Trickling filter technology for biotreatment of nitrogenous compounds emitted in exhaust gases from fishmeal plants.

Odour emissions are a major environmental issue associated with fishmeal production. Laboratory-scale biotrickling filters (BTFs) were inoculated with microbial consortia derived from sewage sludge, with the goal to study the biotreatment of low-loads of methylamines and ammonia that are main components of odorous exhaust gases produced by fishmeal processing plants. A BTF packed with ceramic rings was subjected to a real fishmeal plant emission containing trimethylamine (TMA), dimethylamine (DMA) and monomethylamine (MMA). The highest elimination capacities (ECs) obtained were 372 mg TMA m-3 h-1, 5.518 mg DMA m-3 h-1 and 1.038 mg MMA m-3 h-1, with maximal removal efficiencies of 92% (TMA), 83% (DMA) and 95% (MMA) after 30 days operation. In a different experiment, a polyurethane foam packing was employed to treat ammonia (NH3) at low inlet loads, reaching an EC of 47.19 mg N m-3 h-1 with 99.8% efficiency (inlet load of 47.27 mg N m-3 h-1). Likewise, the microbial community of the polyurethane-associated biofilm was diverse and stable during operation. These results suggested that elimination of volatile amino-compounds using BTFs inoculated with a methylotrophic microbial consortium holds potential for odour removal. In addition, sequencing analysis of 16S rDNA gene fragments allowed the identification of heterotrophic ammonia-oxidizing bacteria that are promising candidates to effectively maintain ammonia elimination in a biotreatment operation of nitrogenous compounds present in exhaust gases from fishmeal facilities.

Epidemiología de la prematuridad y sus determinantes, en una población de mujeres adolescentes y adultas de Colombia / Epidemiology of prematurity and its determinants in a population of adolescent and adult women in Colombia

Antecedentes: La prematuridad es considerada actualmente una prioridad en salud pública para algunos países. Objetivo: Describir la prevalencia del parto prematuro y sus determinantes, en una población de gestantes adolescentes y adultas, que tuvieron su único o último parto en la Fundación Hospital San José de Buga, Colombia, entre los años 2010 a 2015. Métodos. Estudio de casos y controles realizado con 11.881 neonatos mujeres adolescentes y adultas. Los datos fueron analizados en Stata® 11.0, empleando para variables cuantitativas, mediana o promedio y sus medidas de dispersión, comparadas mediante pruebas t, Ranksum, ANOVA o Kruskal Wallis, de acuerdo a su distribución y para variables categóricas; medidas de frecuencia absolutas y relativas, comparadas mediante Pruebas de Chi2 o exacta de Fisher. Para estimar las asociaciones empleamos Odds Ratio con sus intervalos de confianza de 95% y para el análisis multivariado la regresión logística. La significancia estadística fue definida como un valor p<0,05. Resultados. La prevalencia de prematuridad fue 11,4%. Después del análisis multivariado, los determinantes asociados a prematuridad fueron etnia indígena-afrocolombiana o mulato, número de controles prenatales igual o inferior a 6, periodo intergenésico inferior a 2 años, embarazo múltiple, preeclampsia, oligohidramnios, restricción del crecimiento intrauterino y hemorragia del tercer trimestre (incluye desprendimiento prematuro de placenta). Conclusiones. La prematuridad es el resultado de una compleja red de determinantes individuales, sociales, culturales y gestacionales que interactúan, por lo que para su prevención se debe no sólo trabajar en medidas de salud, sino en elaboración de políticas y planes de acción integral.

Background: Prematurity is currently considered a public health priority for some countries. Objective: To describe the prevalence of preterm birth and its determinants in a population of adolescent and adult mothers who had their sole or last delivery in the Fundación Hospital San José de Buga, Colombia, between 2010-2015. Methods: Case-control study conducted with 11,881 infants adolescent and adult women. The data were analyzed in Stata 11.0, using quantitative, medium or average and dispersion measures variables compared using t tests, Ranksum, ANOVA or Kruskal Wallis, according to distribution and for categorical variables, frequency measurements absolute and relative, compared with Chi2 tests or Fisher exact. To estimate associations employ odds ratio with confidence intervals of 95% and multivariate analysis logistic regression. Statistical significance was defined as p <0.05. Results: Prematurity prevalence was 11.4%. After multivariate analysis, the determinants associated with prematurity were indigenous-Afro-Colombian or mulatto ethnicity, number of prenatal visits equal to or less than 6, less than two years intergenesic period, multiple pregnancy, preeclampsia, oligohydramnios, IUGR and bleeding of the third quarter (includes abruption). Conclusions: Prematurity is the result of a complex network of individual, social, cultural and gestational determinants that interact, so that prevention is due not only work on health measures, but in developing policies and plans integral action.

