La Defensa Pasiva y su división médica de emergencia / Passive Defense and its emergency medical division / Passive Defence e sua divisão médica de emergência

Durante la Segunda Guerra Mundial el gobierno de Uruguay intentó prepararse para una eventual defensa militar del territorio y la defensa de la población civil en caso de sufrir ataques aéreos. La Defensa Pasiva, fue la estructura gubernamental que junto a la voluntad en todas las clases sociales, funcionó en todo el territorio nacional con la finalidad de proteger a la población civil de los ataques aéreos y guerra química, generando un espíritu de solidaridad a través de su División Médica de Emergencia.

During the Second World War, the government of Uruguay tried to prepare for an eventual military defense of the territory and the defense of the civilian population in case of air raids. The Passive Defense was the governmental structure that, together with the will of every social class, operated throughout the national territory with the purpose of protecting the civilian population from air raids and chemical weapons, generating a spirit of solidarity through its Emergency Medical Division.

Durante a Segunda Guerra Mundial, o governo uruguaio tentou se preparar para uma eventual defesa militar do território e para a defesa da população civil em caso de ataques aéreos. A Defesa Passiva era a estrutura governamental que, juntamente com a vontade de todas as classes sociais, operava em todo o território nacional com o objetivo de proteger a população civil de ataques aéreos e da guerra química, gerando um espírito de solidariedade por meio de sua Divisão Médica de Emergência.

Higher Virulence of Diplodia seriata Isolates on Vines of cv. Cabernet Sauvignon Associated with 10-Year-Old Wood Compared to Young Tissue.

Botryosphaeria dieback (BD) occurs in young and old plants. In the field, the prevalence and severity of the disease increase proportionally with the age of vineyards. Among the pathogens that cause BD, Diplodia seriata is the most prevalent species in Chile and other countries with a Mediterranean climate. To date, no information is available on the susceptibility of adult wood to infection by this pathogen since most of the pathogenicity tests have been carried out on 1- or 2-year-old shoots or detached canes. Therefore, a pathogenicity test was carried out on plants under field conditions, with inoculations in 1-year-old shoots and 2- and 10-year-old wood in grapevine cv. Cabernet Sauvignon. A pathogenicity test was carried out with two isolates of D. seriata. The results for the plants show that D. seriata was significantly more aggressive on the 10-year-old than on the one- or two-year-old tissue, where the lesions were 4.3 and 2.3 cm on average, respectively. These results were compared with the lesions obtained from two-year-old canes after the isolates were activated in grape berries. Also, the Chilean isolates of D. seriata were compared phylogenetically with those from other countries, and no major differences were found between them. Our results are consistent with the damage observed in the field, contributing to the knowledge of the epidemiology of this disease in Mediterranean climates. In the future, the effect observed in cv. Cabernet Sauvignon with D. seriata on virulence at different tissue ages should be tested for other BD-causing agents and wine varieties.

Treatment completion among justice-involved youth engaged in behavioral health treatment studies in the United States: A systematic review and meta-analysis.

Justice-involved youth (JIY) have high rates of behavioral health disorders, but few can access, much less complete, treatment in the community. Behavioral health treatment completion among JIY is poorly understood, even within treatment studies. Measurement, reporting, and rates of treatment completion vary across studies. This systematic review and meta-analysis synthesizes the literature on rates of treatment completion among JIY enrolled in research studies and identifies potential moderators. After systematically searching 6 electronic databases, data from 13 studies of 20 individual treatment groups were abstracted and coded. A meta-analysis examined individual prevalence estimates of treatment completion in research studies as well as moderator analyses. Prevalence effect sizes revealed high rates of treatment completion (pr = 82.6). However, analysis suggests a high likelihood that publication bias affected the results. Treatment groups that utilized family- or group-based treatment (pr = 87.8) were associated with higher rates of treatment completion compared to treatment groups utilizing individual treatment (pr = 61.1). Findings suggest that it is possible to achieve high rates of treatment completion for JIY, particularly within the context of family- and group-based interventions. However, these findings are limited by concerns about reporting of treatment completion and publication bias.

