Bilateral striopallidal calcinosis secondary to systemic lupus erythematosus.

Bilateral symmetric striatopallidal calcinosis with or without deposits in dentate nucleus, thalamus, and white matter is reported in patients ranging from asymptomatic, metabolic, toxic, and genetic autosomal dominant, familial or sporadic forms. Of the connective tissue diseases, it has been reported in very few cases in patients with systemic lupus erythematosus, many incorrectly labeled as Fahr syndrome without even having hypoparathyroidism. Here we describe a 30-year-old female patient with neuropsychiatric systemic lupus erythematosus manifested at diagnosis with mood disorders and anxiety, and 1-year later develops Lupus headache; Incidentally, an aneurism of the right middle cerebral artery and bilateral and symmetric calcifications of the caudate and lenticular nuclei were noted; this finding is a rarely reported manifestation of neuropsychiatric systemic lupus erythematosus. A review of the literature based on this case was carried out in electronic databases. There are approximately 29 patients reported in the literature, with calcifications in the basal ganglia associated with systemic lupus erythematosus occurs almost exclusively in young women (96.5%) with a mean age of 33.36 years (2 months-76 years), with a race predilection for Asians (65.5%). Regarding the neuropsychiatric syndromes defined by the American College of Rheumatology, the most frequently associated are movement disorders; followed by cognitive dysfunction, seizure disorders, mood disorders, cerebrovascular disease, psychosis, and acute confusional state, transverse myelitis, and demyelinating syndrome. The mean duration time of the SLE to detection of the basal ganglia calcification is 7.62 years (3 days-31 years).

Routine operation theatre extubation after cardiac surgery in the elderly.

OBJECTIVES: The aim was to analyse in-hospital outcomes of patients over 70 years of age undergoing routine immediate operation theatre (OT) extubation after on-pump or off-pump cardiac surgery. METHODS: A retrospective analysis was performed of prospectively collected data over a 4-year period (2011-14) from elderly patients undergoing early extubation after cardiac surgery at a single institution. All patients over 70 years were considered eligible for immediate OT or intensive care unit (ICU) early extubation after meeting specific criteria. All types of non-emergency cardiac surgery were included. Cardiac surgical risk stratification was assessed with EuroSCORE II and age, creatinine level and left ventricular ejection fraction (ACEF) score. RESULTS: Among the 415 patients operated on during the period, 275 (66.3%) were ≥70 years old. One hundred and forty patients (50.9%) of the elderly group were extubated successfully in the OT. Excluding off-pump coronary surgery, OT extubation was achieved in 51.5% of cases. The rate of risk of reintubation within 24 h of surgery after OT extubation was 2.1%. The in-hospital mortality rate was 4.7%, and the complication rate was 11.6%, independently of extubation timing. Elderly patients extubated in the OT had a significantly lower median EuroSCORE II risk level and ACEF score, more isolated valve surgeries, reduced cardiopulmonary bypass time, less complications and shorter length of stay than ICU-extubated patients. In the multivariate analysis, only the ACEF score remained as an independent variable associated with OT extubation in the elderly (odds ratio 25.0, 95% CI 2.74-228.8, P = 0.004), and had good discriminating power [receiver operating characteristics (ROC) area 0.713]. On the other hand, the EuroSCORE ROC area used to predict OT extubation was 0.694, and the cut-off analysis showed that a risk value under 2.11 was associated with 72.1% OT extubation versus 37.3% when the risk value was over 2.11 (P = 0.0002). CONCLUSIONS: OT extubation in the elderly can be safely performed in nearly 50% of patients, without apparently worsening their outcomes. A key point of this success was the use of a short-acting volatile agent to maintain anaesthesia throughout the procedure. Low- or moderate-risk cardiac surgery assessed with a preoperative EuroSCORE II <2.11 will help to better predict successful OT extubation in the elderly.

A novel formulation based on 2,3-di(tetradecyloxy)propan-1-amine cationic lipid combined with polysorbate 80 for efficient gene delivery to the retina.

