Stability and maturity of biowaste composts derived by small municipalities: Correlation among physical, chemical and biological indices.

Stability and maturity are important criteria to guarantee the quality of a compost that is applied to agriculture or used as amendment in degraded soils. Although different techniques exist to evaluate stability and maturity, the application of laboratory tests in municipalities in developing countries can be limited due to cost and application complexities. In the composting facilities of such places, some classical low cost on-site tests to monitor the composting process are usually implemented; however, such tests do not necessarily clearly identify conditions of stability and maturity. In this article, we have applied and compared results of stability and maturity tests that can be easily employed on site (i.e. temperature, pH, moisture, electrical conductivity [EC], odor and color), and of tests that require more complex laboratory techniques (volatile solids, C/N ratio, self-heating, respirometric index, germination index [GI]). The evaluation of the above was performed in the field scale using 2 piles of biowaste applied compost. The monitoring period was from day 70 to day 190 of the process. Results showed that the low-cost tests traditionally employed to monitor the composting process on-site, such as temperature, color and moisture, do not provide consistent determinations with the more complex laboratory tests used to assess stability (e.g. respiration index, self-heating, volatile solids). In the case of maturity tests (GI, pH, EC), both the on-site tests (pH, EC) and the laboratory test (GI) provided consistent results. Although, stability was indicated for most of the samples, the maturity tests indicated that products were consistently immature. Thus, a stable product is not necessarily mature. Conclusively, the decision on the quality of the compost in the installations located in developing countries requires the simultaneous use of a combination of tests that are performed both in the laboratory and on-site.

Spanish Registry for Embolization of Small Intracranial Aneurysms with Cerecyte Coils (SPAREC) Study. Early Experience and Mid-Term Follow-up Results.

SUMMARY: This study aimed to report the results obtained in treating small ruptured and unruptured intracranial aneurysms using Cerecyte coils. A prospective, non-randomized multicenter registry operating in Spain with a reporting period between May 2005 and September 2007.We present clinical and angiographic results for 48 small aneurysms (26 ruptured, five with III cranial nerve paresis, and 17 incidental) that had undergone six months' follow-up. The volumetric percentage occlusion (VPO) achieved and percentage bioactive coils (PBC) used were assessed. No episodes of bleeding occurred during the follow-up period. The technical complication rate was 10.4% (five cases): four thromboembolic complications resolved with medication (8.3%) and one asymptomatic protrusion of a coil into the parent vessel. The clinical complication rate for the procedure was 2.1% (occlusion of the anterior choroidal artery in a ruptured anterior choroidal anaeurysm). Mean VPO was 25.2%. Balloon-assisted technique (BAT) was used in 60.4% of cases. The VPO was higher in the BAT-treated cases (P < 0.05). The overall six-month recanalization rate was 16.7% (12.5% minor and 4.2% major recanalizations). Neck size and VPO were unrelated to the recanalization rate. The PBC was higher in cases with progressive Deployment of the device is safe from the standpoint of periprocedural technical and clinical complications. No episodes of hemorrhage were recorded during follow-up. The sixmonth recanalization and retreatment rates compared favorably with most endovascular platinum and bioactive coil series.

[Clinical and radiologic assessment of vertebroplasty]. / Valoración clínico-radiológica de las vertebroplastias.

INTRODUCTION: Percutaneous vertebroplasty consists of the injection of acrylic cement into weakened vertebral bodies to achieve pain relief and mechanical stability of the spine. OBJECTIVE: To evaluate the characteristics and effectiveness of the vertebroplasties performed at the Hospital Universitario Miguel Servet in Zaragoza. PATIENTS AND METHODS: This is a retrospective study of 147 vertebroplasties performed in 95 patients (60 women and 35 men; age range: 19 to 84 years). The oblique transpedicular approach, which achieves adequate cement injection with a single puncture, is currently used. A visual analogue scale (VAS) was used to evaluate pain before and after the procedure. RESULTS: The osseous lesion most often treated by vertebroplasty is fracture secondary to osteoporosis, accounting for 65% of the cases in this series, followed by hemangiomas (23%), and osteolytic metastases, traumatic fractures, lymphomas, and myelomas. Prior to vertebroplasty, the mean VAS score was 8.88 versus 2.78 after the treatment. Only 7.3% of the patients had symptomatic complications. CONCLUSION: Vertebroplasty is safe and efficacious; it is the treatment of choice for vertebral pain refractory to medication. It enables patients to return to their habitual lifestyle quickly and thus helps reduce hospital stays and costs.

