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The silicon vacancy (SiV) center in diamond is drawing much attention due to its optical and spin properties, attractive for quantum information processing and sensing. Comparatively little is known, however, about the dynamics governing SiV charge state interconversion mainly due to challenges associated with generating, stabilizing, and characterizing all possible charge states, particularly at room temperature. Here, multi-color confocal microscopy and density functional theory are used to examine photo-induced SiV recombination - from neutral, to single-, to double-negatively charged - over a broad spectral window in chemical-vapor-deposition (CVD) diamond under ambient conditions. For the SiV0 to SiV- transition, a linear growth of the photo-recombination rate with laser power at all observed wavelengths is found, a hallmark of single photon dynamics. Laser excitation of SiVâ, on the other hand, yields only fractional recombination into SiV2â, a finding that is interpreted in terms of a photo-activated electron tunneling process from proximal nitrogen atoms.
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INTRODUCTION AND AIMS: Distal pancreatectomy is a frequent procedure and postoperative fistula, its most common complication, has an incidence of 30 to 60%. The aim of the present work was to study the role of the neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio, as indicators of inflammatory response in the setting of pancreatic fistula. METHODS: A retrospective observational study was conducted on patients that underwent distal pancreatectomy. The diagnosis of postoperative pancreatic fistula was made according to the definition proposed by the International Study Group on Pancreatic Fistula. The relation of postoperative pancreatic fistula to the neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio was determined in the postoperative evaluation. SPSS v.21 software was utilized for the statistical analysis and a P<.05 was considered statistically significant. RESULTS: A total of 12 patients (27.2%) developed grade B or grade C postoperative pancreatic fistula. ROC curves were constructed and a threshold of 8.3 (PPV 0.40, NPV 0.86) was established for the neutrophil-to-lymphocyte ratio, with an area under the curve of 0.71, sensitivity of 0.81, and specificity of 0.62, whereas a threshold of 33.2 (PPV 0.50, NPV 0.84) was established for the platelet-to-lymphocyte ratio, with an area under the curve of 0.72, sensitivity of 0.72, and specificity of 0.71. CONCLUSION: The neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio are serologic markers that can aid in identifying patients that will present with grade B or grade C postoperative pancreatic fistula, thus helping to provide an opportune focus on care and resources.
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Introducción: Las disecciones de arterias cervicales (DAC) son la primera causa de accidente cerebrovascular isquémico (ACVi) en personas jóvenes. Los factores asociados (FA) de ACVi y la relación temporal con la DAC no están bien caracterizados. Tampoco disponemos de una clasificación clínico-radio-lógica que permita conocer el riesgo de ACVi. Objetivo: Describir frecuencia y FA y temporalidad de los ACVi en pacientes con DAC. Métodos: Estudio prospectivo de pacientes mayores de 18 años hospitalizados por una DAC carotidea y/o vertebral entre agosto de 2009 y junio de 2017. Las DAC se diagnosticaron clínico-radiológicamente y los ACVi con imagen con infarto. Se utilizo la Clasificación de Borgess para caracterizar radiológicamente las DAC. Se utilizaron análisis de regresión logística uni y multivariable para evaluar las características clínico-radiológicas y los FA. Resultados: 163 pacientes con 182 DAC (60% vertebrales y 40% carotídeas). 73 pacientes (44,8%) tuvieron un ACVi 28 de 68 pacientes (41,2%) tuvieron simultáneamente síntomas de disección y de isquemia. 60 de 68 pacientes (88%) presentan síntomas de isquemia durante la primera semana. FR significativamente asociados a ACVi: Borgess tipo IB (p = 0,001; OR: 4,1; IC: 1,8-9,3), sexo masculino (p < 0,001; OR: 0,2; IC: 0,06-0,8) y anticonceptivos orales (p = 0,02; OR: 0,2; IC: 0,06-0,8). Conclusión: Ocurre aproximadamente en la mitad de los pacientes, en su mayoría dentro de la primera semana, no es la forma habitual de presentación inicial y no se relaciona con el tipo de arteria disecada. El principal FA para desarrollar un ACVi fue la oclusión arterial (Borgess tipo IB).
