Changes of lung microbiome of acute respiratory distress syndrome before and after treatment under open airway / 中华危重病急救医学

Objective:To analyze the differences and similarities of pre-treatment and post-treatment lung microbiome of acute respiratory distress syndrome (ARDS) and find out the change rules of the lung microbiome in the progression of ARDS according to different prognosis.Methods:A retrospective study was conducted. Patients with ARDS caused by severe pneumonia admitted to intensive care unit (ICU) of Jiangmen Central Hospital from February 2019 to January 2020 were enrolled as the study subjects. The patients were divided into pre-treatment (ARDS-preT) group (24 cases), post-treatment survival (ARDS-poT-Survival) group (17 cases), and post-treatment death (ARDS-poT-Dead) group (7 cases). ICU patients with mild pulmonary infection and non-ARDS admitted to ICU during the same period were enrolled as control group (25 cases). The similarities and differences of lung microbiome in four groups were analyzed and compared, and the possible pathogenic bacteria (potential risk factors for death) and probiotics (potential survival and protective factors) related to death caused by ARDS were screened.Results:In terms of pathogenic microorganisms, the positive rates of Escherichia coli and Candida albicans in the ARDS-poT-Dead group were significantly higher than those in the ARDS-poT-Survival group [57.1% (4/7) vs. 5.9% (1/17) and 57.1% (4/7) vs. 0% (0/7), both P < 0.05]. In the screening of background bacteria, the decrease of bacteria in the ARDS-preT group compared with the ARDS-poT-Survival group, the ARDS-poT-Dead group compared with the ARDS-poT-Survival group, the ARDS-poT-Dead group compared with the control group, the reduced bacteria might be pulmonary probiotics (potential protective factor for ARDS). The screening result was Hydrobacter [ARDS-preT group vs. ARDS-poT-Survival group: 62.5% (15/24) vs. 94.1% (16/17); ARDS-poT-Dead group vs. ARDS-poT-Survival group: 14.3% (1/7) vs. 94.1% (16/17); ARDS-poT-Dead vs. control: 14.3% (1/7) vs. 96.0% (24/25), all P < 0.05]. In the screening of background bacteria, the increase of bacteria in the ARDS-poT-Dead group compared with the ARDS-preT group, the ARDS-poT-Dead group compared with the ARDS-poT-Survival group, the ARDS-poT-Dead group compared with the control group, and the increased bacteria might be potential pulmonary pathogen (potential risk factor for death of ARDS), which belonged to Enterobacteria: Edwardsiella, Enterobacteriaceae, Escherichia, Klebsiella, Kluyvera, Lelliottia, Pantoea, Raoultella. Conclusions:The results revealed the increase of Escherichia coli or Candida albicans in pulmonary pathogenic microorganisms, or the increase of Enterobacteria in background bacteria may be the risk factors for the death of ARDS. Additionally, background bacteria Hydrobacter probably is a protective factor for the survival of ARDS. Whether it can be used as a novel treatment for ARDS is worth further investigation.

Composição granulométrica do filtro ascendente para pós-tratamento de lixiviado de aterro sanitário / Granulometric composition of the upflow filter for post-treatment of landfill leachate

RESUMO O lixiviado de aterro sanitário apresenta composição variável e complexa e pode ter elevadas concentrações de nitrogênio amoniacal e matéria orgânica biodegradável e recalcitrante. Devido ao potencial altamente poluidor dos lixiviados estabilizados, além do tratamento biológico convencional, faz-se necessária, em alguns casos, a realização de pós-tratamento para remoção da matéria orgânica recalcitrante, de maneira a atender à legislação vigente. Nesse contexto, os ensaios de coagulação seguida de filtração ascendente em pedregulho como pós-tratamento foram realizados com o objetivo de estabelecer a composição granulométrica que resultasse na melhor condição de eficiência em relação à remoção de matéria orgânica recalcitrante e operação, visando à aplicação do sistema em escala real. Para todos os ensaios, foram aplicados taxa de filtração constante de 15 m3.m-2.dia-1 e dosagem de ferro de 400 mg.L-1 em pH 4,0. A duração das carreiras de filtração, bem como a qualidade do efluente tiveram forte influência em relação à composição granulométrica do filtro, podendo-se constatar a necessidade do emprego de areia fina em sua composição, a fim de garantir a eficiência do tratamento. A concepção técnica de pós-tratamento por coagulação seguida da filtração ascendente com a composição granulométrica definida neste trabalho (tipo 4) foi eficiente para a remoção de matéria orgânica recalcitrante, com remoções de 82,4% de demanda química de oxigênio (valor residual de 194 mg.L-1), de 98,8% de cor verdadeira (valor residual de 49 uH), de 94,3% de carbono orgânico total (valor residual de 52 mg.L-1) e duração de carreira de filtração de 22,6 horas, sem ocorrência de transpasse.

