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In developing nations, outdated technologies and sulfur-rich heavy fossil fuel usage are major contributors to air pollution, affecting urban air quality and public health. In addition, the limited resources hinder the adoption of advanced monitoring systems crucial for informed public health policies. This study addresses this challenge by introducing an affordable internet of things (IoT) monitoring system capable of tracking atmospheric pollutants and meteorological parameters. The IoT platform combines a Bresser 5-in-1 weather station with a previously developed air quality monitoring device equipped with Alphasense gas sensors. Utilizing MQTT, Node-RED, InfluxDB, and Grafana, a Raspberry Pi collects, processes, and visualizes the data it receives from the measuring device by LoRa. To validate system performance, a 15-day field campaign was conducted in Santa Clara, Cuba, using a Libelium Smart Environment Pro as a reference. The system, with a development cost several times lower than Libelium and measuring a greater number of variables, provided reliable data to address air quality issues and support health-related decision making, overcoming resource and budget constraints. The results showed that the IoT architecture has the capacity to process measurements in tropical conditions. The meteorological data provide deeper insights into events of poorer air quality.
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This contribution shows the possibilities of applying a low-cost, multi-purpose data logger built around an Arduino Mega 2560 single-board computer. Most projects use this kind of hardware to develop single-purpose data loggers. In this work, a data logger with a more general hardware and software architecture was built to perform measurement campaigns in very different domains. The wide applicability of this data logger was demonstrated with short-term monitoring campaigns in relation to outdoor air quality, human activity in an office, motion of a journey on a bike, and exhaust gas monitoring of a diesel generator. In addition, an assessment process and corresponding evaluation framework are proposed to assess the credibility of low-cost scientific devices built in-house. The experiences acquired during the development of the system and the short measurement campaigns were used as inputs in the assessment process. The assessment showed that the system scores positively on most product-related targets. However, unexpected events affect the assessment over the longer term. This makes the development of low-cost scientific devices harder than expected. To assure stability and long-term performance of this type of design, continuous evaluation and regular engineering corrections are needed throughout longer testing periods.
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Diabetic foot ulcer is one of the most frightened diabetic complications leading to amputation disability and early mortality. Diabetic wounds exhibit a complex networking of inflammatory cytokines, local proteases, and reactive oxygen and nitrogen species as a pathogenic polymicrobial biofilm, overall contributing to wound chronification and host homeostasis imbalance. Intralesional infiltration of epidermal growth factor (EGF) has emerged as a therapeutic alternative to diabetic wound healing, reaching responsive cells while avoiding the deleterious effect of proteases and the biofilm on the wound's surface. The present study shows that intralesional therapy with EGF is associated with the systemic attenuation of pro-inflammatory markers along with redox balance recovery. A total of 11 diabetic patients with neuropathic foot ulcers were studied before and 3 weeks after starting EGF treatment. Evaluations comprised plasma levels of pro-inflammatory, redox balance, and glycation markers. Pro-inflammatory markers such as erythrosedimentation rate, C-reactive protein, interleukin-6, soluble FAS, and macrophage inflammatory protein 1-alpha were significantly reduced by EGF therapy. Oxidative capacity, nitrite/nitrate ratio, and pentosidine were also reduced, while soluble receptor for advanced glycation end-products significantly increased. Overall, our results indicate that the local intralesional infiltration of EGF translates in systemic anti-inflammatory and antioxidant effects, as in attenuation of the glycation products' negative effects.
