Nitrogen and phosphorus budget in an intensive irrigation area and effects on littoral water and groundwater (Yaqui Valley, Northwestern Mexico).

The Yaqui River Irrigation District is a region in Mexico with intensive agricultural production; thus, large quantities of fertilizers are used, and excess fertilizer can affect the quality of water bodies. The aim of this work was to estimate the water budget and nitrogen (N) and phosphorous (P) mass budgets to evaluate possible contamination of a littoral water body (Tóbari Bay) and leachates into an aquifer (Yaqui Valley aquifer). Wheat and corn crops were studied, climate information was compiled, and soil and water samples were collected for analysis. The water budget showed excess irrigation occurred due to the need for soil washing to prevent salinization. A total of 24% of all irrigation water was used for crops, 60% was discharged into the bay through runoff of the drainage system, and 16% corresponded to effective infiltration (aquifer recharge). The N budget showed that of the 100% N input, the highest percentage was used by plants (63%), and only minimal loss occurred through runoff (11%) and leachate into the aquifer (7%). The remaining N stayed in the soil (18%) or was volatilized (1%). These results indicate that the drainage system prevented large amounts of N from entering the aquifer; thus, the N concentrations in the groundwater did not exceed the regulated maximum limit for drinking water (10 mg N-NO3/L). In terms of the water pollution level in the bay, the presence of NO3- was minimal (concentrations below the quasintifiable limit). Of the 100% of P that was applied, 55% was used by the plants, and 40% remained in the soil; therefore, the P that was transported by runoff or was leached was minimal (3 and 2%, respectively). However, this minimal amount of P ranged from 0.1 to 0.2 mg/L in the bay, and these values exceeded the suggested values for the protection of aquatic life (0.01 mg/L). The administrators of the irrigation district must pay special attention to phosphate fertilizer management and implement irrigation techniques that increase water use efficiency.

A baseline assessment of hydrologic alteration degree for the Mexican catchments at gauged rivers (2016).

River regime has been modified in several freshwater bodies around the world. This alteration has led to species loss, water pollution, higher or lesser economic profits, changes in magnitude, timing, duration and rate change of flow, among others. Thus, hydrologic alteration assessment allows evaluating the regime parameters so that stakeholders, decision-makers, and dams managers may take efficient actions to mitigate or rehabilitate riparian ecosystems. In the present study, Hydrologic Alteration Indexes on Rivers (IAHRIS, for its acronym in Spanish) and the Mexican standard approach were considered to evaluate 1150 gauged catchments in Mexico and come up with an alteration baseline for 67.03% of the country surface. The comparison may assist stakeholders to propose potential changes in the Mexican standard approach. Results reveal that 232 analyzed catchments can be considered as non-altered according to IAHRIS. In stark contrast, there are 281 non-altered catchments in Mexico in agreement with the official standard approach. Altered catchments are mainly impacted by minimum flow metrics and connectivity discharge. Additionally, the correlation between alteration indexes and 5 socio-economic variables was checked to identify which variables may greatly impact hydrologic alteration evolution or mitigation. From the five selected variables, the Human Development Index is significatively correlated to extreme minimum metrics (p = 0.94) while the Gross Domestic Product to extreme maximum metrics (p = 0.90).

Validation of the Spanish-language version of the Montreal Cognitive Assessment test in adults older than 60 years. / Validación del instrumento Montreal Cognitive Assessment en español en adultos mayores de 60 años.

INTRODUCTION: Few studies have validated the Spanish-language version of the Montreal Cognitive Assessment (MoCA-S) test in Latin American populations. OBJETIVE: To evaluate the psychometric properties and discriminant validity of the MoCA-S in elderly patients in Santiago de Chile. METHODS: 172 individuals were grouped according to their clinical diagnosis based on the Clinical Dementia Rating (CDR) scale as follows: amnestic mild cognitive impairment (aMCI; n±24), non-amnestic MCI (naMCI; n±24), mild dementia (n±20), and cognitively normal (n±104). Participants were evaluated with both the MoCA-S and the Mini-Mental State Examination (MMSE) to determine the discriminant validity of the MoCA-S. RESULTS: Mean age and years of schooling were 73±6 and 11±4 years, respectively, with no significant intergroup differences. The MoCA-S displayed good internal consistency (Cronbach's α: 0.772), high inter-rater reliability (Spearman correlation coefficient: 0.846; P<.01), and high intra-rater reliability (test-retest reliability coefficient: 0.922; P<.001). The MoCA-S was found to be an effective and valid test for detecting aMCI (AUC±0.903) and mild dementia (AUC±0.957); its effectiveness for detecting naMCI was lower (AUC±0.629). The optimal cut-off points for aMCI and mild dementia were<21 and<20, respectively, with sensitivity and specificity rates of 75% and 82% for aMCI and 90% and 86% for mild dementia. The level of education had a great impact on scores: as a result, 2 points were added for patients with less than 8 years of schooling and one point for patients with 8-12 years of schooling (MoCA-S1-2). The MoCA-S1-2 showed significantly greater discriminant validity than the MMSE for differentiating aMCI from dementia. CONCLUSIONS: The MoCA-S1-2 is a short, easy-to-use, and useful test for diagnosing aMCI and mild dementia.