PURPOSE: The aim of the present study was to evaluate the potential application of a novel formulation based on a synthesized cationic lipid 2,3-di(tetradecyloxy)propan-1-amine, combined with polysorbate 80 to deliver the pCMS-EGFP plasmid into the rat retina. METHODS: We elaborated lipoplexes by mixing the formulation containing the cationic lipid and the polysorbate 80 with the plasmid at different cationic lipid/DNA ratios (w/w). Resulted lipoplexes were characterized in terms of size, charge, and capacity to condense, protect and release the DNA. In vitro transfection studies were performed in HEK-293 and ARPE-19 cells. Formulations were also tested in vivo by monitoring the expression of the EGFP after intravitreal and subretinal injections in rat eyes. RESULTS: At 2/1 cationic lipid/DNA mass ratio, the resulted lipoplexes had 200 nm of hydrodynamic diameter; were positive charged, spherical, protected DNA against enzymatic digestion and transfected efficiently HEK-293 and ARPE-19 cultured cells exhibiting lower cytotoxicity than LipofectamineTM 2000. Subretinal administrations transfected mainly photoreceptors and retinal pigment epithelial cells; whereas intravitreal injections produced a more uniform distribution of transfection through the inner part of the retina. CONCLUSIONS: These results hold great expectations for other gene delivery formulations based on this cationic lipid for retinal gene therapy purposes.

Open burning of household waste: Effect of experimental condition on combustion quality and emission of PCDD, PCDF and PCB.

Open burning for waste disposal is, in many countries, the dominant source of polychlorinated dibenzodioxins, dibenzofurans and biphenyls (PCDD/PCDF/PCB) release to the environment. To generate emission factors for open burning, experimental pile burns of about 100 kg of household waste were conducted with emissions sampling. From these experiments and others conducted by the same authors it is found that less compaction of waste or active mixing during the fire--"stirring"--promotes better combustion (as evidenced by lower CO/CO(2) ratio) and reduces emissions of PCDD/PCDF/PCB; an intuitive but previously undemonstrated result. These experiments also support previous results suggesting PCDD/PCDF/PCB generation in open burning - while still highly variable - tends to be greater in the later (smoldering) phases of burning when the CO/CO(2) ratio increases.

Emissions of unintentional persistent organic pollutants from open burning of municipal solid waste from developing countries.

Open burning of waste is the most significant source of polychlorinated dibenzo-para-dioxins and dibenzofurans (PCDD/PCDF) in many national inventories prepared pursuant to the Stockholm Convention on Persistent Organic Pollutants. This is particularly true for developing countries. Emission factors for POPs such as PCDD/PCDF, dioxin-like polychlorinated biphenyls (dl-PCB) and penta- and hexachlorobenzenes (PeCBz/HCB) from open burning of municipal solid waste in China and Mexico are reported herein. Six different waste sources were studied varying from urban-industrial to semi-urban to rural. For PCDD/PCDF, the emission factors to air ranged from 3.0 to 650 ng TEQ kg(-1)waste and for dl-PCB from 0.092 to 54 ng TEQ kg(-1)waste. Emission factors for PeCBz (17-1200 ng kg(-1)waste) and HCB (24-1300 ng kg(-1)waste) spanned a wide but similar range. Within the datasets there is no indication of significant waste composition effect on emission factor with the exception of significantly higher Mexico rural samples.

PCDD/F, PBDD/F, and PBDE emissions from open burning of a residential waste dump.

This work reports on the first known field study determining emission factors for polychlorinated and polybrominated dibenzodioxins/dibenzofurans (P[C/B]DDs/Fs) and polybrominated diphenyl ethers (PBDEs) from open burning of domestic waste. Two burning waste dump sites in Mexico were sampled using high-volume samplers mounted to a mobile sampling boom. Concurrent measurements of CO and CO(2) allowed determination of emission factors via the carbon balance method. PCDD/F emission factors averaged 823 ng toxic equivalency (TEQ)/kg C(burned) (N = 8, 68% relative standard deviation, RSD), a value at least five times higher than those from previous tests with domestic waste burned in barrels and approximately 2000 times higher than those from stacks of modern municipal waste combustors. These emission factors appear to be related to combustion quality, as conditions conducive to smoldering combustion, rather than flaming combustion, resulted in higher emission factors. Emissions of 40 PBDE congeners, likely originating from brominated flame retardants, averaged 724 mug/kg C(burned) (RSD = 96%) and had congener patterns similar to those of reported atmospheric sampling. Emissions of PBDDs/Fs were similar in magnitude to their chlorinated counterparts, averaging 470 ng TEQ/kg C(burned) (RSD = 105%), and may originate as reaction products of PBDE combustion or as thermally desorbed impurities from the PBDE flame retardant.