Introduction: Cervical artery dissections (CAD) are the leading cause of ischemic stroke (CVA) in young people. The risk factors for stroke and the temporal relationship with CAD are not well characterized. Nor do we have a clinical-radiological classification that allows knowing the risk of stroke. Objective: To describe the associated factors and temporality of ACVi in patients with CAD. Methods: We performed a prospective study that included patients over 18 years of age, hospitalized for carotid and/or vertebral CAD between August 2009 and June 2017. CAD cases were diagnosed clinically and radiologically; ACVi was diagnosed when the imaging study demonstrated infarction. The Borgess Classification was used to characterize the CAD radiologically. For correlation studies, we used univariate and multivariate logistic regression analyses. Results: We analyzed 163 patients with 182 CAD (60% vertebral and 40% carotid). 28 of 68 patients (41.2%) simultaneously had symptoms of dissection and ischemia. 60 of 68 patients (88%) presented symptoms of ischemia during the first week. CAD: Borgess type IB (p = 0.001; OR: 4.1; CI: 1.8-9.3), male (p < 0.001; OR: 0.2; CI: 0.06- 0.8) were significantly associated with ischemic strokes and oral contraceptives (p = 0.02; OR: 0.2; CI: 0.06-0.8). Conclusion: Stroke associated with CAD has a relatively low frequency. It is not related to the type of dissected artery. It mainly occurs not simultaneously with CAD and within the first week. The main associated factor for developing a stroke is arterial occlusion (Borgess type IB).1,8-9,3), male sex (p < 0.001; OR: 0.2; CI: 0.06-0.8) and oral contraceptives (p = 0.02; OR: 0.2; CI: 0.06-0.8).
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This study reports on a novel composite of bimetallic FeO/ZnO nanoparticles supported by spent coffee grounds (SCGs). The leaves of eucalyptus (Eucalyptus globulus Labill) and trumpet (Cuphea aequipetala Cav), with their high antioxidant content, serve as bio-reductant agents for the green synthesis of nanoparticles. It was characterized using Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS), X-ray diffraction (XRD), and transmission electron microscopy (TEM). Stable nanoparticles were produced with different diameters of 5-30 nm, and they were applied as catalysts in Fenton-like processes. Box-Behnken experimental design (BBD) was used to determine the optimal removal efficiency with three factors and was used in the degradation of textile dyes from wastewater. The nanocomposite displayed a high decolorization ratio (88%) of indigo carmine in the presence of H2O2 combined. This resulted in a reduction in chemical oxygen demand (COD) of 56% at 120 min of contact time at an initial pH of 3.0 and a 0.5 g/L of catalyst dose, a H2O2 concentration of 8.8 mM/L, an initial dye concentration of 100 mg/L, and a temperature of 25 °C.
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Nanocompuestos , Óxido de Zinc , Zinc , Hierro , Café , Peróxido de Hidrógeno , TextilesRESUMEN
Globally increasing concern related to municipal solid waste generation is encouraging research efforts on developing alternative routes to valorize mixed refused wastes. In this way, catalytic pyrolysis is emerging as an interesting and efficient technology due to its great flexibility in terms of feedstock. In the current work, upgrading of a Solid Recovered Fuel (SRF) has been investigated by catalytic pyrolysis over nanocrystalline ZSM-5 zeolite (n-ZSM-5), paying special attention to dechlorination effects due to the high Cl content of the raw waste. Thus, pretreatment of the SRF by water washing and mild thermal processing allows for a significant reduction of the Cl concentration. Regarding the catalytic pyrolysis step, the best conditions correspond with a temperature of 400 °C in the catalyst bed and 0.50 catalyst/SRF mass ratio, which lead to ca. 30 wt% oil yield (rich in aromatic hydrocarbons) together with about 40 wt% gas yield (rich in C3-C4 olefins). Accordingly, these products could find use as raw chemicals or for the production of advanced fuels. In addition, zeolite reutilization has been tested for several cycles, denoting a progressive modification of the products distribution because of coke deposition. However, an almost total recovery of the n-ZSM-5 zeolite catalytic performance is achieved after regeneration by air calcination, affording the production of an oil fraction with a Cl content as low as 40 ppm.