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Pé Diabético/tratamento farmacológico , Fator de Crescimento Epidérmico/uso terapêutico , Proteínas Recombinantes/uso terapêutico , Idoso , Arginina/análogos & derivados , Arginina/sangue , Biomarcadores/sangue , Sedimentação Sanguínea , Proteína C-Reativa/análise , Quimiocina CCL3/sangue , Citocinas/sangue , Feminino , Humanos , Injeções Intralesionais , Lisina/análogos & derivados , Lisina/sangue , Masculino , Pessoa de Meia-Idade , Nitratos/sangue , Nitritos/sangue , Receptor para Produtos Finais de Glicação Avançada/sangue , Cicatrização , Receptor fas/sangueRESUMO
Detailed studies of the middle Ilerdian (lower Ypresian) blue marls of the Gulf of Languedoc (Corbières, Aude, France), belonging to the north Pyrenean foreland basin, have revealed a more abundant and diverse crinoid fauna than previously documented from the Lower Eocene. Here we describe five species of stalked crinoids in the family Rhizocrinidae (Cherbonniericrinus requiensis n. sp., ?Democrinus elongatus, Globulocrinus amphoraformis n. gen., n. sp., Pseudoconocrinus doncieuxi and P. lavadensis n. sp.), one barnacle-like species in the stalkless family Holopodidae (Holopus plaziati n. sp.) and a single feather star in the family Conometridae (Amphorometra atacica). Several sites have yielded brachials and rhizoids in addition to abundant aboral cups and columnals indicating in situ fossilisation of the dissociated skeletal elements. P. lavadensis n. sp. and ?D. elongatus have been collected only from outcrops located in the upper part of the middle blue marls, while P. doncieuxi predominates, with a wide range of morphological variation, in the lower blue marls. The fossil assemblage at the locality of Réqui near Montlaur differs from the others in the smaller size of most individuals and the presence of H. plaziati n. sp., C. requiensis n. sp., G. amphoraformis n. gen., n. sp., and P. doncieuxi suboblongus n. subsp. This particular association with high juvenile mortality corresponds to an unstable environment with mixed substrates (muddy and rocky). The crinoid fauna of the Corbières appears to be the most diverse of Early Eocene age known to date. With the fauna of the London Clay, a boreal formation of the same age, it shares the presence of the genera Democrinus and Amphorometra in an open-sea environment. A comparison with extant faunas allows the depth of deposition at the Ypresian sites in the Gulf of Languedoc to be estimated between from 100 and 140 meters.
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Equinodermos , Fósseis , Animais , Equinodermos/anatomia & histologia , Equinodermos/classificação , França , Oceanos e Mares , Especificidade da EspécieRESUMO
Introducción: La úlcera del pie diabético es una de las principales complicaciones de los pacientes con diabetes, y se ha convertido en una causa importante de amputación no traumática. El 60 por ciento de las úlceras del pie diabético pueden infectarse con microorganismos y aumentar el riesgo de amputación en un 50 por ciento en comparación con pacientes con úlceras en los pies sin infección. La resistencia a los antimicrobianos (RAM) es un fenómeno mundial que ha alcanzado niveles alarmantes. Objetivo: Reportar un caso de un paciente que presentaba úlcera del pie diabético con infección por Acinetobacter lwoffii, al que se le realizó amputación de la extremidad por la multirresistencia del germen. Presentación de caso: Se presenta un caso de un paciente con diagnóstico de pie diabético neuroinfeccioso tipo absceso profundo. Al examen bacteriológico se constató presencia de Acinetobacter lwoffii resistente a casi todos los antibióticos excepto doxiciclina. El paciente requirió amputación de la extremidad como terapia definitiva de control de la sepsis. Conclusión: La evolución de este germen comenzó muy sensible a los antimicrobianos corrientes; después, tras rápida adaptación, devino primero resistente, luego multirresistente y ahora pandroga resistente, término acuñado exclusivamente para este tipo de germen(AU)
