Correction: Martel-Rodríguez et al. Long-Term Performance of a Hybrid-Flow Constructed Wetlands System for Urban Wastewater Treatment in Caldera de Tirajana (Santa Lucía, Gran Canaria, Spain). Int. J. Environ. Res. Public Health 2022, 19, 14871.

There was an error in the original publication [...].

Long-Term Performance of a Hybrid-Flow Constructed Wetlands System for Urban Wastewater Treatment in Caldera de Tirajana (Santa Lucía, Gran Canaria, Spain).

This paper describes the results that have been obtained in a real case study of a hybrid constructed wetlands system, which has been in continuous operation for over 11 years. The main aim of the study was to understand the long-term operation and efficiency of the system (which is situated in the municipality of Santa Lucía, Gran Canaria, Spain), which comprises two vertical-flow and one horizontal-flow constructed wetlands for the treatment of urban wastewater. The system, which was originally designed to treat a flow rate of 12.5 m3/day, with a load of 100 equivalent inhabitants, has been operating since its inauguration (July 2008), with a flow rate of almost 35 m3/day and a load of 400 equivalent inhabitants. Despite this, the mean total removal efficiencies during the study period (2014-2019) are optimal for a system of these characteristics, as follows: 92% for 5-day biochemical oxygen demand (BOD5), 89% for the chemical oxygen demand (COD), and 97% for the total suspended solids (TSS). The system efficiency, with respect to nutrient removal, was somewhat lower, resulting in 48% for total N and 35% for NH4. It has been confirmed with this study that this type of system is an appropriate, robust, resilient nature-based solution for the treatment of the wastewater that is generated in small communities, especially in zones with a warm climate, stable mean temperatures, and mild winters.

Características tromboelastográficas en pacientes con SARS-CoV-2: reporte de casos / Thromboelastographic characteristics in patients with SARS-CoV-2: case report / Características tromboelatográficas em pacientes com SARS-CoV-2: relatos de casos

Resumen: La frecuencia de eventos tromboembólicos de pacientes con enfermedad por coronavirus es alta, sin embargo aún se desconoce cuál es la manera adecuada de identificar a las personas con mayor riesgo de complicaciones trombóticas y definir quiénes pueden beneficiarse de un tratamiento más agresivo, más allá de la tromboprofilaxis estándar. Una gran proporción de pacientes en estado crítico con coronavirus tienen perfil de tromboelastografía hipercoagulable con daño relacionado a fibrinógeno y a la función plaquetaria, la mayoría de pacientes tiene una máxima amplitud elevada en la tromboelastografía. Se hizo una revisión de tromboelastogramas de 11 pacientes en estado crítico por SARS-CoV-2 para caracterizar su estado de coagulación. Se encontró 36.36% de hipercoagulabilidad en la tromboelastografía principalmente con citrato nativo a pesar del tratamiento con heparina de bajo peso molecular a dosis terapéutica. El perfil predominante hipercoagulable no se asoció a la función plaquetaria, ya que la MA (máxima amplitud) se mantuvo dentro de los límites normales.

Abstract: The frequency of thromboembolic events in patients with coronavirus disease is high, however it is still unknown what is the appropriate way to identify people at higher risk of thrombotic complications and define who can benefit from a more aggressive treatment, beyond the standard thromboprophylaxis. A large proportion of critically ill patients with coronavirus have a hypercoagulable thromboelastography profile with damage related to fibrinogen and platelet function; most patients have a high maximum amplitude on thromboelastography. A review of thromboelastograms of 11 critically ill patients due to SARS-CoV-2 was made to characterize their coagulation status. A 36.36% hypercoagulability was found in thromboelastography, mainly with native citrate, despite treatment with low molecular weight heparin at therapeutic doses. The predominant hypercoagulable profile was not associated with platelet function since the MA (maximum amplitude) remained within normal limits.

