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The ISO standard regulating gear-rolling measurement does not specify in detail the calibration and verification procedures for this type of equipment. This may be one of the reasons for the lack of reproducibility in these rolling tests. The uncertainty budget method, which is the most appropriate way to know the accuracy of this dynamic measurement, shows that the measuring sensors' accuracy is only a part of the total measurement process uncertainty. In this work, a new calibration and verification procedure for a worm gear rolling tester is presented, based on machine tool, coordinate measuring machine and gear measuring instruments' calibration techniques. After compensating numerically for the measuring instruments, it has been evaluated how the error components of each movement affect the meshing point, a fundamental factor to ensure a good gear transmission. The study shows that there are unintentional position variations, not detected by the measuring sensors, that have to be identified and quantified in the calibration for their later inclusion in the uncertainty budget. In this way, the measurement uncertainty could be reduced, and thus improve the reproducibility of these testers, as a preliminary stage to the development of optimized rolling measurement equipment to solve current limitations.
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Background: One in every four patients with a first episode of non-gallstone-related acute pancreatitis (AP) develops recurrent disease. Recurrent episodes of AP or acute flares of chronic pancreatitis (CP) are associated with decreased quality of life and progression of the disease. Besides removing the etiology of pancreatitis (which sometimes is not possible), there are no effective measures to prevent recurrence. Meta-analyses of randomized controlled trials, as well as epidemiological and cohort studies, suggest that statins may be protective against the development of index AP. Methods: The SIMBA study is a triple-blind randomized placebo-controlled, parallel-group multicenter trial. Patients with recurrent AP or with acute flares of CP (at least two episodes in the last 12 months) will be randomized to receive simvastatin 40 mg daily or placebo. During a 3-year study period, 144 patients (72 per arm of treatment) from 26 centers will be enrolled. The patients will receive the study treatment for 1 year. The primary aim is to compare the recurrence of AP or acute flares in CP. Secondary endpoints include the incidence of new-onset diabetes mellitus, new-onset exocrine pancreatic insufficiency (EPI), new-onset imaging signs of CP, frequency of all-cause hospital admissions, severity of AP, adherence to treatment, and frequency of adverse events. Discussion: The SIMBA trial will ascertain whether simvastatin, a safe, widely used and inexpensive drug, can change the natural course of recurrent pancreatitis. Trial Registration: ClinicalTrials.gov Identifier: NCT04021498.
RESUMEN
BACKGROUND: Little is known regarding the optimal type of fluid resuscitation in acute pancreatitis (AP). OBJECTIVE: The objective of this article was to compare the effect of lactated Ringer's solution (LR) vs normal saline (NS) in the inflammatory response in AP. METHODS: We conducted a triple-blind, randomized, controlled trial. Patients ≥ 18 admitted with AP were eligible. Patients were randomized to receive LR or NS. Primary outcome variables were number of systemic inflammatory response syndrome (SIRS) criteria at 24 hours, 48 hours and 72 hours and blood C-reactive protein (CRP) levels at 48 hours and 72 hours. In vitro complementary experiments were performed to further explore the interaction between pH, lactate and inflammation. RESULTS: Nineteen patients receiving LR and 21 receiving NS were analyzed. The median (p25-p75) number of SIRS criteria at 48 hours were 1 (1-2) for NS vs 1 (0-1) for LR, p = 0.060. CRP levels (mg/l) were as follows: at 48 hours NS 166 (78-281) vs LR 28 (3-124), p = 0.037; at 72 hours NS 217 (59-323) vs LR 25 (3-169), p = 0.043. In vitro, LR inhibited the induction of inflammatory phenotype of macrophages and NF-κB activation. This effect was not observed when using Ringer's solution without lactate, suggesting a direct anti-inflammatory effect of lactate. CONCLUSIONS: Lactated Ringer's is associated with an anti-inflammatory effect in patients with acute pancreatitis.
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La coexistencia de un teratoma quístico maduro con un adenocarcinoma de células claras en el mismo ovario es rara. No hemos encontrado ninguna referencia sobre esta asociación en la literatura médica.Presentamos el caso de una paciente de 56 años, asintomática, intervenida de masa anexial compleja con elevación de los marcadores tumorales ováricos, en estadio quirúrgico IIc. El resultado anatomopatológico fue teratoma quístico maduro asociado a carcinoma de células claras en el mismo ovario.Los teratomas pueden malignizar (1-2%), pero generalmente a carcinoma epidermoide. No está descrita la transformación a carcinoma de células claras. Existen referencias de degeneración en este sentido de lesiones histológicamente benignas, como la endometriosis. La rareza del caso nos hace plantearnos si se trata de una simple coincidencia o de una malignización del teratoma
The coexistence of mature cystic teratoma and clear cell adenocarcinoma in the same ovary is extremely infrequent. We found no reports of this association in the literature.We report the case of a 56-year-old asymptomatic patient who underwent surgery for a complex annexal mass with elevated ovarian tumoral markers. Surgical stage was IIc. Pathological diagnosis was mature cystic teratoma associated with clear cell carcinoma in the same ovary.Teratomas can become malignant (1-2%) but transformation is usually to epidermoid carcinoma. Transformation to clear cell carcinoma has not previously been described. There have been reports of this type of degeneration inhistologically benign lesions such as endometriosis. The rarity of this case prompted us to question whether the association was coincidental or was due to malignanttransformation of the teratoma