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Hidrocarburos Aromáticos , Zeolitas , Zeolitas/química , Pirólisis , Temperatura , Catálisis , CalorRESUMEN
INTRODUCTION: Cervical artery dissections (CAD) are the leading cause of ischemic stroke (CVA) in young people. The risk factors for stroke and the temporal relationship with CAD are not well characterized. Nor do we have a clinical-radiological classification that allows knowing the risk of stroke. OBJECTIVE: To describe the associated factors and temporality of ACVi in patients with CAD. METHODS: We performed a prospective study that included patients over 18 years of age, hospitalized for carotid and/or vertebral CAD between August 2009 and June 2017. CAD cases were diagnosed clinically and radiologically; ACVi was diagnosed when the imaging study demonstrated infarction. The Borgess Classification was used to characterize the CAD radiologically. For correlation studies, we used univariate and multivariate logistic regression analyses. RESULTS: We analyzed 163 patients with 182 CAD (60% vertebral and 40% carotid). 28 of 68 patients (41.2%) simultaneously had symptoms of dissection and ischemia. 60 of 68 patients (88%) presented symptoms of ischemia during the first week. CAD: Borgess type IB (p = 0.001; OR: 4.1; CI: 1.8-9.3), male (p < 0.001; OR: 0.2; CI: 0.06- 0.8) were significantly associated with ischemic strokes and oral contraceptives (p = 0.02; OR: 0.2; CI: 0.06-0.8). CONCLUSION: Stroke associated with CAD has a relatively low frequency. It is not related to the type of dissected artery. It mainly occurs not simultaneously with CAD and within the first week. The main associated factor for developing a stroke is arterial occlusion (Borgess type IB).1,8-9,3), male sex (p < 0.001; OR: 0.2; CI: 0.06-0.8) and oral contraceptives (p = 0.02; OR: 0.2; CI: 0.06-0.8).
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Disección de la Arteria Carótida Interna , Infarto Cerebral , Disección de la Arteria Vertebral , Humanos , Masculino , Femenino , Factores de Riesgo , Estudios Prospectivos , Disección de la Arteria Vertebral/complicaciones , Disección de la Arteria Vertebral/diagnóstico por imagen , Persona de Mediana Edad , Adulto , Infarto Cerebral/diagnóstico por imagen , Infarto Cerebral/etiología , Disección de la Arteria Carótida Interna/complicaciones , Disección de la Arteria Carótida Interna/diagnóstico por imagen , Factores de Tiempo , Factores Sexuales , AncianoRESUMEN
A methodology is developed to describe time-dependent phenomena associated with nonlocal transport in complex, two-dimensional geometries. It is an extension of the ''iterative method" introduced previously to solve steady-state transport problems [Maggs and Morales, Phys. Rev. E 99, 013307 (2019)10.1103/PhysRevE.99.013307], and it is based on the ''jumping particle" concepts associated with the continuous-time random walk (CTRW) model. The method presented explicitly evaluates the time integral contained in the CTRW master equation. A modified version of the Mittag-Leffler function is used for the waiting-time probability distributions to incorporate memory effects. Calculations of the propagation of ''anomalous transport waves" in various systems, with and without memory, illustrate the technique.
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BACKGROUND: The Aspergillus Galactomannan Ag Virclia® (GMVClia) test is a monotest and automated galactomannan technique based on chemiluminescent immunoassay (CLIA). AIM: To evaluate the performance of the GM-VClia test in serum and bronchioalveolar lavage (BAL) samples previously processed with the Platelia ™ Aspergillus EIA kit (GM-Plat). METHODS: 56 samples of serum 40 from BAL (some of them with galactomaman determination in both samples), from patients with pulmonary diseases, hematological diseases, SLE, Covid-19 and tumors, among others, were studied. Thirteen patients had invasive aspergillosis (1 proven and 12 probable). RESULTS: The correlation between both methods for serum and BAL was r = 0.8861 p < 0.0001 and r = 0.6368 p < 0.001, respectively. There was a global concordance of 67.7% (65/96), being 85.7% (48/56) in sera and 42.5.0% (14/49) in BAL. By raising the cut-off point in LBA by GM-VClia, the agreement increased to 85.7%. CONCLUSION: A greater correlation and concordance was observed in sera than in BAL. The GM-VClia kit had a higher sensitivity and NPV than the GM-Plat kit. The disadvantages of GM-VClia are the "doubtful" category, which makes interpretation difficult and that with the current cut-off points in LBA the correlation with GM-Plat is lower. The advantages are its greater sensitivity, ease of processing and faster results.