Introduction: Diabetic foot ulcer is one of the main complications of patients with diabetes and has become a major cause of non-traumatic amputation. 60 percent of diabetic foot ulcers can become infected with microorganisms, increasing the risk of amputation by 50 percent compared to patients with non-infected foot ulcers. Antimicrobial resistance is a global phenomenon that has reached alarming levels. Objective: To report a case of amputation of a patient with diabetic foot ulcer and Acinetobacter lwoffi infection. Case presentation: It is presented a case of a patient diagnosed with a deep abscess-type neuroinfectious diabetic foot. Bacteriological examination revealed the presence of Acinetobacter lwoffii resistant to almost all antibiotics, except doxycycline. The patient required amputation of the limb as definitive therapy to control sepsis. Conclusions: The evolution of this germ began very sensitive to common antimicrobials, but after a rapid adaptation, it became first resistant, then multidrug-resistant and then pandrug resistant, a term coined exclusively for this type of germ(AU)
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Humanos , Masculino , IdosoRESUMO
Introducción: El pie diabético se considera un problema de salud a escala mundial, debido al alto número de ingresos en los servicios hospitalarios. Objetivo: Caracterizar a los pacientes con pie diabético isquémico sometidos a cirugía revascularizadora en el Instituto Nacional de Angiología y Cirugía Vascular. Métodos: Se llevó a cabo un estudio descriptivo y retrospectivo en 24 pacientes que ingresaron en el Servicio de Angiopatía Diabética del Instituto Nacional de Angiología y Cirugía Vascular con el diagnóstico de pie diabético isquémico, a los cuales se les realizó cualquier tipo de cirugía revascularizadora durante el período comprendido entre abril de 2018 y abril de 2019. Las variables estudiadas fueron: edad, sexo, factores de riesgo ateroscleróticos y enfermedades asociadas, patrón topográfico, clasificación de Fontaine, clasificación hemodinámica según la American College of Cardiology Foundation (ACCF) y técnicas quirúrgicas utilizadas. Se calcularon las frecuencias absolutas y relativas para las variables cualitativas. Resultados: Más del 95 por ciento de los pacientes eran mayores de 50 años. Hubo un predominó del sexo masculino (79,2 por ciento). La hipertensión arterial y el hábito de fumar resultaron los factores de riesgo de mayor frecuencia con igual porcentaje (79,8 por ciento). El patrón oclusivo predominante fue el fémoro-poplíteo (75 por ciento) y la técnica quirúrgica más utilizada resultó el bypass fémoro-poplíteo con prótesis sintética en la primera porción de la poplítea (54,1 por ciento). No se necesitó la amputación después de la cirugía en el 83 por ciento de los enfermos. Conclusiones: Los pacientes se caracterizaron por ser en su mayoría adultos mayores, fumadores e hipertensos. A estos se les realizaron, preferentemente, técnicas quirúrgicas convencionales sobre los procederes endovasculares(AU)
Introduction: Diabetic foot is considered a global health problem, due to the high number of hospital admissions. Objective: Characterize patients with ischemic diabetic foot undergoing revascularization surgery at the National Institute of Angiology and Vascular Surgery. Methods: A descriptive and retrospective study was carried out in 24 patients who were admitted in the Diabetic Angiopathy Service of the National Institute of Angiology and Vascular Surgery with the diagnosis of ischemic diabetic foot, whom underwent any kind of revascularization surgery during the period from April 2018 to April 2019. The variables studied were: age, sex, atherosclerotic risk factors and associated diseases, topographic pattern, Fontaine classification, hemodynamic classification according to the American College of Cardiology Foundation (ACCF) and surgical techniques used. Absolute and relative frequencies for qualitative variables were calculated. Results: More than 95 percent of patients were over 50 years of age. There was a predominance of the male sex (79.2 percent). High blood pressure and smoking habit resulted in the most common risk factors with the same percentage (79.8 percent). The predominant occlusive pattern was the femoro-popliteal (75 percent) and the most commonly used surgical technique was the femoro-popliteal bypass with synthetic prosthetics in the first portion of the popliteal (54.1 percent). No amputation was needed after surgery in 83 percent of patients. Conclusions: Patients were characterized by being mostly older adults, smokers and hypertensive ones. Preferably conventional surgical techniques on endovascular proceedings were performed to these patients(AU)