Implementation of a Brief Dialectical Behavioral Therapy Skills Group in High Schools for At-Risk Youth: Protocol for a Mixed Methods Study.

BACKGROUND: Adolescence is a developmental period marked by engagement in risk-taking behaviors, especially among impulsive or emotionally dysregulated youth. Thus, interventions that teach skills to reduce the risk of negative outcomes associated with emotional dysregulation are required. Social and emotional learning (SEL) programs have been developed to address both adolescent emotional dysregulation and risk-taking behaviors; however, current programs have mostly been implemented among younger youth and are used as a tier 1 universal intervention rather than a targeted tier 2 intervention for youth identified with emotional regulation difficulties. OBJECTIVE: This study aimed to address the need for SEL programming that can be delivered in schools, particularly for older youth who have difficulties with emotional or behavioral dysregulation, to reduce the risk of health-risk behaviors among this population. METHODS: Here, we outline the implementation of an SEL intervention titled Going 4 Goals, a 9-session adaptation of the Dialectical Behavioral Therapy for Adolescents (DBT-A) program delivered to at-risk high school students in a school setting. The primary objectives of the study are to test whether participating in the skills group intervention produces significant increases in the core DBT-A skills of mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness, while also producing significant decreases in substance use and risky behaviors. These primary outcomes are based on changes in participant scores between baseline and after the intervention and follow-ups at 1, 3, and 6 months compared with a control group of youth participating in the school's health curriculum at the same time points. Qualitative interviews will also be conducted with intervention participants and school staff to examine acceptability and facilitators of and barriers to the intervention. RESULTS: A total of 171 participants across 13 groups had been enrolled in the intervention, with data collection ending December 2021. Data analysis will begin in the spring of 2022, with expected results to be published in the spring of 2023. CONCLUSIONS: This paper describes the protocol of the 9-session school-based adaptation of the DBT-A intervention and discusses the strengths and limitations of the study and future directions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/32490.

Do adolescents consider mind-body skills groups an acceptable treatment for depression: results from a pilot study.

BACKGROUND: Mind-Body Skills Groups (MBSGs) have shown promise in reducing adolescent depression symptoms; however, little is known about adolescents' perspectives on this treatment. The objective of this study was to understand the acceptability of a new treatment for depressed adolescents in primary care settings. METHODS: Adolescents participating in a 10-week MBSG treatment were interviewed to understand their perspectives on the acceptability and effectiveness of the treatment. Interviews were collected at post-intervention and at a 3-month follow-up visit. RESULTS: A total of 39 adolescents completed both the post-intervention and 3-month follow-up interview. At post-intervention and follow-up, 84% of adolescents stated the MBSGs helped them. When asked how the MBSGs helped them, 3 areas were identified: learning new MBSG activities and skills, social connection with others within the group, and outcomes related to the group. Many adolescents reported no concerns with the MBSGs (49% at post- intervention; 62% at follow-up). Those with concerns identified certain activities as not being useful, wanting the group to be longer, and the time of group (after school) being inconvenient. Most adolescents reported that their life had changed because of the group (72% at post-intervention; 61% at follow-up), and when asked how, common responses included feeling less isolated and more hopeful. CONCLUSIONS: Adolescents found the MBSGs to be helpful and acceptable as a treatment option for depression in primary care. Given the strong emphasis on treatment preference autonomy and the social activities within the group, MBSGs appear well-suited for this age group. TRIAL REGISTRATION: NCT03363750 ; December 6th, 2017.

Volatile Organic Compounds (VOCs) Produced by Gluconobacter cerinus and Hanseniaspora osmophila Displaying Control Effect against Table Grape-Rot Pathogens.