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COVID-19 , Aspergillus , Líquido del Lavado Bronquioalveolar , Galactosa/análogos & derivados , Humanos , Mananos , Sensibilidad y EspecificidadRESUMEN
INTRODUCTION: Surgical repair of recurrent tracheoesophageal fistula has a high risk of complications. Therefore, various endoscopic techniques have been used to avoid complications. OBJECTIVE: To understand the usefulness of trichloroacetic acid endoscopic application for the treatment of recurrent tracheoesophageal fistula. MATERIALS AND METHODS: An observational, descriptive, retrospective, case-series-based study was carried out in a tertiary pediatric hospital. Records of patients with recurrent tracheoesophageal fistula from 2015 to 2021 were reviewed. All patients within this period underwent brushing and trichloroacetic acid application. RESULTS: Mean time of recurrent tracheoesophageal fistula occurrence was 4.8 months (range: 1-19.2). Two patients had a small fistula (less than 4 mm), three patients had a medium fistula (4 mm), and two patients had a large fistula (more than 4 mm). Mean sessions for fistula closure were 2.2 (range: 1-4). Mean time between procedures was 22 days (range: 14-30). Mean follow-up since fistula closure confirmation was 33 months (range: 9-72), during which no recurrences were noted. CONCLUSION: Endoscopic management of recurrent transesophageal fistula with trichloroacetic acid is a safe and effective procedure. Brushing and trichloroacetic acid combined improve success rates. Fistulas over 4 mm in diameter require more procedures. However, a larger patient cohort and a longer follow-up period are needed to confirm this.
INTRODUCCION: La reparación quirúrgica de la fístula traqueoesofágica recurrente tiene alto riesgo de complicaciones por lo que se han utilizado diversas técnicas endoscópicas para evitarlas. OBJETIVO: Conocer la utilidad de la aplicación endoscópica de ácido tricloroacético para el tratamiento de la fístula traqueoesofágica recurrente. MATERIAL Y METODO: Estudio observacional, descriptivo y retrospectivo, tipo de serie de casos en un hospital pediátrico de tercer nivel. Se revisaron los expedientes de pacientes con fístula traqueoesofágica recurrente de 2015 a 2021. En todos los pacientes durante este periodo se realizó cepillado y aplicación de ácido tricloroacético. RESULTADO: El tiempo medio de aparición de la fístula traqueoesofágica recurrente fue de 4,8 meses (rango 1-19,2). Dos con fístula pequeña (menor a 4 mm), tres con fístula mediana (4 mm) y dos con fístula grande (mayor a 4 mm). El número medio de sesiones para cerrar la fístula fue 2,2 veces (rango 1-4). El intervalo medio entre procedimientos fue 22 días (rango 14-30). El tiempo medio de seguimiento desde la confirmación de cierre de la fistula fue de 33 meses (rango 9-72), periodo de tiempo donde no se observó recurrencia del cuadro. CONCLUSION: El manejo endoscópico de la fístula traqueoesofágica recurrente con la aplicación de ácido tricloroacético es un procedimiento seguro y efectivo. La técnica de cepillado y aplicación de ácido tricloroacético mejora la efectividad de éxito. La fístula mayor de 4 mm de diámetro requiere mayor número de procedimientos; sin embargo, se requiere mayor número de pacientes y mayor tiempo de seguimiento para poder aseverar esta opinión.