ABSTRACT Landfill leachate presents variable and complex composition and may have high concentrations of ammoniacal nitrogen and biodegradable and recalcitrant organic matter. Due to the high polluting potential of stabilized leachate, in addition to conventional biological treatment, it is necessary in some cases to perform post-treatment to remove recalcitrant organic matter to meet the current legislation. In this context, the coagulation followed by upflow gravel filtration experiments were carried out with the objective of establishing the granulometric composition that resulted in the best efficiency condition in relation to the removal of recalcitrant organic matter and operation, aiming at the system's application in real scale. For all the tests, a constant filtration rate of 15 m3 m-2 day-1 and an iron dosage of 400 mg L-1 at pH 4.0 were applied. The duration of filtration cycles, as well as the quality of the effluent were strongly influenced by the filter's particle size, and it is possible to verify the need of using fine sand in its composition to guarantee the treatment's efficiency. The technical design of post-treatment by coagulation followed by upflow gravel filtration with the granulometric composition defined in this study (type 4) was efficient in removing recalcitrant organic matter, with removals of 82.4% for COD (residual value of 194 mg L-1), 98.8% for true color (with residual value of 49 uH), and 94.3% for TOC (residual value of 52 mg L-1), resulting in a filtration cycle duration of 22.6 h, with no loss of filtered solids.

The impact of Karnofsky performance status of posttreatment on survival with concurrent chemotherapy and thoracic three-dimensional radiotherapy for stage Ⅳ non-small cell lung cancer / 中华放射医学与防护杂志

Objective To investigate the impact of the changes of posttreatment karnofsky performance status (KPSpost) on the overall survival (OS) for patients with stage Ⅳ non-small cell lung cancer (NSCLC) underwent concurrent chemoradiation.Methods A total of 279 patients (male 198 and female 81) with histological confirmed stage Ⅳ NSCLC were enrolled in this study with a median age of 58 years old (range 22 to 80 years old).There were 166 cases of squamous carcinoma,87 cases of adenocarcinoma,and 22 cases of unclassified carcinoma,respectively.All enrolled patients received more than 2 cycles of chemotherapy and more than 36 Gy of concurrent radiotherapy.Kaplan-Meier method and Log-rank test were applied to evaluate OS.Multivariate analyses were carried out by the Cox proportionalhazard model.Chi-square test and logistic regression analysis were used to explore the related factors of KPSpost.Results There were 198 patients with improved KPSpost and 81 patients with decreased KPSpost,respectively.Univariate and multivariate analyses indicated that the improvement of KPSpost was associated with longer OS.Logistic regression analysis showed that the improvement of KPSpost was positively related with treatment of more than 4-6 cycles chemotherapy concurrent with over 63 Gy radiation to primary tumor.The improvement of KPSpost also correlated positively with disease control rate (DCR),but negatively with PLT toxicity and radiation esophagitis.Conclusions KPSpost was an independent prognostic factor of OS for patients with stage Ⅳ NSCLC underwent concurrent chemoradiation.Chemotherapy of 4-6 cycles and concurrent over 63 Gy radiotherapy dose to primary tumor,as well as DCR were positive factors for KPSpost improvement.However,stage 3-4 PLT toxicities and radiation esophagitis decreased the KPSpost.

Imaging Evaluation Following ⁹⁰Y Radioembolization of Liver Tumors: What Radiologists Should Know

Radioembolization using beta-emitting yttrium-90 microspheres is being increasingly used for the treatment of primary and metastatic liver cancers. It is a form of intra-arterial brachytherapy which delivers intense radiation to liver tumors with little embolic effect; this mode of action results in unique post-treatment imaging findings. It is important to understand these imaging findings to avoid misinterpretation of tumor response and to determine further management of the disease. Herein, we discuss the current concepts for assessing tumor response, common post-treatment imaging features, and associated complications following radioembolization.

Electroacupuncture Treatment Conduced Before and After Surgery Is Better in Promoting Reco-very of Gastrointestinal Function in Colorectal Cancer Patients Undergoing Radical Resection / 针刺研究

OBJECTIVE: To investigate the effect of electroacupuncture (EA) at different time-points on postoperative gastrointestinal function in patients undergoing colorectal cancer surgery. METHODS: Eighty patients with colorectal cancer undergoing laparotomy were randomly assigned to intravenous anesthesia, EA A, EA B, and EA C groups (n＝20 cases in each group). All the patients in the four groups received intravenous anesthesia with midazolam, sufentanil, cisatracurium besylate and Propofol, postoperative gastrointestinal decompression and drug analgesia. EA (2－3 mA, 2 Hz) was applied to Zhongwan (CV 12) and Tianshu (ST 25), Neiguan (PC 6), Zusanli (ST 36), Shangjuxu (ST 37), Xiajuxu (ST 39) on the right side for 30 min, once (one day before surgery) in the EA A group, twice (one day and 30 min before surgery) in the EA B group, and 3 times (one day, 30 min before and one day after surgery) in the EA C group. The acupoints used after surgery were PC 6, ST 36, ST 37 and ST 39. The time of postoperative ventilation, defecation, food-intake and water drinking, stomach tube removal and abdominal drainage tube removal, the volumes of stomach tube drainage and abdominal drainage, and postoperative adverse reactions were recorded. RESULTS: The first ventilation time, after surgery in the EA C group was significantly earlier than those in the intravenous anesthesia, EA A and EA B groups (P0.05)．. CONCLUSION: EA treatment combined with intravenous anesthesia conducted before and after surgery is effective in promoting the recovery of gastrointestinal function in patients undergoing colorectal cancer laparotomy, and is obviously better than simple pre-operative EA.