Social/economic costs and health-related quality of life in patients with juvenile idiopathic arthritis in Europe.

OBJECTIVE: The aim of this study was to determine the economic burden from a societal perspective and the health-related quality of life (HRQOL) of patients with juvenile idiopathic arthritis (JIA) in Europe. METHODS: We conducted a cross-sectional study of patients with JIA from Germany, Italy, Spain, France, the United Kingdom, Bulgaria, and Sweden. Data on demographic characteristics, healthcare resource utilization, informal care, labor productivity losses, and HRQOL were collected from the questionnaires completed by patients or their caregivers. HRQOL was measured with the EuroQol 5-domain (EQ-5D-5L) questionnaire. RESULTS: A total of 162 patients (67 Germany, 34 Sweden, 33 Italy, 23 United Kingdom, 4 France, and 1 Bulgaria) completed the questionnaire. Excluding Bulgarian results, due to small sample size, country-specific annual health care costs ranged from €18,913 to €36,396 (reference year: 2012). Estimated direct healthcare costs ranged from €11,068 to €22,138; direct non-healthcare costs ranged from €7837 to €14,155 and labor productivity losses ranged from €0 to €8715. Costs are also shown to differ between children and adults. The mean EQ-5D index score for JIA patients was estimated at between 0.44 and 0.88, and the mean EQ-5D visual analogue scale score was estimated at between 62 and 79. CONCLUSIONS: JIA patients incur considerable societal costs and experience substantial deterioration in HRQOL in some countries. Compared with previous studies, our results show a remarkable increase in annual healthcare costs for JIA patients. Reasons for the increase are the inclusion of non-professional caregiver costs, a wider use of biologics, and longer hospital stays.

[Study of physician satisfaction as a quality criterion in Nuclear Medicine]. / Estudio de satisfacción de facultativos como criterio de calidad en Medicina Nuclear.

OBJECTIVE: To determine the perception and satisfaction level of referring physicians requesting scans as final users of the Nuclear Medicine Department. MATERIAL AND METHODS: A self-administered questionnaire was designed; it was composed of 10 closed questions (5 categorised and 5 with numerical scale) and 3 open questions. The indicators evaluated were: physician's information about available tests, test indications and diagnostic information, accessibility, delay in the examination and reception of the diagnostic report, usefulness of diagnostic information and overall satisfaction with the department. Two hundred and fifteen questionnaires were sent. RESULTS: Seventy eight questionnaires were returned, so the response index was 36.3 %. The 44.6 % of physicians surveyed considered that they had sufficient information about the tests and 59.5 % were satisfied with the indications and diagnostic information. The accessibility was 7 or more out of 10 for 78.5 %. The 64.9 % of physicians considered the delay in performing examinations to be correct but the satisfaction was lower in the delay between performance and reception of the diagnostic report. The diagnostic information was considered useful by 81.9 % and relevant in the management of patients by 70.5 % of the participants surveyed. The overall satisfaction was > or = 7 out of 10 in 86.8 %. CONCLUSIONS: Overall satisfaction was high, although the level of knowledge about available tests and the delay between test performance and report reception could be improved.

[Utility of 123-I ioflupane SPECT in the assessment of patients with Parkinsonian syndrome and cerebral vasculopathy]. / SPECT con ioflupano I-123 en la catalogación de pacientes con síndrome parkinsoniano y vasculopatía cerebral.

OBJECTIVE: To assess the utility of 123-I Ioflupane SPECT (IS) in the identification of the origin of Parkinsonism (vascular or idiopathic) in patients with cerebral vasculopathy (CV) demonstrated by morphological imaging techniques. Also, to assess the therapeutic impact. MATERIALS AND METHODS: 42 patients (16 males and 26 females) with a Parkinsonian syndrome were studied. Average age was 78.7 years (50-88). A dose of 185 MBq of 123 I-Ioflupane was injected in all subjects. SPECT imaging was obtained 5 hours later. All patients had a CT and/or MRI. The final diagnoses, after a minimal follow-up of 12 months, was established by a neurologist expert in movement disorders, based on clinical and imaging features and response to treatment. RESULTS: 14 patients were diagnosed of functional vascular Parkinsonism by alteration of association pathways, 3 of structural vascular Parkinsonism (SVP) with anatomical and functional vascular lesion in striatum, 14 of Parkinson's disease (PD) with CV, 2 of mixed Parkinsonism (PD + SVP) and 9 with others diagnoses different to the previous. The result of IS changed the treatment in 7/42 patients. CONCLUSION: The IS can have a complementary role to clarify the etiology of Parkinsonism in patients with cerebral vasculopathy. Interpretation of functional and anatomical images within the clinical context of each patient is necessary.

