Necrosis grasa subcutánea múltiple: correlación ecográficohistopatológica. Multiple encapsulated fat necrosis: histopathological relation to ultrasound findings.

Encapsulated fat necrosis is a benign entity that has multiple possible conditions in the differential diagnosis. Because of this, the ultrasound and histological studies become highly relevant. We present a 14-year-old boy with this condition who exhibited numerous nodules that were detected after an intentional weight loss of 20kg. The ultrasound and histopathological examinations were necessary to confirm the diagnosis. Even though there is not a clear traumatic record in all cases, trauma constitutes the main hypothesis for its development, by decreasing the blood supply to the adipose tissue lobules and causing subsequent ischemic necrosis. Similar lesions have been described in the omentum and in the breast after surgical procedures or invasive diagnostic tests. In the ultrasound study, at least three presentation patterns have been described, which might match the three histological states, from early fat tissue degeneration to ultimate necrosis and even calcification. It is important to know the clinical characteristics, the ultrasound patterns, and the histological findings of this condition for an accurate diagnosis.

Eccrine Porocarcinoma: Patient Characteristics, Clinical and Histopathologic Features, and Treatment in 7 Cases. / Porocarcinoma ecrino: aspectos demográficos, clínicos, histopatológicos y terapéuticos en una serie de 7 pacientes.

Eccrine porocarcinoma is a rare, malignant cutaneous adnexal tumor that arises from the ducts of sweat glands. Found mainly in patients of advanced age, this tumor has diverse clinical presentations. Histology confirms the diagnosis, detects features relevant to prognosis, and guides treatment. Growth is slow, but the prognosis is poor if the tumor metastasizes to lymph nodes or visceral organs. We report 7 cases of eccrine porocarcinoma, describing patient characteristics, the clinical and histopathologic features of the tumors, and treatments used. Our observations were similar to those of other published case series. Given the lack of therapeutic algorithms or protocols for this carcinoma, we propose a decision-making schema based on our review of the literature and our experience with this case series. The algorithm centers on sentinel lymph node biopsy and histologic features.

Total ammoniacal nitrogen biofiltration of wastewaters from aquaculture systems using Macrocystis spp.

The results of total ammoniacal nitrogen (NH(3) + NH(4) (+)) removal in aquaculture systems using two experimental sets, aquatic seedlings produced in laboratory controlled conditions and wild seaweed (Macrocystis spp.) in reproductive state, are shown in this work. Biofiltration assays were carried out using a load of total ammoniacal nitrogen (TAN) of 1 mg/L. Absorption rates were measured taking into account a previous surface characterization, which gave values of 44 ± 14 cm(2)/g and 18 ± 6 cm(2)/g for aquatic seedlings and wild algae, respectively. The following parameters were measured during the experimental runs: temperature, pH, O(2), illuminance or light intensity, salinity and total solids. TAN removals of 61% and 70% were achieved for the seedlings and Macrocystis spp., respectively, after 17 h of treatment. The TAN absorption results were expressed as a function of surface and mass achieving the following values: 3.0 nmol N cm(-2) h(-1) and 111 nmol N g(-1) h(-1) for the seedlings, and 6.9 nmol N cm(-2) h(-1) and 122.4 nmol N g(-1) h(-1) for the macroalgae. In the light of these biofiltration processes, the initial TAN concentration decreased by 90% for the seedlings and wild algae over approximately 110 and 41 h, respectively. In addition, TAN removals achieved with Macrocystis spp. were always higher than those obtained with aquatic seedlings for the same operating periods.

Influence of the food to microorganisms (F/M) ratio and temperature on batch anaerobic digestion processes with and without zeolite addition.