Comparison of effects of post-treatment with inhalation anesthetics on rat myocardial ischemia reperfusion injury / 重庆医学

Objective To compare the myocardial protective effects of post-treatment with sevoflurane and isoflurane on myocardial ischemia-reperfusion injury(MIRI) in adult rats.Methods Twenty-four adult male SD rats were divided into four groups (n =6) by using the random number table,control group (C),isehemia-reperfusion group (R),sevoflurane post-treatment (S) and isoflurane post-treatment group(I).The Langendorff isolated heart perfusion model was established.The heart rate(HR),left ventricular end-diastolic pressure(LLVEDP),left ventricular developed pressure(LVDP),maximum rate of rise of left ventricular pressure(LV+-dp/dtmax),and maximum rate of decrease of left ventricular pressure(LV-dp/dtmax) were recorded at the end of equilibrium perfusion,and at 30,90 min of reperfusion,respectively.At the end of infusion,1 mm3.of apical myocardial tissue was removed for observing mitochondrial structure under electron microscopy and scoring.The myocardial infarct size(MIS) in the remaining heart tissue was measured by TTC staining.Results Compared with the R group,the S and I groups showed improved cardiac function indicators,decreased MIS,and reduced mitochondrial damage after reperfusion(P＜0.05).Compared with the S group,the I group showed worse heart function,increased MIS,and more severe mitochondrial damage after reperfusion(P＜0.05).Conclusion Post-treatment with sevoflurane and isoflurane has a protective effect on MIRI in adult rats.Post-treatment with sevoflurane has a better cardioprotective effect than that with isoflurane.

High rates of relapse in adolescents crack users after inpatient clinic discharge / Alto índice de recaída em adolescentes usuários de crack após a alta da internação

ABSTRACT Objective The objective of the present study was to evaluate 88 adolescent crack users referred to hospitalization and to follow them up after discharge to investigate relapse and factors associated with treatment. Methods Cohort (30 and 90 days after discharge) from a psychiatric hospital and a rehab clinic for treatment for chemical dependency in Porto Alegre between 2011 and 2012. Instruments: Semi-structured interview, conducted to evaluate the sociodemographic profile of the sample and describe the pattern of psychoactive substance use; Crack Use Relapse Scale/CURS; Questionnaire Tracking Users to Crack/QTUC; K-SADS-PL. Results In the first follow-up period (30 days after discharge), 65.9% of participants had relapsed. In the second follow-up period (90 days after discharge), 86.4% of participants had relapsed. Conclusion This is one of the first studies that show the extremely high prevalence of early relapse in adolescent crack users after discharge, questioning the cost/benefit of inpatient treatment for this population. Moreover, these results corroborate studies which suggested, young psychostimulants users might need tailored intensive outpatient treatment with contingency management and other behavioral strategies, in order to increase compliance and reduce drug or crime relapse, but this specific therapeutic modality is still scarce and must be developed in Brazil.

RESUMO Objetivo O objetivo do presente estudo foi avaliar 88 adolescentes usuários de crack no que se refere à hospitalização e dar-lhes seguimento após a alta, para investigar as recaídas e os fatores associados ao tratamento. Métodos Coorte (30 e 90 dias após a alta) de um hospital psiquiátrico e uma clínica de reabilitação, para o tratamento de dependência química em Porto Alegre, entre 2011 e 2012. Instrumentos: entrevista semiestruturada, realizada para avaliar o perfil sociodemográfico da amostra e descrever o padrão de uso de substâncias psicoativas; Escala de Recaída dos Usuários de Crack/ERUC; Questionário de Seguimento de Usuários de Crack/QSUC; K-SADS-PL. Resultados No primeiro período de seguimento (30 dias após a alta), 65,9% dos participantes recaíram. No segundo período de seguimento (90 dias após a alta), 86,4% dos participantes tiveram recaíram. Conclusão Este é um dos primeiros estudos que mostram a prevalência extremamente alta de recaída precoce em adolescentes usuários de crack após a alta, questionando o custo-benefício do tratamento em regime de internação para essa população. Além disso, esses resultados corroboram estudos que sugerem que usuários de psicoestimulantes jovens podem precisar de um adaptado Tratamento Ambulatorial Intensivo, com manejo de contingências e outras estratégias comportamentais, a fim de aumentar a adesão, reduzir o uso da droga ou recaída ao crime. No entanto, essa modalidade terapêutica específica ainda é escassa e deve ser desenvolvida no Brasil.

Detección molecular del papilomavirus humano de alto riesgo en el seguimiento de mujeres tratadas por lesión escamosa intraepitelial / Molecular detection of high risk human papillomavirus in following women treated for squamous intraepithelial lesion

El cáncer de cuello uterino (CCU) es la primera causa de muerte por cáncer en mujeres en países en vías de desarrollo. La infección persistente por el virus papiloma humano (VPH) es un factor necesario en lesiones preneoplásicas y CCU. La citología cervicovaginal es el método mayormente utilizado para detectar el CCU y su uso combinado con la de detección de ADN viral seis meses post-tratamiento aumenta la efectividad para identificar mujeres tratadas con riesgo de lesión residual/recidiva. El objetivo fue describir la frecuencia de VPH de alto riesgo (AR) en mujeres tratadas por lesión escamosa intraepitelial (SIL) que acudieron al Servicio de Patología Cervical del Hospital San Pablo de enero-diciembre/2014. Se realizó un estudio descriptivo de corte transverso, que incluyó 80 pacientes que acudieron al servicio para control post-tratamiento por SIL. Se utilizó Cobas 4800 HPV Test (Roche) para la detección individual de VPH-16 y 18, y un pool de 10 VPH-AR (31,33,35,39,45,51,52,56,58,59) y dos de “probable” alto riesgo (66,68). Se encontró infección viral en el 7,5% (6/80) de las pacientes tratadas; identificándose VPH-16 en 3/6 de los casos positivos. En Paraguay existe alta incidencia de lesiones pre-neoplásicas y CCU siendo un problema de salud pública. Los datos observados sugieren que la utilización de este sistema para la detección viral puede llevar a optimizar el seguimiento post-tratamiento y la identificación de VPH-16 y 18 podría contribuir a la selección de pacientes en mayor riesgo de desarrollar una lesión cervical que deben someterse a una vigilancia frecuente y meticulosa.

