Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 46
Filter
1.
Environ Res ; : 119424, 2024 Jun 13.
Article in English | MEDLINE | ID: mdl-38879109

ABSTRACT

Birds are good bioindicators of disturbance in the environment. They are present in different habitats and trophic levels. In addition, rapid urbanization has led birds to use cities as shelter and for seeking food resources. Sewage treatment plants (STPs) are suitable locations for free-living birds within cities. However, few studies address the impacts of emerging pollutants from sewage treatment plants on wild birds. In this sense, the aim of this study was to analyze the genotoxic, mutagenic, and immunological impacts from metal and pollutant exposure on free-living birds collected at a STP. For comparison, birds were collected in a preserved environment, the Silvania National Forest (FLONA). To achieve this, we used non-destructive biomarkers sensitive to environmental changes. Birds were collected in both environments using mist nets. After collection, birds were weighed, measured, species-identified, and released. Blood was collected for comet assay, micronucleus test, and leukocyte profile, while feathers were collected for metal concentration analysis. Water physicochemical parameters were measured at both sites, and water samples were collected for metal analysis. Our results demonstrated that birds collected at the STP exhibit a higher frequency of genotoxic damage and erythrocyte abnormalities, and increased immune response compared to FLONA birds. Traces of potentially toxic metals, such as Hg and As, were found in the birds feathers from both environments, raising concerns about metal contamination in both environments. Trophic guilds appear to respond similarly to exposure. The parameters and metals found in the water reflect environmental characteristics and may be influencing pollutant availability. Finally, despite the advancement of our findings, studies linking these damages to detrimental effects on behavior and reproduction are encouraged.

2.
EJVES Vasc Forum ; 61: 99-103, 2024.
Article in English | MEDLINE | ID: mdl-38560760

ABSTRACT

Introduction: Horseshoe kidney (HK) is an anatomical variant characterised by abnormalities in the position, rotation, and vascular supply of the kidney, with functioning renal masses on both sides of the vertebral column fused together at the isthmus. Due to the altered pattern of kidney vasculature, endovascular aortic repair for aortic abdominal aneurysm (AAA) in the presence of HK requires vascular anatomy specific planning. Report: A 68 year old male, with multiple comorbidities, presented with an asymptomatic AAA and HK. The kidney vasculature was characterised by the presence of three arteries: two arising laterally at the same level and a third polar artery arising from below. The polar artery was 6 mm in diameter and larger than the other two; therefore, in order to preserve this artery, a custom-made device with a single side branch was implanted below the main renal arteries. A balloon expandable covered stent was used to complete the side branch into the polar renal artery. The follow-up computed tomography angiography revealed a successful outcome, with total aneurysm exclusion, branched graft patency, no endoleak, and unchanged renal function. Discussion: This case report shows a possible surgical solution for a case of HK with AAA and the importance of accurate endovascular planning. Large polar arteries, if present, need to be preserved, and custom-made devices in the modern endovascular era permit that. This approach could represent the best option for complicated patients.

3.
Environ Toxicol Chem ; 42(11): 2422-2439, 2023 11.
Article in English | MEDLINE | ID: mdl-37477494

ABSTRACT

Changes in the natural landscape and the indiscriminate use of pesticides can have a major impact on aquatic environments and have contributed to the worldwide decline of amphibian populations. In the present study, we sampled tadpoles of three anuran amphibians (Boana albopunctata, Physalaemus cuvieri, and Dendropsophus minutus) from ponds in six different agricultural landscapes of the Brazilian Cerrado savanna and evaluated whether and to what extent genotoxic and mutagenic damage was related to land use (the amount of forest and agricultural remnants, and related physicochemical factors) and the presence of pesticides in the water of the study ponds. We also evaluated the hepatotoxicity in P. cuvieri, which was the most abundant species at five of the six sampling points. Clomazone and atrazine were the most common pesticides found in the ponds. The B. albopunctata and P. cuvieri tadpoles presented similar patterns of DNA damage among the sampling points. The least DNA damage was found in the D. minutus tadpoles, although this species was present in only one of the study ponds. More binucleated and anucleated cells were observed in B. albopunctata, but there was no significant variation among species in terms of the number of micronuclei or other erythrocytic nuclear abnormalities. Land use and physicochemical factors did not explain the variation in the DNA damage observed in the three anurans. The hepatotoxicity analyses of P. cuvieri revealed the presence of a series of alterations, including the enlargement of the sinusoids, vacuolization of the hepatocytes, the infiltration of inflammatory cells, hepatic steatosis, and dilation of the blood vessels. The interaction between physicochemical factors and the biomarkers analyzed in the present study is complex. In particular, it will be important to better elucidate which factors are contributing, either directly or indirectly, to the decline of anuran amphibian populations, especially in threatened biomes, such as the Brazilian Cerrado. In this case, we would encourage further in situ studies that assess the ecotoxicology of the landscape, together with the systematic monitoring of aquatic environments, to guarantee the long-term integrity of amphibian populations, and those of other organisms that play an essential functional role in the ecosystem. Environ Toxicol Chem 2023;42:2422-2439. © 2023 SETAC.


