Optimization of the synthesis of a new coagulant from a tannin extract.

The current article studies the optimization of a new coagulant agent for water purification and wastewater remediation. Design of experiments is used for optimizing the production of this new tannin-based coagulant by using Acacia mearnsii de Wild tannin extract, NH(4)Cl and formaldehyde. The effectiveness of this product was confirmed on dye-polluted wastewater and surfactant wastewater. This cationic coagulant seems to be sensitive to temperature and tannin-NH(4)Cl ratio (g of ammonium chloride per g of tannin extract). NH(4)Cl ratio was found to be more influent than temperature and no interaction is presented between these two parameters. For each system, an optimum combination NH(4)Cl ratio and temperature was found: 24.9°C and 2 g g(-1) for dye removal and 36.4°C and 1.87 g g(-1) for surfactant elimination. The optimal conditions were merged to produce a combined coagulant that was tested on dye, surfactant, surface river water and municipal wastewater. Predicted levels of remediation were experimentally confirmed.

Estándares de calidad asistencial y catálogo de procedimientos de las unidades de dolor crónico / Quality care standards and procedures catalogue in chronic pain units

Objetivos: Desarrollar unos estándares de calidad asistencial y un catálogo de procedimientos para las unidades de dolor crónico. Material y métodos: Un comité científico, formado por 6 expertos en el tratamiento del dolor crónico, seleccionó después de una revisión sistemática de la bibliografía un conjunto de 130 criterios de calidad asistencial y 80 procedimientos. Posteriormente, siguiendo la metodología Delphi, un panel formado por el propio comité científico y otros 12 expertos introdujo 4 criterios y 5 procedimientos adicionales, y valoró su grado de acuerdo sobre cada uno de los 134 criterios, y el grado de prioridad de los 85 procedimientos seleccionados. Resultados: Se ha obtenido un grado elevado de consenso sobre la mayoría de los estándares de calidad propuestos. En particular, se han consensuado 31 estándares generales sobre instalaciones y equipamiento, 15 sobre recursos humanos y 13 sobre procesos. Se han desarrollado 40 estándares sobre consultas externas, que incluyen parámetros estructurales, organizativos y de tiempo, como el número de consultas necesario por cada 100.000 habitantes asignados (1,5 consultas), el número máximo de horas de consulta diarias que debe tener un facultativo (5 horas), el número máximo de días de consulta semanales por facultativo (3 días), el tiempo necesario para completar una primera consulta (50 min) y una sucesiva (20 min), y el tiempo máximo que debe permanecer un paciente en lista de espera en función de la enfermedad subyacente, entre otros. También se han desarrollado 18 estándares de hospitalización y hospital de día, que incluyen estándares como el número de camas y sillones de readaptación al medio necesarios en el hospital de día por cada 100.000 habitantes (1 cama y 1 sillón), el número máximo de pacientes hospitalizados que puede tener a su cargo un especialista en el tratamiento del dolor (4 si es la unidad del dolor la responsable del ingreso, 7 si son otros servicios los responsables, 8 si son pacientes del hospital de día de la unidad), el tiempo necesario para realizar la primera consulta de un paciente hospitalizado (60 min si está ingresado a cargo de la unidad del dolor y 45 min si son otros servicios los responsables del ingreso). El estudio también incluye 8 estándares sobre actividad científica y docente. Finalmente, se ha evaluado la prioridad de 85 procedimientos (18 del hospital de día, 24 de las salas de bloqueo y 43 del quirófano) para que formen parte de la cartera de servicios de las unidades del dolor, y se han establecido unos estándares de tiempo para 76 de ellos. Conclusiones: Con el debido rigor científico y técnico, se han desarrollado unos estándares de calidad y un catálogo actualizado de procedimientos propios de las unidades del dolor crónico, que deben resultar útiles tanto para la actualización de la estructura y la organización de las unidades ya existentes, como para la planificación y el desarrollo de futuras unidades. Esperamos contribuir con este trabajo a la mejora de la calidad asistencial de los pacientes con dolor crónico (AU)