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Rinoplastia , Fístula Traqueoesofágica , Niño , Endoscopía , Humanos , Estudios Retrospectivos , Fístula Traqueoesofágica/cirugía , Ácido TricloroacéticoRESUMEN
INTRODUCCIÓN: La prueba Aspergillus galactomannan Ag Virclia® (GM-VClia) es una técnica de galactomanano monotest, auto-matizada, basada en inmunoensayo quimioluminiscente (CLIA). OBJETIVO: Evaluar el desempeño del test de GM-VClia en muestras de suero y lavado bronquioalveolar (LBA) procesadas previamente con el kit Platelia™ Aspergillus EIA (GM-Plat). MATERIALES Y MÉTODOS: Se estudiaron 56 muestras de suero y 40 de LBA, correspondientes a un total de 59 pacientes (algunos con determinación de galactomamano en ambas muestras) con enfermedades pulmonares, hematológicas, LES, Covid-19 y tumores, entre otros. Trece pacientes tuvieron aspergilosis invasora (1 probada y 12 probables). RESULTADOS: La correlación entre ambos métodos para suero y LBA fue r = 0,8861 p < 0,0001 y r = 0,6368 p < 0,001, respectivamente. Hubo una concordancia global de 67,7% (65/96), siendo de 85,7% (48/56) en sueros y 42,5,0% (14/49) en LBA. Al subir el punto de corte en LBA por GM-VClia la concordancia aumentó a 85,7%. CONCLUSIONES: Se observó una mayor correlación y concordancia en sueros que en LBA. El kit GM-VClia presentó una mayor sensibilidad y valor predictor negativo (VPN), que el kit GM-Plat. Las desventajas de GM-VClia, la constituyen la categoría "dudoso", que dificulta la interpretación y que, con los puntos de corte actuales en LBA, la correlación con GM-Plat es menor. Las ventajas son su mayor sensibilidad, facilidad de procesamiento y una mayor rapidez en los resultados.
BACKGROUND: The Aspergillus Galactomannan Ag Virclia® (GMVClia) test is a monotest and automated galactomannan technique based on chemiluminescent immunoassay (CLIA). AIM: To evaluate the performance of the GM-VClia test in serum and bronchioalveolar lavage (BAL) samples previously processed with the Platelia ™ Aspergillus EIA kit (GM-Plat). METHODS: 56 samples of serum 40 from BAL (some of them with galactomaman determination in both samples), from patients with pulmonary diseases, hematological diseases, SLE, Covid-19 and tumors, among others, were studied. Thirteen patients had invasive aspergillosis (1 proven and 12 probable). RESULTS: The correlation between both methods for serum and BAL was r = 0.8861 p < 0.0001 and r = 0.6368 p < 0.001, respectively. There was a global concordance of 67.7% (65/96), being 85.7% (48/56) in sera and 42.5.0% (14/49) in BAL. By raising the cut-off point in LBA by GM-VClia, the agreement increased to 85.7%. CONCLUSION: A greater correlation and concordance was observed in sera than in BAL. The GM-VClia kit had a higher sensitivity and NPV than the GM-Plat kit. The disadvantages of GM-VClia are the "doubtful" category, which makes interpretation difficult and that with the current cut-off points in LBA the correlation with GM-Plat is lower. The advantages are its greater sensitivity, ease of processing and faster results.
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Humanos , Aspergilosis/diagnóstico , Galactosa/análogos & derivados , Aspergillus , Líquido del Lavado Bronquioalveolar , Sensibilidad y Especificidad , COVID-19 , MananosRESUMEN
Resumen Introducción: Esta sistematización recoge las riquezas de notas de campo escritas por siete encuestadoras de siete ciudades de Colombia (Bogotá, Medellín, Cali, Barranquilla, Bucaramanga, Manizales y Pasto), realizadas durante una prueba piloto, en donde se reconocieron sus dinámicas y aprendizajes. Objetivo: Sistematizar las experiencias de los traslados hacia los terrenos de campo y de las experiencias del parto de mujeres entrevistadas, a través de las voces de las encuestadoras. Método: Se plantearon tres fases para seguir la metodología de la sistematización de experiencias: fase de reconstrucción, fase de la interpretación y fase de la potenciación de la experiencia. Resultados: Se evidenciaron tres categorías de análisis: el trayecto y el entorno, las convergencias en la maternidad y la experiencia del parto. Conclusiones: Las notas de campo de las encuestadoras se convirtieron en fuente primordial de informaciones no homogéneas y muy diversas. Se hizo imprescindible analizar sus experiencias durante sus traslados a los terrenos de campo y, de esta forma, aplicar un enfoque intersectorial para entender e interpretar lo que ellas escucharon de parte de las madres encuestadas, por ejemplo: circunstancias cálidas y respetuosas a la hora de recibir la atención clínica del parto, así como situaciones de maltrato en la asistencia obstétrica, donde han sido culturalmente jerarquizadas por la medicalización del parto, lo que constituye una posición de subordinación hacia la paciente.