Knowledge and beliefs of breast cancer among elderly Puerto Rican women: validation process of scales.

This paper presents the results of the validation process to determine the concepts for knowledge and beliefs about breast cancer early detection practices among Puerto Rican elderly women. An initial questionnaire was designed based on the scientific literature review and focus group experiences. To determine its reliability and validity, 50 elderly women, stratified by type of profession and place of residence, were interviewed twice. Consistency of the questionnaire was analyzed using binomial test, matched t-test, Pearson correlation coefficient, and Cronbach's coefficient effect. Factor analysis (FA) was the statistical technique used to analyze the grouping of the knowledge and beliefs statements. FA indicated that three scales for knowledge and one for beliefs can be constructed. The purpose of the scales was to identify differences among groups, according to breast cancer early detection practices. Construct validity was performed to determine the number of statistical associations between the scales and these practices. The results showed that beliefs scales was associated with practice of mammogram (p < 0.05), and visit to the gynecologist (p < 0.05) while the knowledge scale for early-detection was associated with the clinical breast examination (p < 0.05). The beliefs scale had better consistency than the knowledge scale. The Cronbach's alpha was 0.75 for the beliefs' scale and 0.30, 0.41 and 0.43 for each defined knowledge scale, respectively.

Recuperación de jeringas de vidrio rotas en su punta: nuevo valor económico / Recovery of glass syringes broken in their points a new economic value

Motivados, porque cuando las jeringas de vidrio se rompen en la punta, son deshechadas (arrojadas a la basura o vendidas por kilo como chatarra), se propone recuperarlas dándoles otro uso, ya no como jeringas para colocar inyectables, sino como instrumentos de uso urológico, reemplazando a las jeringas "asepto" y a los evacuadores de Ellick o Alexander que se usan en la resección transuretal. Se ha inventado un anillo metálico especial para adaptar a las jeringas. Los cálculos económicos los hemos hecho en el supuesto de que el IPSS cuenta con cuatro mil camas en todo el Perú (ocho veces el total de Arequipa), y que, adquiere un aproximado de 3,840 jeringas de vidrio (de 50 y 100 cc.). Según lo informado por la oficina de adquisiciones las jeringas cuestan treinta o treintaicinco soles según sean de 50 ó 100cc. respectivamente lo que daría un total de 118,400.00. Valores muy por debajo del valor comercial actual, pues la jeringa de 100cc. cuesta 127.00, y la de 50cc. 75.00 nuevos soles. Lo que indica que el IPSS emplea más de trecientos mil nuevos soles anuales en jeringas de 50 ó 100cc. Dinero que se puede recuperar en gran parte, si se aplica este método de recuperación.

Assessment of tricuspid regurgitation by Doppler color flow imaging: angiographic correlation.

The correlation between data obtained by Doppler color flow imaging and angiographic severity has been investigated in mitral and aortic regurgitation. However, similar studies have not been performed for tricuspid regurgitation (TR). This study was performed to establish the correlation between measurements of regurgitant jet area by Doppler color flow imaging and the angiographic severity of TR. Fifty-four patients with rheumatic heart disease who underwent right ventriculography and transthoracic Doppler color flow imaging were studied. The regurgitant jet area was measured as the largest clearly definable flow disturbance in apical four-chamber and right ventricle inflow views, and expressed in both views as the absolute jet area or as the ratio of maximal jet area to right atrial area. Correlation of all Doppler color flow measurements with angiographic grades of TR were comparable, absolute jet area in apical four-chamber view being closest at r = 0.80. A regurgitant jet area in apical four-chamber view < 5 cm2 predicted minimal or mild TR by angiography with a sensitivity of 78% and a specificity of 100%, whereas a regurgitant jet area > 10 cm2 predicted severe TR with a sensitivity of 92% and a specificity of 91%. Values between 5 and 10 cm2 predicted moderate TR with a sensitivity of 89% and a specificity of 89%. Sensitivity and specificity were not improved with use of the ratio of jet area to right atrial area or with use of right ventricle inflow view. Thus, Doppler color flow jet measurements correlate closely with angiographic results in the evaluation of TR.(ABSTRACT TRUNCATED AT 250 WORDS)