Evolución hasta el fallecimiento de dos miembros de una familia con la mutación A3243G y fenotipo MELAS frente a diabetes mellitus / Evolution until death of two members of a family with A3243G mutation and MELAS phenotype versus diabetes mellitus

Introducción. La mutación A3243G en el gen tRNALeu(UUR) tiene expresiones fenotípicas diversas. Se desconoce la evolución y supervivencia de cada fenotipo. Describimos la evolución clínica de tres miembros de una familia, portadores de la mutación A3243G, en dos de ellos hasta el fallecimiento. Casos clínicos. El caso probando tenía fenotipo MELAS (miopatía mitocontrial, encefalopatía, acidosis láctica y episodios de isquemia cerebral transitoria). Aunque se inició con un ictus, la evolución posterior fue la de una epilepsia sintomática, con crisis de diferente semiología, no asociadas a ictus, y deterioro cognitivo lentamente progresivo. Tras sufrir un estado epiléptico de crisis parciales complejas quedó con demencia severa. Falleció de shock séptico posbronconeumonía por aspiración. Su hermana permanece asintomática. Su madre padecía una diabetes mellitus y sordera neurosensorial desde los 53 años. Sufrió un único cuadro ictal transcurridos 17 años. Falleció a los 18 años del diagnóstico de diabetes de fracaso renal agudo y shock cardiogénico postsimpatectomía. En el caso probando ni el tratamiento crónico con idebenona, ni la sustitución del valproato por otros fármacos antiepilépticos, lograron reducir la frecuencia de las crisis ni la extensión de las lesiones detectadas en RM. En la madre la evolución de la diabetes no difiere de la esperada. Conclusiones. En esta familia el fenotipo diabetes mellitus y sordera muestra una mayor supervivencia que el fenotipo MELAS. La causa de la muerte estuvo estrechamente relacionada con el fallo orgánico prevalente en cada paciente en el momento del fallecimiento (AU)

Introduction: The A3243G gene tRNALeu(UUR) mutation has different phenotypic expressions. The clinical outcome and survival of each phenotype are mostly unknown. We followed-up two of three family members, carriers of the A3243G mutation, until their death. Clinical case: The proband case had MELAS (mitochondrial myopathy, encephalopathy, lactacidosis, stroke) phenotype. Although he presented with a stroke-like episode, he developed recurrent generalized and partial epileptic seizures without associated stroke-like episodes over time as well as slowly progressive dementia. The cognitive performance greatly worsened after a complex partial epileptic status. He died from bronchopneumonia and septic shock eleven years after diagnosis. His sister remains asymptomatic. His mother was diagnosed of diabetes mellitus and deafness when she was 53. Seventeen years later she developed a single stroke-like episode. She died one year after from acute renal failure and cardiogenic shock following sympathectomy for ischemic angiopathy. In the MELAS case neither idebenone treatment nor valproate substitution by other anticonvulsants reduced seizure frequency nor the spreading of lesions evaluated by MRI. In the phenotype with diabetes and deafness the outcome diabetes mellitus was as expected. Conclusions: In this family with A3243G mutation, the phenotype with neurosensorial deafness and diabetes mellitus seems to have longer survival than the MELAS phenotype. The cause of death in both cases was closely related to medical complications prevalent in each patient at the time of death (AU)

Valoración clínico-radiológica de las vertebroplastias / Clinical and radiologic assessment of vertebroplasty