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Humanos , Masculino , Pessoa de Meia-Idade , Próteses e Implantes , Fatores de Risco , Pé Diabético , Angiopatias Diabéticas , Procedimentos Cirúrgicos Vasculares/métodosRESUMO
Introducción: La amputación provoca discapacidad física e invalidez como consecuencia de la enfermedad vascular periférica. Objetivo: Caracterizar a los pacientes amputados de miembros inferiores por causas vasculares en el municipio Cerro. Métodos: Se realizó un estudio descriptivo en los 114 amputados de miembros inferiores que estaban registrados, entre 2016 y 2018, en la Dirección Municipal de Salud del municipio Cerro. La muestra quedó constituida por los 64 amputados de causa vascular. Las variables de estudio fueron: edad, sexo, factores de riesgo, tipo de amputación y su nivel, miembro más afectado y causa vascular de amputación. Se estimaron las frecuencias absolutas y relativas, y la prueba de chi cuadrado, para identificar la asociación entre las variables. Resultados: Hubo predominio de los amputados de causa vascular (56,1 por ciento), el sexo femenino (54,7 por ciento), el grupo etáreo de 60 años y más (84,4 por ciento), y la HTA y el tabaquismo (ambos con 60,9 por ciento). La amputación supracondílea fue la más realizada (64,1 por ciento). El pie diabético isquémico y la aterosclerosis obliterante resultaron las causas vasculares que provocaron los mayores porcentajes de amputación. Se halló asociación altamente significativa entre el sexo masculino y la ateroesclerosis obliterante (X2 = 5,4; p = 0,113, OR = 2,68 y RR = 1,81), lo que señaló a este como un factor de riesgo de amputación. Conclusiones: Las amputaciones aparecieron con mayor frecuencia en las mujeres mayores de 60 años, del tipo supracondílea y por pie diabético como causa vascular. La ateroesclerosis obliterante en los hombres constituyó un factor de riesgo de amputación(AU)
Introduction: Amputation as a result of peripheral vascular disease causes physical disability and impairment. Objective: Characterize amputee patients of lower limbs due to vascular causes in Cerro municipality. Methods: A descriptive study was carried out in the 114 lower limbs amputee patients that were registered, between 2016 and 2018, in the Municipal Health Division of Cerro municipality. The sample consisted of the 64 vascular-cause amputees. The study variables were: age, sex, risk factors, type of amputation and its level, most affected limb and vascular cause of amputation. Absolute and relative frequencies were estimated, and the chi square test was used to identify the association between variables. Results: There was predominance of vascular-cause amputees (56.1 percent), the female sex (54.7 percent), the 60-year-old and older age group (84.4 percent), and HTA and smoking having (both 60.9 percent). Supracondylar amputation was the most performed one (64.1 percent). Ischemic diabetic foot and obliterating atherosclerosis resulted in the vascular causes that produce the highest percentages of amputation. A highly significant association was found between the male sex and obliterating atherosclerosis (X2 = 5.4; p = 0.113; OR = 2.68 and RR = 1.81), which pointed to this as an amputation risk factor. Conclusions: Amputations most often appeared in women over the age of 60, as supracondyle type and diabetic foot as a vascular cause. Obliterating atherosclerosis in men was a risk factor for amputation(AU)
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Humanos , Feminino , Pessoa de Meia-Idade , Doenças Vasculares Periféricas/epidemiologia , Pé Diabético/etiologia , Extremidade Inferior/cirurgia , Amputação Cirúrgica/métodos , Epidemiologia Descritiva , Fatores de RiscoRESUMO
