RESUMO
The classification of Respirable Crystalline Silica (RCS) as carcinogenic for humans has drawn greater attention to crystalline silica exposure in the workplace in recent years, leading to recommendations by safety and health bodies in Europe and the U.S. for lower occupational exposure limits. In view of this new scenario, the present study examined quartz dustiness, as quartz handling is a major source of crystalline silica in the workplace. The study was conducted on test samples with different mean particle sizes, prepared from several commercial quartzes. The quartz particle samples were characterised and the influence of certain quartz particle parameters on quartz dustiness was determined. The results indicate that quartz dustiness may be significantly affected by mean particle size, specific surface area, the Hausner ratio, and fine particle content. The study shows that, in order to minimise the adverse health effects associated with the inhalation of crystalline silica, quartz dustiness may be deemed a key factor in controlling the generation of fugitive quartz emissions during quartz processing, both into the outside atmosphere (air pollution) and inside the facilities (occupational health).
Assuntos
Exposição por Inalação/análise , Exposição Ocupacional/análise , Quartzo/análise , Dióxido de Silício/análise , Poeira/análise , Humanos , Exposição por Inalação/prevenção & controle , Exposição Ocupacional/prevenção & controle , Tamanho da Partícula , Local de TrabalhoRESUMO
Sentiment and emotion play a crucial role in financial journalism, influencing market perceptions and reactions. However, the impact of the COVID-19 crisis on the language used in financial newspapers remains underexplored. The present study addresses this gap by comparing data from specialized financial newspapers in English and Spanish, focusing on the years immediately prior to the COVID-19 crisis (2018-2019) and during the pandemic itself (2020-2021). We aim to explore how the economic upheaval of the latter period was conveyed in these publications and investigate the changes in sentiment and emotion in their language compared to the previous timeframe. To this end, we compiled comparable corpora of news items from two respected financial newspapers (The Economist and Expansión), covering both the pre-COVID and pandemic periods. Our corpus-based, contrastive EN-ES analysis of lexically polarized words and emotions allows us to describe the publications' positioning in the two periods. We further filter lexical items using the CNN Business Fear and Greed Index, as fear and greed are the opposing emotional states most often linked to financial market unpredictability and volatility. This novel analysis is expected to provide a holistic picture of how these specialist periodicals in English and Spanish have emotionally verbalized the economic havoc of the COVID-19 period compared to their previous linguistic behaviour. By doing so, our study contributes to the understanding of sentiment and emotion in financial journalism, shedding light on how crises can reshape the linguistic landscape of the industry.
Assuntos
Epilepsia Tônico-Clônica/etiologia , Leucoencefalite Hemorrágica Aguda/complicações , Antivirais/uso terapêutico , Afasia/etiologia , Edema Encefálico/tratamento farmacológico , Edema Encefálico/etiologia , Edema Encefálico/cirurgia , Terapia Combinada , Craniectomia Descompressiva , Humanos , Leucoencefalite Hemorrágica Aguda/diagnóstico por imagem , Leucoencefalite Hemorrágica Aguda/tratamento farmacológico , Leucoencefalite Hemorrágica Aguda/cirurgia , Masculino , Metilprednisolona/uso terapêutico , Paresia/etiologia , Plasmaferese , Infecções Respiratórias/complicações , Adulto JovemRESUMO
TITLE: Hemorragias cerebrales múltiples secundarias a coagulación intravascular diseminada en un paciente con COVID-19.
