30-Day Mortality Following Palliative Radiotherapy.

PURPOSE: 30-day mortality (30-DM) is a parameter with widespread use as an indicator of avoidance of harm used in medicine. Our objective is to determine the 30-DM followed by palliative radiation therapy (RT) in our department and to identify potential prognosis factors. MATERIAL/METHODS: We conducted a retrospective cohort study including patients treated with palliative RT in our center during 2018 and 2019. Data related to clinical and treatment characteristics were collected. RESULTS: We treated 708 patients to whom 992 palliative irradiations were delivered. The most frequent primary tumor sites were lung (31%), breast (14.8%), and gastrointestinal (14.8%). Bone was the predominant location of the treatment (56%), and the use of single doses was the preferred treatment schedule (34.4%). The 30-DM was 17.5%. For those who died in the first month the median survival was 17 days. Factors with a significant impact on 30-DM were: male gender (p < 0.0001); Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) of 2-3 (p = 0.0001); visceral metastases (p = 0.0353); lung, gastrointestinal or urinary tract primary tumors (p = 0.016); and single dose RT (p = <0.0001). In the multivariate analysis, male gender, ECOG PS 2-3, gastrointestinal and lung cancer were found to be independent factors related to 30-DM. CONCLUSION: Our 30-DM is similar to previous studies. We have found four clinical factors related to 30-DM of which ECOG was the most strongly associated. This data may help to identify terminally ill patients with poor prognosis in order to avoid unnecessary treatments.

Management of swine mortalities through the use of a mixed composting-accelerating bio-inoculant.

A composting-accelerating bio-inoculant (Bacillus subtilis, Talaromyces sayulitensis (HC1), Steinernema sp., and Heterorhabditis sp.) was evaluated in a composting process made up of a different mix of wood chips, pig manure, urine, and swine mortality (raw material RM). Three different treatments (T1, T2, and T3) were assessed, and physicochemical, microbiological, and entomological evaluations were carried out at 0 and 45 days of the composting process. The highest organic nitrogen (1.34 %) concentration was detected in swine mortality, whereas the highest total oxidizable organic carbon (39.1 %) concentration was observed in wood chips. Salmonella spp., was not identified in any of the raw materials. Clostridium spp., count was 5.5, 2.0, and 1.0 Log10 unit, for pig manure, wood chips, and swine mortality, respectively. Pig manure, swine mortality, and wood chip total coliform count was 6.21, 5.32, and 1 Log10 unit, respectively. Helminth eggs were not detected in any of the RM and Cryptosporidium spp., oocysts were occasionally found in pig manure and wood chips. Several types of flies were identified, Musca domestica, Muscina stabulans, Stomoxys calcitrans, Fannia canicularis, Sarcophaga sp., and Calliphora sp. Treatment 3 (45.11 % swine mortality, 33.33 % wood chips, and 21.55 %, urine and bio-inoculant) had the greatest total oxidizable organic carbon availability, the highest carbon/nitrogen (C/N) ratio (20.67, p < 0.05), and the lowest dipterous larvae count. Moreover, Salmonella sp., was not observed and had only low Clostridium spp., and fecal coliform count. The bio-inoculant's effect on C/N ratio, cation exchange capacity, and electrical conductivity were beneficial, and resulted in production of a fertilizer complying with EPA 600/1-87-014, EPA 40 CFR Part 258, and NTC5167/11 norms. According to the characterization protocols used in this study the compost was apparently free from bacterial and parasitic pathogens and minimal dipteran counts. Last, maturation time was 15 days shorter compared with control (C4).

Alteraciones hematológicas como manifestación inicial del síndrome de Sjögren primario / Haematological changes as the initial manifestation of primary Sjögren's syndrome

RESUMEN Se presenta el caso de una mujer de 50 arios de edad con cuadro de hemorragia uterina anormal persistente, síndrome anémico secundario, astenia y adinamia, en quien se documenta bicitopenia con anemia normocítica normocrómica y trombocitopenia. Después de realizar un minucioso estudio de las causas de la bicitopenia, se diagnostica síndrome de Sjögren primario, en ausencia de síntomas secos.

ABSTRACT The case is presented of a woman 50 years old with persistent box abnormal uterine bleeding. She has secondary anaemia, adynamia, and asthenia, which is documented as microcytic normochromic anaemia and bicytopenia with thrombocytopenia. After conducting a thorough study of the causes of bicytopenia, the diagnosis of Sjögren's syndrome was made, in the absence of dry symptoms.