Table grapes (Vitis vinifera) are affected by botrytis bunch rot and summer bunch rot, the latter a complex disease caused by Botrytis cinerea, Aspergillus spp., Penicillium expansum and Rhizopus stolonifer. To search for biocontrol alternatives, a new bioproduct composed of Gluconobacter cerinus and Hanseniaspora osmophila, a consortium called PUCV-VBL, was developed for the control of fungal rots in table grapes. Since this consortium presents new biocontrol species, the effect of their VOCs (volatile organic compounds) was evaluated under in vitro and in vivo conditions. The VOCs produced by the PUCV-VBL consortium showed the highest mycelial inhibition against Botrytis cinerea (86%). Furthermore, H. osmophila was able to inhibit sporulation of A. tubingensis and P. expansum. VOCs' effect in vivo was evaluated using berries from Red Globe, Thompson Seedless and Crimson Seedless grapes cultivars, demonstrating a mycelial inhibition by VOCs greater than 70% for all evaluated fungal species. The VOC identification of the PUCV-VBL consortium was analyzed by solid-phase microextraction coupled to gas chromatography-mass spectrometry (SPME-GCMS). A total 26 compounds were identified, including 1-butanol 3-methyl, propanoic acid ethyl ester, ethyl acetate, phenylethyl alcohol, isobutyl acetate and hexanoic acid ethyl ester. Our results show that VOCs are an important mode of action of the PUCV-VBL biological consortium.

Patient Monitoring Alarms in an Intensive Care Unit: Observational Study With Do-It-Yourself Instructions.

BACKGROUND: As one of the most essential technical components of the intensive care unit (ICU), continuous monitoring of patients' vital parameters has significantly improved patient safety by alerting staff through an alarm when a parameter deviates from the normal range. However, the vast number of alarms regularly overwhelms staff and may induce alarm fatigue, a condition recently exacerbated by COVID-19 and potentially endangering patients. OBJECTIVE: This study focused on providing a complete and repeatable analysis of the alarm data of an ICU's patient monitoring system. We aimed to develop do-it-yourself (DIY) instructions for technically versed ICU staff to analyze their monitoring data themselves, which is an essential element for developing efficient and effective alarm optimization strategies. METHODS: This observational study was conducted using alarm log data extracted from the patient monitoring system of a 21-bed surgical ICU in 2019. DIY instructions were iteratively developed in informal interdisciplinary team meetings. The data analysis was grounded in a framework consisting of 5 dimensions, each with specific metrics: alarm load (eg, alarms per bed per day, alarm flood conditions, alarm per device and per criticality), avoidable alarms, (eg, the number of technical alarms), responsiveness and alarm handling (eg alarm duration), sensing (eg, usage of the alarm pause function), and exposure (eg, alarms per room type). Results were visualized using the R package ggplot2 to provide detailed insights into the ICU's alarm situation. RESULTS: We developed 6 DIY instructions that should be followed iteratively step by step. Alarm load metrics should be (re)defined before alarm log data are collected and analyzed. Intuitive visualizations of the alarm metrics should be created next and presented to staff in order to help identify patterns in the alarm data for designing and implementing effective alarm management interventions. We provide the script we used for the data preparation and an R-Markdown file to create comprehensive alarm reports. The alarm load in the respective ICU was quantified by 152.5 (SD 42.2) alarms per bed per day on average and alarm flood conditions with, on average, 69.55 (SD 31.12) per day that both occurred mostly in the morning shifts. Most alarms were issued by the ventilator, invasive blood pressure device, and electrocardiogram (ie, high and low blood pressure, high respiratory rate, low heart rate). The exposure to alarms per bed per day was higher in single rooms (26%, mean 172.9/137.2 alarms per day per bed). CONCLUSIONS: Analyzing ICU alarm log data provides valuable insights into the current alarm situation. Our results call for alarm management interventions that effectively reduce the number of alarms in order to ensure patient safety and ICU staff's work satisfaction. We hope our DIY instructions encourage others to follow suit in analyzing and publishing their ICU alarm data.

Hourly Relationship between Reference Evapotranspiration and Shoot Shrinkage in Walnut Trees and Pomegranate under Deficit Irrigation.