Introducción. La vertebroplastia percutánea consiste en la inyección de cemento acrílico en los cuerpos vertebrales debilitados, con el fin de obtener un efecto analgésico y la estabilización mecánica de la columna vertebral. Objetivo. Valorar las características y efectividad de las vertebroplastias realizadas en el Hospital Universitario Miguel Servet de Zaragoza. Pacientes y métodos. Se han estudiado, de forma retrospectiva, 147 vertebroplastias efectuadas entre 1994 y 2003, a 95 pacientes (60 mujeres y 35 hombres), con un rango de edad entre 19 y 84 años. La vía de abordaje utilizada actualmente es la transpedicular oblicua, que con una sola punción consigue una buena expansión del cemento dentro del cuerpo vertebral. Resultados. La lesión ósea más frecuentemente tratada con vertebroplastia es la fractura secundaria a osteoporosis, con un 65% de los casos, le sigue con un 23% los hemangiomas y, en menor proporción, las metástasis osteolíticas, fracturas traumáticas, linfomas y mielomas. Para valorar la reducción del dolor empleamos la escala analógica visual (VAS), pasando de un VAS previo a la vertebroplastia de 8,88 a un VAS de 2,78 después del tratamiento. Solamente el 7,4% de los pacientes tuvieron complicaciones sintomáticas. Conclusión. La vertebroplastia es un procedimiento seguro y eficaz, de elección en el tratamiento del dolor vertebral refractario a la medicación, que permite una rápida incorporación del paciente a su vida habitual y una reducción de los costes hospitalarios

Introduction. Percutaneous vertebroplasty consists of the injection of acrylic cement into weakened vertebral bodies to achieve pain relief and mechanical stability of the spine. Objective. To evaluate the characteristics and effectiveness of the vertebroplasties performed at the Hospital Universitario Miguel Servet in Zaragoza. Patients and methods. This is a retrospective study of 147 vertebroplasties performed in 95 patients (60 women and 35 men; age range: 19 to 84 years). The oblique transpedicular approach, which achieves adequate cement injection with a single puncture, is currently used. A visual analogue scale (VAS) was used to evaluate pain before and after the procedure. Results. The osseous lesion most often treated by vertebroplasty is fracture secondary to osteoporosis, accounting for 65% of the cases in this series, followed by hemangiomas (23%), and osteolytic metastases, traumatic fractures, lymphomas, and myelomas. Prior to vertebroplasty, the mean VAS score was 8.88 versus 2.78 after the treatment. Only 7.3% of the patients had symptomatic complications. Conclusion. Vertebroplasty is safe and efficacious; it is the treatment of choice for vertebral pain refractory to medication. It enables patients to return to their habitual lifestyle quickly and thus helps reduce hospital stays and costs

[Evolution until death of two members of a family with A3243G mutation and MELAS phenotype versus diabetes mellitus]. / Evolución hasta el fallecimiento de dos miembros de una familia con la mutación A3243G y fenotipo MELAS frente a diabetes mellitus.

INTRODUCTION: The A3243G gene tRNALeu(UUR) mutation has different phenotypic expressions. The clinical outcome and survival of each phenotype are mostly unknown. We followed-up two of three family members, carriers of the A3243G mutation, until their death. CLINICAL CASE: The proband case had MELAS (mitochondrial myopathy, encephalopathy, lactacidosis, stroke) phenotype. Although he presented with a stroke-like episode, he developed recurrent generalized and partial epileptic seizures without associated stroke-like episodes over time as well as slowly progressive dementia. The cognitive performance greatly worsened after a complex partial epileptic status. He died from bronchopneumonia and septic shock eleven years after diagnosis. His sister remains asymptomatic. His mother was diagnosed of diabetes mellitus and deafness when she was 53. Seventeen years later she developed a single stroke-like episode. She died one year after from acute renal failure and cardiogenic shock following sympathectomy for ischemic angiopathy. In the MELAS case neither idebenone treatment nor valproate substitution by other anticonvulsants reduced seizure frequency nor the spreading of lesions evaluated by MRI. In the phenotype with diabetes and deafness the outcome diabetes mellitus was as expected. CONCLUSIONS: In this family with A3243G mutation, the phenotype with neurosensorial deafness and diabetes mellitus seems to have longer survival than the MELAS phenotype. The cause of death in both cases was closely related to medical complications prevalent in each patient at the time of death.

Prediction of temperature and thermal inertia effect in the maturation stage and stockpiling of a large composting mass.