Cervical cancer is the leading cause of cancer death in women in developing country.Persistent infection with human papillomavirus (HPV) is a necessary factor in premalignantlesions and cervical cancer. The Pap smear is the method most commonly used to detect thecervical cancer and its combined with the detection of viral DNA six months post-treatment increases effectiveness to identify women treated in risk with residual/recurrent lesion. Theaim was to describe the frequency of high-risk HPV (HR) in treated women for squamousintraepithelial lesion (SIL) who attended the Cervical Pathology Service of Hospital San Pablofrom January to December/2014. It is cross sectional, descriptive study which included 80patients who attended the service for post-treatment control. The 4800 Cobas HPV Test(Roche) was used, which detects HPV-16 and 18, and a pool of 10 HR-HPV(31,33,35,39,45,51,52,56,58,59) and two "probable" high risk (66,68). Viral infection wasfound in 7.5% (6/80) of patients treated; identifying HPV-16 in 3/6 of positive cases. InParaguay there is a high incidence of pre-neoplastic lesions and cervical cáncer remains apublic health problem. The observed data suggest that the use of this system for viraldetection can lead to optimize the post-treatment monitoring and the identification of HPV-16and 18 could contribute to the selection of patients at increased risk of developing cervicalinjury should undergo to frequent and careful monitoring.

Posttreatment human papillomavirus testing for residual or recurrent high-grade cervical intraepithelial neoplasia: a pooled analysis / 부인종양

OBJECTIVE: We conducted a pooled analysis of published studies to compare the performance of human papillomavirus (HPV) testing and cytology in detecting residual or recurrent diseases after treatment for cervical intraepithelial neoplasia grade 2 or 3 (CIN 2/3). METHODS: Source articles presenting data on posttreatment HPV testing were identified from the National Library of Medicine (PubMed) database. We included 5,319 cases from 33 articles published between 1996 and 2013. RESULTS: The pooled sensitivity of high-risk HPV testing (0.92; 95% confidence interval [CI], 0.90 to 0.94) for detecting posttreatment CIN 2 or worse (CIN 2+) was much higher than that of cytology (0.76; 95% CI, 0.71 to 0.80). Co-testing of HPV testing and cytology maximized the sensitivity (0.93; 95% CI, 0.87 to 0.96), while HPV genotyping (detection of the same genotype between pre- and posttreatments) did not improve the sensitivity (0.89; 95% CI, 0.82 to 0.94) compared with high-risk HPV testing alone. The specificity of high-risk HPV testing (0.83; 95% CI, 0.82 to 0.84) was similar to that of cytology (0.85; 95% CI, 0.84 to 0.87) and HPV genotyping (0.83; 95% CI, 0.81 to 0.85), while co-testing had reduced specificity (0.76; 95% CI, 0.75 to 0.78). For women with positive surgical margins, high-risk HPV testing provided remarkable risk discrimination between test-positives and test-negatives (absolute risk of residual CIN 2+ 74.4% [95% CI, 64.0 to 82.6] vs. 0.8% [95% CI, 0.15 to 4.6]; p<0.001). CONCLUSION: Our findings recommend the addition of high-risk HPV testing, either alone or in conjunction with cytology, to posttreatment surveillance strategies. HPV testing can identify populations at greatest risk of posttreatment CIN 2+ lesions, especially among women with positive section margins.

Uso de fotorreatores UV para a remoção de diclofenaco, bezafibrato e etinilestradiol de esgoto tratado em sistema UASB-FBP / Use of UV photoreactors to remove diclofenac, bezafibrate and ethynylestradiol from sewage treated in UASB-TF system

RESUMOEste trabalho avaliou a remoção de diclofenaco (DCF), bezafibrato (BZF) e etinilestradiol (EE2) de efluentes de sistema UASB-FBP (reator anaeróbio de manta de lodo seguido de filtro biológico percolador) em fotorreatores UV de lâmpadas imersas (FRI) e emersas (FRE). Os resultados mostram que baixa eficiência de remoção de tais compostos foi obtida em ambos fotorreatores quando se utilizou baixo tempo de contato (~10 min) e baixa concentração inicial de fármacos (0,5 µg.L-1 para EE2, e 21 µg.L-1 para DCF e BZF). O aumento da concentração inicial de DCF (para 20 mg.L-1) e do tempo de contato (para 20 min) resultaram em aumento da eficiência de remoção (de 31 para 83% no FRI e de 36 para 86% no FRE), indicando que compostos dissolvidos presentes no efluente biológico afetaram adversamente a remoção de fármacos nos fotorreatores devido a competição pela radiação UV incidente.

