Genitourinary syndrome of menopause. Prevalence and quality of life in Spanish postmenopausal women. The GENISSE study.

OBJECTIVE: To determine the prevalence of genitourinary syndrome of menopause (GSM) and urogynecological conditions associated with menopause, and to evaluate the impact of GSM on quality of life in a cohort of Spanish postmenopausal women. METHODS: Multicenter, cross-sectional, and observational study involving 430 women. RESULTS: The prevalence of GSM was 70%. GSM was diagnosed in 60.2% of women with no known diagnosis of vulvovaginal atrophy or GSM. Most prevalent symptoms were vaginal dryness (93.3%) and reduced lubrication with sexual activity (90.0%). Most prevalent signs were decreased moisture (93.7%) and loss of vaginal rugae (78.4%). GSM was significantly associated with stress or mixed urinary incontinence, overactive bladder, and vaginal prolapse. Symptoms showed a low-moderate impact on quality of life, mainly in sexual functioning and self-concept and body image. CONCLUSIONS: The GSM is very prevalent in Spanish postmenopausal women, affecting up to 70% of those consulting the gynecologist. Despite the high prevalence of symptoms and signs and its impact on the women's well-being, GSM remains underdiagnosed and undertreated. Given its relationship with urogynecological conditions, it seems necessary to provide an adequate evaluation of postmenopausal women for identifying potential co-morbidities and providing most adequate treatments. An adequate management of GSM will contribute to an improvement in the quality of life of these women.

Faraday effect in hybrid magneto-plasmonic photonic crystals.

We present a theoretical study of the Faraday effect in hybrid magneto-plasmonic crystals that consist of Au-Co-Au perforated membranes with a periodic array of sub-wavelength holes. We show that in these hybrid systems the interplay between the extraordinary optical transmission and the magneto-optical activity leads to a resonant enhancement of the Faraday rotation, as compared to purely ferromagnetic membranes. In particular, we determine the geometrical parameters for which this enhancement is optimized and show that the inclusion of a noble metal like Au dramatically increases the Faraday rotation over a broad bandwidth. Moreover, we show that the analysis of the Faraday rotation in these periodically perforated membranes provides a further insight into the origin of the extraordinary optical transmission.

Quantification of the composition of pyrolysis oils of complex plastic waste by gas chromatography coupled with mass spectrometer detector.

Waste valorisation through pyrolysis generates solid, liquid and gaseous fractions that need to be deeply characterised in order to try to recover secondary raw materials or chemicals. Depending on the waste and the process conditions, the liquid fraction obtained (so-called pyrolysis oil) can be very complex. This work proposes a method to quantitatively measure the composition of pyrolysis oils coming from three types of polymeric waste: (1) plastic packaging from sorting plants of municipal solid waste, (2) plastic rich fractions rejected from sorting plants of waste of electrical and electronic equipment and (3) end-of-life carbon/glass fibre reinforced thermoset polymers. The proposed methodology uses a gas chromatography (GC) coupled with mass spectrometer detector (MS) analytical technique, a certified saturated alkanes' mix, an internal standard and fourteen model compounds. Validation of the methodology concluded that the average relative error was between -59 wt% and +62 wt% (with standard deviations between 0 wt% and 13 wt%). Considering that the state-of-the-art scenario to quantify complex plastic pyrolysis oils as a whole is almost none and that they are usually evaluated only qualitatively based on the area percentage of the GC-MS chromatograms, the presented quantification methodology implies a clear step forward towards complex pyrolysis oil compositional quantification in a cost-effective way. Besides, this quantification methodology enables determining what proportion is being detected by GC-MS with respect to the total oil. Finally, the presented work includes all the Kováts RI for complex temperature-program gas chromatography of all the signals identified in the analysed pyrolysis oils, to be readily available to other researchers towards the identification of chemical compounds in their studies.

Composite waste recycling: Predictive simulation of the pyrolysis vapours and gases upgrading process in Aspen plus.