Resumo: A frequência de eventos tromboembólicos em pacientes com doença por coronavírus é alta, no entanto, ainda não se sabe qual é a forma adequada de identificar as pessoas com maior risco de complicações trombóticas e definir quem pode se beneficiar de um tratamento mais agressivo, além da tromboprofilaxia padrão. Uma grande proporção de pacientes críticos com coronavírus apresenta um perfil de tromboelastografia hipercoagulável com danos relacionados ao fibrinogênio e função plaquetária, a maioria dos pacientes apresentam uma amplitude máxima elevada na tromboelastografia. Foi feita uma revisão de tromboelastogramas de 11 pacientes en estado crítico devido a SARS-CoV-2 para caracterizar seu estado de coagulação. Encontrou-se hipercoagulabilidade de 36.36% na tromboelastografia, principalmente com citrato nativo, apesar do tratamento com heparina de baixo peso molecular em dose terapêutica. O perfil predominantemente hipercoagulável não foi associado à função plaquetária, uma vez que a AM (amplitude máxima) permaneceu dentro dos limites da normalidade.

Consenso de leucemia mieloide aguda en México / Mexican consensus in acute myeloid leukemia in Mexico

resumen está disponible en el texto completo

Abstract Acute myeloid leukemia (AML) comprises a heterogeneous group of hematopoietic cell neoplasms of myeloid lineage that arise from the clonal expansion of their precursors in the bone marrow, interfering with cell differentiation, leading to a syndrome of bone marrow failure. AML is a consequence of genetic and epigenetic changes (point mutations, gene rearrangements, deletions, amplifications, and arrangements in epigenetic changes that influence gene expression) in hematopoietic precursor cells, which create a clone of abnormal cells that are capable of proliferating but cannot differentiate into mature hematopoietic cells or undergo programmed cell death. The diagnosis requires more than 20% myeloid blasts in the bone marrow and certain cytogenic abnormalities. Treatment will depend on age, comorbidities, and cytogenetic risk among the most frequent.

Perfil tromboelastográfico en pacientes con neumonía por SARS-CoV-2 / Thromboelastographic profile in patients with SARS-CoV-2 pneumonia / Perfil da tromboelastografia em pacientes com pneumonia por SARS-CoV-2

Resumen: Introducción: La enfermedad por coronavirus 2019 (COVID-19) es una enfermedad viral causada por el síndrome agudo respiratorio severo coronavirus 2 (SARS-CoV-2). El riesgo de eventos trombóticos venosos (ETV), que aumenta en pacientes críticamente enfermos, probablemente sea aún mayor en aquéllos con SARS-CoV-2 y enfermedad crítica. Objetivos: Investigar el perfil hemostático mediante tromboelastograma (TEG) en pacientes con neumonía por COVID-19. Material y métodos: Estudio observacional, retrospectivo de un solo centro hospitalario. Se inscribieron retrospectivamente pacientes hospitalizados con diagnóstico de neumonía por COVID-19, se les realizó TEG a las 24 y 72 horas. Se realizó un análisis bivariado, para las variables cuantitativas continuas y discretas se emplearon las pruebas t de Student o U de Mann-Whitney. Para las variables categóricas y nominales se empleó la prueba de χ2 de Pearson. Además, se realizó una curva ROC (característica de funcionamiento del receptor) para determinar el punto de corte del índice de masa corporal (IMC) con mayor sensibilidad y especificidad con relación al desarrollo de alteraciones en el TEG. Después se realizó un análisis multivariado de regresión binaria logística, ajustado para las variables con significancia clínica y estadística. La significancia estadística se estableció como una p < 0.05 o < 5%. Resultados: Se incluyó un total de 66 pacientes, se observó un predominio del perfil hipercoagulable en 28 pacientes (42.4%) a las 24 horas y 20 (30.3%) a las 72 horas a pesar de dosis profiláctica de enoxaparina. Para determinar el punto de corte con mayor asociación entre el IMC y la presencia de trastorno en el TEG, se realizó una curva ROC, obteniendo un ABC de 64.7% (p = 0.003). Encontramos un odds ratio (OR) 1.8 por cada kilogramo de peso por arriba de un IMC > 26.2 kg/m2, para desarrollar hipercoagulabilidad. Conclusión: El alto porcentaje de pacientes con estado hipercoagulable e hiperfibrinogenemia podría condicionar un aumento de la formación y polimerización de fibrina que puede predisponer a la trombosis. La mayoría de la población en nuestro medio cuenta con sobrepeso u obesidad, por lo que probablemente tengan necesidad de un régimen más alto de anticoagulación. Dicho esquema de tromboprofilaxis no debe ser guiado por parámetros como dímero D, sino con una prueba más amplia del perfil hemostático como el TEG.