ABSTRACTThis paper evaluated the removal of diclophenac (DCF), bezafibrate (BZF) and ethynylestradiol (EE2) from effluent of an anaerobic reactor coupled to a trickling filter (UASB-TF) in two types of UV photoreactors (immerse UV lamps - FRI and emmersed UV lamps - FRE). The results showed low removal efficiencies in both photoreactors when low contact times (10 min) and low initial concentration of such compounds was used (0.5 µg.L-1 for EE2 and 21 µg.L-1 for DCF and BZF). An increase in the initial concentration of DCF (to 20 mg.L-1) and of the contact time (to 20 min) led to an increase in the removal efficiency (from 31 to 83% in FRI and from 36 to 86% in FRE), suggesting that dissolved compounds present in the biological effluent adversely affected the removal of the pharmaceutical tested due to competition for the incident UV radiation.

Eficiência de lagoas de polimento no pós-tratamento de reator UASB no tratamento de águas residuárias de suinocultura / Efficiency of a polishing pond for the post-treatment of the effluent from UASB reactor treating swine wastewater

Avaliou-se o desempenho de um sistema de lagoas seriadas que recebeu efluentes de reator UASB, no tratamento de águas residuárias de suinocultura. O sistema foi composto de reator anaeróbio de chicanas (RAC), reator UASB, em escala real, e uma série de lagoas (uma lagoa facultativa e três de maturação), em escala piloto. As análises físico-químicas realizadas foram: pH, demanda bioquímica de oxigênio (DBO), demanda química de oxigênio (DQO), sólidos suspensos totais (SST), sólidos suspensos voláteis (SSV), nitrogênio amoniacal (N-am.), fósforo total (Pt), coliformes totais (CT) e Escherichia coli (EC). As lagoas de pós-tratamento contribuíram eficientemente para remoção de nutrientes, matéria orgânica e sólidos, fornecendo um efluente com qualidade para o reuso agrícola ou lançamento em corpos d'água...

The performance of a post-treatment pond for treating swine wastewater from an UASB reactor was evaluated. The system was assembled with an anaerobic baffle reactor (RAC), followed by an UASB reactor (UASB) on a real scale, and a post-treatment pond on a demonstration scale. The following parameters were analyzed: pH, biochemical oxygen demand (BOD), chemical oxygen demand (COD), total suspended solids (TSS), volatile suspended solids (VSS), ammonia nitrogen (N-am.), total phosphorus (Pt), total coliforms (CT) and Escherichia coli (E coli.). The post-treatment lagoons contributed efficiently to remove nutrients, organic matter and solids, providing an effluent quality for agricultural reuse or discharge into a body of water...

Detección del virus del papiloma humano de alto riesgo por captura híbrida II® según hallazgos citológicos en mujeres tratadas por lesiones escamosas intraepiteliales de cuello uterino, período 2006/2010 / Detection of high risk human papillomavirus by hybrid capture II(r) according cytological findings in women treated for squamous intraepithelial lesions of the cervix, period 2006/2010

OBJETIVO: Determinar la frecuencia del virus de papiloma humano de alto riesgo oncogénico (HR-HPV) por captura híbrida II (r) (CH II(r)) según hallazgos citológicos en mujeres tratadas por lesiones escamosas intraepiteliales (SIL) de cuello uterino. MATERIAL Y MÉTODO: Estudio descriptivo de corte transverso de una serie de casos, en donde se incluyeron 122 mujeres tratadas, 79 (65%) por SIL de bajo grado (LSIL) y 43 (35%) por SIL de alto grado (HSIL) que concurrieron al Laboratorio de HPV del Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, para realizarse un control post-tratamiento, periodo 2006/2010. RESULTADOS: Se observó un total del 28% (34/122) de mujeres tratadas por SIL positivas para HR-HPV, detectándose infección viral en un 20% de las mujeres con ausencia de SIL (NSIL) (22/108), 83% de las mujeres con LSIL (10/12) y 100% de las mujeres con HSIL (2/2). De las 34 mujeres positivas para HR-HPV, 10 mujeres (29%) presentaron valores altos (100 pg/mL o más) de carga viral relativa, detectándose un aumento de casos positivos con la severidad de la lesión (28% NSIL, 30% LSIL, 50% HSIL). CONCLUSION: La detección de HR-HPV por CH II(r), así como los valores de carga viral relativa altos, en especial en mujeres con NSIL podrían ayudar a identificar mujeres tratadas con riesgo a desarrollar recidivas, contribuyendo así a fortalecer el programa de prevención de cáncer de cuello uterino. .

OBJECTIVE: To determinate the frequency of high risk human papillomavirus (HR-HPV) by hybrid capture II (r) (CH II(r)), according cytology results in women treated for squamous intraepithelial lesions of the cervix (SIL). MATERIAL AND METHODS: A descriptive cross-sectional study of a series of cases that included 122 women treated, 79 (75%) for low grade SIL (LSIL) and 43 (35%) for high grade SIL (HSIL) attending at the HPV Laboratory at the Health Sciences Research Institute (IICS), National University of Asunción (UNA), for post-treatment control during period 2006/2010. RESULTS: A total of 28% (34/122) of women treated for SIL were positive for HR-HPV, detecting viral infection in 20% of women with no SIL (NSIL) (22/108), in 83% of women with LSIL (10/12) and in 100% of women with HSIL (2/2). Of 34 women positive for HR-HPV, 10 women (29%) had high values (100 pg / mL or more) of relative viral load, detecting an increase of positive cases with severity of the lesion (28% NSIL, 30% LSIL, 50% HSIL). CONCLUSION: HR-HPV detection by CH II(r) and high relative viral load values especially in women with NSIL could help to identify treated women at risk of developing recurrence, thereby contributing to strengthening the cervical cancer prevention program. .