Una observación de tricomonas / An observation of trichomonads

Los comentarios que hizo en el último número de Gaceta Médica, a una tesis de doctorado, el doctor José Gregario Ferreira, nos han inducido a dar a la publicidad una larga historia clínica que no deja de tener señalada importancia ya que con ella se pue­den sacar grandes conclusiones en lo que se refiere al tratamiento y diagnóstico del presente caso. Señora NN, casada y natural de Uijes, pueblo que mora en la ribera derecha del río Cauca, Departa­mento del Valle y que goza de un clima medio de 26º. Antecedentes personales. - Casa a los dieciocho años; tuvo muchos abortos, dieciséis, al decir de ella, abortos que se hacían entre el tercero y cuarto me­ses. De todos sus embarazos, no recordamos cual, sólo uno llegó a término, con el nacimiento de una hija que hoy vive y goza de buena salud. Dice haber vivido los primeros años de su vida en el pueblo men­cionado, el cual, refiere, goza de aguas muy puras y ricas en cal por ser ese el lugar donde existen las más ricas minas de esta sustancia. Antecedentes patológicos. -A excepción hecha en sus abortos, en los cuales nunca tuvo ninguna infección, su salud sólo ha sido alterada por algunas fiebres palúdicas y por frecuentes metrorragias.

Mechanical protection of cardiac microcirculation during percutaneous coronary intervention of saphenous vein grafts.

Saphenous vein bypass grafts permeability is one of the most important limitations of open heart surgery. The risks associated with surgical re-intervention are greater than those associated with the initial procedure. While native coronary arteries usually have fixed, fibrotic or calcified atherosclerotic plaques, the disease in the vein grafts contains soft material. When this material is compressed during percutaneous angioplasty, there is an unfavorable immediate outcome due to distal embolization of thrombus and plaque debris. In addition, the risk of post-procedure adverse events are higher when the grafts have a long time of implantation, due to a greater risk of branch occlusion or no-reflow at the adjacent microcirculation. The clinical consequence is a Non-Q-Wave Myocardial Infarction that is reflected in the increased serum cardiac enzymes. It is because of this complication that the distal protection devices were developed. The purpose of this paper is to review and discuss the current data on the distal protection devices available now for the treatment of degenerative saphenous vein graft disease. Currently, there are two distal protection devices approved in the United States: the Guardwire Balloon and Aspiration (Export) System and the Filter Wire EX. Other devices like the Triactiv System, Angioguard XP/ECW, DOW, MedNova Cardioshield, Medtronic-AVE DPD and the E-Trap Filter are still being studied. The first observational studies showed the safety and efficacy of the approved devices. A large randomized trial initially confirmed a significant decrease of in-hospital and 30-day cardiac adverse events, mainly Non-Q-Wave Myocardial Infarction, when angioplasty was performed with the assistance of the Guardwire System. Subsequently, another randomized study showed an equivalence between the Guardwire System and the Filter Wire EX. Distal protection devices have an acceptable performance, however, further technological improvements are warranted for a quick preparation, delivery and/or retrieval of these devices.

The cutting balloon for in-stent restenosis: a review.

Extraordinary advances have been made in the prevention, medical treatment, and the surgical and percutaneous intervention of coronary artery disease. However, despite the vast contribution of coronary artery stenting, coronary artery disease remains a major health problem. The massive treatment of symptomatic coronary artery disease with non-drug-eluting stents in the past, accounts for a large incidence of in-stent restenosis (ISR). We know today that in the following days after coronary artery angioplasty, new layers of intimal cells, called neo-intima, scaffold the endothelium forming a rubbery membrane. Numerous attempts have been made, and are still ongoing, to prevent the formation or to remove the neo-intima with suboptimal results and cost-effectiveness. Drug-eluting stents seem to be the most promising approach to date, however, the high cost of these devices may limit their use. In the mean time, new cases of ISR present to our cardiology practices. Because of its lower cost and identical technique to a regular balloon, the cutting balloon has emerged in numerous observational studies, and in a few randomized studies as a practical alternative to treat ISR. Although a few randomized studies have compared angioplasty with the cutting balloon versus angioplasty with a regular balloon, there are no randomized or economic studies comparing this device to excimer laser or intracoronary radiation in the treatment of this complication of coronary stenting. We reviewed the most prominent studies to date, on the performance of the cutting balloon in the treatment of ISR.