The main objective of this work was to evaluate the influence of the food to microorganisms (F/M) ratio and temperature on batch anaerobic digestion processes carried out with and without zeolite addition as a microbial carrier. Three laboratory-scale experimental runs were conducted using a synthetic substrate with a COD:N:P ratio of 500:5:1. The first run (I) was conducted at a constant temperature of 27°C, increasing the F/M ratio from 0.21 to 0.40 (g COD/g VSS). During the second run (II) the temperature and the F/M ratio increased from 27°C to 37°C and from 0.21 to 0.40, respectively. Finally, in the third experimental run (III) the F/M ratio achieved high values (1.92 and 1.30) either by varying the substrate concentration at a constant biomass concentration or by increasing the biomass concentration at a constant substrate concentration. Higher biomass growth rate, COD removal and methane production were found in the reactors with zeolite, especially at the highest F/M assayed during the first run. The highest ammonium removals were also achieved at the highest F/M ratio (0.40) in the reactors with zeolite. Within the range studied (25°C-37°C) in the reactors with zeolite operating at 37°C, the second run demonstrated the low influence of temperature on substrate consumption and ammonia removal, with 93% and 70% of COD and ammonia removal efficiencies, respectively. The third run corroborated the results previously obtained and fit the experimental results to simple kinetic models, the Monod model being the most adequate for predicting the behavior of the systems studied. The maximum specific microorganism growth rate (µ(max)) values for the reactors with zeolite were almost twice as high as those obtained for the reactors without zeolite for similar F/M ratios.

Evaluation of natural zeolite as microorganism support medium in nitrifying batch reactors: influence of zeolite particle size.

An evaluation of natural zeolite as a microorganism carrier in nitrifying reactors operated in batch mode was carried out. Specifically, the influence of zeolite particle sizes of 0.5, 1.0 and 2.0 mm in diameter on microorganism adherence to zeolite, ammonium adsorption capacity and the identification of microbial populations were assessed. The greatest amount of total biomass adhered was observed for a zeolite particle size of 1 mm (0.289 g) which was achieved on the 12th day of operation. The highest ammonium adsorption capacity was observed for a zeolite particle size of 0.5 mm, which was 64% and 31% higher than that observed for particle sizes of 1.0 and 2.0 mm, respectively. The maximum de-sorption values were also found for a zeolite particle size of 0.5 mm, although when equilibrium was reached the ammonium concentrations were similar to those observed for a zeolite particle size of 1.0 mm. It was also found that the experimental data on ammonium adsorption fitted very well to the Freundlich isotherm for the three particle sizes studied. Finally, the nitrifying reactors showed similar microbial populations independently of the particle size used as microorganism carrier. The dominant bacterial community was Gammaproteobacteria making up 80% of the total population found. Betaproteobacteria were also identified and made up 12% approx. of the total population. Ammonium Oxidant Betaproteobacteria and Nitrobacter were also detected.

The impact of ammonia nitrogen concentration and zeolite addition on the specific methanogenic activity of granular and flocculent anaerobic sludges.

This work presents the effect of ammonia nitrogen concentration and zeolite addition on the specific methanogenic activity (SMA) of different anaerobic sludges with various physical structures (granular and flocculent), operating in batch conditions. Piggery, malting production and urban sludges derived from full-scale anaerobic reactors were tested in the experiment as the source of inoculum in batch digesters. It was found that piggery sludge was the most affected by the increase of ammonia nitrogen concentration while malting producing and municipal sludges were less affected. In general, the addition of zeolite at doses in the range of 0.01-0.1 g/g VSS reduced the inhibitory effect of N-NH(4)(+) for piggery sludge (P.S.). For this sludge, the propionic:acetic ratio increased when the concentration of N-NH(4)(+) increased, indicating that methanogenesis was affected. Finally, a study of the microbial population involved in this study for P.S. by using 16S rRNA based molecular techniques revealed a presence of microorganisms following the order: Methanococcaceae > Methanosarcina > Methanosaeta.

Influence of heavy metal supplementation on specific methanogenic activity and microbial communities detected in batch anaerobic digesters.