A macroscopic non-steady state energy balance was developed and solved for a composting pile of source-selected organic fraction of municipal solid waste during the maturation stage (13,500 kg of compost). Simulated temperature profiles correlated well with temperature experimental data (ranging from 50 to 70 degrees C) obtained during the maturation process for more than 50 days at full scale. Thermal inertia effect usually found in composting plants and associated to the stockpiling of large composting masses could be predicted by means of this simplified energy balance, which takes into account terms of convective, conductive and radiation heat dissipation. Heat losses in a large composting mass are not significant due to the similar temperatures found at the surroundings and at the surface of the pile (ranging from 15 to 40 degrees C). In contrast, thermophilic temperature in the core of the pile was maintained during the whole maturation process. Heat generation was estimated with the static respiration index, a parameter that is typically used to monitor the biological activity and stability of composting processes. In this study, the static respiration index is presented as a parameter to estimate the metabolic heat that can be generated according to the biodegradable organic matter content of a compost sample, which can be useful in predicting the temperature of the composting process.

Deep Impact: observations from a worldwide Earth-based campaign.

On 4 July 2005, many observatories around the world and in space observed the collision of Deep Impact with comet 9P/Tempel 1 or its aftermath. This was an unprecedented coordinated observational campaign. These data show that (i) there was new material after impact that was compositionally different from that seen before impact; (ii) the ratio of dust mass to gas mass in the ejecta was much larger than before impact; (iii) the new activity did not last more than a few days, and by 9 July the comet's behavior was indistinguishable from its pre-impact behavior; and (iv) there were interesting transient phenomena that may be correlated with cratering physics.

Optic nerve aspergillosis: report of a case diagnosed by fine-needle aspiration biopsy.

The aim of this study was to describe the fine-needle aspiration biopsy (FNAB) procedure in patient with a optic nerve lesion. A case of optic nerve and brain aspergillosis, an infrequent condition that can mimic tumor or tumor-like lesions, is reported. The patient was studied by CT and MRI and definite diagnosis was established by means of an ultrasound-guided FNAB. Specimen preparation revealed the presence of multiple hyphae of Aspergillus fumigatus in the optic nerve lesion. The FNAB procedure is a safe and reliable diagnostic method for suspected intraorbitary tumors and tumor-like conditions especially when other less-invasive modalities have failed to establish the diagnosis and when cytologic confirmation is needed to implement aggressive therapy.

[Preoperative percutaneous++ vertebroplasty in hemangioma compression]. / Vertebroplastia percutánea preoperatoria en hemangioma compresivo.

INTRODUCTION: Vertebroplasty is a new procedure used in interventional neuroradiology, involving percutaneous introduction of acrylic cement. CLINICAL CASE: We present the case of a D10 vertebral hemangioma, which had progressed so as to cause compression of the spinal cord. We used combined treatment. Vertebroplasty was done with acrylic cement, using transpedicular percutaneous puncture, with subsequent bilateral laminectomy to decompress the spinal cord. One year later the clinical condition is completely satisfactory. The signs of paraparesia and dorsalgia have disappeared. Posterior fixation was not necessary. CONCLUSIONS: Vertebroplasty is effective since the vertebral body is consolidated and pain avoided. We give details of the methodology, indications and possible complications of the technique of percutaneous vertebroplasty.

Technical Aspects of Intra-arterial Electroencephalogram Recording.

SUMMARY: The purpose of this prospective study is to show a technique for recording electroencephalographic activity via an endovascular approach in presurgical evaluation of epileptic patients. Technical aspects and insertion strategy are outlined. Advantages of intra-arterial electroencephalography have been demonstrated. It is a semi-invasive procedure that provides information in temporal lobe and extratemporal epilepsy. It allows a dynamic electroencephalographic recording and patient tolerance is excellent. Risks are practically absent. Disadvantages are: in comparison to ovale electrodes, chronic and multicontact recording is not possible and the recording is only intercritical.

[Wegener's granulomatosis with meningeal involvement: clinic-radiological correlations]. / Granulomatosis de Wegener con afectación meníngea: correlación clinicorradiológica.