Diameter fluctuations of branches, shoots, or fruits are related to plant transpiration and water potential. In the past, several models have related dendrometric variables and evapotranspiration on a daily scale. However, trunk-branch shrinkage occurs only between dawn and midday, while evapotranspiration occurs most of the day from sunrise to sunset. Previous models have failed to incorporate this key fact. The objective of the present study was to assess the relationship of hourly daily shrinkage (HDS) between dawn and the next 4 h to the hourly reference evapotranspiration (EToh) of the same period in walnut trees and pomegranate plants under different irrigation regimes. Our data show that the relationship between EToh and HDS is much better than several previous models that included maximum daily shrinkage (MDS) and reference evapotranspiration (ETo). The novel slope analysis of the relationship between HDS versus time used here corresponds to the velocity at which the HDS occurs, which depends on the ETo intensity at that moment. This new method of analyzing this type of data calls for a revision of these models and sets a new baseline for future analysis.

Mind-Body Skills Groups for Adolescents With Depression in Primary Care: A Pilot Study.

INTRODUCTION: The objective of this study was to determine the acceptability and preliminary effectiveness of Mind-Body Skills Groups (MBSGs) as a treatment for depressed adolescents in primary care. METHOD: A single-arm clinical trial was conducted. A 10-week MBSG program was implemented in primary care. Participants completed self-report measures at baseline, postintervention, and 3 months following the MBSGs. Measures included the Children's Depression Inventory-2, Suicidal Ideation Questionnaire, Mindful Attention Awareness Scale, Self-Efficacy for Depressed Adolescents, rumination subscale of the Children's Response Style Questionnaire, and a short acceptability questionnaire. RESULTS: Participants included 43 adolescents. The total depression scores significantly improved following the MBSG intervention and continued to improve significantly from posttreatment to follow-up. Mindfulness, self-efficacy, rumination, and suicidal ideation all had significant improvement following the intervention. Acceptability of the program was strong, and attendance was excellent. DISCUSSION: Preliminary evidence suggests that MBSGs are an acceptable treatment for primary care settings and lead to improved depression symptoms in adolescents.

Advanced determination of the spatial gradient of human health risk and ecological risk from exposure to As, Cu, Pb, and Zn in soils near the Ventanas Industrial Complex (Puchuncaví, Chile).

The townships of Puchuncaví and Quintero, on the coast of central Chile, have soils contaminated by atmospheric deposition of sulfur dioxide and trace elements from the nearby Ventanas Industrial Complex. The purpose of this study was to evaluate potential human health and ecological risks, by determining the spatial distribution of soil total concentrations arsenic (As), copper (Cu), lead (Pb), and zinc (Zn) in these townships. Total concentrations of these elements were determined in 245 topsoil samples, used to generate continuous distribution maps. The background concentrations of Cu, As, Pb, and Zn in the studied soils were 100, 16, 35, and 122 mg kg-1, respectively. The concentrations of Cu, As, and Pb were positively correlated with each other, suggesting that their source is the Ventanas copper smelter. On the other hand, correlations for Zn were weaker than for other trace elements, suggesting low impact of the Ventanas copper smelter on spatial distribution of Zn. Indeed, only 6% of the study area exhibited Zn concentrations above the background level. In contrast, 77, 32 and 35% of the study area presented Cu, As, and Pb concentrations, respectively, above the background level. The carcinogenic risk due to exposure to As was above the threshold value of 10-04 in the population of young children (1-5 years old) on 27% of the study area. These risk values are classified as unacceptable, which require specific intervention by the Chilean government. Based on the estimated concentrations of exchangeable Cu, 10, 15, and 75% of the study area exhibited high, medium, and low phytotoxicity risk, respectively.

Cell cycle arrest and cell death correlate with the extent of ischaemia and reperfusion injury in patients following kidney transplantation - results of an observational pilot study.