Natural and modified zeolites (0.5-1.0 mm) from the Tasajera deposit in Cuba were used to enhance the anaerobic digestion process of synthetic substrates. Natural zeolites were modified by ionic exchange and by adsorption with nickel, cobalt and magnesium. The experiments were carried out by using an inoculum from a full-scale anaerobic reactor treating winery wastewater. Modified natural zeolites not only enhanced the anaerobic digestion process, but also increased the specific methanogenic activity (SMA) of the sludges. The textural and chemical surface characteristics of the modified zeolites were related to the process performance, volatile fatty acid (VFA) production and microbial communities found in the digesters. For the selected dose of modified zeolites [0.05 g/g of volatile suspended solids (VSS)], the lowest concentration was found for cobalt followed by nickel and magnesium. Based on the analyses of anaerobic biofilms, the heavy metal incorporated into the zeolite was shown to have a great influence on the predominance of species. For example, the presence of nickel and cobalt favoured Methanosaeta, while at the same dose magnesic zeolite stimulated the presence of Methanosarcina and sulfate-reducing bacteria (SRB). In digesters with modified zeolites and metal supplementations the values of SMA were higher than those obtained in the control and natural zeolite digesters.

Application of zeolites for biological treatment processes of solid wastes and wastewaters - A review.

This review reports the use of zeolites in biological processes such as anaerobic digestion, nitrification, denitrification and composting, review that has not been proposed yet. It was found that aerobic processes (activated sludge, nitrification, Anammox) use zeolites as ion-exchanger and biomass carriers in order to improve the seattlebility, the biomass growth on zeolite surface and the phosphorous removal. In the case of anaerobic digestion and composting, zeolites are mainly used with the aim of retaining inhibitors such as ammonia and heavy metals through ion-exchange. The inclusion of zeolite effect on mathematical models applied in biological processes is still an area that should be improved, including also the life cycle analysis of the processes that include zeolites. At the same time, the application of zeolites at industrial or full-scale is still very scarce in anaerobic digestion, being more common in nitrogen removal processes.

Elemental sulfur-based autotrophic denitrification in stoichiometric S0/N ratio: Calibration and validation of a kinetic model.

The inclusion of S0 hydrolysis in a kinetic model of autotrophic denitrification has been recently proposed; however the model has not been calibrated or validated yet. Thus, a new methodology was developed and applied to calibrate and validate this kinetic model for the first time. An inoculum adapted from a poultry wastewater treatment plant at stoichiometric S0/NO3- ratio was used. The model was calibrated with batch data (initial nitrate concentrations of 50 and 6.25 mg NO3--N/L) at an S0/N ratio = 2.29 mg S/mg N and validated with seven different batch data. The sensitivity analysis showed that the most sensitive parameters are related to S0 hydrolysis. The kinetic model was successfully calibrated with the new methodology and validated, with Theil inequality coefficient values lower than 0.21. Thus, the proposed model and methodology were proved to be well suited for the simulation of elemental sulfur-based autotrophic denitrification in batch systems.

[Dermatological emergencies: a cross-sectional study of a hospital of intermediate complexity]. / Urgencias dermatológicas: estudio transversal de un hospital de complejidad intermedia.

OBJECTIVE: To determine if the introduction of some referral criteria in the dermatology emergency department has changed the number of patients referred from the emergency department, as well as the type of diseases, and the profile of the patient who uses this service. MATERIAL AND METHODS: A cross-sectional study was conducted on all consecutive patients attended in the emergency department of the Hospital Príncipe de Asturias during a 31-day period from March 2015 to May 2015 and in the same period in 2016. Variables collected were: gender, age, days from the onset, day of the week, complementary diagnostic tests, referral, reason for consultation, diagnosis and group, whether or not they met the criteria, destination, and whether or not they had a previous appointment. RESULTS: A total of 525 patients were seen in dermatology emergency department in 2015, and 371 in 2016 (P<.001). Of the 896 patients seen 55.7% were women and 44.3% men (14.45 patients per day). A total of 121 diagnoses were made, with the most common being: other dermatitis, drug reactions, and atopic dermatitis. Only 32 pathologies made up 70% of the diagnoses. More than half (51.6%) did not meet the referral criteria. CONCLUSIONS: The introduction of referral criteria has led to a reduction of 30% in the number of patients in 2016. The main diagnoses in both groups were other dermatitis and drug reactions. The profile of the patient is in accordance with the description in the literature.

Treatment of wastewater from red and tropical fruit wine production by zeolite anaerobic fluidized bed reactor.

