Life Cycle Thinking for the environmental and financial assessment of rice management systems in the Senegal River Valley.

Rice is a staple food in Senegal, which however imports more than 70% of the rice consumed annually to meet its domestic demand. Despite governmental efforts to increase rice self-sufficiency, both rice supply and yields remain low. Senegalese farmers face challenges related to irrigation infrastructure and fertiliser access, besides those derived from climate change. This study applies Life Cycle Assessment (LCA) combined with financial Life Cycle Costing (LCC) to evaluate alternative scenarios for rice management in the Senegal River Valley and identify sustainability hotspots and potential improvements. Specifically, rice cultivation in Ross Béthio (Saint Louis, Senegal) is assessed based on the observed agricultural practices during the dry seasons of 2016 and 2017. Two scenarios capturing conventional (CONV) and intensive (INT) practices are compared to two reference scenarios (SAED scenarios) according to the recommendations of the official agricultural advisory service. The INT scenario generates the lowest impacts per kg of paddy rice in seven out of thirteen impact categories, including climate change, freshwater and marine eutrophication, ozone depletion and water scarcity. This is due to the higher yields (7.4 t ha-1) relative to CONV (4.8 t ha-1) and the two reference SAED scenarios (6.0 t ha-1). The two latter scenarios show the lowest values in the remaining categories, although they also generate slightly lower profits than INT (138 € t-1 vs. 149 € t-1) due to increased labour costs for additional fertilisation treatments. The results from both LCA and LCC underline the importance of increasing yields to decrease environmental impacts and production costs of rice when estimated per kg of product. Well-designed fertiliser application doses and timing and increased mechanisation can deliver further environmental benefits. Additional improvements (e.g. in irrigation, crop rotations, straw management) could be considered to promote the long-term sustainability and profitability of rice production in Senegal. LCA in combination with financial LCC is identified as a decision-support tool for evaluating the sustainability of alternative crop management practices. Life Cycle Thinking can still benefit from experiential learning based on information exchange between farmers, researchers and extension agents to contribute to a sustainable agriculture and ultimately to food security in Africa.

[Analysis of predictive factors of success for prostate photovaporization in benign prostatic hyperplasia by greenlight laser]. / Análisis de factores predictivos de éxito para la fotovaporización próstatica en hiperplasia benigna de próstata mediante láser verde.

OBJECTIVE: To conduct a descriptive study of the implementation of greenlight laser photovaporization in a local hospital and to identify the ideal preoperative and intraoperative conditions to obtain a successful outcome. MATERIAL AND METHODS: A retrospective review of 179 photovaporizations performed between January 2007 and June 2010 was done. Preoperative data (age, prostate volume, PSA, IPSS, Qmax, medical history, ASA classification), intraoperative parameters (surgeon's experience, operating time, transfusion requirements, type of laser used, reconversion to transurethral resection of the prostate or TURP) and post-operative data (post-op complications, post-op PSA, post-op IPS score, post-op Qmax and reoperations) were analyzed. We performed a univariate and multivariate analysis to identify which preoperative and intraoperative parameters influence therapeutic failure. RESULTS: The descriptive study shows similarity in all parameters compared to the available literature. In the multivariate analysis, it was found that the surgeon's experience and prostate volume over 40 cc were independent predictive factors for success of greenlight laser photovaporization. CONCLUSIONS: Greenlight laser photovaporization is an effective and reproducible procedure for treating lower urinary tract obstruction due to benign prostatic hyperplasia (BPH). Multicenter, prospective and randomized studies are needed to confirm the results of this study. There are few studies available in the literature that provide a high level of evidence and grade of recommendation.