A prolonged cold ischaemia time (CIT) is suspected to be associated with an increased ischaemia and reperfusion injury (IRI) resulting in an increased damage to the graft. In total, 91 patients were evaluated for a delayed graft function within 7 days after kidney transplantation (48 deceased, 43 living donors). Blood and urine samples were collected before, immediately after the operation, and 1, 3, 5, 7 and 10 days later. Plasma and/or urine levels of total keratin 18 (total K18), caspase-cleaved keratin 18 (cc K18), the soluble receptor for advanced glycation end products (sRAGE), tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein-7 (IGFBP7) were measured. As a result of prolonged CIT and increased IRI, deceased donor transplantations were shown to suffer from a more distinct cell cycle arrest and necrotic cell death. Plasmatic total K18 and urinary TIMP-2 and IGFBP7 were therefore demonstrated to be of value for the detection of a delayed graft function (DGF), as they improved the diagnostic performance of a routinely used clinical scoring system. Plasmatic total K18 and urinary TIMP-2 and IGFBP7 measurements are potentially suitable for early identification of patients at high risk for a DGF following kidney transplantation from deceased or living donors.

Analysis of the Environmental Management System based on ISO 14001 on the American continent.

The American continent is in broad economic and industrial development. Consequently, a more detailed discussion of the impacts generated by such development is needed. Moreover, there is an increase in the number of ISO 14001 certificates issued to this continent. Given the above, no studies were found that bridge the gap to identify the influence of different factors on ISO 14001 in the Americas. Thus, this article has as its main aim to check which economic, environmental and cultural factors have influence on ISO 14001 Certification in the American Continent. The data were collected in the ISO Survey, World Bank, United Nations Development Programme and International Energy Agency. Among the countries of that continent, thirteen were analyzed and only two did not show the economic factors as the influence factor in the multiple regression models fitted with Brazil and the United State. In these models, all presented environmental factors as influencing factors. Only in Brazil the index HDI presented as cultural factor in multiple regression model fitted. The economic factors: Gross Domestic Product and exports of goods and services and environmental: Carbon Dioxide (CO2) and fossil fuel consumption were the most influential in ISO 14001 certification. Venezuela, Uruguay, Colombia and the United States were countries that had factors dependent on each other, featuring the environmental marketing. Briefly, this study brings up several implications: to the academy, with the proposal of new concepts and guidance on the factors that assist in ISO 14001 certification in the American Continent. Additionally, taking into account the industry, the factors serve as efficiency parameters for the implementation of ISO 14001 standard, and for the Government to improve through factors that do not fit in multiple regression models.

The role of unfractionated heparin for the antiaggregatory effect of aspirin in patients undergoing carotid endarterectomy: Results of an observational clinical study.

The aims of the present study were to examine the influence of a low-dose unfractionated heparin regime on platelet aggregation and to additionally assess the prevalence of primary aspirin resistance in patients undergoing carotid endarterectomy. Therefore, 50 patients undergoing carotid endarterectomy were enrolled. A bolus of 3000 IU unfractionated heparin was administered 2 min before carotid cross-clamping additionally to standard antiaggregatory therapy. Haemostaseological point of care testing was performed twice, prior to surgery and 10 min after unfractionated heparin administration by the use of aggregometric and viscoelastic point of care testing. Following unfractionated heparin administration, the activated partial thromboplastin time increased significantly and clotting time in viscoelastic INTEM test was shown to be significantly prolonged. In contrast, the antiaggregatory effect of aspirin was not diminished in aggregometric ASPI test. A low-dose unfractionated heparin regime during carotid endarterectomy was therefore considered to be safe, without diminishing the antiplatelet effect of aspirin. Moreover, aggregometric point of care testing was identified to be a suitable tool for the identification of patients with primary aspirin resistance ( n = 3).

[Caustics injuries in the upper gastrointestinal tract: clinical and endoscopic features]. / Lesiones por cáusticos del tracto digestivo superior: características clínicas y endoscópicas.