Subject(s)
Chemical and Drug Induced Liver Injury , Pesticides , Animals , Brazil , Ecotoxicology , Ecosystem , Grassland , Anura , Larva/genetics , Biomarkers
4.
Environ Monit Assess ; 195(8): 1000, 2023 Jul 27.
Article in English | MEDLINE | ID: mdl-37495738

ABSTRACT

Exposure to heavy metals in mining zones is a significant threat, which can affect ecosystem services and contribute to the decline of wild bat populations. The present study investigated the impacts caused by mining on two bat species in central Brazil, the nectarivorous Glossophaga soricina and the frugivorous Carollia perspicillata. The bats were collected from a nickel-mining zone (treatment) and a protected area (control). The leukocyte profile of each species was compiled and genotoxicity (comet assay) and mutagenicity (micronucleus test) were determined using the appropriate procedures. Glossophaga soricina presented significantly higher frequencies of eosinophils and monocytes in the mining zone in comparison with the protected area, whereas C. perspicillata presented higher frequencies of lymphocytes in the mining zone, but significantly lower frequencies of monocytes. Concomitantly, G. soricina also presented a higher frequency of DNA damage, although no variation was found in this parameter in C. perspicillata when comparing environments. We also found no significant differences between populations in terms of the frequency of micronuclei and other nuclear abnormalities. Overall, the results of the study indicate that bats are susceptible to immunological disorders and DNA damage in mining zones, with the nectarivorous G. soricina appearing to be relatively more susceptible and thus a potentially effective bioindicator of the impact of contamination in these environments.


Subject(s)
Chiroptera , Metals, Heavy , Animals , Brazil , Nickel , Chiroptera/genetics , Ecosystem , Environmental Monitoring , Metals, Heavy/toxicity , Mining , DNA Damage , DNA
5.
J Vasc Surg Cases Innov Tech ; 9(2): 101183, 2023 Jun.
Article in English | MEDLINE | ID: mdl-37274437

ABSTRACT

Objective: We evaluated the patency of the spinal arteries (intercostal and lumbar) after the STABILISE (stent-assisted balloon-induced intimal disruption and relamination in aortic dissection repair) technique. Methods: A retrospective analysis of all patients with aortic dissection treated with the STABILISE technique between April 2018 and July 2021 was performed. Imaging analysis of the spinal cord vascular supply was accomplished using multiplanar and maximum intensity projection reconstructed images of pre- and postoperative computed tomography angiograms at 1 month, 12 months, and annually thereafter. Results: Twelve patients were treated for complicated aortic dissection. Primary technical success was 100% and mid-term clinical success, at a mean follow-up of 27 ± 12 months, was 90%. No cases of spinal cord ischemia were identified. One patient died after 1 year (non-aortic related), and one patient was lost to follow-up. A significant decrease was found in the mean number of patent spinal arteries in the stent graft area at 1 month (P < .001), 1 year (P < .001), and 2 years (P = .004). However, no significant reduction was found in the number of spinal arteries in either the bare metal stented or nonstented aorta (P > .05). Conclusions: Use of the STABILISE technique decreased intercostal artery patency in the thoracic stent graft area, but spinal artery patency was not significantly affected by the bare metal stent nor its aggressive ballooning. These findings constitute a step toward a better understanding of the safety of this technique.