Abstract Introduction: This systematization gathers the richness of the field notes written by seven interviewers from seven cities in Colombia (Bogotá, Medellin, Cali, Barranquilla, Bucaramanga, Manizales and Pasto), carried out during a test pilot, where their dynamics and learning were recognized. Objective: To systematize experiences of itineraries to the territories, as well as childbirth from the voices of the interviewers. Method: The methodological process presented three phases designed to follow the methodology of systematization of experiences. Reconstruction phase; interpretation phase and experience empowerment phase. Results: Three categories of analysis were evidenced: the journey and the environment, the convergences in motherhood and the experience of childbirth. Conclusions: The field notes of the pollsters became a primary source of inhomogeneous and highly diverse information. It became essential to analyze their experiences during their transfers to the fields and thus apply an intersectoral approach to understand and interpret what they heard from the surveyed mothers: warm and respectful circumstances when receiving clinical care of childbirth, as well as situations of abuse in obstetric care that are and have been culturally hierarchical by the medicalization of childbirth, constituting a subordinate position towards the patient.
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Humanos , Femenino , Embarazo , Parto Humanizado , Servicios de Salud , AprendizajeRESUMEN
BACKGROUND: Stroke is the second cause of death and the first cause of disability in Europe. The number of stroke patients shows a rapidly increasing due to the increase in the elderly population. The aim of this meta-analysis is to evaluate the prevalence and incidence of stroke in Europe. METHOD: We conducted a literature search in MEDLINE, SCOPUS, CINAHL Complete and EMBASE, using the keywords "stroke", "cerebrovascular accident", "epidemiology", "prevalence", "incidence" and "Europe". In order to evaluate the quality and risk of bias, we used the Hoy's modified scale for prevalence studies and the Newcastle Ottawa Scale for incidence studies. A random effects model with 95% confidence intervals (95%CI) was used for the meta-analysis. The I2 statistic was applied to assess heterogeneity. RESULTS: The prevalence of stroke in Europe adjusted for sex was estimated at 9.2% (95%CI: 4.4-14.0). The prevalence was 9.1% (95%CI: 4.7-13.6) in men and 9.2% (95%CI: 4.1-14.4) in women, and increased with age. The incidence of stroke in Europe adjusted for sex was 191.9 per 100,000 person-years (95%CI: 156.4-227.3); it was 195.7 per 100,000 person-years (95%CI: 142.4-249.0) in men and 188.1 per 100,000 person-years (95%CI: 138.6-237.7) in women. Again, these rates increased with age. CONCLUSION: The prevalence of stroke in Europe is 9.2%. The incidence of stroke in Europe is 191.9 per 100,000 person-years. The prevalence of stroke has increased, whereas the incidence of stroke is stable in comparison with studies conducted at the beginning of the 21st century.
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Accidente Cerebrovascular , Anciano , Estudios de Cohortes , Europa (Continente)/epidemiología , Femenino , Humanos , Incidencia , Masculino , Prevalencia , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/etiologíaRESUMEN
INTRODUCTION AND AIMS: The standard of care for gallbladder disease is laparoscopic cholecystectomy. Difficult dissection of the hepatocytic triangle and bleeding can result in conversion to open cholecystectomy, which is associated with increased morbidity. Identifying risk factors for conversion in the context of acute cholecystitis will allow patient care to be individualized and improve outcomes. MATERIALS AND METHODS: A retrospective case-control study included all patients diagnosed with acute cholecystitis, according to the 2018 Tokyo Guidelines, admitted to a tertiary care academic center, from January 1991 to January 2012. Using logistic regression, we analyzed variables to identify risk factors for conversion. Variables that were found to be significant predictors of conversion in the univariate analysis were included in a multivariate model. We then performed an exploratory analysis to identify the risk factor summation pathway with the highest sensitivity for conversion. RESULTS: The study included 321 patients with acute cholecystitis. Their mean age was 49 years (±16.8 SD), 65% were females, and 35% were males. Thirty-nine cases (12.14%) were converted to open surgery. In the univariate analysis, older age, male sex, gallbladder wall thickness, and pericholecystic fluid were associated with a higher risk for conversion. In the multivariate analysis all of the variables, except pericholecystic fluid, were associated with conversion. Our risk factor summation model had a sensitivity of 84%. CONCLUSIONS: Preoperative clinical data can be utilized to identify patients with a higher risk of conversion to open cholecystectomy. Being aware of such risk factors can help improve perioperative planning and preparedness in challenging cases.