Objectives: To develop quality care standards and a procedures catalogue for Chronic Pain Units. Material and methods: A scientific committee consisting of 6 experts in the treatment of chronic pain selected, after a literature review, a group of 130 quality care criteria and 80 procedures. Later, following Delphi methodology, a panel made up of the scientific committee itself and 12 other experts introduced 4 additional criteria and 5 more procedures, and evaluated their level of agreement on each of the 134 criteria and the priority level of the 85 procedures selected. Results: A high level of consensus agreement was obtained on the majority of the care standards proposed. In particular, there was consensus on 31 general standards for installations and equipment, 15 on human resources and 13 on procedures. A total of 40 standards have been developed for outpatient clinics, which include structural, organisational and time parameters, such as the number of clinics required for every 100,000 inhabitants (1.5 clinics), the maximum number of daily clinic hours that a physician has to attend (5 h), the maximum number of clinic days per week per physician (3 days), the time required to complete a first visit (50 min) and successive ones (20 min), and the maximum time that a patient must remain on a waiting list depending on their underlying illness, among others. Another 18 standards have been developed for hospitalisation and day hospital, which include standards such as the number of rehabilitation beds and chairs (1 bed and 1 chair), the maximum number of hospitalised patients that a specialist in pain treatment could be responsible for (4 if the Pain Unit is responsible for the admission, and 7 if other departments are responsible, 8 if they are hospital day unit patients), the time required for the first visit to a hospitalised patient (60 minutes if admitted by the Pain Unit and 45 if other departments are responsible for the admission). The study also included 8 standards on scientific activity and teaching. Finally, the priority of the 85 procedures was evaluated (18 for the day hospital, 24 for wards and 43 for operating room) so that they formed part of a services menu for the Pain Units, as well as establishing 76 time standards for these. Conclusions: Quality standards and an updated procedures catalogue have been developed appropriate for chronic pain units, which should be useful for updating the structure and organisation of already existing units, as well as for the planning and development of future units. We hope that this work will contribute to the improvement in the quality of health care for patients with chronic pain (AU)

Varón joven con fiebre, clínica neurológica y deposiciones patológicas / Young male with fever, neurological symptoms and pathological stools

Las parasitosis por tenias constituyen una patología de baja incidencia en nuestro entorno predominando en zonas rurales en consumidores de carne poco preparada y de animales no inspeccionados de origen porcino o vacuno. Los síntomas más frecuentes que pueden ocasionar son de origen gastrointestinal aunque las reacciones urticariales, cefalea y anorexia pueden estar presentes. Las complicaciones como apendicitis, obstrucción o perforación intestinal y afectación muscular o cerebral no son habituales. Se presenta un caso de parasitosis por Taenia saginata cuya manifestación clínica sugirió inicialmente un proceso neurológico de gravedad

Parasitosis due to taenia is a disease with low incidence in our setting, it predominating in the rural area in those who eat undercooked meat and animal origin food such as pork or beef. The most frequent symptoms that they can cause are gastrointestinal. However, urticarial reactions, headache and anorexia may be present. Complications such as appendicitis, obstruction or intestinal perforation and muscle or brain involvement are unusual. A case of parasitosis due to Taenia Saginata whose clinical manifestation initially suggested a serious neurological condition is presented

¿Para qué sirve un neurólogo en una Unidad del Dolor? / The role of the neurologist in the pain unit?