Introducción: La indicación más clara de revascularización en las extremidades inferiores lo constituye la presencia de lesiones isquémicas y el tratamiento de elección, siempre que sea posible, es el endovascular debido a su buena permeabilidad, baja morbilidad y mortalidad. Objetivo: Presentar un caso en el que se utilizó la angioplastia transluminal percutánea del sector fémoro-poplíteo. Presentación del caso: Se presenta un caso con diagnóstico de enfermedad arterial periférica en la extremidad inferior derecha. La angioplastia transluminal percutánea se utilizó para cicatrizar lesiones isquémicas aún en presencia de oclusiones no revascularizables de las arterias infra-poplíteas. El paciente presentaba al examen físico lesión isquémica en el primer dedo y patrón esteno-oclusivo fémoro-poplíteo. Se detectó disminución de los índices de presiones en poplítea y distales. En la arteriografía se apreciaron lesiones esteno-oclusivas en la femoral superficial y oclusión de las arterias infra-poplíteas. Se realizó angioplastia transluminal percutánea de la femoral superficial y el paciente recuperó pulso poplíteo con mejoría hemodinámica. Evolucionó satisfactoriamente y egresó con tratamiento médico. A los cinco meses de operado mantiene su pulso poplíteo presente y la lesión cicatrizada. Conclusión: La angioplastia del sector fémoro-poplíteo es beneficiosa para la cicatrización de la lesión isquémica aún en presencia de oclusiones infra-poplíteas no revascularizables(AU)
Introduction: The clearest indication for revascularization in lower limbs is the presence of ischemic lesions. The treatment of choice, whenever possible, is the endovascular one, due to its good permeability, as well as low morbidity and mortality. Objective: To present a case in which percutaneous transluminal angioplasty of the femoro-popliteal sector. Case presentation: A case is presented with a diagnosis of peripheral arterial disease in the right lower limb. The percutaneous transluminal angioplastywas used to heal ischemic lesions even in the presence of nonrevascularizable occlusions of the infra-popliteal arteries. On physical examination, the patient presented an ischemic lesion on the first finger and a femoro-popliteal steno-occlusive pattern. Decrease in pressure indices was detected in the popliteal and the distal ones. Arteriography showed steno-occlusive lesions in the superficial femoral and occlusion of the infra-popliteal arteries. Percutaneous transluminal angioplasty of the superficial femoral artery was performed and the patient recovered the popliteal pulse with hemodynamic improvement. The patient evolved satisfactorily and was discharged with medical treatment. Five months after surgery, the patient maintains popliteal pulse and the lesion has cicatrized. Conclusion: Angioplasty of the femoro-popliteal sector prove beneficial for the healing of the ischemic lesion even in the presence of nonrevascularizable infra-popliteal occlusions(AU)
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Humanos , Masculino , Pessoa de Meia-Idade , Artéria Poplítea , Angiografia/métodos , Angioplastia/métodos , Artéria Femoral , Doença Arterial Periférica/diagnósticoRESUMO
Introducción: El Heberprot-P® es un medicamento novedoso y único, prescrito para los pacientes con úlcera del pie diabético. El factor de crecimiento humano recombinante que contiene este fármaco induce el crecimiento de tejido de granulación útil. La ozonoterapia tiene propiedades como oxigenante, antioxidante, inmunomodulador, regenerador, antiinflamatorio y germicida y se utiliza para la desinfección de heridas desde la Primera Guerra Mundial. Objetivo: Determinar la evolución de las úlceras del pie diabético con el tratamiento mixto de Heberprot-P® y ozonoterapia. Métodos: Se realizó un estudio retrospectivo y descriptivo en todos los pacientes ingresados en el Instituto Nacional de Angiología y Cirugía Vascular con el diagnóstico de diabetes mellitus y úlcera de pie diabético que recibieron tratamiento mixto de Heberprot-P® y ozonoterapia. El período de estudio osciló de enero de 2016 hasta enero de 2017. Las variables estudiadas fueron: sexo, edad, tipo de diabetes, estadía hospitalaria, necesidad de ser reintervenido, tiempo de granulación y respuesta al tratamiento. Resultados: Se encontró que los pacientes tratados con el Heberprot-p® y ozonoterapia tuvieron una buena respuesta al tratamiento (60,5 por ciento), un tiempo de granulación entre 2 y 4 semanas (55,6 por ciento) con predominio de la estadía hospitalaria de 11 a 21 días. Conclusiones: Los pacientes con el tratamiento mixto de Heberprot-P® y ozonoterapia tienen una respuesta muy favorable(AU)