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Colecistectomía Laparoscópica , Laparoscopía , Anciano , Estudios de Casos y Controles , Colecistectomía , Colecistectomía Laparoscópica/efectos adversos , Análisis Factorial , Femenino , Humanos , Laboratorios , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de RiesgoRESUMEN
INTRODUCTION AND AIM: Total gastrectomy is utilized in different pathologies. Esophagojejunostomy leakage is a frequent complication. Our aim was to determine the association of the neutrophil-lymphocyte ratio (NLR) with esophagojejunostomy leakage that subsequently required invasive treatment. MATERIALS AND METHODS: A retrospective study included patients that underwent esophagojejunostomy within the time frame of 2002-2017. Patients were grouped into those with or without anastomotic leakage that had conservative treatment (group A) and those with anastomotic leakage that had invasive treatment (group B). ROC curves and the Youden index were used for the optimum cutoff values of the NLR. RESULTS: Fifty-seven patients were included. Thirty-two (56.14%) were men, and mean patient age was 61.8 ± 13.4 years. Forty-five patients were assigned to group A and 12 to group B. Mean NLR was higher for group B on postoperative day 3 (group A 9.5 ± 7.5 vs. group B 13.9 ± 4.9) (p = 0.05). Mean total leukocytes was higher in group B on postoperative day 5 (group A 7.8 ± 3.4 × 103/mcl vs. group B 10.3 ± 4.4 × 103/mcl) (p = 0.03). NLR and total leukocyte accuracy on postoperative day 3 was calculated with ROC curves, at 0.78 and 0.63, respectively. For the NLR and leukocyte count, sensitivity was 91.7% and 58%, specificity was 64.4% and 60%, positive predictive value was 40% and 28%, and negative predictive value was 96% and 84%, respectively. CONCLUSIONS: Postoperatively, the NLR identified the total gastrectomy with esophagojejunostomy patients that subsequently required an invasive procedure secondary to esophagojejunostomy leakage.
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Esofagoplastia , Gastrectomía , Anciano , Anastomosis Quirúrgica , Fuga Anastomótica/diagnóstico , Gastrectomía/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
Powering electrochemical technologies with renewable energies is a promising way to get more sustainable environmental remediation techniques. However, the operational conditions of those processes must be optimized to undergo fast and efficient treatments. In this work, the influence of electrical and hydraulic connections in the performance of a set of two electrolyzers directly powered by photovoltaic panels was evaluated. Despite both electrolyzers were assembled using the same electrode material, they showed different performances. Results indicate that the electrolyzer with higher ohmic resistance and higher overpotential attained a greater production of oxidant species, being produced under the most efficient strategy around 4.8 and 15.1 mmol of oxidants per Ah by electrolyzer 1 and 2, respectively. Nevertheless, an excess of oxidant production because of an inefficient energy management, led to low removal efficiencies as a consequence of a waste of energy into undesirable reactions. Regarding the hydraulic distribution of wastewater between the cells, it was found to influence on the total remediation attained, being the serial connection 2.5 and 1.8 more efficient than a parallel wastewater distribution under series and parallel electrical strategies, respectively. Regarding electrical strategies, parallel connections maximize the use of power produced by the photovoltaic panels. Furthermore, this allows the system to work under lower current densities, reducing the mass transfer limitations. Considering both advantages, a hydraulic connection of the cells in series and an electrical connection in parallel was found to reach the highest specific removal of pollutant, 2.52 mg clopyralid (Wh)-1. Conversely, the opposite strategy (parallel hydraulic connection-series electrical connection) showed the lowest remediation ratio, 0.48 mg clopyralid (Wh)-1. These results are important to be considered in the design of electrolytic treatments of waste directly powered by photovoltaic panels, because they show the way to optimize the cells stack layout in full-scale applications, exhibiting significant impact on the sustainability of the electrochemical application.