Bacillus thuringiensis: avances y perspectivas en el control biológico de Aedes aegypti / Bacillus thuringiensis: Advances and perspectives in the biological control of Aedes aegypti

Bacillus thuringiensis (Bt) se presenta como una alternativa atractiva para el control de Aedes aegypti por sus claras ventajas sobre insecticidas químicos, a saber: alta especificidad, inocuidad sobre el medio ambiente y lento desarrollo de resistencia. Las nuevas tendencias en formulaciones que utilizan agentes encapsulantes como almidón, o adsorción a partículas de arcilla, ayudan a proteger los productos Bt de factores que afectan su actividad, tales como la radiación UV, la temperatura y la degradación microbiana, mejorando la persistencia del producto, al tiempo que pueden actuar como fago-estimulantes. No obstante, es necesario evaluar estas propuestas en el contexto del control de Aedes aegypti, sobretodo en relación a la manipulación humana de los criaderos y el estado nutricional de la larva. Bt también ofrece la posibilidad de obtener productos variados que permitan la alternancia de aplicaciones y, posiblemente, productos que, de ser necesario, se adecuen a las necesidades específicas de cada región

Bacillus thuringiensis is an attractive alternative for the control of Aedes aegypti for its clear advantages over chemical insecticides, high specificity, safety on the environment and slow development of resistance. New trends in formulations using encapsulating agents such as starch, or adsorption to clay particles that help protect the products of Bt factors affecting their activity, such as UV radiation, temperature and microbial degradation, enhance the persistence of the product, which can act as phage-type stimulants. However, it is necessary to evaluate these proposals in the context of the control of Ae. aegypti, especially in relation to the human manipulation of breeding sites and nutritional status of the larva. Bt also offers the possibility of obtaining products that enable a variety of alternate applications, and possibly products, if necessary, to suit the specific needs of each region

Factores asociados a falla de extubación inmediata en el quirófano después de cirugía cardíaca con y sin circulación extracorpórea / Operating room extubation (ultra fast-track anesthesia) in patients undergoing on-pump and off-pump cardiac surgery

OBJECTIVE: The potential benefit of immediate operating room extubation after cardiac surgery remains controversial. Since safety and effectiveness of ultra fast-track anesthesia is mandatory, we developed this work to identify preoperative and operative variables associated to failed extubation after on-pump and off-pump cardiac surgery. METHODS: Three hundred ninety eight consecutive patients undergoing coronary, valve or combined surgery were included in a prospective observational study of ultra fast-track anesthesia. Primary outcome was failed tracheal extubation, defined as the impossibility to extubate in the operating room immediately after surgery. Secondary outcomes evaluated need for postoperative tracheal reintubation, morbidity and mortality. Univariate analysis and multivariate logistic regression were done over 24 preoperative and operative variables to determine factors associated with failed tracheal extubation after on-pump and off-pump surgery. RESULTS: Sixty eight per cent of patients undergoing on-pump surgery, and 87.1% of those undergoing off-pump coronary revascularization were successfully extubated in the operating room. Univariate analysis in the on-pump group found that heart failure, left ventricular dysfunction, urgency, cross-clamping time, pacemaker requirement and difficult cardiopulmonary by-pass weaning were related to failed tracheal extubation; while heart failure and difficult cardiopulmonary bypass weaning were variables associated in the multivariate analysis. In the off-pump coronary surgery group, univariate analysis showed that pulmonary disease, urgency, pacemaker requirement and hemodynamic compromise during 'heart dislocation' were associated to failed extubation in the operating room. In this case, logistic analysis found obesity, pacemaker usage and hemodynamic compromise as factors related to failed extubation. CONCLUSIONS: Preoperative and operative factors associated to failed extubation could be used as guidelines to improve safety in ultra fast-track cardiac anesthesia. Especially, patients undergoing on-pump surgery with antecedents of heart failure or difficult cardiopulmonary by-pass weaning should not be extubated in the operating room. In the same way, immediate extubation should be avoided in obese patients with hemodynamic compromise during off-pump coronary surgery.

Indicadores bioquímicos sanguíneos en ganado de lidia mantenido en pastoreo en la cordillera central colombiana / Blood chemistry in bullfighting cattle maintained under grazing conditions in Andes Mountains from colombia