6.
Article in English | MEDLINE | ID: mdl-37255494

ABSTRACT

In this new millennial, endovascular strategies have revolutionized the treatment of acute type B aortic dissection (aTBAD). With reduced in-hospital mortality and good long-term outcomes TEVAR has become the gold standard for the treatment of complicated dissection and is gaining increasing support for its preventive applicability in some uncomplicated dissections. With this new paradigm came a shift of the treatment goal where just covering the entry tear is not enough and instead achieving long-term positive thoracoabdominal remodeling is needed. More extensive approaches with composite device designs (covered stent graft and bare metal stent) emerged to answer this aortic conundrum. At 5-year of follow-up, "Provisional ExTension To Induce COmplete Attachment technique" (PETTICOAT) and its evolution "Stent assisted balloon induced intimal disruption and relamination in aortic dissection repair" (STABILISE) seem to be safe techniques that can allow, when anatomically feasible, excellent aortic remodeling and, in some cases, even the healing of the dissection. Nevertheless, STABILISE results, although promising, are mostly based on small series and therefore need to be validated by analyzing medium-long-term results from the international registry. Given the plethora of new data and the disparity of expert opinions on the best treatment to adopt, in this review we aim to summarize the current knowledge on the results of these different strategies for acute TBAD.

7.
Rev Port Cardiol ; 42(7): 603-612, 2023 07.
Article in English, Portuguese | MEDLINE | ID: mdl-37072084

ABSTRACT

INTRODUCTION AND OBJECTIVES: Management of aortic dissection is rapidly evolving. The present study aims to assess paradigm shifts in type B aortic dissection (TBAD) treatment modalities and their outcomes according to clinical presentation and type of treatment. We also aim to assess the impact of endovascular technology in TBAD management in order to define organizational strategies to provide an integrated cardiovascular approach. METHODS: We performed a retrospective review with descriptive analysis of the last 100 consecutive patients with TBAD admitted to the Vascular Surgery Department of Centro Hospitalar Universitário Lisboa Norte over a 16-year period. Results were stratified according to treatment modality and stage of the disease. The study was further divided into two time periods, 2003-2010 and 2011-2019, respectively before and after the introduction of a dedicated endovascular program for aortic dissections. RESULTS: A total of 100 patients (83% male; mean age 60 years) were included, of whom 59 were admitted in the acute stage (50.8% with complicated dissections). The other 41 patients were admitted for chronic dissections, most of them for surgical treatment of aneurysmal degeneration. Temporal analysis demonstrated an increase in the number of patients operated for aortic dissection, mainly due to an increase in chronic patients (33.3% in 2003-2010 vs. 64.4% in 2011-2019) and a clear shift toward endovascular treatment from 2015 onward. Overall in-hospital mortality was 14% and was significantly higher in the chronic phase (acute 5.1% vs. chronic 26.8%; OR 5.30, 95% CI 1.71-16.39; p=0.003) and in patients with aneurysmal degeneration, regardless of the temporal phase. Only one death was recorded in the endovascular group. CONCLUSION: Management of TABD carried an overall mortality of 14% during a 16-year period, but the appropriate use of endovascular technology has substantially reduced in-hospital mortality.


Subject(s)
Aortic Aneurysm, Thoracic , Aortic Dissection , Endovascular Procedures , Humans , Male , Middle Aged , Female , Endovascular Procedures/methods , Treatment Outcome , Risk Factors , Aortic Dissection/surgery , Hospitalization , Retrospective Studies , Aortic Aneurysm, Thoracic/surgery
8.
J Endovasc Ther ; 30(6): 817-821, 2023 12.
Article in English | MEDLINE | ID: mdl-35698790

ABSTRACT

The absence of an adequate ileo-femoral access is usually considered an absolute contraindication to fenestrated and branched aortic repairs. Alternative routes and dedicated stent-graft designs have been advocated. Hereby, we describe the case of a 73-year-old man with a recurrent type IV thoracoabdominal aortic aneurysm and complete thrombotic pararenal aortic occlusion treated successfully with a tri-branch custom-made endograft deployed via a transaxillary access.


Subject(s)
Aortic Aneurysm, Abdominal , Aortic Aneurysm, Thoracic , Arterial Occlusive Diseases , Blood Vessel Prosthesis Implantation , Endovascular Procedures , Male , Humans , Aged , Blood Vessel Prosthesis , Aortic Aneurysm, Thoracic/diagnostic imaging , Aortic Aneurysm, Thoracic/surgery , Aortic Aneurysm, Abdominal/surgery , Risk Factors , Treatment Outcome , Stents , Prosthesis Design , Arterial Occlusive Diseases/surgery
9.
Vet World ; 16(12): 2457-2463, 2023 Dec.
Article in English | MEDLINE | ID: mdl-38328362