Recidiva do apinhamento anterossuperior nas más oclusões de Classe I e Classe II tratadas ortodonticamente sem extrações / Relapse of maxillary anterior crowding in Class I and Class II malocclusions orthodontically treated without extractions

OBJETIVO: o presente estudo objetivou comparar retrospectivamente a estabilidade pós-contenção do alinhamento dos incisivos anterossuperiores em pacientes com Classe I e Classe II. MÉTODOS: a amostra consistiu de 38 pacientes de ambos os sexos, tratados sem extrações e com mecânica Edgewise, divididos em dois grupos - Grupo 1, constituído por 19 pacientes, com idade inicial média de 13,06 anos, portadores da má oclusão de Classe I com apinhamento anterossuperior inicial maior que 3mm; Grupo 2, constituído por 19 pacientes, com idade inicial de 12,54 anos, portadores da má oclusão de Classe II e, também, com apinhamento anterossuperior inicial maior que 3mm. Foram medidos nos modelos de estudo, das fases pré- e pós-tratamento e pós-contenção, o índice de irregularidade de Little, as distâncias intercaninos e entre os primeiros e segundos pré-molares, a distância intermolares e o comprimento da arcada superior. Para a comparação intragrupo nos 3 tempos de avaliação, utilizou-se os testes ANOVA e Tukey. A comparação intergrupos foi realizada pelo teste t independente. Para verificação da presença de correlação, utilizou-se o teste de correlação de Pearson. RESULTADOS: os resultados evidenciaram maior estabilidade do tratamento no Grupo 2 (Classe II), pois, durante o período pós-contenção, foi observada recidiva do apinhamento dos dentes anterossuperiores menor no Grupo 2 (0,80mm) do que no Grupo 1 (1,67mm). CONCLUSÃO: concluiu-se que o tratamento do apinhamento dos dentes anterossuperiores é mais estável na má oclusão de Classe II do que na má oclusão de Classe I.

OBJECTIVE: The present study aimed to retrospectively compare the postretention stability of maxillary anterior incisors alignment in Class I and Class II patients. METHODS: The sample comprised 38 patients of both genders, treated with nonextraction and Edgewise mechanics, divided into two groups: Group 1, comprised of 19 patients, at a mean age of 13.06 years, with Class I malocclusion and initial maxillary anterior crowding greater than 3 mm; Group 2, comprised of 19 patients, at a mean age of 12.54 years, with Class II malocclusion, and also with a initial maxillary anterior crowding greater than 3 mm. In the dental casts of pretreatment, posttreatment and postretention phase, the Little's irregularity index, intercanine distance and distance between first and between second premolars, intermolar distance and maxillary arch length were measured. For intragroup comparison among the three times of evaluation, it was used the one-way ANOVA followed by Tukey test. Intergroup comparison was performed by independent t tests. To verify the presence of correlation, the Pearson correlation test was used. RESULTS: It was evidenced greater stability of treatment in Group 2 (Class II), because during the postretention period it was observed a softer relapse of maxillary anterior crowding in Group 2 (0.80mm) than in Group 1 (1.67mm). CONCLUSION: It can be concluded that the treatment of maxillary anterior crowding is more stable in Class II malocclusion than in Class I malocclusion.

Operação de filtros biológicos percoladores pós-reatores UASB sem a etapa de decantação secundária / Operation of trickling filters post-UASB reactors without the secondary sedimentation stage

A pesquisa teve por objetivo avaliar filtros biológicos percoladores (FBP) pós-reatores UASB operando sem a etapa de decantação secundária, em termos da remoção da demanda bioquímica e química de oxigênio (DBO e DQO) e sólidos suspensos totais (SST). O aparato experimental consistia em um reator UASB que alimentava quatro FBP em paralelo, preenchidos com diferentes materiais suporte. O reator UASB operou em regime hidráulico permanente, e três condições operacionais foram impostas aos FBP durante o período experimental. Em geral, os sistemas UASB/FBP foram capazes de promover o atendimento aos padrões de lançamento. Em condições de baixas cargas orgânicas volumétricas (COV), o uso de materiais de enchimento de maior área superficial específica não proporcionou ganhos expressivos em termos de desempenho. Contudo, o uso de meio suporte baseado em espumas de poliuretano propiciou melhoria significativa na qualidade do efluente final. O uso de sistemas UASB/FBP sem decantadores secundários parece ser uma promissora alternativa para a simplificação operacional da tecnologia, e uma importante estratégia para o tratamento de efluentes domésticos em países em desenvolvimento. No entanto, o sucesso do emprego desta tecnologia fica condicionado ao correto gerenciamento do lodo anaeróbio do reator UASB, a fim de que sejam evitadas sobrecargas nos FBP.