Para determinar valores referenciales séricos de ganado de lidia y describir el metabolismo de la vaca de lidia en el periparto, se seleccionaron dos explotaciones ubicadas en la cordillera central colombiana. La alimentación estaba basada en pastoreo directo con pasto Kikuyo (Pennisetum clandestinum) en praderas fertilizadas dos veces por año según análisis de suelos. El pasto presentaba un contenido de proteína cruda promedio de 13 por ciento, además los machos recibían una suplementación diaria de 2 kilos de cogollo de caña y entre 2 y 3 kilos de un concetrado comercial para bovinos, el cual tenía una proteína cruda de 14 por ciento y una energía metabolizable estimada en 2.8 Mcal/kilo de materia seca. La suplementación con cogollo de caña y concentrado se empezaba entre 8 y 9 meses antes de la temporada taurina colombiana en los meses de diciembre a marzo del año siguiente. Se escogieron al azar 39 animales (Grupo 1) categorizados según sexo-edad así: machos jóvenes y adultos, y hembras jóvenes y adultas, a cada animal se le extrajo sangre en un tubo sin anticoagulante. También se seleccionaron al azar 5 vacas (Grupo 2) cuatro semanas antes del parto, quincenalmente de cada vaca se tomó sangre sin anticoagulante terminando en la semana 10 postparto. En ambos grupos se analizó la glucosa, la fructosamina (Grupo 2), el colesterol, el ß-hidroxibutirato (ß-OHB), los triacilgliceroles, las proteínas totales, la albúmina, las globulinas y la urea. Los datos se analizaron mediante estadística descriptiva y ANOVA. Los promedios obtenidos fueron: glucosa 6.4±2.1 mmol/L, colesterol 2.9±0.5 mmol/L, ß-OHB 0.2±0.1 mmol/L, triacilgliceroles 0.3±0.1 mmol/L, proteínas totales 89±14 g/L, albúmina 31±4 g/L, globulinas 55±13 g/L y urea 6.9±1.5 mmol/L. En el Grupo 1 se observaron diferencias sólo para la concentración de urea (p<0.05). En el Grupo 2 se presentaron diferencias en ß-OHB, la albúmina y la urea, observándose valores más altos en el postparto (p<0.05). Los valores....

[Operating room extubation (ultra fast-track anesthesia) in patients undergoing on-pump and off-pump cardiac surgery]. / Factores asociados a falla de extubación inmediata en el quirófano después de cirugía cardíaca con y sin circulación extracorpórea.

OBJECTIVE: The potential benefit of immediate operating room extubation after cardiac surgery remains controversial. Since safety and effectiveness of ultra fast-track anesthesia is mandatory, we developed this work to identify preoperative and operative variables associated to failed extubation after on-pump and off-pump cardiac surgery. METHODS: Three hundred ninety eight consecutive patients undergoing coronary, valve or combined surgery were included in a prospective observational study of ultra fast-track anesthesia. Primary outcome was failed tracheal extubation, defined as the impossibility to extubate in the operating room immediately after surgery. Secondary outcomes evaluated need for postoperative tracheal reintubation, morbidity and mortality. Univariate analysis and multivariate logistic regression were done over 24 preoperative and operative variables to determine factors associated with failed tracheal extubation after on-pump and off-pump surgery. RESULTS: Sixty eight per cent of patients undergoing on-pump surgery, and 87.1% of those undergoing off-pump coronary revascularization were successfully extubated in the operating room. Univariate analysis in the on-pump group found that heart failure, left ventricular dysfunction, urgency, cross-clamping time, pacemaker requirement and difficult cardiopulmonary by-pass weaning were related to failed tracheal extubation; while heart failure and difficult cardiopulmonary bypass weaning were variables associated in the multivariate analysis. In the off-pump coronary surgery group, univariate analysis showed that pulmonary disease, urgency, pacemaker requirement and hemodynamic compromise during 'heart dislocation' were associated to failed extubation in the operating room. In this case, logistic analysis found obesity, pacemaker usage and hemodynamic compromise as factors related to failed extubation. CONCLUSIONS: Preoperative and operative factors associated to failed extubation could be used as guidelines to improve safety in ultra fast-track cardiac anesthesia. Especially, patients undergoing on-pump surgery with antecedents of heart failure or difficult cardiopulmonary by-pass weaning should not be extubated in the operating room. In the same way, immediate extubation should be avoided in obese patients with hemodynamic compromise during off-pump coronary surgery.

Teoría y determinación de parámetros físicos

Analiza las características físicas de las aguas residuales y presenta la descripción de los métodos para la determinación de parámetros físicos del agua, la importancia de esta determinación es de suma importancia ya que es un instrumento básico para el diseño de los diferentes procesos de tratamiento

Características de las aguas residuales

Describe las características de las aguas residuales, las cuales se clasifican de una manera muy general en: a) físicas de las cuales las mas importantes son el contenido total de sólidos, temperatura, color, olor y turbiedad; b) químicas que comprende la materia organica e inorganica presente en las aguas residuales; c) biológicas, por la presencia de microorganismos principalmente, aunque es posible encontrar ciertos organismos superiores

Memoria del curso: microbiología y aplicaciones en los procesos biológicos de tratamiento de aguas

Describe los procesos biológicos de tratamiento de aguas residuales; señala las características que los hacen adecuados para aplicarlos en los países en vias de desarrollo. Capacita al personal técnico involucrado en la operación y mantenimiento de los sistemas de tratamiento basados en dichos procesos