Assuntos
COVID-19 , Coagulação Intravascular Disseminada , Hemorragia Cerebral/etiologia , Coagulação Intravascular Disseminada/etiologia , Humanos , SARS-CoV-2RESUMO
OBJECTIVE: To establish variations in clinical practice associated with maintaining the patency of peripheral intravenous catheters (PIC) and to determine to what extent such clinical practice falls within the limits of the available scientific evidence, based on a random sample Spanish public hospitals. METHODS: A cross-sectional, descriptive study was carried out in non-psychiatric public hospitals and their associated medical and surgical units. Cluster (hospitals), stratified (hospital size), and single level (all units) sampling was applied. A questionnaire was mailed to all of the units involved. RESULTS: A sample of 341 valid questionnaires was analysed (response rate 54.5%). Only one praxis-modality was carried out in the majority of units. Intermittent flushing and heparin saline versus normal saline was the most frequent modality employed, over those of continuous flushing and non-heparinised saline. There was a high degree of variation in the quantity of heparin administered: 81.7% when flushing was carried out with heparinised saline and 48.2% when it was conducted with concentrated heparin. About 40% of this variation was associated with the hospital in question, rather than with the unit. The clinical practice fell within the limits of available scientific evidence in fewer than half of the units studied. CONCLUSIONS: There was a high degree of variability in the practice of maintaining PIC patency. A significant part of this variation was attributable to the hospital in which the practice was carried out. Moreover, most of this practice was carried out beyond the limits of available scientific evidence.
Assuntos
Cateterismo Periférico/instrumentação , Cateterismo Periférico/normas , Análise de Variância , Protocolos Clínicos , Estudos Cross-Over , Fibrinolíticos/administração & dosagem , Heparina/administração & dosagem , Hospitais Públicos , Humanos , Cloreto de Sódio/administração & dosagem , Espanha , Inquéritos e Questionários , Irrigação Terapêutica/métodosAssuntos
COVID-19/epidemiologia , Hospitalização/estatística & dados numéricos , Unidades de Terapia Intensiva/estatística & dados numéricos , Pandemias , SARS-CoV-2 , Adulto , Idoso , COVID-19/complicações , COVID-19/mortalidade , Teste para COVID-19/métodos , Comorbidade , Estudos Transversais , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Respiração Artificial/estatística & dados numéricos , Insuficiência Respiratória/terapia , Estudos Retrospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Estatísticas não Paramétricas , Traqueostomia/estatística & dados numéricosRESUMO
We retrospectively analyzed our experience with the Quinton-Mahurkar dual-lumen hemodialysis catheter as short-term central venous access for harvesting peripheral blood stem cells (PBSC) for autologous transplantation. For intensification therapy for various malignancies 370 leukaphereses were performed in 110 candidates. The catheter was placed percutaneously under local anesthesia only for the time of blood collection and in no case was it used for the PBSC transplant. No systemic antithrombotic prophylaxis was administered. PBSC were collected using a continuous flow cell separator, COBE Spectra, after mobilization with chemotherapy followed by cytokine: rhGM-CSF and rhG-CSF s.c. (35 patients) or rhG-CSF s.c. alone (75 patients). The median number of aphereses was two (1-13). Eighty-nine patients (81.3%) required three or fewer sessions to collect the minimum mononuclear cell target number of 6 x 10(8) MNC/kg. The volume of blood per kg body weight processed for each apheresis was 240 ml (range 150-560 ml) equivalent to 13 l (6-30 l) and the median flow rate was 61 ml/min (range 30-90 ml/min). The total CD34+ cell yield per patient was 3.55 x 10(6)/kg (0.26-34.8) and the MNC yield was 6.1 x 10(8)/kg (2.96-12.6). We observed the following complications: local infection in four cases (3.6%), catheter occlusion for local thrombosis in two cases (1.8%) and pneumothorax in one case (0.97%). In our experience the Mahurkar-Quinton catheter, when placed specifically for apheresis sessions, was very effective and safe for PBSC harvesting with a low incidence of complications.