Abstract: Introduction: Coronavirus disease 2019 (COVID-19) is a viral disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The risk of venous thrombotic events (VTE), which is increased in critically ill patients, is likely to be even higher in those with SARS-CoV-2 and critical illness. Objectives: To investigate the haemostatic profile by TEG in patients with COVID-19 pneumonia. Material and methods: Observational, retrospective study of a single hospital centre. Patients hospitalised with a diagnosis of COVID-19 pneumonia were retrospectively enrolled and underwent thromboelastogram (TEG) at 24 and 72 hours. Bivariate analysis was performed, in which Student's t-tests or Mann-Whitney U-tests were used for continuous and discrete quantitative variables. For categorical and nominal variables, Pearson's χ2 test was used. In addition, a receiver operating characteristic (ROC) curve was performed to determine the body mass index (BMI) cut-off point with the highest sensitivity and specificity in relation to the development of TEG alterations. Subsequently, a multivariate logistic binary regression analysis was performed, adjusted for variables with clinical and statistical significance. Statistical significance was established as a p < 0.05 or < 5%. Results: A total of 66 patients were included, a predominance of hypercoagulable profile was observed in 28 patients (42.4%) at 24 hours and 20 (30.3%) at 72 hours despite prophylactic doses of enoxaparin. To determine the cut-off point with the strongest association between BMI and the presence of TEG disorder, a ROC curve was performed, yielding an ABC of 64.7% (p = 0.003). We found an odds ratio (OR) of 1.8 for each kilogram of weight above a BMI > 26.2 kg/m2, for developing hypercoagulability. Conclusion: The high percentage of patients with hypercoagulable status and hyperfibrinogenemia could lead to an increase in fibrin formation and polymerisation that may predispose to thrombosis. The majority of the population in our setting is overweight or obese and therefore probably requires a higher anticoagulation regimen. Such a thromboprophylaxis scheme should not be guided by parameters such as dimer D but by a broader haemostatic profile test such as TEG.

Resumo: Introdução: A doença de coronavírus 2019 (COVID-19) é uma doença viral causada pelo coronavírus 2 da síndrome respiratória aguda grave (SARS-CoV-2). O risco de eventos trombóticos venosos (ETV), que é aumentado em pacientes críticos, provavelmente será ainda maior naqueles com SARS-CoV-2 e doença crítica. Objetivos: Investigar o perfil hemostático por TEG em pacientes com pneumonia por COVID-19. Material e métodos: Estudo observacional retrospectivo de um único centro hospitalar. Pacientes hospitalizados diagnosticados com pneumonia por COVID-19 foram incluídos retrospectivamente, tromboelastograma (TEG) foi realizado em 24 e 72 horas. Realizou-se análise bivariada, para variáveis ​​quantitativas contínuas e discretas, foram utilizados os testes t de Student ou U de Mann-Whitney. Para variáveis ​​categóricas e nominais, foi utilizado o teste χ2 de Pearson. Além disso, foi realizada uma curva ROC (receiver operating characteristic) para determinar o ponto de corte do índice de massa corporal (IMC) com maior sensibilidade e especificidade em relação ao desenvolvimento de alterações do TEG. Posteriormente, realizou-se análise de regressão binária logística multivariada, ajustada para as variáveis ​​com significância clínica e estatística. A significância estatística foi estabelecida como p < 0.05 ou < 5%. Resultados: Foram incluídos 66 pacientes, sendo observado predomínio do perfil hipercoagulável em 28 pacientes (42.4%) em 24 horas e 20 (30.3%) em 72 horas apesar da dose profilática de enoxaparina. Para determinar o ponto de corte com maior associação entre o IMC e a presença de alteração no TEG, foi realizada uma curva ROC, obtendo-se uma AUC de 64.7% (p = 0.003). Encontramos um Odds Ratio (OR) de 1.8 para cada quilograma de peso acima de um IMC > 26.2 kg/m2, para desenvolver hipercoagulabilidade. Conclusão: O alto percentual de pacientes com estado de hipercoagulabilidade e hiperfibrinogenemia pode condicionar um aumento na formação e polimerização de fibrina que pode predispor à trombose. A maioria da população em nosso meio está acima do peso ou obesa, então eles provavelmente precisam de um regime de anticoagulação mais alto. Esse esquema de tromboprofilaxia não deve ser guiado por parâmetros como o D-dímero, mas sim com um teste mais amplo do perfil hemostático como o TEG.