A study of the anaerobic treatment of wastewaters derived from red (RWWW) and tropical fruit wine (TFWWW) production was carried out in four laboratory-scale fluidized bed reactors with natural zeolite as bacterial support. These reactors operated at mesophilic temperature (35 degrees C). Reactors R1 and R2 contained Chilean natural zeolite, while reactors R3 and R4 used Cuban natural zeolite as microorganism support. In addition, reactors R1 and R3 processed RWWW, while reactors R2 and R4 used TFWWW as substrate. The biomass concentration attached to zeolites in the four reactors studied was found to be in the range of 44-46 g volatile solids (VS)/L after 90 days of operation time. Both types of zeolites can be used indistinctly in the fluidized bed reactors achieving more than 80%-86% chemical oxygen demand (COD) removals for organic loading rates (OLR) of up to at least 20 g COD/L d. pH values remained within the optimal range for anaerobic microorganisms for OLR values of up to 20 and 22 g COD/L d for RWWW and TFWWW, respectively. Toxicity and inhibition levels were observed at an OLR of 20 g COD/L d in reactors R1 and R3 while processing RWWW, whereas the aforementioned inhibitory phenomena were not observed at an OLR of 24 g COD/L d in R2 and R4, treating TFWWW as a consequence of the lower phenolic compound content present in this substrate. The volatile fatty acid (VFA) levels were always lower in reactors processing TFWWW (R2 and R4) and these values (< 400 mg/L, as acetic acid) were lower than the suggested limits for digester failure. The specific methanogenic activity (SMA) was twice as high in reactors R2 and R4 than in R1 and R3 after 120 days of operation when all reactors operated at an OLR of 20 g COD/L d.

Anaerobic fluidized bed reactor application to tropical fruit wine effluent.

The influence of the organic loading rate (OLR), the fluidization level (FL) and the particle diameter of natural zeolite used as support (D(p)), was evaluated at a laboratory scale anaerobic fluidized bed reactor (AFBR), treating tropical fruit wine effluent (vinasse). The experiment was carried out at an OLR from 2-5 kg COD/m3 d, FL of 20 and 40% and D(p) from 0.25 to 0.80 mm. It was demonstrated that OLR and FL had a slight influence on chemical oxygen demand removal and strong influence on the methane production rate. The COD removal was slightly higher for the higher particle diameter used. Additionally using the scanning electron microscope (SEM), it was observed that natural zeolites have excellent physical characteristics as a support medium in AFBR.

Use of solid residue from thermal power plant (fly ash) for enhancing sewage sludge anaerobic digestion: Influence of fly ash particle size.

The influence of fly ash particle size on methane production and anaerobic biodegradability was evaluated. Assays with different fly ash particle sizes (0.8-2.36mm) at a concentration of 50mg/L were ran under mesophilic conditions. In anaerobic processes operating with fly ash, greater removal of both volatile total and suspended solids, chemical oxygen demand (total and soluble) was achieved, with an increase of methane production between 28% and 96% compared to the control reactors. The highest increase occurred at ash particles sizes of 1.0-1.4mm. The metal concentrations in the digestates obtained after anaerobic digestion of sewage sludge are far below those considered as limiting for the use of sludge in soils.

Solid mining residues from ni extraction applied as nutrients supplier to anaerobic process: optimal dose approach through Taguchi's methodology.

The use of solid mining residues (Cola) which contain a certain amount of Ni, Fe and Co, to stimulate anaerobic processes was evaluated. The effect over methane production and chemical oxygen demand (COD) removal efficiency was analysed. The studies were carried out in discontinuous reactors at lab scale under mesophilic conditions until exhausted. 0, 3, 5 and 7 mg Cola l(-1) doses were applied to synthetic wastewater. Volatile fatty acids (VFA) and sucrose were used as substrate, sulphur and nitrogen concentration, being the noise variable. Cola addition at dose around 5 mg I(-1), turned out to be stimulating for the anaerobic process. It was the factor that most influenced on methane production rate together with VFA and high content of volatile suspended solids. In the case of methane yield, pH was the control factor of strongest influence. Higher values of COD removal efficiency were obtained when the reactors were operated with sucrose at relatively low pH and at the smallest concentration of nitrogen and sulphur. Solid residues dose and the type of substrate were the factors that had most influence on COD removal efficiency.