Assuntos
Cateterismo Venoso Central/instrumentação , Transplante de Células-Tronco Hematopoéticas , Leucaférese/instrumentação , Transplante de Células-Tronco Hematopoéticas/instrumentação , Transplante de Células-Tronco Hematopoéticas/métodos , Humanos , Estudos Retrospectivos , Transplante AutólogoRESUMO
We present herein a case of acute nonlymphocytic leukemia, type M2 of the FAB classification, in which the cytogenetic study of the bone marrow cells showed a trisomy 4 as the only alteration. This case was detected from among 118 cases of acute nonlymphocytic leukemia under cytogenetic study.
Assuntos
Cromossomos Humanos Par 4 , Leucemia/genética , Trissomia , Doença Aguda , Marcadores Genéticos , Humanos , Cariotipagem , Masculino , Pessoa de Meia-IdadeRESUMO
Auditory neuropathy is a sensorineural disorder characterized by absent or abnormal auditory brainstem evoked potentials and normal cochlear outer hair cell function. A variety of processes is thought to be involved in its pathophysiology and their influence on hearing may be different. We present here the diagnostic sequence and management of two new cases of auditory neuropathy in breastfeeding children.
Assuntos
Perda Auditiva Neurossensorial/diagnóstico , Doenças do Nervo Vestibulococlear/diagnóstico , Estimulação Acústica , Transtornos da Percepção Auditiva/diagnóstico , Transtornos da Percepção Auditiva/fisiopatologia , Tronco Encefálico/fisiopatologia , Nervo Coclear/fisiopatologia , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Feminino , Seguimentos , Células Ciliadas Auditivas Externas/fisiopatologia , Perda Auditiva Neurossensorial/fisiopatologia , Humanos , Lactente , Masculino , Emissões Otoacústicas Espontâneas/fisiologia , Doenças do Nervo Vestibulococlear/fisiopatologiaRESUMO
UNLABELLED: Tunneled cuffed hemodialysis catheters (THC) are developed as a means of short hemodialysis access while a more permanent form of access are maturing. The aim of this study is to investigate the effectiveness, survival and complications of the THC used for long-term vascular access. METHODS: In a retrospective study we looked at 42 THC inserted between November 2000 and October 2003, in 40 elderly patients, with systemic disease or when other vascular access was not possible. RESULTS: Procedural complications occurred in 5 cases (11.9%), which included: local haemorrhage (3), hemothorax (1) and one fatal venous tear. 6 catheters (14.2%) were removed due to complications (non-function 3 and bacteraemia 3). The total incidence of THC related infections was 0.18 episodes/1,000 catheters-days. Patients were followed up for a mean 379 days (range 1-1,140) and a total of 15,946 catheter-days. Qb and KT/V achieved at one month were 278.3 +/- 34.1 ml/min and 1.48 +/- 0.27 respectively. At the end of the follow-up, 23 patients (54.7%) were alive with catheter functioning. One, three and twelve months survival was 90.4%, 73.1% and 59.5% respectively. CONCLUSION: The THC may be a useful alternative permanent vascular access for hemodialysis patients when others vascular access are not possible.
Assuntos
Cateterismo Venoso Central/efeitos adversos , Cateterismo Venoso Central/métodos , Cateteres de Demora/efeitos adversos , Falência Renal Crônica/terapia , Diálise Renal/métodos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do TratamentoRESUMO
The purpose of this study has been to refer the main clinico-biologic characteristics, the evolution and the response to therapy in 6 patients with acute myelomonocytic leukemia with eosinophilia and inversion of chromosome 16 (AML4Eo inv[16]) belonging to a series of 92 patients with acute myeloblastic leukemia diagnosed in a single hospital between 1987 and 1995. The main clinical manifestations were anemic syndrome and hemorrhage. Anemia and thrombocytopenia were present in all cases, high white blood cell count in 4, monocytosis in 5 and eosinophilia in one. Bone marrow aspirate showed myeloid and monocytic blast infiltration (43-62%), eosinophilia (5-19%) and atypical monocytic precursors (6-18%). Induction therapy consisted in one or two cycles of daunorubicin (or idarubicin), cytosine arabinoside and etoposide, followed by two cycles of consolidation treatment, the first with mitoxanthrone and cytosine arabinoside and the second with amsacrine and cytosine arabinoside. One patient died in the induction phase, while complete remission was obtained in the remaining 5. One patient died during the consolidation therapy. Allogeneic bone marrow transplant (BMT) was performed to one patient and autologous BMT to another. The first patient remains in complete remission (CR) at 68 months from diagnosis, and the second relapsed 12 months after BMT. Another patient relapsed at 13 months from diagnosis and the remaining persists in CR 13 months from diagnosis. Actuarial probabilities of CR duration and survival were 50% at 5 years. The clinico-biologic characteristics and the response to therapy of patients with AML4Eo inv(16) are similar to those referred in other series. There is a high probability of CR attainment and, probably, the relapse rate is lower than that of other subtypes of AML.