Acute Promyelocytic Leukemia: A Long-Term Retrospective Study in Mexico.

BACKGROUND: The present retrospective study reviewed acute promyelocytic leukemia (APL) cases recorded in Mexico between January 2007 and January 2017. The primary objective of the study was to evaluate overall survival (OS) in Mexican patients with APL. Secondary objective was to evaluate the impact of induction treatment with different anthracyclines on OS, event-free survival (EFS) and complications in this patient population. METHODS: The medical charts of patients referred to medical institutions in Mexico from January 2007 through January 2017 for the treatment of suspected APL were reviewed retrospectively. Patients aged 15 - 75 years, in whom the diagnosis of APL was confirmed, who had an Eastern Cooperative Group performance status of 0 - 2, and who were eligible for combined treatment with intensive chemotherapy and all-trans retinoic acid (ATRA), were included in the study. Study participants received induction and consolidation treatment with ATRA plus either daunorubicin or idarubicin, followed by 2 years of single-agent ATRA as maintenance therapy. Patients who were unable to pay for ATRA treatment received anthracycline-based induction and consolidation, with methotrexate plus mercaptopurine as maintenance therapy. RESULTS: A total of 360 patients from 21 public and private hospitals were included in the study. The median age of the population was 37 years, and 51% were male. Of the 360 patients, 205 (57%) vs. 155 (43%) received daunorubicin vs. idarubicin as induction treatment for APL. ATRA was administered to 201 (98%) patients in the daunorubicin group vs. 138 (89%) in the idarubicin group (P = 0.001), and was initiated at diagnosis in 92% vs. 73% of recipients, respectively (P = 0.0001). At 150 months, OS and EFS for the entire population were 84% and 79%, respectively. Both OS (90% vs. 76%, P = 0.003) and EFS (85% vs. 72%, P = 0.001) were significantly prolonged in daunorubicin vs. idarubicin recipients. Rates of complications were similar in the two groups. CONCLUSIONS: As arsenic trioxide (ATO) is not currently available in Mexico, anthracycline plus ATRA is the mainstay of treatment for APL here. Our results confirm the efficacy of this strategy, with high OS and EFS rates being observed 12.5 years after diagnosis.

Epidemiology and Clinical Characteristics of Non-Hodgkin Lymphoma in Mexico.