The research aimed at evaluating the operation of trickling filters (TF) post-UASB reactors without the secondary sedimentation stage, in terms of biochemical and chemical oxygen demand (BOD and COD) and total suspended solids (TSS) removal. The experimental apparatus consisted of one UASB reactor followed by four TF in parallel, each one filled with a different packing media. The UASB reactor was operated at a permanent hydraulic regime, while three operational conditions were imposed to the TF during the experimental period. In general, the UASB/TF systems were able to comply with the discharge standards. At low organic loading rates (OLR), no improvements in terms of organic matter removal, with the use of higher surface area packing media were observed. However, the use of a sponge-based packing media provided significant improvements on final effluent quality. The use of UASB/TF systems without secondary sedimentation can constitute an attractive alternative in terms of operational simplification of this technology, and an important strategy for domestic wastewater treatment in developing countries. However, the success of this technology is strictly connected to the correct anaerobic sludge management of the UASB reactor, in order to avoid overloads on the TF.

Dysfunctional beliefs and attitudes on sleep and sleep disturbances pre- and post-antidepressant treatments in patients with major depression / 中南大学学报(医学版)

Objective To explore the relationship between dysfunctional beliefs and attitudes on sleep and sleep disturbances before and after a short-term pharmacotherapy in patients with major depression. Methods Sixty-six (29 male, 37 female, 34.0±9.5 years old) patients with major depression were recruited before the treatment. Dysfunctional Beliefs and Attitudes about Sleep (DBAS) questionnaire, Pittsburgh Sleep Quality Index (PSQI), Hamilton Depression Rating Scale (HDRS), and Hamilton Anxiety Scale (HAMA) were assessed before and after a 4-week antidepressant treatment. Results After the 4-week antidepressant treatment, depressive and anxiety symptoms were alleviated significantly, whereas sleep disturbance still persisted. And sleep quality was closely related with problematic sleep beliefs after the treatment.Conclusion Some evidences are provided for cognitive behavioral therapy during antidepressant therapy, and the therapy should be matched with problematic beliefs and attitudes.

Caracterização e tratabilidade biológica dos efluentes líquidos gerados em cabines de pintura de uma indústria moveleira / Characterization and treatability of wastewater from a dying hood of a furniture industry

O objetivo deste trabalho foi caracterizar os efluentes gerados em cabines de pintura de uma indústria moveleira e avaliar a eficiência de sistemas biológicos (anaeróbio e aeróbio) para o seu tratamento. O efluente industrial apresentou elevado teor de matéria orgânica (DQO total de 634 a 2.790 mg.L-1; DBO5 total de 360 a 972 mg.L-1) e baixos teores de macronutrientes (NTK de 1,9 mg.L-1 e Ptotal de 0,5 mg.L-) e metais tóxicos. Os ensaios de tratabilidade em reator UASB (~25ºC e tempo de detenção hidráulica - TDH = 10 horas), indicaram uma eficiência máxima de remoção de matéria orgânica de 90 por cento na composição volumétrica 70:30 (efluente industrial:esgoto sanitário). A alimentação do reator UASB só com efluente industrial resultou em acúmulo de ácidos graxos voláteis e inibição microbiana, mas o uso de pós-tratamento aeróbio (TDH = 96h) garantiu elevada eficiência global (~88 por cento) de remoção de matéria orgânica.

The main objective of this work was to characterize the wastewater from the dying hood of a woven furniture industry, and to assess the efficiency of biological processes (anaerobic and aerobic) for its treatment. The physical-chemical characterization of the industrial wastewater showed a high organic matter content (total COD from 634 to 2,790 mg.L-1; total BOD5 from 360 to 972 mg.L-1), low content of macronutrients (NTK of 1.9 mg.L-1 and P of 0.5 mg.L-1) and toxic metals. The anaerobic degradation tests in a bench-scale UASB reactor (25ºC and hydraulic retention time - HRT = 10 hours) showed that a maximum removal efficiency of 90 percent was obtained when the reactor was fed with 30 percent raw sewage and 70 percent industrial wastewater. The feeding of UASB reactor with only industrial wastewater resulted in volatile fatty acids accumulation and microbial inhibition; however, the use of aerobic post-treatment (HRT = 96 hours) granted a high (~88 percent) organic matter removal efficiency.

Remoção de matéria orgânica e sólidos suspensos por nova configuração de biofiltro aeróbio submerso no pós-tratamento de efluente de reator UASB / Removal of organic matter and suspended solids by a new configuration of biological aerated filter in the post-treatment of UASB reactor effluent

O pós-tratamento de efluentes de reatores anaeróbios é um processo necessário para o atendimento dos padrões de emissão. Os resultados aqui apresentados mostram a viabilidade de uso de uma nova configuração de biofiltro aeróbio submerso (BAS) no pós-tratamento desses efluentes. Os BAS multiestágio apresentam uma câmara anaeróbia (V=12,6L), seguido de uma câmara aeróbia (V=30L) e uma câmara anóxica (V=26,4L), todas em série (V total=70L). Neste estudo, foi analisada a remoção de sólidos suspensos (SS), DQO e DBO5. Foram utilizados três BAS multi-estágio preenchidos com três diferentes materiais-suporte: tampas e gargalos PET (165m²/m³), pedra britada n. 4 (50m²/m³) e anéis Pall 1,5'' (135m²/m³). Os reatores foram operados com valores de tempos de detenção hidráulicas (TDH) de 4,1, 8,2 e 12,3 horas, e três taxas de aplicação superficial (TAS) (21, 12 e 8m³/m².d). A associação dos reatores UASB+BAS possibilitou remoções de DQO total superiores a 90 por cento para os BAS 1 e 3, e 85 por cento para o BAS 2, sendo independente do TDH aplicado. A remoção de SS foi maior no BAS contendo anéis Pall, provavelmente devido ao maior índice de vazios desse material.