Introducción:La Unidad Multidisciplinaria de Dolor Crónico del Hospital Universitario 12 de Octubre está compuesta por una anestesióloga, una internista y un reumatólogo con dedicación absoluta. Con ellos colaboran una rehabilitadora y una psicóloga. Se analiza la utilidad de una consulta de apoyode neurología, en principio destinada a contribuir al manejo de pacientes con dolor neuropático, especialidad que en nuestro medio tradicionalmente no ha participado en la atención a estos pacientes dentro de las Unidades del Dolor. Métodos: Se describe la actividad de la consulta de neurología durante seis meses. Dicha consulta está integrada en la Unidad, es desempeñada por un neurólogo que un día a la semana valora a los pacientes remitidos por la propia Unidad,emite un informe de interconsulta y discute con el médico remitente, o con toda la Unidad, su opinión. Se analizan las características demográficas, lugar de procedencia a la unidad,motivo de consulta en la unidad, motivo de consulta neurológico, tratamiento previo, intensidad del dolor, tiempo de evolución, diagnóstico, presencia e importancia del dolor neuropático, presencia o ausencia de patología psiquiátrica, laboral o judicial, y si hubo o no tras la consulta, modificación en el diagnóstico etiológico, de los mecanismos fisiopatogénicos involucrados en el dolor, en el plande estudio, tratamiento, seguimiento y destino. Resultados: Al analizar nuestra población, en comparación con el conjunto de la población de la Unidad destaca que este subgrupo es de mayor edad que el atendido en la Unidad y es de gran complejidad, no sólo debido a su dolor sinotambién a su cronicidad, intensidad y larga historia de tratamientos previos. Llama la atención que en un porcentaje significativo de los pacientes remitidos no había dolor neuropático,se modificó el diagnóstico etiológico en una minoría, pero en la mayoría una mejor exploración de los mecanismos fisiopatogénicos del dolor neuropático contribuyó a la variación del estudio diagnóstico, opciones de tratamiento y pronóstico. Por último, al comparar los pacientesatendidos con los de una consulta de neurología ambulatoria sorprende la ausencia en esta no sólo de cefaleas sino también de pacientes con dolores centrales que se podrían beneficiar de las posibilidades terapeúticas de una unidad del dolor. Conclusiones: Demostramos cómo un neurólogo consultor en una Unidad del Dolor puede ser útil para contribuir al diagnóstico etiológico de pacientes complejos, confirmar o descartar la presencia de dolor neuropático, contribuir al estudio y disección de los diferentes fenómenos positivos presentes y su posible adscripción a mecanismos fisiopatológicos concretos, base de la indicación de pruebas complementarias,de tratamientos dirigidos a esos mecanismos, explicar al paciente la naturaleza de su dolor, ayudar al seguimiento y pronóstico. Creemos que el modelo de un neurólogo consultor integrado en una Unidad Multidisciplinar de Dolor Crónico, frente a otros modelos de consultas unidisciplinareso en paralelo con las unidades de dolor ya existentes, enriquece la atención y la gama de opciones terapéuticas de los pacientes con dolor crónico