Reestenose de stents coronarianos: resultados imediatos e tardios do tratamento com excimer laser / In-stent restenosis: acute and long-term outcomes after excimer laser coronary angioplasty

Objective - With the increased use of intracoronary stents, in-stent restenosis has become a clinically significant drawback in invasive cardiology. We retrospectively assessed the short-and long-term outcomes after excimer laser coronary angioplasty of in-stent restenosis. Methods - Twenty-five patients with 33 incidents of in-stent restenosis treated with excimer laser coronary angioplasty (ELCA) were analyzed. Sixty-six percent were males, mean age of 73+ 11 years, and 83 per cent were functional class III-IV (NYHA). ELCA was performed using 23 concentric and 10 eccentric catheters with a diameter of 1.6-2.2 mm, followed by balloon angioplasty (PTCA) and untrasound monitoring. The procedure was performed in the following vessels: left anterior descending artery, 10; left circunflex artery, 8; right coronary artery, 6; left main coronary artery; 2 and venous bypass graft, 7. Results - The ELCA was successful in 71 per cent of the cases, and PTCA was 100 per cent successful. The diameter of the treated vessels was 3.44+0.5 mm; the minimal luminal diameter (MLD) increased from 0.30mm pre-ELCA to 1,97mm post-ELCA, and to 2.94mm post-PTA (p<0.001). The percent stenosis was reduced from 91.4+9.5 per cent before ELCA to 42.3+14.9 per cent after ELCA and to 14.6+9.3 per cent after PTCA (P<0.001). Seventeen (68 per cent) patients were asymptomatic at 6 months and 15 (60 per cent) at 1 year. New restenosis rates were 8/33 (24.2 per cent) at 6 months and 9/33 (27.3 per cent) at 12 months. Conclusion - ELCA is safe effective for the treatment of in-stent restenosis. In the present sample, a slight increase in new restenotic lesions between 6 and 12 months was found.

Relación entre el nivel de conocimientos y actitudes de los docentes varones de la Facultad de Medicina de la UNSA sobre la vasectomía, 1997

OBJETIVOS: Determinar el nivel de conocimientos que tienen los docentes varones de la Facultad de Medicina de la UNSA sobre vasectomía. Determinar las actitudes de los docentes varones de la Facultad de Medicina de la UNSA respecto a la vasectomía. Establecer la relación que existe entre los conocimientos y las actitudes de los docentes varones de la Facultad de Medicina de la UNSA acerca de la vasectomía. TIPO DE ESTUDIO: Observacional y analítico. MATERIAL Y METODOS: Se evaluó a 105 docentes de la Facultad de Medicina de la UNSA, a través de una ficha-encuesta, los conocimientos (bueno, aceptable, deficiente) y actitudes (acuerdo, incertidumbre, desacuerdo) respecto a la vasectomía representando una tasa de respuesta de 88.98 por ciento. CONCLUSIONES: La mayoría de los docentes varones de la Facultad de Medicina de la UNSA (71.44 por ciento) tiene un aceptable nivel de conocimientos sobre la vasectomía. En la misma población hay una actitud favorable hacia la vasectomía en el 85.71 por ciento. Existe una correlación directa entre su nivel de conocimientos y sus actitudes sobre vasectomía (p<0.001).

La salud y la educación, fundamentos de la democracia americana / Health and education, bases of American democracy

It would prove impracticable to review all the problems now facing the peoples of the Americas. The subjects most important vary in their aspects in each country. Health, politics, industry, art, civic organiztion, science, philosophy, and especially medicine are problems frankly faced by a number of scientists and philanthropists. The work of a number of international institutions and the opening of the Panama Canal brought about a new era in the health and living conditions of the peoples of the American Republics. Great cultural and artistic opportunities are offered by the vast number of universities, hundreds of museums and public libraries to be found in the United States. The American people have made a cult of health, though in a vastly different manner than was done in Greece and Rome. Health is the basis of democracy in the United States, which is guarded even before birht and is given the best of care throughout childhood, adolescence and maturity. This respect for health, the zealous vigilance on the part of the Government, the schools and universities, is the secret of the extraordinary might of the American people. In the United States Health and Education represent a second national emblem which protects its citizens wherever they may pitch their tents(AU)