Assuntos
Inversão Cromossômica , Cromossomos Humanos Par 16 , Eosinofilia , Leucemia Mielomonocítica Aguda , Adolescente , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Transplante de Medula Óssea , Feminino , Humanos , Leucemia Mielomonocítica Aguda/genética , Leucemia Mielomonocítica Aguda/terapia , Masculino , Pessoa de Meia-Idade , Indução de RemissãoRESUMO
Although cardiac infiltration is common in advanced stage of acute leukaemia, it is not usually diagnosed at life and it is extremely rare for it to become pseudotumoral. A 25-years-old patient with an acute monoblastic leukaemia who had a leukaemic infiltration which affected the main part of the left ventricle at the time of diagnosis, is referred. The heart infiltration was detected by a two dimension echocardiography. In spite of a massive infiltration, heart failure was not present and the left ventricle's ejection fraction was 50%. Even though chemotherapy was administered, the patient died four days after diagnosis due to septic shock of respiratory origin. The most relevant autopsy finding was a widespread pseudotumoral infiltration of the left ventricle, the back side of the right ventricle and the interventricular wall. The pseudotumoral infiltration of the heart by acute leukaemia is uncommon and must be differentiated from granulocytic sarcoma. The usefulness of the different diagnostic procedures is discussed.
Assuntos
Neoplasias Cardíacas/patologia , Leucemia Monocítica Aguda/patologia , Adulto , Autopsia , Ecocardiografia , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/etiologia , Ventrículos do Coração/patologia , Humanos , Leucemia Monocítica Aguda/complicações , Masculino , Volume SistólicoRESUMO
Sevoflurane is a fluoridated derivative of methyl isopropyl ether. Its administration does not require the use of sophisticated vaporizers and its blood/gas partition coefficient is 0.69. Sevoflurane is the only ethereal anesthesia that does not trigger a reflex response or cause airway irritation during inhaled induction. It offers a high level of precision in the control of deep anesthesia during maintenance, recovery is rapid, and MAC is 2%. Sevoflurane seems to be the pediatric anesthetic of choice and it is also highly useful for anesthesia in ambulatory patients. Sevoflurane gives rise to hemodynamic stability, is not arrhythmogenic, and does not sensitize the myocardium to the effects of catecholamines. The effects on cerebral blood flow are minimal at low concentrations. Metabolism is 3-4%. Renal toxicity has not been reported even though fluoride is a metabolic product. Sevoflurane breaks down in the presence of soda lime, producing compound A and giving rise to controversy and investigation although the toxicity of compound A is more theoretical than real. Sevoflurane is not harmful to the ozone layer.