INTRODUCTION: Wegener's granulomatosis is a systemic vasculitis which, in its classical form, is characterized by involvement of the superior and inferior respiratory tract and the kidneys. The vasculitis may be multisystemic. Ophthalmic and neurological involvement are common (22% and 54% of those affected respectively). When considering involvement of the nervous system, the commonest finding is peripheral neuropathy, particularly in the form of multiple mononeuritis. Meningeal involvement is exceptional. CLINICAL CASE AND CONCLUSIONS: We present a case of Wegener's granulomatosis with meningeal involvement, studied using CT and MR. The findings using imaging techniques are described, and conditions which should be considered in the differential diagnosis are discussed.

[Idiopathic hypophyseal hyperplasia: diagnosis by magnetic resonance]. / Hiperplasia hipofisaria idiopática: diagnóstico por resonancia magnética.

INTRODUCTION: Hypophyseal hyperplasia is an uncommon disorder in which the gland increase in size due to excessive proliferation of strings of normal cells, which usually secrete prolactin. Different aetiologies may cause this disorder of the hypophyseal gland. However, in a small number of cases the hyperplasia is not due to any of these aetiologies and is therefore known as idiopathic hypophyseal hyperplasia. There are few references in the literature to idiopathic hypophyseal hyperplasia with hyperprolactinaemia. Usually diagnosis is reached after treatment for a hypophyseal adenoma, since the clinical features are similar. CLINICAL CASES: We present three cases seen in our department, in which hormone and endocrine studies were done to exclude known causes of hyperplasia, together with CT and MR scans. We analyzed the behaviour of hypophyseal hyperplasia by using imaging techniques, and the differential aspects with regard to hypophyseal adenomas. Firm diagnosis is only made on anatomopathological study of the hypophysis. However, we consider that sound knowledge of the characteristics of this condition may help to establish the correct diagnosis and thus avoid unnecessary surgery. CONCLUSIONS: We review the information published in the literature on this subject, emphasizing the importance of differential diagnosis by means of imaging techniques.

[Electroclinical and neuroimaging studies in epilepsy]. / Estudio electroclínico y de neuroimagen en epilepsia.

INTRODUCTION AND MATERIAL: During 54 months, we have studied the electro-clinical and neuroimaging features in outpatients with active epilepsy. Each patient was interviewed for one of us. Then, we have reviewed the medical records about both the clinical featuring. EEG and neuroimaging (NI) studies and seizures frequency (SF) outcome. Differences in crude proportions were assessed by chi 2 test for independence by 2 x 2 tables. RESULTS AND CONCLUSIONS: It has been 207 patients with 49 +/- 19.6 years of mean age at review. Partial seizures was significantly related with both a higher SF at onset and politherapy. Also, with a focal EEG distribution but only in case of complex partial seizures. Abnormal NI was significantly more frequent in oldest patients. A greater proportion of patients were in politherapy in four situation: SF at onset > 1 by day, a focal EEG distribution, duration of epilepsy longer than 20 years and age of onset lesser than 60 years. A 37.2% was seizures-free in the last year and in 34% the SF was improved a 50% or more from the beginning. A significantly greater proportion of patients was following with seizures in four cases: when the SF at onset has been > or = 1 by day, being partial seizures, women and having politherapy.

[Pineal gland cysts: clinical and radiological course]. / Quistes de glándula pineal: evolución clínica y radiológica.

We describe the clinical and radiologic evolution of pineal gland cysts found in computed tomography or magnetic resonance images in 12 patients. The patients had complained of headache and/or lateralized sensory symptoms. None had signs of intracranial hypertension or tectal dysfunction. Only one patient, who had partial epilepsy and a large cyst, was treated by ventriculo-cystic shunt; the rest were treated conservatively. The follow-up period in 11 patients was from 2 to 5 years. No changes were observed in cyst size or radiological characteristics; nor did signs of tectal dysfunction develop. In patients with no signs or symptoms directly attributable to these cysts, surgery can be avoided if no radiological changes are found upon follow-up.

[Epilepsy as the first sign of multiple sclerosis]. / Epilepsia como primera manifestación de esclerosis múltiple.