Introduction: Heberprot-P® is a novel and unique medication, prescribed for patients with diabetic foot ulcer. It is based on recombinant human growth factor that induces the growth of useful granulation tissue. The properties as oxygenating, antioxidant, immunomodulator, regenerator, anti-inflammatory and germicide of ozone therapy are used for the disinfection of wounds since the First World War. Objective: To determine the evolution of diabetic foot ulcers with the mixed treatment of Heberprot-P® and ozone therapy. Methods: A retrospective and descriptive study was conducted in all patients admitted to the National Institute of Angiology and Vascular Surgery (INACV) with the diagnosis of Diabetes Mellitus and diabetic foot ulcer who received mixed treatment of Heberprot-P® and ozone therapy. The study period ranged from January 2016 to January 2017. The studied variables were: sex, age, type of diabetes, hospital stay, need to be reoperated, granulation time and response to the treatment. Results: It was found that the highest percentage of patients who used the mixed treatment of Heberprot-P® and ozone therapy had a good response to treatment (60.5 percent) and a granulation time between 2 and 4 weeks (55.6 percent); and a hospital stay from 11 to 21 days. Conclusions: Patients with the mixed treatment of Heberprot-P® and ozone therapy have a very favorable response(AU)
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Humanos , Masculino , Feminino , Ozônio/uso terapêutico , Pé Diabético/tratamento farmacológico , Medicamentos de Referência , Epidemiologia Descritiva , Estudos RetrospectivosRESUMO
Introducción: La isquemia crítica es la más severa condición que afecta a los pacientes con enfermedad arterial periférica, con tendencia al empeoramiento progresivo y asociada con una alta tasa de amputación mayor, mortalidad y pobre calidad de vida. Objetivo: Exponer la arterialización del sistema venoso superficial como alternativa a la amputación mayor en pacientes con isquemia crítica sin opciones de revascularización Presentación del caso: Se presenta un caso con diagnóstico de isquemia crítica en el miembro inferior derecho, con alto riesgo de amputación mayor y sin posibilidades de revascularización. La paciente presentaba lesiones isquémicas en el pie y patrón oclusivo distal en el miembro inferior derecho, con un patrón hemodinámico calcificado. En la arteriografía se apreció oclusión de la arteria poplítea en su segunda porción sin restitución del flujo. Se le realizó arterialización de la vena safena mayor mediante tratamiento quirúrgico convencional desde la primera porción de la arteria poplítea. Conclusión: la arterialización del sistema venoso superficial permitió que la paciente salvara su extremidad y egresara sin una amputación mayor(AU)
Introduction: The critical ischemia is the most severe condition that affects patients with peripheral arterial illness, with tendency to progressive worsening and it is associated with a high rate of major amputation, mortality and poor quality of life. Objective: To present a case with critical limb ischemia without revascularization options and the arterialization of the superficial venous system as an alternative to major amputation. Case presentation: A case is presented with diagnostic of critical ischemia in the right lower limb with high risk of major amputation and without revascularization options. The patient presented ischemic lesions in the right foot and an occlusive distal pattern in the right lower limb with a calcified hemodynamic pattern. In the arteriography it was found an occlusion of the popliteal artery in its second portion without restitution of the flow. It was carried out the arterialization of the major safena vein by means of conventional surgical treatment from the first portion of the popliteal artery. Conclusions: The arterializations of the superficial venous system allowed the patient to save her limb and that discharged from the institution without a major amputation(AU)