Waste generation is one of the greatest problems of present times, and the recycling of carbon fibre reinforced composites one big challenge to face. Currently, no resin valorisation is done in thermal fibre recycling methods. However, when pyrolysis is used, additional valuable compounds (syngas or H2-rich gas) could be obtained by upgrading the generated vapours and gases. This work presents the thermodynamic and kinetic multi-reaction modelling of the pyrolysis vapours and gases upgrading process in Aspen Plus software. These models forecast the theoretical and in-between scenario of a thermal upgrading process of an experimentally characterised vapours and gases stream (a blend of thirty-five compounds). Indeed, the influence of temperature (500 °C-1200 °C) and pressure (ΔP = 0, 1 and 2 bar) operating parameters are analysed in the outlet composition, residence time and possible reaction mechanisms occurring. Validation of the kinetic model has been done comparing predicted outlet composition with experimental data (at 700 °C and 900 °C with ΔP = 0 bar) for H2 (g), CO (g), CO2 (g), CH4 (g), H2O (v) and C (s). Kinetic and experimental results show the same tendency with temperature, validating the model for further research. Good kinetic fit is obtained for H2 (g) (absolute error: 0.5 wt% at constant temperature and 0.3 wt% at variable temperature) and H2O (v) shows the highest error at variable T (8.8 wt%). Both simulation and experimental results evolve towards simpler, less toxic and higher generation of hydrogen-rich gas with increasing operating temperature and pressure.

Mandibular solitary plasmocytoma of the jaw: a case report.

Plasma cell tumors are lymphoid neoplasms with an uncontrolled proliferation of B cells. These are divided into localized forms (solitary bone plasmocytoma -SBP- and extramedullary plasmocytoma -EP-) and disseminated forms (multiple myeloma-MM-). The SBP is a rare and controversial disease. The aim of this article is the analysis of this entity based on the presentation of a 64-year-old man without previous medical history, with a mass in the left mandibular angle extending to the parotid region on the same side. The panoramic radiography, computed tomography and magnetic resonance imaging showed an osteolytic lesion 6.5 x 5 x 6.7 cm in the mandibular angle with infiltration of the masticator space and left parotid region. The normality of the extension study, and histopathological examination confirmed the diagnosis of SBP. The patient received treatment with radiotherapy with good outcome.

Production of hydrogen-rich gases in the recycling process of residual carbon fiber reinforced polymers by pyrolysis.

In this work, a novel method to valorize the polymeric matrix of residual carbon fiber reinforced polymers (CFRP) in the recycling process of carbon fibers by pyrolysis is presented. The experiments have been carried out with an expired epoxy-based pre-preg and in a lab-scale installation composed of two reactors. In the first one, pyrolysis and oxidation have been carried out, while in the second one, the gases and vapors resulting from the thermal decomposition of the polymeric resin have been thermally treated. The following operating parameters have been studied in the pyrolysis step: dwell time, the use of N2 (N2 flow, no N2 flow and not even to inert the reaction medium) and the solid bed material of the second reactor. In the oxidation step, temperature and time have been optimized by using the theory of experiments based on 2 k factorial design was used. It has been demonstrated that clean carbon fibers and a gaseous fraction with 75% by volume of H2 can be obtained. This is possible through a combined process of (1) CFRP thermal decomposition at 500 °C, (2) thermal treatment of gases and vapors at 900 °C in a solid bed tubular reactor filled with a waste refractory material and (3) oxidation of pyrolysis solid at 500 °C during 165 min in presence of 1.3 L air min-1.

Multifocal presentation in 2 cases of unilateral acute idiopathic maculopathy. / Presentación multifocal en 2 casos de maculopatía unilateral aguda idiopática.

Two cases of multifocal unilateral acute idiopathic maculopathy are presented, one in a 24 year-old man, and another in a 37 year-old woman. Both of them presented with acute vision loss and clinical findings compatible with unilateral acute idiopathic maculopathy. As a relatively uncommon finding, they had multifocal lesions around a larger central lesion. They experienced a spontaneous improvement of their vision. Atypical presentations of unilateral acute idiopathic maculopathy like multifocal lesions are possible. Ophthalmologists should be aware of this rare form of presentation.

Invasive aspergillosis manifesting as retinal necrosis in a patient treated with ruxolitinib. / Necrosis retiniana como manifestación de aspergilosis invasiva en un paciente tratado con ruxolitinib.

A 30 year-old man with acute myeloblastic leukaemia and secondary myelodysplastic syndrome developed graft-versus-host disease. The patient was treated with ruxolitinib. After being treated for 3 months with ruxolitinib, an inhibitor of Janus kinase, he developed Aspergillus retinal necrosis resistant to common treatment. Treatment with Janus kinase inhibitors may lead to an increased incidence of opportunistic infections. Janus kinase inhibitor administration may result in poor treatment efficacy.