INTRODUCTION: Epileptic crises are uncommon in patients with multiple sclerosis. However, epilepsy is commoner in these patients than in the general population. An epileptic crisis as the presenting feature of multiple sclerosis is even rarer. The lesions involved in the pathogenesis of these crises are plaques of demyelinization which affect the cortical or subcortical areas. Other factors, some of which are still not clearly understood, such as the fibre, electrolytic changes, size of the plaque, reactive gliosis and the enzyme (Na(+)-K+)ATPase, seem also to play a part in the production mechanism. Magnetic resonance is a very sensitive technique used in the detection of demyelinating lesions during the acute phase. The sensitivity is further increased by the use of gadolinium. CLINICAL CASES AND CONCLUSIONS: We present two cases of multiple sclerosis which presented as epileptic crises. In one there were generalized tonic-clonic crises and in the other partial sensitive crises. We mention the EEG findings, CSF analysis and neuroimaging diagnostic techniques.

[Magnetic resonance imaging usefulness in the diagnosis of intratumor bleeding in hypophyseal adenomas]. / Aportación de la resonancia magnética en el diagnóstico del sangrado intratumoral en los adenomas hipofisarios.

Hypophyseal adenomas are the most frequent intrasella tumours. They are classified as macroadenomas or as microadenomas depending on whether their size is greater or less than 1 cm. Hypophyseal tumours may undergo ischaemic necrosis and haemorrhage when the blood supply is reduced. Intratumoural bleeding is found in varying percentages, between 9.9% and 26%. We review our series of 122 patients with hypophyseal adenomas in whom MR was done. Signs of bleeding were found in 12 patients (9%). In five cases, bleeding had presented as hypophyseal apoplexy, in five cases with subacute symptoms and in two cases was asymptomatic and diagnosis fortuitous. Of the adenomas with intratumoural bleeding, 9 were functioning tumours (4 secreted PRL, 4 ACTH and 1 GH) and 3 non-functioning. The risk factors considered in the pathogenesis of intratumoural bleeding are numerous. The increased incidence of bleeding in large and in invasisve adenomas, especially when treated with bromocriptin, is well established. MR is the ideal technique to detect intratumoural bleeding, T2 weighted sequences being very useful in the diagnosis of bleeding in the acute phase. In the subacute phase, focal areas of hyperintensity are seen in T1 and of hypo/hyperintensity in T2. In the chronic phase, areas of hypodensity are seen both in T1 and in T2. In our study we analyze the clinico-radiological correlation in patients with signs of intratumoural bleeding.

[Etiology in complex partial epilepsy. II. Correlation between EEG topography and neuroimaging]. / Etiología en epilepsia parcial compleja. II. Correlación entre la topografía en EEG y neuroimagen.

Neuro-imaging studies (NI) in patients with complex partial seizures (CPC) demonstrate the epileptogenicity of a more or less localized underlying lesion. Correlation with the topography of the EEG focus permits affirmation of the origin. We analyze anomalies on NI and on the EEG of 151 patients with CPC. The EEG was abnormal in 128 and showed a unilateral epileptic focus in 117. NI was focal and unilateral in 72 of the 102 abnormal cases. Topographic correlation was 78.5%. This close correlation in our series makes us consider the localized lesions to be the probable aetiological factor.

[Etiology in complex partial epilepsy. I. Neuroimaging studies]. / Etiología en epilepsia parcial compleja. I. Estudios de neuroimagen.

With the appearance of MR, a great advance has been made in the study of the aetiology of epilepsy. This technique can show anomalies not detected in CT scans, obtain images of multiple planes, improve the differentiation of cerebral tissues and allow improved visualization of the temporal lobe, making it very useful in the study of patients with complex partial crises (CPC). We studied 151 epileptics with CPC by means of CT scan and MR in all cases; the anomolous topography was the same in all cases, but the diagnosis was not. In patients with a previously normal CT scan, on MR anomalies were detected in 24 cases. We found a statistical differences on evaluation of the MR anomaly depending on whether the CT scan was normal or abnormal. Statistical differences were also found when there were a greater number of anomalies on MR depending on the frequency of crises at the onset of the disorder.