Insights into the role of microRNAs in cardiac diseases: from biological signalling to therapeutic targets.

microRNAs have recently opened new pathways to explain gene expression and disease biology in many scenarios, including cardiac diseases. microRNAs are endogenous small non-coding RNAs that mediate post-transcriptional repression or messenger RNA degradation. By annealing to inexactly complementary sequences in the 3' untranslated region of the target messenger RNA, protein level is down-regulated. Several microRNAs appear to act cooperatively through multiple target sites in one gene and, conversely, most microRNAs can target several genes. miR-133 and miR-1 are specifically expressed in cardiac and skeletal muscle and control myogenesis, cardiac development, cardiac performance and cardiomyocyte hypertrophy (mainly by tuning transcription factors and other growth-related targets). They also modulate the expression of certain cardiac ion channels and related proteins with proarrhythmic effect. Besides them, other microRNAs have been shown to exert influence on the myocardial growth, the electrical balance and the angiogenesis processes that take place in the heart. Bioinformatics is a useful tool to identify potential targets of a given microRNA, although there is still substantial concern about their reliability. Experimental manipulation of microRNAs has provided a tantalizing basis to speculate that future research on microRNAs may yield important progress in the prevention of sudden cardiac death and in the treatment of cardiac heart failure. However, the final effect of the blockage of microRNAs in vivo remains unclear, since each of them can target hundreds of genes with different intensity. The era of the microRNAs in cardiovascular diseases has just started.

Analysis of heart rate turbulence in advanced heart failure and heart transplantation patients.

OBJECTIVE: The objective of this study was to describe heart rate turbulence (HRT) in advanced heart failure (HF) patients and in a group of patients who underwent heart transplantation (HT). MATERIALS AND METHODS: We performed 24-hour Holter recordings in 20 patients with advanced HF referred to our hospital for HT, including 16 males of overall mean age of 44 +/- 13 years and with a mean ejection fraction (EF) 21 +/- 7%. An additional set of recordings was obtained in a second group of 27 patients who had already undergone HT, including of 21 males of overall mean age of 47 +/- 14 years. We recorded the number of premature ventricular contractions (PVCs), mean heart rate (MHR), and 2 parameters of HRT-turbulence onset (TO) and turbulence slope (TS). RESULTS: Patients with HT showed a low density of premature ventricular complexes, in contrast to patients in the advanced HF group. For this reason, HRT could only be analyzed in 15 of the patients with advanced HF (66%) and in 10 of the patients who underwent HT (37%). MHR was 77 +/- 10 bpm in the advanced HF group and 90 +/- 10 bpm in the HT group. In both groups, TO and TS showed highly attenuated values. CONCLUSIONS: Patients with advanced HF showed a high number of PVCs with attenuated HRT parameters, reflecting increased circulating catecholamine levels and decreased response of the autonomic nervous system. Patients who underwent HT showed elevated MHRs, a small number of PVCs, and attenuated HRT values, as corresponds to a denervated heart.

Radioimmunometric assay of natriuretic peptide type-B (BNP) in heart failure.

The aim of this study was to assess the value of the radioimmunometric determination of natriuretic peptide type-B (brain natriuretic peptide, BNP) in the diagnosis and prognosis of heart failure, and to study the association between BNP and the clinical, analytical and echocardiographic variables associated with the evolution of heart failure. The study group included 169 patients (74 women and 95 men; mean, 66 years) with heart failure of different causes, admitted consecutively to our hospital. BNP levels were measured with a radioimmunometric assay (Shionora BNP Cis ) after day 3 of admission. Patients were also studied by echocardiography. A significant association between the cause of heart failure and the BNP concentration was found (patients with ischaemic disease had the highest BNP values). Systolic function was worse in patients with ischaemic disease or dilated cardiomyopathy. High BNP values were also associated with advanced functional class and male sex. Plasma creatinine correlated positively with plasma BNP. However, we found no significant association with the other clinical variables evaluated. Of the echocardiographic variables analysed, BNP correlated positively with the ventricular diameter and pulmonary artery systolic pressure, and inversely with the shortening fraction; patients with severely impaired systolic function had the highest BNP values. It can be concluded that BNP levels (by radioimmunometric assay) are increased in patients with heart failure, and increase in relation to left ventricular dysfunction and the severity of heart failure. The strong independent association of plasma BNP with the left ventricular ejection fraction, its stability and the low cost of measurement suggest that plasma BNP assay could become a routine test. BNP assay could be included as an important factor in clinical and therapeutic decision making, as it complements the information provided by other variables used in the diagnosis of heart failure.

[Aortic periprosthetic abscess with extension to both atria]. / Absceso periprotésico aórtico con extensión a ambas aurículas.