ABSTRACT

Background and Aim: Hydrodissection is a liquid injection technique that is rarely used in animal ophthalmic procedures. The use of this technique in the creation of conjunctival flaps for the treatment of corneal ulcers in dogs can improve the outcome, task, and comfort for patients. This study aimed to evaluate the use of hydrodissection in the creation of conjunctival flaps in dogs with corneal ulcers. Materials and Methods: This study focused on a surgical procedure for creating conjunctival flaps in the eyes of 17 dogs with deep corneal ulcers. We divided the patients into two groups: Hydrodissection was performed in the first group (G1) and conventional divulsion without hydrodissection in the second group (G2). In G1, the conjunctival flap was created by subconjunctival injection of 1 mL of 0.9% sodium chloride, followed by flap construction. The flap was constructed through conventional divulsion using iris scissors in the G2. The operative time, degree of bleeding, and ease of conjunctival divulsion were evaluated during the procedure. Blepharospasm, hyperemia, edema, and scarring of the conjunctiva were evaluated during the post-operative period. Post-operative complications, notably suture dehiscence, were recorded in each group. Results: Hydrodissection is an easy-to-perform maneuver that optimizes the construction of conjunctival flaps. There were no statistical differences in the parameters used to evaluate the trans- and post-operative period between the groups. The volume of sodium chloride administered in the conjunctiva ranged from 0.5 mL to 1 mL in G1. Dehiscence of the flap sutures was observed in four patients (two in G1 and two in G2), with no significant difference between the groups. Conclusion: Hydrodissection facilitates the construction of conjunctival flaps in dogs with corneal ulcers, affording greater comfort to patients and proving to be an excellent option for ophthalmologists.

10.
J Endovasc Ther ; : 15266028221105186, 2022 Jun 23.
Article in English | MEDLINE | ID: mdl-35735197

ABSTRACT

INTRODUCTION: Initiating an endovascular aortic program for treatment of complex aortic aneurysms with fenestrated and branched grafts (FB-EVAR) is challenging. Using a Proctor is one option for training and development of the team. However, this approach has not been formally analyzed. The aim of this study was to analyze the learning curve and the effect of the Proctor regarding safety and effectiveness in FB-EVAR. METHODS: A single-center retrospective cohort study was performed, including all consecutive elective patients submitted to FB-EVAR (including both thoraco-abdominal-TAAA and complex abdominal aortic aneurysms-C-AAA) from 2013 to 2021. Patients were divided into 2 groups, the first operated with the Proctor present and the second without. Primary outcomes were 30-day mortality (safety) and technical and procedure success (efficacy). Secondary outcomes included treatment performance (procedure time, blood loss, contrast, and radiation use), re-interventions, aneurysm shrinking, target vessel patency, 30-day mortality, aneurysm-related mortality, and overall mortality. RESULTS: Overall, 105 patients were included in the study, 35 operated with Proctor and 70 operated without. The first 20 patients were operated always with the Proctor, and the remaining were operated with the Proctor selectively. Mean age was 71.8 (±7.3) years and 95 patients were male (90.5%). Overall, 62 (65%) patients had C-AAA or extent IV TAAAs and 43 (35%) had extensive TAAAs. There were no significant differences regarding 30-day mortality (Log Rank=0.99), technical success (p=0.4), or procedure success (p=0.8). Mean surgical time was longer in the non-Proctor group (p=0.005), as well as significant intra-operative blood loss (p=0.042). Contrast use (p=0.5) and radiation (p=0.53) were non-significantly different between groups. There were no significant differences regarding length of stay (p=0.4), major adverse events (p=0.6), target vessel patency (Log Rank=0.97), early (p=0.7) and late endoleaks (0.7), aneurysm shrinking (p=0.6), re-interventions (p=0.2), and overall mortality (Log Rank=0.87). CONCLUSION: In our experience, the use of a Proctor to start and accompany our complex endovascular aortic program for FB-EVAR was both safe and effective and may serve as a template by other countries and centers that aim to developing their programs.