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Restauración y Remediación Ambiental , Aguas Residuales , Electricidad , Electrodos , ElectrólisisRESUMEN
INTRODUCTION AND AIM: The Revista de Gastroenterología de México (RGM), founded in 1935, is one of the most influential journals of scientific dissemination in Mexico and Latin America. The aim of the present review was to characterize the RGM's most frequently cited original articles, review articles, and consensuses. METHODS: The most cited original articles, review articles, and consensuses of the RGM were identified using the Scopus, PubMed, and Google Scholar databases. Their designs and topics, as well as their authors and participating institutions, were analyzed. RESULTS: The most highly cited articles of the RGM corresponded to the period from 1996 to 2018, with a mean of 16.5 citations per article. Fifty-eight percent (n = 29) of the articles belonged to the area of gastroenterology and 20% (n = 10) to surgery. The most frequent topics were functional gastrointestinal disorders, hepatitis virus, and gastric cancer. Thirty-six percent of the articles had a nonrandomized prospective design, followed by cross-sectional studies (26%) and randomized prospective studies (18%). CONCLUSION: The 50 most-cited articles included a total of 826 citations and the 10 most-cited consensuses and review articles had a total of 208 citations. Those studies encompass a diversity of disciplines related to gastroenterology that have impacted the scientific community and correspond to the work of different active research groups in Mexico and other countries.
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INTRODUCTION AND AIM: Pancreatic cancer is considered one of the most aggressive solid tumors. In Mexico, it is the twelfth cause of cancer, with 4,489 cases diagnosed annually, and accounts for 4.9% of oncologic deaths. The aim of our study was to describe the clinical and epidemiologic characteristics of the patients diagnosed with pancreatic cancer spanning an 11-year period at the Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán". METHODS: A retrospective, cross-sectional study was conducted that included 479 patients diagnosed with pancreatic cancer, within the time frame of 2003-2013. The documented findings were summarized through descriptive statistics. RESULTS: Of the patients with pancreatic ductal adenocarcinoma, 50.9% were women, and the mean patient age at diagnosis was 61.5 years. A total of 48.4% of the cases were diagnosed at clinical stage IV, 12.9% presented with clinical stage III, and 25.0% had localized disease. Surgery was performed on 37.5% of the patients, the most frequent of which was pancreatoduodenectomy. The surgical mortality rate was 5.5%. CONCLUSION: The clinical characteristics in our study group were similar to those described in the literature. However, the number of candidates for surgical treatment was higher than that reported in other hospitals and the percentage of borderline tumors was lower. Those differences, respectively, are possibly associated with the nature of our referral center and the prolonged intervals between diagnosis and treatment that result in the loss of potential surgical patients.
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Monocytes and macrophages belong to the mononuclear phagocyte system and play important roles in both physiological and pathological processes. The cells belonging to the monocyte/macrophage system are structurally and functionally heterogeneous. Several subsets of monocytes have been previously identified in mammalian blood, generating different subpopulations of macrophages in tissues. Although their distribution and phenotype are similar to their human counterpart, bovine monocytes and macrophages feature differences in both functions and purification procedures. The specific roles that monocytes and macrophages fulfil in several important diseases of bovine species, including among the others tuberculosis and paratuberculosis, brucellosis or the disease related to peripartum, remain still partially elusive. The purpose of this review is to discuss the current knowledge of bovine monocytes and macrophages. We will describe methods for their purification and characterization of their major functions, including chemotaxis, phagocytosis and killing, oxidative burst, apoptosis and necrosis. An overview of the flow cytometry and morphological procedures, including cytology, histology and immunohistochemistry, that are currently utilized to describe monocyte and macrophage main populations and functions is presented as well.