Hypertensive choroidopathy, retinopathy and optic neuropathy in renal transplantation failure. / Coroidopatía, retinopatía y neuropatía óptica hipertensiva en un paciente con fracaso de trasplante renal.

A 32 year-old man who presented with severe elevation of blood pressure after failure of kidney transplant. The patient had multiple serous retinal detachments, venous dilation, arteriolar narrowing, retinal haemorrhages, as well as optic disc oedema. Due to the impossibility of performing a fluorescein angiography, an angiotomography and en-face optical coherence tomography images were used to identify the vascular alterations in the retina, choroid, and choriocapillaris. Angiotomography and en face-optical coherence tomography mode images are very useful in cases where it is not possible to perform fluorescein angiography.

Immune recovery uveitis in a patient with herpes retinitis as a complication of hairy cell leukaemia. / Respuesta similar a la uveítis de recuperación inmune en un paciente con retinitis herpética como complicación de una leucemia de células peludas.

A 51 year-old man with hairy cell leukaemia was treated with pentostatin. While receiving the treatment, he was diagnosed with herpes retinitis in his right eye. After the last cycle of pentostatin the patient developed a mild vitritis and cystoid macular oedema. There were no signs of herpes retinitis reactivation. After excluding other possible causes of intraocular inflammation, a diagnosis of immune recovery uveitis was made. The patient was treated with 2-monthly retro-septal injections of triamcinolone, oral corticosteroids, intravitreal dexamethasone implants and, finally, pars plana vitrectomy. An immune recovery uveitis-like response is possible in HIV negative individuals. The immune reconstitution after the treatment of hairy cell leukaemia may have led to intraocular inflammation. Management of immune recovery uveitis is challenging and difficult. Pars plana vitrectomy may be necessary. Ophthalmologists should be alert to the possibility of immune recovery uveitis in HIV negative patients.

Importance of 68Ga-PSMA PET/CT in hospital practice. View of the radiation oncologist. / PET/TC con 68Ga-PSMA, importancia en la práctica hospitalaria. Visión del oncólogo radioterápico.

Radiotherapy is a treatment with curative intent, both in patients with primary diagnosis of prostate cancer (PCa) and in patients presenting with biochemical recurrence after radical prostatectomy (RP). Moreover, the use of stereotactic body radiotherapy as a metastasis directed therapy in patients with oligometastatic PCa has significantly increased in the recent years. Conventional imaging techniques, including transrectal ultrasound, computed tomography (CT), morphologic magnetic resonance and bone scintigraphy have traditionally played a minor role in all those clinical scenarios due to its low diagnostic accuracy. The recent development of the positron emission tomography (PET) radiotracer 68Ga-PSMA binding to the prostate specific membrane antigen (PSMA), a transmembrane glycoprotein overexpressed in PCa cells, has shown promising results. Detection rates for PCa lesions are higher than CT and higher than the best technique available, the PET/CT with choline. Its superiority has been demonstrated even at very low PSA levels (<1 ng/ml). This increase in diagnostic accuracy represents a potential impact on patient management, especially in radiotherapy. Even if this imaging technique is already available for routine clinical practice in some European countries, in Spain, unfortunately, there is very limited access. In this review, we analyze the main studies that investigate the usefulness of 68Ga-PSMA PET/CT in patients with PCa and its potential impact on radiotherapy treatments. In addition, we compared the 68Ga-PSMA PET/CT, with the multiparametric magnetic resonance imaging and the PET/CT with choline, in the different clinical scenarios.

Preventing childhood obesity in Latin America: an agenda for regional research and strategic partnerships.

The increasing prevalence of childhood obesity in Latin America poses a major public health challenge to the region. In response, many countries are implementing obesity prevention programmes aimed at modifying known risk factors. However, the limited scientific evidence inhibits the development and implementation of novel, effective interventions across the region. To address these gaps, the NIH Fogarty International Center convened a workshop of researchers, policymakers, programme implementers and public health advocates who are actively engaged in the region to prevent childhood obesity. Major aims of the meeting were to define the current status of childhood obesity, identify the scientific gaps in our understanding of the epidemic, point out the barriers and opportunities for research and outline a plan for capacity building in the region in the area of childhood obesity. This series of articles reflects the key outcome of the meeting and offers an analysis of the knowledge translation needed for evidence-based policy initiatives, a review of the research agenda and an evaluation of research capacity in the region. The goal of the papers is to inform the development of multidisciplinary and multisector research collaborations, which are essential to the implementation of successful childhood obesity prevention strategies in the region.