The periprosthetic abscess due to infective endocarditis constitutes a severe complication of an aortic valve replacement, causing high mortality, despite combined medical and surgical treatment, especially in "early" endocarditis. Transthoracic echocardiography, and especially transesophageal study, is the election procedure for a non invasive diagnosis of vegetation and local complications. We report the aggressive and fulminant case of a 43 year old woman with aortic periprosthetic abscess and the extension to both auricles, due to Staphylococcus epidermidis.

Focal xanthogranulomatous pyelonephritis: partial nephrectomy as definitive treatment.

OBJECTIVES: We report 11 cases of focal xanthogranulomatous pyelonephritis (FXGP), a disease that is very uncommon. The aim of the present work is to assess the effectivity of conservative treatment. MATERIAL AND METHODS: Eleven of the 82 cases of XGP (12.5%) diagnosed between 1970 and 1995 presented the focal form (FXGF). Clinical features, laboratory findings, radiological imaging studies, surgical treatment and follow-up were evaluated. RESULTS: FXGP occurred in middle-aged women (female/male ratio 4.5:1) who had a history of calculosis, urinary infections produced by Escherichia coli and Proteus mirabilis, or urinary tract abnormalities. FXGP was unilateral in all cases. The most frequent symptom was flank pain. Some hematological and biochemical parameters were altered. Intravenous urography and sonography revealed calculosis, hydronephrosis or renal mass, but these findings are nonspecific. Only abdominal CT scan can establish the correct diagnosis. Five of these patients (45.5%) underwent partial nephrectomy at our hospital. During the follow-up, patients showed no relapse in the ipsilateral or contralateral kidney. Serum parameters were in normal range. CONCLUSION: When FXGP is diagnosed, local excision is recommended in all cases, since relapse in the affected kidney is unusual.

[Spanish bibliographic production on AIDS. Bibliometric approach]. / Producción bibliográfica española sobre el sida. Acercamiento bibliométrico.

BACKGROUND: We analyze Spanish production of the books published in Spain about AIDS and they are put together in the database ISBN. METHODS: For every book there considered various things: author, year of publication, ISBN classification, language, edition, place publicated and publishers were analyzed. RESULTS: There are 275 books analyzed. Which they are classified in the Data Base under 33 different classes. The principal class is general pathology, clinic medicine and therapeutics with 113 books. The places in which more books where published was Barcelona (39.63%) and Madrid (30.54%). The publishing house were the ones which published more books (44.26%). The 81.81% of the books were written originally by some of the languages of our country, with at 18.18% which were transduced by other languages. The ones that were transduced were principally english (54%) and french (34%). CONCLUSIONS: These results confirm the tendency observed in other studies and indicate the increase of Spanish publications on AIDS, this is observe after the years.

[10 years of literature on AIDS (1983-1992): bibliometric analysis]. / Diez años de literatura sobre el sida (1983-1992): análisis bibliométrico.

BACKGROUND: Reasons for the quantitative study of the Spanish publications on AIDS are both the huge volume attained by the printed material on the subject since the first case was described in 1981 by the Center for Disease Control, and the high incidence of the cases reported on this disease. METHODOLOGY: Searches have been performed on the subject through the database of the Indice Médico Español (IME), the Indice Español de Ciencia y Technología (ICYT), the ISBN and Bibliografía Española in order to retrieve all possible Spanish journal papers' and books. The references were distributed using criteria of documentary tipology, publication date, institutions involved, autonomous communities, and, finally, after its relation with the confirmed cases of AIDS. RESULTS: A total 2,013 items have been retrieved, 1,821 journal papers' and 192 books. More than 50% of the papers are published only by five journals, being 139 the total number of journals able to carry pertinent information. The most productive journals were Medicina Clínica and Enfermedades Infecciosas y Microbiología Clínica. CONCLUSIONS: The results confirm exponential growth of the publications from 1983, the first year when a paper was published on AIDS in Spain. The grow is similar to the tend observed in other countries. Parallelism has been detected between growth in the number of publications and in the number of journals publishing on the subject, the growth in the number of journals publishing on the subject, the growth in the number of institutions which collaborate and the growing tend of reported cases in Spain. The results of the bibliometric study, showing an epidemiological growth out of comparison in the history of the scientific literature, could be useful both to information scientists, and to the research inside this scientific field.

Renal aspergillosis and AIDS.