11.
Acta Med Port ; 35(7-8): 558-565, 2022 Jul 01.
Article in English | MEDLINE | ID: mdl-35139009

ABSTRACT

INTRODUCTION: The aim of this study was to assess the pattern of anti-atherosclerosis medicines in patients admitted to a vascular surgery department, the effective control of the target values and its subsequent modification by the vascular surgery team. MATERIAL AND METHODS: A retrospective single-center cohort study of prospectively collected data was performed between May 2017 and May 2018 in a tertiary center. The STROBE guidelines were followed. All patients undergoing a primary elective surgery for carotid disease, aortic aneurysm and peripheral arterial disease were included. 'Best medical treatment' was defined as treatment with both anti-thrombotic and lipid-lowering treatment and, when appropriate, antihypertensive and anti-diabetic drugs. Both baseline and post-discharge best medical treatment were recorded. Blood work-up was performed at admission and 'adequately controlled patient' was defined if all blood test values were in agreement with the guidelines. RESULTS: A total of 279 patients (78% male; mean age 69 years-old) were included. Optimal medical therapy was registered in 58.8% upon admission but improved to 73.8% (95% CI, 2.197 - 7.781; p < 0.001) after discharge. At baseline, a total of 65.4% of patients were on lipid-lowering agents and of these, only 37% had LDL-C values within the targets. Likewise, only 34.6% of the 78 patients with diabetes had glycated hemoglobin within the normal range. Additionally, 8.5% of the remaining cohort had undiagnosed diabetes. CONCLUSION: In our current practice, only 75% of the patients receive best medical treatment. Although the admission in a Vascular Surgery department was an opportunity to optimize medical therapy, treatment remains suboptimal in one-quarter of patients. Further efforts should be carried out to alert vascular surgeons to this problem and to find future multidisciplinary solutions that can improve the cardiovascular risk profiles of these patients.


Introdução: Este estudo pretendeu avaliar o padrão de tratamento médico antiaterosclerótico em doentes internados num serviço de cirurgia vascular, o controlo efetivo dos valores-alvo e a sua posterior modificação pela equipa vascular. Material e Métodos: Foi realizado um estudo de coorte retrospetivo com dados coletados prospectivamente entre maio de 2017 e maio de 2018 num centro terciário. Foram seguidas as guidelines da STROBE e incluídos todos os doentes submetidos a cirurgias primárias eletivas para correção de doença carotídea, aneurisma de aorta e doença arterial periférica. Definiu-se como 'tratamento médico otimizado' o tratamento com fármacos anti-trombóticos e hipolipemiantes e, quando apropriado, com agentes anti-hipertensivos e antidiabéticos. Foi registado tratamento médico otimizado à entrada bem como após a alta. À admissão foi igualmente realizado um controlo analítico e os doentes foram classificados como 'adequadamente controlados' se todos os valores analíticos estivessem de acordo com as normas de orientação clínica. Resultados: Foram incluídos 279 pacientes (78% homens; idade média de 69 anos). O tratamento médico otimizado foi registado em 58,8% à data de admissão, tendo melhorado para 73,8% (IC 95%, 2,197 ­ 7,781; p < 0,001) após alta da enfermaria vascular. No início do estudo, 65,4% dos doentes estavam sob agentes hipolipemiantes e, destes, apenas 37% tinham valores de LDL-C dentro dos valores-alvo estabelecidos pelas normas de orientação clínica. Da forma semelhante, apenas 34,6% dos 78 doentes com diabetes tinham hemoglobina glicada dentro da normalidade. Da restante coorte, 8,5% tinha diabetes não diagnosticada. Conclusão: Na nossa prática atual apenas 75% dos pacientes seguem o tratamento médico otimizado. Apesar do internamento num serviço de Cirurgia Vascular ser uma oportunidade única para otimizar o tratamento médico, este permanece abaixo do ideal em cerca de um quarto dos doentes. Devem ser realizados esforços adicionais no sentido de alertar os cirurgiões vasculares para esse problema e encontrar soluções multidisciplinares futuras que permitam melhorar o perfil de risco cardiovascular destes doentes.


Subject(s)
Antihypertensive Agents , Atherosclerosis , Humans , Male , Aged , Female , Antihypertensive Agents/therapeutic use , Cholesterol, LDL , Retrospective Studies , Cohort Studies , Glycated Hemoglobin , Aftercare , Patient Discharge , Vascular Surgical Procedures , Risk Factors
13.
Int J Cardiol Heart Vasc ; 38: 100934, 2022 Feb.
Article in English | MEDLINE | ID: mdl-35005212