Assuntos
Anestésicos Inalatórios/farmacologia , Éteres/farmacologia , Éteres Metílicos , Anestésicos Inalatórios/efeitos adversos , Anestésicos Inalatórios/química , Anestésicos Inalatórios/farmacocinética , Biotransformação , Quelantes/metabolismo , Interações Medicamentosas , Éteres/efeitos adversos , Éteres/química , Éteres/farmacocinética , Hemodinâmica/efeitos dos fármacos , Humanos , Rim/efeitos dos fármacos , Fígado/efeitos dos fármacos , Respiração/efeitos dos fármacos , SevofluranoRESUMO
Following the development of an up-to-date audiological technique--as it seems to be--the register of acoustic distortion products 2F1-F2, the AA. have undertaken the study of the characteristics of otoacoustic emissions in a new-born normal hearing group. They describe the features of distortion products audiogram (DP-gram) of the collective, the limitations of the test and its possible clinical appliances.
Assuntos
Estimulação Acústica , Cóclea/fisiologia , Potenciais Evocados Auditivos do Tronco Encefálico , Recém-Nascido , Audiometria de Tons Puros , Transtornos da Audição/diagnóstico , Humanos , Triagem NeonatalRESUMO
Fifty patients (32 women, 18 men) who underwent stapedectomy [FISCH, V. (1), 1982] for otosclerosis were studied. Histo-compatibility antigens were typed in all patients using the microlymphocytic test to determine antigens of the HLA system loci A and B. Statistical comparison of results with those obtained in a control group of 339 persons without otosclerosis showed that otosclerosis has a genetic HLA-related component.
Assuntos
Antígenos HLA/genética , Otosclerose/genética , Cromossomos Humanos Par 6 , Feminino , Histocompatibilidade , Humanos , Masculino , Otosclerose/cirurgia , Cirurgia do EstriboRESUMO
A group of 122 patients that underwent a total laryngectomy and phonatory prosthesis surgery are evaluated after five years follow up. We compared three different techniques. 1) Herrmann technique; 2) total laryngectomy and inferior pharyngeal constrictor myotomy, and 3) classic total laryngectomy. Failures and complications are analyzed. A functional evaluation of the patients is made by means of oesophageal manometry and pharyngo-oesopyhageal isotopic transport. Voice quality is assessed in each group. As a conclusion inferior pharyngeal constrictor myotomy is very positively evaluated.
Assuntos
Músculos Laríngeos/cirurgia , Laringectomia/métodos , Laringe Artificial , Idoso , Seguimentos , Humanos , Laringectomia/efeitos adversos , Laringe Artificial/efeitos adversos , Pessoa de Meia-Idade , Fatores de Tempo , Falha de TratamentoRESUMO
We report three cases of ceruminoma seen in our department over a 1-year period and review the neoplasms of the ceruminous glands. According to the Welti classification, our three cases were ceruminous adenocarcinomas. Based on existing literature, ceruminous adenocarcinoma is the least frequent neoplasm of the ceruminous glands.
Assuntos
Adenocarcinoma/patologia , Neoplasias da Orelha/patologia , Orelha Externa/patologia , Orelha Média/patologia , Idoso , Neoplasias da Orelha/ultraestrutura , Orelha Externa/ultraestrutura , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Invasividade NeoplásicaRESUMO
We present the case of a thirty-eight years-old man bearing of frequent crisis of asphyxiating wakefulness and breathnessless whenever he was asleep. There also were excessive daytime sleepiness and a strong snore before every wakefulness, but not for the rest of sleep. A polysomnographic study revealed normal values in the oxygen desaturation index, minimum oxygen saturation, an sleep structure alteration with a decrease of III-IV stages, high arousals index and RDI < 5. Pharyngeal diameters measured by mean of TC were normal, but sleepiness degree detected in the Epworth scale was high. Nasal fiberoptic endoscopy study allowed to see a swinging epiglottis that closed totally the upper airway during forced inspiration. The lack of desaturation episodes with numerous wakefulness along the sleep and excessive daytime sleepiness drove to the diagnosis of upper airway resistance syndrome (UARS). Treatment whit C-PAP just provoked an impairment in symptoms, but a CO2-laser partial epiglottectomy improved them. Patophysiological aspects of UARS, as well as its follow-up and therapeutic alternatives are commented.