BACKGROUND: There is no epidemiological registry in Mexico. The information about the epidemiology in our country is obtained by these types of studies, such as multicentric studies. A lot of improvements in the survival in non-Hodgkin lymphoma patients had occurred in the last 20 years. The access to treatment in these types of pathology could change the prognostic factors in Mexican Mestizos patients. The primary objective of the study was to learn what the most frequent histological varieties of non-Hodgkin lymphoma in Mexico are. The secondary objectives included clinical characteristics, treatments used, treatment response, disease-free survival and overall survival. METHODS: A retrospective, descriptive study of consecutive cases was carried out in 14 hospitals across 14 Mexican states with patients diagnosed with non-Hodgkin lymphoma using the World Health Organization (WHO) 2008 criteria. Inclusion criteria included: ≥ 18 years of age, male or female, any clinical stage at diagnosis, who had received any chemotherapy regimen, with a known outcome. Descriptive statistics was performed for all variables, and survival was assessed using Kaplan-Meier curves. RESULTS: Totally, 609 patients were enrolled, of which 545 were B-cell lymphomas and 64 were T-cell lymphomas. Median ages were 61 and 50, respectively. B-cell lymphomas were more common in males with 52.1%, and 65.5% of T-cell lymphomas occurred in females. For B-cell lymphomas, the two most frequent histological subtypes were diffuse large B-cell lymphoma in 63.9%, followed by follicular lymphoma at 18%. Meanwhile, 50% of T-cell lymphomas were of the T/natural killer (NK) subtype, and 87.1% of the patients received a CHOP-like regimen. Radiotherapy was given to 31% of B-cell Lymphomas and 46.9% of T-cell lymphomas. Overall survival at 9 years was 84.6% for B-cell lymphomas, and 73.4% for T-cell lymphomas. CONCLUSIONS: Diffuse large B-cell lymphoma constitutes the most frequent subtype for B-cell lymphomas in Mexico. The most frequent T-cell lymphoma is the NK/T histological subtype.

Schwannoma: Differential diagnosis of a subepithelial gastric lesion. Two case report.

The pre-operative differential diagnosis of gastric subepithelial lesions is complex. We can find pathologies with a very different behavior. Some of them, like gastrointestinal (GI) stromal tumors, can present a malignant behavior, and others like schwannomas are practically benign. Schwannomas of the GI tract originate from the Schwann cells of the Auerbach plexus and their most frequent location is the stomach. The definitive diagnosis is made by immunohistochemical analysis of the surgical specimen and its resection is curative. We report two cases of gastric subepithelial lesions with a definitive diagnosis of schwannoma.

El diagnóstico diferencial preoperatorio de las lesiones subepiteliales gástricas es complejo. Podemos encontrar patologías con un comportamiento muy diferente. Algunas de ellas, como los GIST (gastrointestinal stromal tumours), pueden presentar un comportamiento maligno, y otras, como los schwannomas, son prácticamente benignas. Los schwannomas del tracto gastrointestinal se originan de las células de Schwann del plexo de Auerbach y su localización más frecuente es el estómago. El diagnóstico definitivo se realiza mediante el análisis inmunohistoquímico de la pieza quirúrgica, y su resección es curativa. Reportamos dos casos de lesiones subepiteliales gástricas con diagnóstico definitivo de schwannoma.

[Satisfaction, health and work-related stress of the university professorship according to their contractual status]. / Satisfacción, salud y estrés laboral del profesorado universitario según su situación contractual.

OBJECTIVE: There's a lot of literature about teachers' work conditions and the effects of such conditions on them. The goal of this research focuses on the analysis of the effects derived from the type of labour relationship with the University on the psycho-social dimensions of satisfaction, stress and perceived health. METHODS: Quasi-experimental study on a sample of 145 university professors from the seven public universities from Catalonia (Spain). The data was obtained in April 2014, by means of ISTAS21 questionnaire, intermediate version, in Spanish. From the 21 subscales in the instrument, only seven were used for data-gathering since they encompassed the dimensions of interest. A series of ANOVA analyses were performed, taking the three psycho-social dimensions as dependent variables and work stability and dedication (e.g. full- vs. partial-time) as independent variables. RESULTS: Professors with full-time work and unstable contracts showed worse health (both physical and mental) despite being the youngest, as well as larger symptoms of stress and lower job-satisfaction, compared with full-time professors with stable contracts and even compared part-time-jobs professors. CONCLUSION: Job-stability seems to be a central variable in work-quality and health for the professors whose labour situation is unstable, something that influences both their teaching and research quality.