ABSTRACT

OBJECTIVES: Acute Aortic dissection (AAD) may present as out-of-hospital cardiac arrest (OHCA). However, the incidence of this presentation is not well known. Our aim was to perform a systematic review and meta-analysis of all observational studies reporting on the incidence of AAD in patients with OHCA. METHODS: We searched MEDLINE, CENTRAL, PsycInfo, Web of Science Core Collection and OpenGrey databases from inception to March-2021, for observational studies reporting on the incidence of AAD in patients with OHCA. Data was pooled using a random-effects model of proportions. The primary outcome was the incidence of AAD in OHCA patients. Secondary outcomes were the incidence of type A aortic dissections (TAAD) and type B aortic dissections (TBAD) in OHCA patients, overall mortality following AAD-OHCA and risk of death in AAD-OHCA patients compared to risk of death of non-AAD-OHCA patients. RESULTS: Fourteen studies were included. The pooled calculated incidence of OHCA due to AAD was 4.39% (95 %CI: 2.55; 6.8). Incidence of OHCA due to TAAD was 7.18% (95 %CI: 5.61; 8.93) and incidence of OHCA due to TBAD was 0.47% (95 %CI: 0.18; 0.85). Overall mortality following OHCA due to AAD was 100% (95 %CI: 97.62; 100). The risk of death in AAD-OHCA patients compared with non-AAD-OHCA patients was 1.10 (95 %CI: 0.94; 1.30). CONCLUSION: AAD as a cause of OHCA is more frequent than previously thought. Prognosis is dire, as it is invariably lethal. These findings should lead to a higher awareness of AAD when approaching a patient with OHCA and to future studies on this matter.

14.
Semin Thorac Cardiovasc Surg ; 34(1): 1-16, 2022.
Article in English | MEDLINE | ID: mdl-33705940

ABSTRACT

Thoracic aortic aneurysms (TAA) may grow asymptomatically until they rupture, with a mortality over 90%. The true incidence and prevalence of this condition is uncertain and epidemiologic data is scarce, understudied and dispersed. Therefore, we aimed to conduct a systematic review and meta-analysis of the incidence and prevalence of TAAs in population-based studies. We searched MEDLINE, EMBASE and CENTRAL from inception to October 2020 for all population-based studies reporting on incidence and/or prevalence of TAAs. Data were pooled using a random effects model. The main outcome was the overall available worldwide incidence and prevalence of TAAs. The secondary outcomes were to evaluate the incidence of ruptured TAAs, differences in the location of these aneurysms (either ascending, arch or descending aorta) and differences in prevalence/incidence across different study designs. Twenty-two studies were included in the review and meta-analysis. The pooled incidence and prevalence of TAAs was 5.3 per 100,000 individuals/year (95% confidence interval [CI]: 3.0; 8.3) and 0.16% (95% CI: 0.12; 0.20), respectively. The pooled incidence of ruptured aneurysms was 1.6 per 100,000 individuals/year (95% CI: 1.3; 2.1). We found a significant difference of the prevalence in autopsy-only studies, which was 0.76% (95% CI: 0.47; 1.13) and the prevalence of TAAs dropped down to 0.07% (95% CI: 0.05;0.11) when these studies were excluded from the overall analysis. The current epidemiologic information provided serve as a base for future public-health decisions. The lack of well-design population-base studies and the limitations encountered serve as calling for future research in this field.


Subject(s)
Aortic Aneurysm, Thoracic , Aortic Aneurysm , Aortic Aneurysm/complications , Aortic Aneurysm, Thoracic/diagnostic imaging , Aortic Aneurysm, Thoracic/epidemiology , Humans , Incidence , Prevalence , Treatment Outcome
15.
J Vasc Surg ; 75(2): 709-720, 2022 02.
Article in English | MEDLINE | ID: mdl-34560218

ABSTRACT

OBJECTIVE: To perform a systematic review and meta-analysis of all population-based studies reporting on incidence of acute aortic dissections (AADs). METHODS: We searched the MEDLINE, EMBASE, CENTRAL, and Open Grey databases from inception to August 2020 for population-based studies reporting on the incidence of AAD. A systematic review was conducted following the PRISMA guidelines using a registered protocol (CRD42020204007). Data were pooled using a random effects model of proportions using Freeman-Tukey double arcsine transformation. The main outcome was the incidence of AAD. Secondary outcomes were incidence type A aortic dissections (TAAD) and type B aortic dissections (TBAD), the incidence of aortic dissection repair and medical management, and the incidence of in-hospital mortality. In addition, we estimated the proportion of aortic dissection repair and mortality (in hospital, overall and specific mortality according to subtype) among patients with AAD. RESULTS: Thirty-three studies were included. The pooled incidence of AADs was 4.8 per 100,000 individuals/year (95% confidence interval [CI], 3.6-6.1). The incidence of TAAD was 3.0 per 100,000/year (95% CI, 1.8-4.4) and the incidence of TBAD was 1.6 per 100,000/year (95% CI, 1.1-2.2). The incidence of AAD needing repair was 1.4 per 100,000/year (95% CI, 1.0-2.0) (or 1.4 [95% CI, 1.2-1.7] for TAAD and 0.4 [95% CI, 0.2-0.7] for TBAD). The incidence of medically managed AAD was 3.4 per 100,000/year (95% CI, 2.4-4.5). The incidence of in-hospital death owing to AAD was 1.3 per 100,000 individuals/year (95% CI, 0.9-1.9), 1.0 (95% CI, 0.6-1.4; I2 = 97%) for TAAD, and 0.3 for TBAD (95% CI, 0.2-0.4; I2 = 96%). CONCLUSIONS: A global estimate regarding the incidence rate of AADs was achieved. The incidence of AAD varied significantly between study designs and geographical regions. More accurate information on AAD epidemiology is crucial for public health decisions, clinical understanding, and healthcare management.