The post-treatment of effluents from anaerobic reactors is normally a mandatory step to meet the emission standards. The results presented here show the feasibility of using a new configuration of biological aerated filter (BAF) in the post-treatment of UASB reactors. The multi-stage BAF presents an anaerobic chamber (V=12.6L), followed by an aerobic chamber (V=30L) and an anoxic chamber (V=26.4L), all in series (total V=70L). This study examined the removal of suspended solids (SS), COD and BOD5. Three multi-stage BAF filled with three different packing materials were used: lids and bottlenecks of PET bottles (165m²/m³), gravel n. 4 (50m²/m³) and Pall rings 1.5'' (135m²/m³). The reactors were operated with the values of hydraulic detention time (HDT) of 4.1, 8.2 and 12.3 hours, and three superficial application rates (21, 12 and 8m³/m².d). COD removal efficiencies of 90 percent for BAF 1 and 3, and 85 percent for BAF 2 were obtained, being the removal independent of the HDT applied to BAF. The removal of SS was higher in BAF containing Pall rings, probably due to the higher voidage of this material.

The Analgesic Effects of Intrathecal Pregabalin in Rat Formalin Tests: Comparison between Pre- and Post-treatment / 대한마취과학회지

BACKGROUND: Pregabalin is an analog of gamma aminobutyric acid, and selectively interacts with the alpha-2-delta subunit of the voltage dependent calcium channels. The aims of this study were to investigate the analgesic effects of intrathecal pregabalin in rat formalin tests and to compare between the pre-treatment and post-treatment group. METHODS: All experimental animals were randomly divided into pre- and post-treatment groups. In pre-treatment groups, pregabalin (0.003g, 0.01g, 0.03g, 0.1g, n = 6 at each group) was administered through the intrathecal catheter 10 min prior to formalin injection. In post-treatment groups, pregabalin (0.01g, 0.03g, 0.1g, 0.3g, n = 6 at each group) was administered through the catheter 10 min after formalin injection. Formalin (50 ml, 5%) was injected in the left hind paw. We counted the number of flinching as a pain behavior for 60 min to quantify the nociceptive response. RESULTS: The withdrawal responses which were represented by flinching count, were decreased dose dependently in the phase 2, in all groups (pre-treatment and post-treatment group), while there were less analgesic effects and ceiling effects in the phase 1. There was more significant decreasing flinching number in the pre-treatment group than that in the post-treatment group. CONCLUSIONS: Intrathecal pregabalin has preemptive analgesic effect and may be useful in the management of inflammation induced hyperalgesia.

The effect of calcium hydroxide on post-treatment pain / 대한치과보존학회지

The purpose of this clinical study is to assess whether calcium hydroxide as an intracanal medication affects post-treatment pain in teeth especially odontogenic pain which comes from inflammation of the pulp and periradicular tissues when compared with no intracanal medication. From 213 patients who has been treated 237 root canals due to significant pain (moderate-to-severe), we recorded their age, sex, treated tooth, degree of pain, pre-operative states of the tooth. We classified patients into 2 test group; Group 1 (not gain intracanal Ca(OH)2), Group 2 (gain intracanal Ca(OH)2). Through the survey from the patients, we let them write down the occurrence and degree of post-treatment pain in 4hours, 2days, 7days after treatment as none, mild, moderate or severe. The followings were evaluated; the overall incidence of flare-ups, the overall incidence of post-treatment pain in each group at each time period, the incidence of post-treatment pain in each group at each time period as related to pre-operative states of the teeth. These were compared statistically with Chi-square analysis (p < 0.05). Under the condition of this investigation, no difference was observed in the incidence of post-treatment pain between the two groups. Therefore, Ca(OH)2 as intracanal medication had no effect on preventing or decreasing the post-treatment pain.

Post-treatment Bleeding of Cerebral Arteriovenous Malformations after Gamma Knife Radiosurgery

OBJECTIVE: This study is designed to assess the cause of post-treatment bleeding after gamma knife radiosurgery(GKRS) for cerebral arteriovenous malformation(AVM). METHODS: We experienced post-treatment bleeding in seven cases out of 214 AVM patients group before complete obliteration and analyzed their clinical characteristics, angiographic architecture and radiosurgical dosimetry. RESULTS: Hemorrhage rate was 3.2% (7/214) and the bleeding occurred individually at 4, 8, 9, 20, 44, 44 and 115 months after GKRS. Annual bleeding rate was 0.6% (7 episodes of bleeding / 1131 patient years). Three patients presented with hemorrhage as initial symptom upon admission and four patients were admitted with other symptom rather than hemorrhage. AVM was deep-seated in 4 cases, and at motor cortex in three patients. Average marginal dose was 18.9Gy (range;10-25Gy). Most of patients showed angiographic risk factor for bleeding such as venous aneurysm, multiple venous drainage, dual arterial supply and shunt type. Upon bleeding incidence, emergency operation was performed in 5 cases and two patients received second GKRS. Two patients were expired after emergency operation. CONCLUSION: The risk of hemorrhage from GKRS for AVMs is inevitable, even if patients are in non-hemorrhagic group before complete obliteration. In order to minimize hemorrhage rate, intensive follow-up is strongly suggested after radiosurgery, and the retreatment for a residual nidus is recommended at early point after the latency period.