Use of body mass index to identify obesity-related metabolic disorders in the Chinese population.

OBJECTIVE: To identify the body mass index (BMI; in kg/m2) cutoff that predicts the risk for obesity-related metabolic disorders for the Chinese population. DESIGN: Community-based cross-sectional survey. SETTING: Rural regions of Jiangxi and Anhui provinces and an urban community of Jing'an District of Shanghai, China. SUBJECTS: Five hundred and twenty-nine non-pregnant, non-lactating urban and rural adults, aged 20-64 years without diagnosed diabetes. RESULTS: Subjects were divided into two groups: with or without obesity-related metabolic disorders, which was defined as having at least one of the following: hypertension, insulin resistance, high plasma triacylglycerol, low-density lipoprotein-cholesterol or glucose. Gender-specific multiple logistic regression analysis demonstrated a significant dose-response relationship between BMI and obesity-related metabolic disorders, after adjusting for potential confounders. The lowest BMI interval associated with significant risk for both men and women (odds ratios of 2.67 and 3.46, respectively) was that of 22.5-24.4. Receiver-operating characteristic (ROC) curve analysis indicated that a BMI cutoff of 23 had the best combination of sensitivity and specificity and the shortest distance in the ROC curve, with positive and negative predictive values of 0.6-0.7 in both genders. CONCLUSIONS: A BMI cutoff of 23 might be appropriate for use in identification of high risk of obesity-related metabolic disorders and serve as a public health action threshold in the Chinese population. SPONSORSHIP: Center of a Livable Future, John Hopkins Bloomberg School of Public Health.

Possibilities and limits of pyrolysis for recycling plastic rich waste streams rejected from phones recycling plants.

The possibilities and limits of pyrolysis as a means of recycling plastic rich fractions derived from discarded phones have been studied. Two plastic rich samples (⩾80wt% plastics) derived from landline and mobile phones provided by a Spanish recycling company, have been pyrolysed under N2 in a 3.5dm3 reactor at 500°C for 30min. The landline and mobile phones yielded 58 and 54.5wt% liquids, 16.7 and 12.6wt% gases and 28.3 and 32.4wt% solids respectively. The liquids were a complex mixture of organic products containing valuable chemicals (toluene, styrene, ethyl-benzene, etc.) and with high HHVs (34-38MJkg-1). The solids were composed of metals (mainly Cu, Zn, and Al) and char (≈50wt%). The gases consisted mainly of hydrocarbons and some CO, CO2 and H2. The halogens (Cl, Br) of the original samples were mainly distributed between the gases and solids. The metals and char can be easily separated and the formers may be recycled, but the uses of the char will be restricted due to its Cl/Br content. The gases may provide the energy requirements of the processing plant, but HBr and HCl must be firstly eliminated. The liquids could have a potential use as energy or chemicals source, but the practical implementation of these applications will be no exempt of great problems that may become insurmountable (difficulty of economically recovering pure chemicals, contamination by volatile metals, etc.).

Plasma insulin levels and incidence of hypertension in African Americans and whites.

BACKGROUND: Hyperinsulinemia may play an important role in the pathogenesis of hypertension in whites but the role of hyperinsulinemia in hypertension in African Americans is controversial. SUBJECTS AND METHODS: We studied the relationship between insulin levels and subsequent incidence of hypertension in 140 African Americans and 237 whites who were initially screened for possible participation in the Trials of Hypertension Prevention, phase 1. Plasma insulin and serum glucose were measured at baseline and at a follow-up examination 7 years later. Blood pressure was measured by trained observers using a random-zero sphygmomanometer. Incident hypertension was defined as an average systolic pressure of 160 mm Hg or higher and/or diastolic pressure of 95 mm Hg or higher at a single visit and/or use of antihypertensive medication during follow-up. RESULTS: Over the 7 years of follow-up, the incidence of hypertension was 25.7% in the African Americans and 25.3% in the whites. Baseline plasma insulin and insulin-to-glucose ratio were associated with an increased risk of hypertension in both the African Americans and the whites. After adjustment for age, sex, race, body mass, heart rate, and alcohol consumption at baseline as well as intervention assignment in the Trials of Hypertension Prevention, phase 1, a 1-SD (21 pmol/mmol) difference in baseline insulin-to-glucose ratio was associated with a 2.77 (95% confidence interval, 1.48-5.19) odds ratio of hypertension in the African Americans and a 1.69 (95% confidence interval, 1.08-2.64) odds ratio in the whites. CONCLUSION: These results suggest that higher plasma insulin levels are associated with an increased risk of hypertension in both African Americans and whites.