Subject(s)
Aortic Aneurysm/epidemiology , Aortic Dissection/epidemiology , Population Surveillance , Acute Disease , Global Health , Humans , Incidence , Risk Factors
16.
Sci Total Environ ; 804: 149936, 2022 Jan 15.
Article in English | MEDLINE | ID: mdl-34509850

ABSTRACT

Separately collected organic fraction of municipal solid waste, also known as biowaste, is typically used to fill the available capacity of digesters at wastewater treatment plants. However, this approach might impair the use of the ensuing digestate for fertilizer production due to the presence of sewage sludge, a contaminated substrate. Worldwide, unsorted municipal solid household waste, i.e. residual waste, is still typically disposed of in landfills or incinerated, despite its high content of biodegradables and recyclables. Once efficiently separated from residual waste by mechanical processes, the biodegradables might be appropriate to substitute biowaste at wastewater treatment plants. Thus, the biowaste would be available for fertilizer production and contribute to a reduction in the demand on non-renewable fertilizers. This study aimed at determining the technical feasibility of co-digesting the mechanically separated organic fraction of residual waste with sewage sludge. Further, key parameters for the implementation of co-digestion at wastewater treatment plants were determined, namely, degradation of the solids and organics, specific methane production, flocculant demand, and dewatered sludge production. The microbial community and diversity in both mono- and co-digestion was also investigated. Semi-continuous laboratory scale experiments showed that the co-substrate derived from the residual waste provided a stable anaerobic co-digestion process, producing 206 to 245 L of methane per kg of volatiles solids added to the digester. The dewaterability of the digestate increased by 4.8 percentage points when the co-substrate was added; however, there was also an increase in the flocculant demand. The specific dewatered sludge production was 955 kg per ton of total solids of co-substrate added to the digester. Amplicon sequencing analysis provided a detailed insight into the microbial communities, which were primarily affected by the addition of co-substrate. The microbiota was fully functional and no inhibition or problems in the anaerobic digestion process were observed after co-substrate addition.


Subject(s)
Methane , Water Purification , Anaerobiosis , Bioreactors , Sewage , Solid Waste
17.
Environ Pollut ; 289: 117911, 2021 Nov 15.
Article in English | MEDLINE | ID: mdl-34365244

ABSTRACT

Herbicides improve the productivity of a monoculture by eliminating weeds, although they may also be toxic and have negative effects on non-target organisms, such as amphibians. The present study evaluated the genotoxic, mutagenic, and histopathological hepatic responses of Dendropsophus minutus tadpoles to acute exposure (96 h) to the herbicide glyphosate (GLY, 65, 130, 260 and 520 µg/L) and the surfactant polyoxyethylene amine (POEA, 1.25, 2.5, 5 and 10 µg/L). On average, 174 % more genomic damage was observed in the tadpoles exposed to all concentrations of POEA in comparison with the control, while up to seven times more micronuclei were recorded, on average, at a concentration of 5 µg/L of POEA. All the individuals exposed to 10 µg/L of POEA died. The tadpoles exposed to GLY presented 165 % more DNA damage than the control, on average, at the highest concentrations (260 and 520 µg/L), and up to six times more micronuclei at 520 µg/L. The Erythrocyte Nuclear Abnormality test (ENA) detected a relatively high frequency of cells with lobed nuclei in the tadpoles expose to POEA at 5 µg/L and binucleated cells in those exposed to GLY at 520 µg/L. The hepatic histopathological observations revealed several types of lesions in the tadpoles exposed to both GLY and POEA. Overall, then, the results of the study indicate that both GLY and POEA have potential genotoxic, mutagenic, and hepatotoxic effects in D. minutus tadpoles. We emphasize the need for further studies to monitor the amphibian populations, such as those of D. minutus, which breed in aquatic environments associated with agricultural areas. The release of pollutants into natural habitats may have significant long-term impacts on the survival of anuran tadpoles.