OBJECTIVE: To describe the clinical and endoscopic features of caustics injuries in the upper gastrointestinal tract in patients of the National Hospital Daniel Alcides Carrión. MATERIALS AND METHODS: A descriptive study was conducted; the study populations were patients diagnosed with caustic ingestion who were admitted into the Gastroenterology service of the HNDAC to perform an upper endoscopy during the period of January 2009 to December 2012. We documented the type of caustic substance ingested, cause of intake, amount ingested, intake mode, signs or symptoms present, endoscopic findings as classified by Zargar, presence of complications and treatment performed. Analysis was performed comparing them based on the ingested caustic type: acid or alkali. RESULTS: We obtained 91 patients; the average age was 30.6±16.3 years. Caustic substances ingested were: bleach (sodium hypochlorite) in 71 (78%) patients, muriatic acid (hydrochloric acid) in 18 (20%) patients, caustic soda in 2 (2%) patients. The average intake was 136ml (30-500 ml). The most frequent signs and symptoms were vomiting, abdominal pain, nausea and sore throat. The 46% of patients had injuries. 100% of patients who ingested acid and 33% who ingested alkali had lesions. Five (5%) patients had oropharyngeal lesions, 24 (26%) in the esophagus, 36 (40%) in the stomach and 12 (13%) in the duodenum. Grade I lesions were found in 10 (11%) patients, 16 (18%) patients with grade II lesions and 15 (16%) of patients with grade III, 12 patients who toke acid had lesions of grade III. Esophageal stricture was found in 2 (2%) patients, gastric stenosis in 7 (8%) patients and esophageal and gastric stenosis in 3 (3%) patients. Two patients required pneumatic dilation and 10 surgical treatments. CONCLUSION: Most injuries were found in the stomach. Acidic injuries occur more frequently and with greater severity than alkaline. Acidic substances produce esophageal or gastric stenosis more frequently than alkaline.

Lesiones por cáusticos del tracto digestivo superior: características clínicas y endoscópicas / Caustics injuries in the upper gastrointestinal tract: clinical and endoscopic features

Describir las características clínicas y endoscópicas de las lesiones producidas por cáusticos en el tracto digestivo superior en pacientes del Hospital Nacional Daniel Alcides Carrión. Materiales y métodos: Se realizó un estudio descriptivo, se incluyó a pacientes con diagnóstico de ingesta de cáusticos admitidos en el servicio de Gastroenterología del HNDAC para la realización de una endoscopia digestiva alta durante el periodo de enero del 2009 a diciembre del 2012. Se documentó el tipo de sustancia cáustica ingerida, causa de ingesta, cantidad ingerida, modo de ingesta, síntomas o signos presentes, hallazgos endoscópicos según la clasificación de Zargar, presencia de complicaciones y tratamiento realizado. Se realizó el análisis descriptivo comparándolos según la sustancia cáustica ingerida: ácido o álcali. Resultados: Se obtuvieron 91 pacientes, la edad promedio fue de 30,6 +/- 16,3 años. Las sustancias caústicas ingeridas fueron: lejía (hipoclorito de sodio) en 71 (78%) pacientes, ácido muriático (ácido clorhídrico) en 18 (20%) pacientes, soda cáustica en 2 (2%) pacientes. La cantidad promedio ingerida fue de 136ml (entre 30-500 ml). Los síntomas y signos más frecuentes fueron: vómitos, dolor abdominal, náuseas y odinofagia. El 46% de los pacientes presentaron lesiones. El 100% de los pacientes que ingirieron ácido y el 33% de los que ingirieron álcali presentaron lesiones. Cinco (5%) pacientes presentaron lesiones orofaríngeas, 24 (26%) en esófago, 36 (40%) en estómago y 12 (13%) en duodeno. Se encontró 10 (11%) pacientes con lesiones de grado I, 16 (18%) pacientes con lesiones de grado II y 15 (16%) de pacientes con lesiones de grado III; 12 pacientes que consumieron ácido presentaron lesiones de grado III. Estenosis esofágica se encontró en 2 (2%) pacientes, estenosis gástrica en 7 (8%) pacientes y estenosis esofágica y gástrica en 3 (3%) pacientes. Dos pacientes requirieron dilataciones neumáticas y 10 tratamiento quirúrgico...