Introduction:In the Multidisciplinary Chronic Pain Unit at the University Hospital “12 de Octubre” work a full-time anesthesiologist, a full-time specialist in internal medicine and a fulltime rheumatologist. They are supported by an occupational therapist and a psychologist. We review the usefulness of a neurology support service, which was originally aimed to contribute to the management of patientswith neuropathic pain, an specialty that in our hospital setting has traditionally not been involved in the care of these patients referred to pain units. Methods: We describe the activity of a neurology service over a sixmonth period. Such service is integrated in the Pain Unit and it is staffed by a neurologist that one day during the week assesses the patients referred to him by the Unit, issuesan interconsultation report and discuss his/her opinion with the referring physician or with the whole Unit. Demographic data, source of referrals to the Unit, reason of the referral to the Unit, reason of the referral to the neurology service, prior treatment, pain severity, length of evolution,diagnosis, presence and severity of neuropathic pain, presence or absence of occupational or legal psychiatric disorders, and whether the etiological diagnosis changed after consultation, physiopathogenic mechanisms involved in pain, and study plan, treatment, follow-up and destination. Results: The analysis of our study population, compared to the overall population of patients referred to the Unit, shows that our subpopulation has a greater mean age comparedto the population referred to the Unit and is of a high complexity, not only due to pain, but also to chronicity, severity and a long history of prior treatments. Interestingly, a significant percentage of the patients referred did not have neuropathic pain. Etiological diagnosis was changed in afew cases, but is most of them a better exploration of physiopathogenic mechanisms involved in neuropathic pain resulted in the variation of diagnosis study, therapeutic options and prognosis. Finally, when comparing the patients referred to our service with those of an outpatient neurologyservice, the absence of headaches and central pain conditions that could benefit from therapeutic options provided by a pain unit is surprising. Conclusions: We have shown how a consultant neurologist can be useful in a Pain Unit in order to contribute to the etiological diagnosis of complex patients, to confirm or discard the presence of neuropathic pain, to contribute to the study anddescription of several positive phenomena that are present and its potential relationship with specific physiopathological mechanisms, as the basis for ordering additional tests and treatments aimed to such mechanisms, to explain the patient the nature of his/her pain, and to help in the followup and prognosis. We believe that the model of a consultant neurologist integrated in a multidisciplinary chronic pain unit or working in parallel with an existing pain unit, improvesthe health care and the range of therapeutic options provided to patients with chronic painIntroduction: In the Multidisciplinary Chronic Pain Unit at the University Hospital “12 de Octubre” work a full-time anesthesiologist, a full-time specialist in internal medicine and a fulltime rheumatologist. They are supported by an occupational therapist and a psychologist. We review the usefulness of a neurology support service, which was originally aimed to contribute to the management of patients with neuropathic pain, an specialty that in our hospital setting has traditionally not been involved in the care of these patients referred to pain units. Methods: We describe the activity of a neurology service over a sixmonth period. Such service is integrated in the Pain Unit and it is staffed by a neurologist that one day during the week assesses the patients referred to him by the Unit, issues an interconsultation report and discuss his/her opinion with the referring physician or with the whole Unit. Demographic data, source of referrals to the Unit, reason of the referral to the Unit, reason of the referral to the neurology service, prior treatment, pain severity, length of evolution, diagnosis, presence and severity of neuropathic pain, presence or absence of occupational or legal psychiatric disorders, and whether the etiological diagnosis changed after consultation, physiopathogenic mechanisms involved in pain, and study plan, treatment, follow-up and destination. Results: The analysis of our study population, compared to the overall population of patients referred to the Unit, shows that our subpopulation has a greater mean age compared to the population referred to the Unit and is of a high complexity, not only due to pain, but also to chronicity, severity and a long history of prior treatments. Interestingly, a significant percentage of the patients referred did not have neuropathic pain. Etiological diagnosis was changed in a few cases, but is most of them a better exploration of physiopathogenic mechanisms involved in neuropathic pain resulted in the variation of diagnosis study, therapeutic options and prognosis. Finally, when comparing the patients referred to our service with those of an outpatient neurology service, the absence of headaches and central pain conditions that could benefit from therapeutic options provided by a pain unit is surprising. Conclusions: We have shown how a consultant neurologist can be useful in a Pain Unit in order to contribute to the etiological diagnosis of complex patients, to confirm or discard the presence of neuropathic pain, to contribute to the study and description of several positive phenomena that are present and its potential relationship with specific physiopathological mechanisms, as the basis for ordering additional tests and treatments aimed to such mechanisms, to explain the patient the nature of his/her pain, and to help in the followup and prognosis. We believe that the model of a consultant neurologist integrated in a multidisciplinary chronic pain unit or working in parallel with an existing pain unit, improves the health care and the range of therapeutic options provided to patients with chronic pain

Applicability of RAPD markers on silver-stained polyacrylamide gels to ascertain genetic diversity in Peripatus acacioi (Peripatidae; Onychophora)