Primary renal aspergillosis is an extremely rare entity. Only 19 cases have been reported, 3 of them in patients with AIDS. We report one new case of renal aspergillosis in a patient with AIDS. His disease pattern was multiple bilateral renal abscesses with a normal excretory pathway. The treatment established was percutaneous drainage and systemic antifungal drugs. He had a bad evolution and died 14 weeks after diagnosis. In the previously reported cases of aspergillosis in patients with AIDS, the manifestation was unilateral renal abscess.

[Neoplasms in kidney transplant patients]. / Neoplasias en pacientes con trasplante renal.

Our service performed a total of 619 kidney transplants between February 1980 and March 1993. Among them, 41 new neoplasias (6.6%) were diagnosed. Most frequent tumour was epithelioma (25) with a presentation age lower than in the normal population. Amongst the remaining tumours (16), the occurrence of 2 lymphoma and 2 Kaposi's sarcoma should be emphasized, together with the fast evolution progression of the others. Using a multiple regression model, an analysis is made on the influence certain factors have in the development of neoplasias, age being selected as the only significant one. The relative risk transplanted subjects have of suffering some type of neoplasia compared with the normal population is 36.

[Lymphocele as a complication of renal transplantation]. / Linfocele como complicación del transplante renal.

Lymphoceles are a complication of renal transplantation surgery. The source of this lymphatic collections is the lymph draining through the lymphatic vessels located in the transplanted kidney sinus and surrounding the iliac vessels of the receptor. The main etiological factor is the surgical technique used when dissecting these structures for graft placement. Several factors have been suggested as favouring their occurrence, acute rejection being highlighted as one. This paper reviews a series of 517 renal transplantations performed in our service, with a lymphocele incidence of 5.2% (28). Using a log regression model, the influence of age, sex, time in dialysis, presence of tubular acute necrosis in the graft following placement, acute rejection and immunological regime, for the appearance of lymphocele were analyzed. Age and lack of acute tubular necrosis were the only two factors selected by the model. Also, clinical signs and symptoms as well as therapy instituted were analyzed, emphasizing that puncture-drainage and instillation of iodine povidone was 100% effective.

Urological manifestations of herpes zoster.

Herpes zoster is an infection caused by the varicella virus. Inflammatory reaction can involve the spinal cord and anterior horn cells causing varied neurological disorders including urological alterations. We reviewed 57 patients who suffered herpes zoster between 1984 and 1991. 15 of them (26%) showed urological manifestations: 2 cases acute urinary retention, 3 patients urinary incontinence and 10 cases had a cystitis-like syndrome. The clinical findings and diagnostic procedures are studied. The possible etiological mechanisms are discussed. The literature is reviewed.

Laser treatment of glans penis hemangioma.

We present a case of a glans penis hemangioma. These lesions are extremely rare, and as a consequence there is controversy concerning their treatment and outcome. Our patient was treated with a neodymium:YAG laser irradiation, with complete morphological recuperation. To our knowledge this is the first case of a glans penis hemangioma treated with this technique.

[Abdominal echography to determine the weight of the prostate]. / La ecografía abdominal en la determinación del peso prostático.

The relationship of post-operatively determined prostatic gland weight and that calculated prior the procedure, by means of abdominal ultrasound techniques using the "ellipsoid method", has been studied in 88 patients undergoing retropubic adenectomy. The regression line was nearly optimal, Y = 0.946 X + 2.295, and the correlation coefficient between both weight measures was r = 0.915. Abdominal ultrasound examinations are a simple, quick and safe means to evaluate prostate weight, prior to deciding the type of surgery (open adenectomy or transurethral resection) for prostate adenoma.

[Surgical treatment of uretero-vaginal fistulae caused by gynecologic surgery]. / Tratamiento quirúrgico de las fístulas uretero-vaginales debidas a cirugía ginecológica.

The present paper is a review of 71 cases of uretero-vaginal fistulae secondary to pelvic surgery which were treated in the Urology Unit of our hospital. Surgical management of these fistula intrinsically depends on their number, location and severity. The results obtained by the different techniques were analyzed, emphasizing their merit when using the Turner-Warwick technique (uretero-cystoneostomy on psoic bladder) and any urodynamic troubles this technique can bring about when used bilaterally in patients from radical gynaecological surgery.