Subject(s)
Herbicides , Water Pollutants, Chemical , Amines , Animals , DNA Damage , Glycine/analogs & derivatives , Herbicides/toxicity , Humans , Larva , Mutagens/toxicity , Polyethylene Glycols , Water Pollutants, Chemical/toxicity , Glyphosate
18.
Waste Manag ; 133: 110-118, 2021 Sep.
Article in English | MEDLINE | ID: mdl-34390961

ABSTRACT

The methane and digestate production from biowaste (BW, 95% food waste and 5% garden waste based on fresh mass) and grease trap sludge (GTS) co-digestion at the Grossache-Nord WWTP (Austria) as a basis for a cost-benefit analysis was determined using two approaches: The first one was to determine the specific methane yields (SMY) and total solids (TS) removals (%) of the used substrates in biomethane potential (BMP) tests. In the second, the full-scale process data from a supervisory control and data acquisition (SCADA) system were analyzed. From these data, the SMY of the sewage sludge (SS) was calculated for a period without co-digestion and applied to the study period. Thus, it was possible to calculate the methane and digestate production from the co-substrates. Both approaches produced different co-substrate SMYs and TS degradation results. In the approach using the BMP, the SMY was 518 m3/t TSadded and the TS degradation was 77%. For the full-scale method, these values were found to be 620 m3/t TSadded and 66%, respectively. However, the cost-benefit analysis of both approaches indicated that electricity generation from co-digestion can cover the associated costs. The benefit to cost ratio was 1.14 and 1.08 for the BMP and full-scale approach, respectively. The application of the respective approach depends on the availability and quality of full-scale process SCADA data.


Subject(s)
Bioreactors , Refuse Disposal , Anaerobiosis , Digestion , Food , Methane , Sewage
19.
Prospects (Paris) ; 51(1-3): 95-102, 2021.
Article in English | MEDLINE | ID: mdl-34024945

ABSTRACT

This article questions the centrality of knowledge and learning in the curriculum, as well as the restriction of education to learning even when education is thought of as consisting of ways to combat anti-science discourses in the name of combating Covid-19. Based on discourse theory and deconstruction, with a focus on the notions of radical investment, contextualization, interpretation, and fantasy, the article reaffirms a post-foundational notion of curriculum theory and defends the possibility that curriculum and school can be spaces of affective relationships, bonds, and subjectivities willing to invest in life and thereby contribute to fighting the current pandemic.

20.
Waste Manag ; 126: 632-642, 2021 May 01.
Article in English | MEDLINE | ID: mdl-33866139

ABSTRACT

Co-digestion is the simultaneous digestion of two or more substrates and a common practice at wastewater treatment plants (WWTPs). The amounts of methane and digested sludge produced are key parameters for evaluating the economic efficiency of co-digestion. However, the share of dewatered digestate produced from co-substrates is not known. Synergistic effects in co-digestion, i.e. a better biodegradability compared to the mono-digestion of each substrate, might reduce the amounts of digested sludge and increase methane yields. However, these effects might also influence the calculation of methane and digestate quantities from co-substrates. The main objective of this work was to provide a basis for the cost-benefit analysis of biowaste (BW) co-digestion at WWTPs for this data. Therefore, continuous and batch experiments with sewage sludge (SS) and BW co-digestion were conducted and evaluated for methane and digestate production, and possible synergistic effects. BW co-digestion led to an additional production of 0.35 t total solids (TS) of dewatered sludge per ton TSadded in continuous and 0.23 t TS of dewatered sludge per ton of TSadded in batch experiments. The methane yield from BW was 441 L/kg TSadded in continuous experiments and 482 L/kg TSadded batch test. No synergistic effects were observed in both batch and continuous co-digestion experiments. Batch tests were found to be suitable for a rough estimation of the co-digestion economic efficiency key parameters. Continuous experiments are recommended to obtain more robust data. A cost-benefit analysis found that electricity production from co-digestion can generate savings of 88-170 €/t TSadded compared to grid purchase.


Subject(s)
Bioreactors , Methane , Anaerobiosis , Cost-Benefit Analysis , Digestion , Sewage
SELECTION OF CITATIONS
SEARCH DETAIL
...