the environmental conditions that influence the appearance and magnitude of O. cf. ovata blooms, as well as how climate change will modify its future distribution and dynamics, is crucial for predicting and managing their effects. This study investigates whether the spatio-temporal distribution of this microalga and the frequency of its blooms could be altered in future climate change scenarios in the Mediterranean Western basin. For the first time, an ecological habitat model (EHM) is forced by physico-chemical climate change simulations at high-resolution, under the strong greenhouse gas emission trajectory (RCP8.5). It allows to characterize how O. cf. ovata may respond to projected conditions and how its distribution could shift over a wide spatial scale, in this plausible future. Before being applied to the EHM, future climate simulations are further refined by using a statistical adaptation method (Cumulative Distribution Function transform) to improve the predictions robustness. Temperature (optimum 23-26 °C), high salinity (>38 psu) and high inorganic nutrient concentrations (nitrate >0.25 mmol N·m-3 and phosphate >0.035 mmol P·m-3) drive O. cf. ovata abundances. High spatial disparities in future abundances are observed. Namely, O. cf. ovata abundances could increase on the Mediterranean coasts of France, Spain and the Adriatic Sea while a decrease is expected in the Tyrrhenian Sea. The bloom period could be extended, starting earlier and continuing later in the year. From a methodological point of view, this study highlights best practices of EHMs in the context of climate change to identify sensitive areas for current and future harmful algal blooms.
Assuntos
Mudança Climática , Dinoflagellida , Mar Mediterrâneo , Proliferação Nociva de Algas , Monitoramento Ambiental , EcossistemaRESUMO
BACKGROUND AND OBJECTIVE: In Spain, Quality Units play a key and unique role in advising healthcare centers on the methodology of healthcare quality. The objectives of the study were to develop computer algorithms to obtain a synthetic indicator of standard compliance for Quality Units and to pilot its functioning in these units. MATERIALS AND METHODS: The Excel program was used to establish evaluation algorithms, and quantitatively interrelate and weight various categories of standards, as a computer evaluation tool, to build a continuous improvement cycle system, and offer a global synthetic indicator of compliance. The tool was tested in a prospective multicenter pilot study, in which coordinators of Quality Units from different health centers and care settings participated, to evaluate the usefulness of the tool and compliance with the standards, in addition to analyzing the content validity of each standard. RESULTS: The formulas for the structured computer algorithms were developed, consecutively, in a «PLAN-DO-CHECK-ACT¼ improvement cycle for the 9 categories of standards, resulting in a single synthetic indicator of compliance. Twenty-one Quality Units participated in the piloting. The overall average compliance rate for the synthetic indicator was 55.63% with differences between centers (P=.002) and between categories (P<.0001), but not by autonomous communities (P=.86) or by areas (P=.97). Content validity was ensured through the variable of «understanding¼ of the standards (P<.001), and through their «justification¼ with documentary evidence (P<.001). CONCLUSIONS: The computer tool with the synthetic indicator have allowed for the evaluation of standard compliance in Quality Units of healthcare centers.
Assuntos
Fidelidade a Diretrizes , Indicadores de Qualidade em Assistência à Saúde , Projetos Piloto , Estudos Prospectivos , Espanha , Humanos , Algoritmos , Melhoria de Qualidade , Qualidade da Assistência à Saúde/normasRESUMO
Se presenta el caso clínico de un varón de 80 años diagnosticado de leiomiosarcoma testicular primario, a raíz de alteraciones del perfil hepático en analítica sanguínea y lesiones ocupantes de espacio (LOE) hepatoesplénicas en ecografía abdominal. En primer lugar, se realizó punción de lesión hepática y posteriormente orquiectomía radical, revelando concordancia histológica, compatible con leiomiosarcoma intratesticular. Presentamos el caso clínico debido a la rareza de ese tipo de tumores, sobre todo en estadio III, y su peculiar diagnóstico, tras la detección de alteración hepática tanto analítica como ecográfica
We present a case of an 80-year-old male diagnosed with primary testicular leiomyosarcoma due to the detection of hepatic profile analytical alterations and hepatosplenic space-occupying lesions in abdominal ultrasound. Puncture of hepatic lesion was performed first and radical orchiectomy later, revealing histological concordance, compatible with intratesticular leiomyosarcoma. We present the case due to the uncommon of this type of tumors, especially in stage III and its peculiar diagnosis, secondary of hepatic alteration, both analytic and ultrasound.
Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Neoplasias Testiculares , Orquiectomia , Leiomiossarcoma , Fígado/anormalidades , Neoplasias Hepáticas , Biópsia , Ultrassonografia , NeoplasiasRESUMO
O intuito deste trabalho foi determinar a dosagem da lisozima na lagrima humana, sem fazer comparacoes com valores determinados por outros autores. Sapse (1968). A amostragem foi de 95 voluntarios, com uma faixa etaria variando de 17 a 22 anos de idade. A partir dos dados obtidos, chegamos a conclusao de que a media e de 1.975,5 +/- 593,1 mcg/ml