RAPD (random amplification of polymorphic DNA) molecular markers can be utilized for analyzing genetic variability in populations for which only a few or no molecular markers are available. They were used in a study of an endangered species, Peripatus acacioi, found in the Tripuí Ecological Station, in Ouro Preto, MG, Brazil. The ecological station was specifically created to protect this velvet worm species, the first of this group found in Brazil. For an initial evaluation of the genetic diversity of this species, DNA samples from the lobopods of four individuals, collected at random, were analyzed using RAPD. Each reaction was run with a different primer (Operon RAPD 10-mer Kits), totaling 13 primers (OPC2, OPC3, OPC4, OPC6, OPC8, OPC10, OPC11, OPL2, OPL7, OPL11, OPL13, OPL18, and OPL19). Due to the low amplification yield, RAPD fragments were separated in polyacrylamide gels and stained with silver nitrate. Numerous bands were observed. Fifty-five of the amplified bands proved to be reproducible, both in terms of presence and intensity. Among these, 27 were variable and 28 were constant. The average number of bands per gel was 4.2. Nine of the 13 primers tested allowed the identification of constant and variable bands among these four individuals. RAPD analysis of genetic variation using silver-stained polyacrylamide gel electrophoresis provided measures of band sharing among the individuals, and therefore could be used in population genetics studies of P. acacioi.

Trastornos de la reactividad al dolor / Pain reactivity disorders

La función protectora del dolor es bien conocida. Existen algunas enfermedades que cursan con la ausencia de la percepción dolorosa y conllevan a múltiples problemas para los pacientes afectados. En los trastornos de la reactividad al dolor se pueden distinguir trastornos congénitos y adquiridos. Dentro de los congénitos se incluyen dos cuadros clínicos bien diferenciados: la insensibilidad congénita al dolor o analgesia congénita y la indiferencia congénita al dolor. En el primer caso el estímulo doloroso no es transmitido adecuadamente al sistema nervioso central debido a un defecto en las vías sensitivas; mientras que en el segundo la vía sensorial está integra pero el paciente no identifica el estímulo doloroso como desagradable. Actualmente la insensibilidad congénita al dolor se encuadra dentro de un grupo de neuropatías hereditarias llamadas sensitivo-autonómicas, con afectación de la sensibilidad dolorosa, en relación con la implicación de las fibras nerviosas mielínicas pequeñas y amielínicas, vehículos de la mayor parte de la sensibilidad dolorosa, así como de las fibras autonómicas. Se distinguen cinco tipos de neuropatía hereditaria sensitivo-autonómica, que se describen en el texto, existiendo alteración de la percepción dolorosa en todas ellas, aunque con mayor grado en alguna de ellas como en el caso de la neuropatía hereditaria sensitivo-autonómica tipo IV o insensibilidad congénita al dolor con anhidrosis. Clínicamente en estas neuropatías se pueden producir lesiones a diversos niveles como consecuencia de la pérdida de la sensibilidad dolorosa. Las alteraciones que se asocian con mayor frecuencia son: fracturas múltiples, articulaciones de Charcot, dismetría de extremidades inferiores, osteomielitis, artritis séptica, luxaciones, autoamputaciones, automutilaciones y escoliosis progresiva. Es necesario un tratamiento multidisciplinar y especializado junto con la colaboración paterna para minimizar las complicaciones de esta enfermedad potencialmente grave. En ausencia de tratamiento etiológico, el tratamiento sintomático adquiere una gran importancia. Se evitaran en lo posible los procesos de riesgo, producción de fracturas, mordeduras, roces, infecciones y mutilaciones. Cuando se producen lesiones en áreas del cerebro que sustentan el procesamiento del estímulo doloroso, pueden tener lugar déficits en uno o varios componentes de la percepción dolorosa, y pueden producirse situaciones clínicas similares a la insensibilidad congénita al dolor. Dentro de los trastornos adquiridos se describen la asimbolia dolorosa, la analgotimia y la hemiagnosia dolorosa (AU)

Genetic diversity and structure of natural populations of Plathymenia reticulata (Mimosoideae), a tropical tree from the Brazilian Cerrado.