E2F1 controls germ cell apoptosis during the first wave of spermatogenesis.

Cell cycle control during spermatogenesis is a highly complex process owing to the control of the mitotic expansion of the spermatogonial cell population and following meiosis, induction of DNA breaks during meiosis and the high levels of physiological germ-cell apoptosis. We set out to study how E2F1, a key controller of cell cycle, apoptosis, and DNA damage responses, functions in the developing and adult testis. We first analyzed the expression pattern of E2f1 during post-natal testis development using RNA in situ hybridization, which showed a differential expression pattern of E2f1 in the adult and juvenile mouse testes. To study the function of E2f1, we took advantage of the E2F1(-/-) mouse line, which was back-crossed to C57Bl/6J genetic background. E2f1 loss led to a severe progressive testicular atrophy beginning at the age of 20 days. Spermatogonial apoptosis during the first wave of spermatogenesis was decreased. However, already in the first wave of spermatogenesis an extensive apoptosis of spermatocytes was observed. In the adult E2F1(-/-) testes, the atrophy due to loss of spermatocytes was further exacerbated by loss of spermatogonial stem cells. Surprisingly, only subtle changes in global gene expression array profiling were observed in E2F1(-/-) testis at PND20. To dissect the changes in each testicular cell type, an additional comparative analysis of the array data was performed making use of previously published data on transcriptomes of the individual testicular cell types. Taken together, our data indicate that E2F1 has a differential role during first wave of spermatogenesis and in the adult testis, which emphasizes the complex nature of cell cycle control in the developing testis.

A detailed protocol for a rapid analysis of testicular cell populations using flow cytometry.

Accurate analysis and quantification of different testicular cell populations are of central importance in studies of male reproductive biology. The traditional histomorphometric and immunohistochemical methods remain the gold standard in studying the complex dynamics of the testicular tissue. Through past years advances have been made in the application of flow cytometry for the rapid analysis of testicular cell populations. Detection of DNA content and of surface antigens and fluorescent reporters have been widely used to analyze and sort cells. Detection of intracellular antigens can broaden the possibilities of applying flow cytometry in studies of male reproduction. Here, we report a detailed protocol for the preparation of rat testicular tissue for detection of intracellular antigens by flow cytometry, and a pipeline for subsequent data analysis and troubleshooting. Rat testicular ontogenesis was chosen as the experimental model to validate the performance of the assay using vimentin and γH2AX as intracellular markers for the somatic and spermatogenic cells, respectively. The results show that the assay is reproducible and recapitulates the rat testis ontogenesis.

Monounsaturated fatty acid (avocado) rich diet for mild hypercholesterolemia.

To assess the effect of a high monounsaturated fatty acids (MFA) diet on serum lipids, 30 healthy adult normolipidemic volunteers and 37 adult patients with mild hypercholesterolemia (5.4-9.3 mmol/l), 15 of them also with hypertriglyceridemia (2.3-4.8 mmol/l), were studied. Fifteen healthy and 30 hypercholesterolemic subjects (15 of them with associated type 2 diabetes mellitus) received an avocado enriched diet (2000 Kcal, lipids 53% MFA 49 g saturated/unsaturated ratio 0.54), and seven non-diabetic hypercholesterolemic individuals received an isocaloric control diet (MFA 34 g, saturated/unsaturated ratio 0.7). Serum total cholesterol, LDL-cholesterol, HDL-cholesterol and triglyceride concentrations were measured before and after a 7-day diet period. In healthy individuals a 16% decrease of serum total cholesterol level followed the high MFA diet, while it rose after the control diet (p < 0.001 between diets). In hypercholesterolemic subjects a significant (p < 0.01) decrease of serum total cholesterol (17%), LDL-cholesterol (22%) and triglycerides (22%), and increase of HDL-cholesterol (11%) levels occurred with the avocado diet, while no significant changes were noticed with the control diet. High lipid, high MFA-avocado enriched diet can improve lipid profile in healthy and especially in mild hypercholesterolemic patients, even if hypertriglyceridemia (combined hyperlipidemia) is present.