To describe the clinical and endoscopic features of caustics injuries in the upper gastrointestinal tract in patients of the National Hospital Daniel Alcides Carrión. Materials and methods: A descriptive study was conducted; the study populations were patients diagnosed with caustic ingestion who were admitted into the Gastroenterology service of the HNDAC to perform an upper endoscopy during the period of January 2009 to December 2012. We documented the type of caustic substance ingested, cause of intake, amount ingested, intake mode, signs or symptoms present, endoscopic findings as classified by Zargar, presence of complications and treatment performed. Analysis was performed comparing them based on the ingested caustic type: acid or alkali. Results: We obtained 91 patients; the average age was 30.6 +/- 16.3 years. Caustic substances ingested were: bleach (sodium hypochlorite) in 71 (78%) patients, muriatic acid (hydrochloric acid) in 18 (20%) patients, caustic soda in 2 (2%) patients. The average intake was 136ml (30-500 ml). The most frequent signs and symptoms were vomiting, abdominal pain, nausea and sore throat. The 46% of patients had injuries. 100% of patients who ingested acid and 33% who ingested alkali had lesions. Five (5%) patients had oropharyngeal lesions, 24 (26%) in the esophagus, 36 (40%) in the stomach and 12 (13%) in the duodenum. Grade I lesions were found in 10 (11%) patients, 16 (18%) patients with grade II lesions and 15 (16%) of patients with grade III, 12 patients who toke acid had lesions of grade III. Esophageal stricture was found in 2 (2%) patients, gastric stenosis in 7 (8%) patients and esophageal and gastric stenosis in 3 (3%) patients. Two patients required pneumatic dilation and 10 surgical treatments...

Thresholds of copper phytotoxicity in field-collected agricultural soils exposed to copper mining activities in Chile.

It has been argued that the identification of the phytotoxic metal thresholds in soil should be based on field-collected soil rather than on artificially-contaminated soils. However, the use of field-collected soils presents several difficulties for interpretation because of mixed contamination and unavoidable covariance of metal contamination with other soil properties that affect plant growth. The objective of this study was to estimate thresholds of copper phytotoxicity in topsoils of 27 agricultural areas historically contaminated by mining activities in Chile. We performed emergence and early growth (21 days) tests (OECD 208 and ISO 11269-2) with perennial ryegrass (Lolium perenne L.). The total Cu content in soils was the best predictor of plant growth and shoot Cu concentrations, while soluble Cu and pCu(2+) did not well correlate with these biological responses. The effects of Pb, Zn, and As on plant responses were not significant, suggesting that Cu is a metal of prime concern for plant growth in soils exposed to copper mining activities in Chile. The effects of soil nutrient availability and shoot nutrient concentrations on ryegrass response were not significant. It was possible to determine EC10, EC25 and EC50 of total Cu in the soil of 327 mg kg(-1), 735 mg kg(-1) and 1144 mg kg(-1), respectively, using the shoot length as a response variable. However, the derived 95% confidence intervals for EC10, EC25 and EC50 values of total soil Cu were wide, and thus not allowing a robust assessment of metal toxicity for agricultural crops, based on total soil Cu concentrations. Thus, plant tests might need to be performed for metal toxicity assessment. This study suggests shoot length of ryegrass as a robust response variable for metal toxicity assessment in contaminated soils with different nutrient availability.

Joint-position sense is altered by football pre-participation warm-up exercise and match induced fatigue.

BACKGROUND: The demands to which football players are exposed during the match may augment the risk of injury by decreasing the sense of joint position. This study aimed to assess the effect of pre-participation warm-up and fatigue induced by an official football match on the knee-joint-position sense of football players. METHODS: Fourteen semi-professional male football players (mean age: 25.9±4.6 years old) volunteered in this study. The main outcome measures were rate of perceived exertion and knee-joint-position sense assessed at rest, immediately after a standard warm-up (duration 25 min), and immediately after a competitive football match (90 minutes duration). RESULTS: Perceived exertion increased significantly from rest to the other assessments (rest: 8.6±2.0; after warm-up: 12.1±2.1; after football match: 18.5±1.3; p<0.001). Compared to rest, absolute angular error decreased significantly after the warm-up (4.1°±2.2° vs. 2.0°±1.0°; p=0.0045). After the match, absolute angular error (8.7°±3.8°) increased significantly comparatively to both rest (p=0.001) and the end of warm-up (p<0.001). Relative error showed directional bias with an underestimation of the target position, which was higher after the football match compared to both rest (p<0.001) and after warm-up (p<0.001). CONCLUSIONS: The results indicate that knee-joint-position sense acuity was increased by pre-participation warm-up exercise and was decreased by football match-induced fatigue. CLINICAL RELEVANCE: Warm-up exercises could contribute to knee injury prevention, whereas the deleterious effect of match-induced fatigue on the sensorimotor system could ultimately contribute to knee instability and injury.