Plathymenia reticulata is a tropical tree native to the Brazilian Cerrado, one of the most important and endangered ecosystems in Brazil. This species presents high-quality wood and potential for recovery of degraded areas. Despite its importance, almost nothing is known about its genetic or ecological features. Random amplified polymorphic DNA (RAPD) markers were used to investigate the genetic diversity and structure of six natural populations of P. reticulata. DNAs from 117 adult individuals were amplified with 10 random primers and Shannon's index and amova were used to evaluate the levels of genetic diversity within and among populations. Through 72 markers, 70.8% of which were polymorphic, it was possible to obtain 117 unique RAPD phenotypes. The levels of genetic variability found in the six populations of P. reticulata were considerable and most of the genetic variation was found between individuals within populations, although pairwise PH(ST) values indicated significant divergence between populations. The among-population component accounted for, respectively, 12.3% and 16% of the genetic variation, according to amova and Shannon's index. These results were compared with other genetic studies on plant species and such a level of differentiation among populations corresponds to that which has usually been observed for outcrossing plants. The importance of maintenance of the P. reticulata populations and implications of the analysis of adult individuals, considering the longevity of this species and the relatively recent Cerrado fragmentation, are discussed.

A study of the response of Y3Al5O12:Ce phosphor powder screens in the vacuum ultraviolet and soft X-ray regions using synchrotron radiation.

Phosphor screens find application in many fields because of their ability to convert incident radiation to wavelengths that are readily measured by modern detectors. While the response of such screens in the X-ray region has been widely studied, much work still remains to be done regarding their response in the vacuum ultraviolet and soft X-ray regions, where the response is predicted to be non-linear owing to the presence of elemental absorption edges. Here, an experiment using synchrotron radiation to determine the response of thin Y(3)Al(5)O(12):Ce (1-21 mg cm(-2)) and Y(2)O(3):Eu (2.64 mg cm(-2)) powder phosphor screens in the spectral range 20-900 A (13.8-620 eV) is reported. Also, a custom-built camera is described which permits simultaneous collection of the forward- and backward-emitted light and that enables measurements to be made at various positions across the screens and at several screen/incident beam angles. Finally, features in the response spectra are identified, and efficiencies across the spectral range indicated for different screen thicknesses and operating modes are plotted, before a curve of the intrinsic radiant efficiency of Y(3)Al(5)O(12):Ce is produced. The results are discussed in the context of other measurements.

Analysis of sulfamethazine in the presence of sulfamerazine or sulfadiazine by first-derivative photochemically induced fluorescence.

A first-derivative photochemically-induced fluorescence method is proposed for the determination of sulfamethazine (SMTZ) in the presence of sulfamerazine (SMRZ) or sulfadiazine (SDZ). Linear calibration plots were obtained for SMTZ in SMTZ-SMRZ or SMTZ-SDZ binary mixtures with correlation coefficients larger than 0.999. For SMTZ the lower limits of detection were 7-13 ppb. Recoveries of 91-114% were obtained in the analysis of SMTZ in pharmaceutical formulations.

A simple method for N-15 labelling of exocyclic amino groups in synthetic oligodeoxynucleotides.

The use of the ammonia deprotection step to introduce (15)N labels at specific exocyclic amino positions of adenine, cytosine, guanine or 2-aminopurine of oligodeoxynucleotides is described.

Estudo do comportamento dos linfocitos derivados do timo em pacientes com penfigo foliaceo na presenca de levamisol. / Behaviour of T - lymphocytes in patients with foliaceus pemphigus at the presence of levamisole

Foram estudados linfocitos T de pacientes portadores de penfigo foliaceo em relacao a sua capacidade de formar rosaceas "E", diante de concentracoes do imunopotenciador levamisol. O levamisol e uma substancia que estimula formacao de rosaceas de linfocitos T ativos em individuos normais: Os linfocitos de pacientes antes da corticoterapia sistemica nao responderam ao levamisol ja os linfocitos de pacientes em tratamento com corticoides tiveram inibida sua capacidade de formar rosaceas. Esses achados sugerem altecao no metabolismo celular dos linfocitos de pacientes penfigosos devido provavelmente a alguma falha no sistema enzimatico dessas celulas envolvendo a fosfodiesterase do AMPc