Effect of animal mixing as a stressor on biomarkers of autophagy and oxidative stress during pig muscle maturation.

The objective of this work was to study the postmortem evolution of potential biomarkers of autophagy (Beclin 1, LC3-II/LC3-I ratio) and oxidative stress (total antioxidant activity, TAA; superoxide dismutase activity, SOD and catalase activity, CAT) in the Longissimus dorsi muscle of entire male ((Large White×Landrace)×Duroc) pigs subjected to different management treatments that may promote stress, such as mixing unfamiliar animals at the farm and/or during transport and lairage before slaughter. During the rearing period at the farm, five animals were never mixed after the initial formation of the experimental groups (unmixed group at the farm, UF), whereas 10 animals were subjected to a common routine of being mixed with unfamiliar animals (mixed group at the farm, MF). Furthermore, two different treatments were used during the transport and lairage before slaughter: 10 pigs were not mixed (unmixed group during transport and lairage, UTL), whereas five pigs were mixed with unfamiliar animals on the lorry and during lairage (mixed group during transport and lairage, MTL). These mixing treatments were then combined into three pre-slaughter treatments - namely, UF-UTL, MF-UTL and MF-MTL. The results show that MF-UTL and MF-MTL increased significantly the muscle antioxidant defense (TAA, SOD and CAT) at short postmortem times (4 and 8 h; P<0.001), followed by an earlier depletion of the antioxidant activity at 24 h postmortem (P<0.05). We also found that mixing unfamiliar animals, both at the farm and during transport and lairage, triggers postmortem muscle autophagy, which showed an earlier activation (higher expression of Beclin 1 and LC3-II/LC3-I ratio at 4 h postmortem followed by a decreasing pattern of this ratio along first 24 h postmortem) in the muscle tissues of animals from the MF-UTL and MF-MTL groups, as an adaptive strategy of the muscle cells for counteracting induced stress. From these results, we propose that monitoring the evolution of the main biomarkers of autophagy (Beclin 1, LC3-II/LC3-I ratio) and muscle antioxidant defense (TAA, SOD, CAT) in the muscle tissue within the first 24 h postmortem may help the detection of animal stress and its potential effect on the postmortem muscle metabolism.

Psychobiological effects of carbohydrate- and protein-rich meals in patients with seasonal affective disorder and normal controls.

Patients with seasonal affective disorder (SAD) frequently report carbohydrate craving and note that carbohydrate ingestion energizes them. Bright artificial light has been shown to reverse the symptoms of SAD, including carbohydrate craving. In this study, 16 depressed SAD patients and 16 matched controls were fed two different isocaloric meals, one rich in protein and one rich in carbohydrates, in a crossover design. Although their biochemical response in terms of plasma large neutral amino acid concentrations was identical, SAD patients reported activation following carbohydrate ingestion, whereas normal controls reported sedation. Marked ordering effects on psychological parameters were noted, suggesting that order should be taken into account as a methodological consideration in meal studies.

Plasma amino acid concentrations in healthy elderly men and women.

Postabsorptive plasma concentrations of the large neutral amino acids (LNAAs) were measured in 74 elderly (age 71 +/- 8 y) and 138 young (age 26 +/- 5 y) healthy subjects. Plasma concentrations of valine, leucine, and isoleucine were significantly lower in young females than in young males. This gender-related difference was not observed among elderly subjects because aging was associated with a significant rise in plasma LNAAs in females but not in males. Multiple-regression analysis of plasma amino acid concentrations from female subjects revealed a significant and positive effect of age on plasma valine, leucine, isoleucine, phenylalanine, and tyrosine but not on plasma tryptophan or methionine. Tryptophan was the only amino acid to exhibit a significant response to age in males, consisting of a 14% decline in the elderly subjects. Percentile ranges are presented for young and elderly females and males for each of the amino acids.