Methylglyoxal as a new biomarker in patients with septic shock: an observational clinical study.

INTRODUCTION: The role of reactive carbonyl species, such as methylglyoxal (MG), has been overlooked within the context of the sepsis syndrome. The aims of this study were to assess the impact of MG formation in different inflammatory settings and to evaluate its use for early diagnosis as well as prognosis of the sepsis syndrome. METHODS: In total, 120 patients in three groups were enrolled in this observational clinical pilot study. The three groups included patients with septic shock (n = 60), postoperative controls (n = 30), and healthy volunteers (n = 30). Plasma samples from patients with septic shock were collected at sepsis onset and after 24 hours and 4, 7, 14, and 28 days. Plasma samples from postoperative controls were collected prior to surgery, immediately following the end of the surgical procedure as well as 24 hours later and from healthy volunteers once. Plasma levels of MG were determined by high-performance liquid chromatography. Additionally, plasma levels of procalcitonin, C-reactive protein, soluble CD14 subtype, and interleukin-6 were determined. RESULTS: Patients with septic shock showed significantly higher plasma levels of MG at all measured times, compared with postoperative controls. MG was found to identify patients with septic shock more effectively-area under the curve (AUC): 0.993-than procalcitonin (AUC: 0.844), C-reactive protein (AUC: 0.791), soluble CD14 subtype (AUC: 0.832), and interleukin-6 (AUC: 0.898) as assessed by receiver operating characteristic (ROC) analysis. Moreover, plasma levels of MG in non-survivors were significantly higher than in survivors (sepsis onset: *P = 0.018 for 90-day survival; **P = 0.008 for 28-day survival). Plasma levels of MG proved to be an early predictor for survival in patients with septic shock (sepsis onset: ROC-AUC 0.710 for 28-day survival; ROC-AUC 0.686 for 90-day survival). CONCLUSIONS: MG was identified as a marker for monitoring the onset, development, and remission of sepsis and was found to be more useful than routine diagnostic markers. Further studies are required to determine the extent of MG modification in sepsis and whether targeting this pathway could be therapeutically beneficial to the patient. TRIAL REGISTRATION: German Clinical Trials Register DRKS00000505. Registered 8 November 2010.

[Rectal mucosal prolapse syndrome: study of cases. Hospital Daniel A Carrion, Lima, Peru, 2010-2013]. / Síndrome de prolapso de mucosa rectal: estudio de casos. Hospital Daniel A Carrión,Lima, Perú. 2010-2013.

OBJECTIVE: to describe the clinical, endoscopic, and histological characteristics of rectal mucosal prolapse syndrome, formerly known as Solitary rectal ulcer, in patients from a general hospital. MATERIAL AND METHODS: All patient diagnosed as rectal mucosal prolapse syndrome during 2010-2013 was selected; the medical history war reviewed and the histological slides were reevaluated by two pathologists. RESULTS: 17 cases of rectal mucosal prolapse syndrome were selected, the majority were males under 50 years, the most common clinical findings were rectal bleeding (82%) and constipation (65%), the endocopic findings were heterogeneous,: erythema (41%), ulcers (35%) and elevated lesions (29%). All cases presented fibromuscularhyperplasia in lamina propia and crypt distortion in the microscopic evaluation. CONCLUSION: In our study of rectal mucosal prolapse syndrome. The most common clinical findings were rectal bleeding and constipation. Erythematous mucosa was the most common endoscopic finding.