OBJETIVO: Analizar los efectos de la estabilidad contractual de los profesores universitarios en las dimensiones psicosociales de satisfacción, salud y estrés. MÉTODO: Estudio descriptivo cuasi-experimental, tomando como muestra a 145 profesores de siete universidades públicas catalanas. El estudio se realizó durante el mes de abril de 2014. Se utilizó como base el cuestionario ISTAS21, versión media, en lengua castellana, del Cuestionario Psicosocial de Copenhaguen. De las 21 escalas incluidas, sólo se han tenido en cuenta las siete escalas relacionadas con los factores evaluados. Se realizaron una serie de análisis de varianza (ANOVA) considerando las puntuaciones obtenidas en las tres dimensiones psicosociales evaluadas como variables dependientes y la estabilidad laboral (permanencia y dedicación laboral) como variable independiente. RESULTADOS: Los profesores de tiempo completo con contratos laborales temporales muestran una peor salud física y mental -a pesar de ser el grupo más joven-, mayores síntomas de estrés y una menor satisfacción laboral, en comparación con profesores a tiempo completo y contrato estable; o profesores de tiempo parcial. CONCLUSIONES: La estabilidad laboral tiene repercusiones en la salud y calidad de vida laboral de los profesores que se encuentran en situación de inestabilidad, teniendo ello además repercusiones en la docencia y la investigación.

Satisfacción, salud y estrés laboral del profesorado universitario según su situación contractual / Satisfaction, health and work-related stress of the university professorship according to their contractual status

RESUMEN Objetivo Analizar los efectos de la estabilidad contractual de los profesores universitarios en las dimensiones psicosociales de satisfacción, salud y estrés. Método Estudio descriptivo cuasi-experimental, tomando como muestra a 145 profesores de siete universidades públicas catalanas. El estudio se realizó durante el mes de abril de 2014. Se utilizó como base el cuestionario ISTAS21, versión media, en lengua castellana, del Cuestionario Psicosocial de Copenhaguen. De las 21 escalas incluidas, sólo se han tenido en cuenta las siete escalas relacionadas con los factores evaluados. Se realizaron una serie de análisis de varianza (ANOVA) considerando las puntuaciones obtenidas en las tres dimensiones psicosociales evaluadas como variables dependientes y la estabilidad laboral (permanencia y dedicación laboral) como variable independiente. Resultados Los profesores de tiempo completo con contratos laborales temporales muestran una peor salud física y mental -a pesar de ser el grupo más joven-, mayores síntomas de estrés y una menor satisfacción laboral, en comparación con profesores a tiempo completo y contrato estable; o profesores de tiempo parcial. Conclusiones La estabilidad laboral tiene repercusiones en la salud y calidad de vida laboral de los profesores que se encuentran en situación de inestabilidad, teniendo ello además repercusiones en la docencia y la investigación.(AU)

ABSTRACT Objective There's a lot of literature about teachers' work conditions and the effects of such conditions on them. The goal of this research focuses on the analysis of the effects derived from the type of labour relationship with the University on the psycho-social dimensions of satisfaction, stress and perceived health. Methods Quasi-experimental study on a sample of 145 university professors from the seven public universities from Catalonia (Spain). The data was obtained in April 2014, by means of ISTAS21 questionnaire, intermediate version, in Spanish. From the 21 subscales in the instrument, only seven were used for data-gathering since they encompassed the dimensions of interest. A series of ANOVA analyses were performed, taking the three psycho-social dimensions as dependent variables and work stability and dedication (e.g. full- vs. partial-time) as independent variables. Results Professors with full-time work and unstable contracts showed worse health (both physical and mental) despite being the youngest, as well as larger symptoms of stress and lower job-satisfaction, compared with full-time professors with stable contracts and even compared part-time-jobs professors. Conclusion Job-stability seems to be a central variable in work-quality and health for the professors whose labour situation is unstable, something that influences both their teaching and research quality.(AU)