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1.
J Environ Manage ; 365: 121505, 2024 Jun 21.
Article in English | MEDLINE | ID: mdl-38908156

ABSTRACT

Selecting the optimal monitoring points in a water distribution network is challenging due to the complex spatiotemporal variability of water quality degradation. The lack of a standardized methodology for monitoring point selection forces operators to rely on general recommendations, historical data and professional experience, which can mask water quality problems and increase the risk to consumers. This study proposes a new methodology to optimize the selection of monitoring points in distribution networks. The method considers the spatiotemporal degradation of water quality, the definition of representative zones and two selection criteria: global representativeness and potential health risk. Representative zones were determined for each node of the network based on hydraulic paths and their water quality spatial variability. Part of the distribution network in Quebec City, Canada was used as the case study, in which four water quality parameters were investigated: free chlorine residual (FRC), heterotrophic plate counts (HPC), trihalomethanes (THMs) and haloacetic acids (HAAs). Seasonal variabilities (summer and winter) were also analyzed. The results obtained for the two criteria and for both seasons were compared, and methodological and practical recommendations were established for dynamic monitoring programs that respond to the needs of operators.

2.
Water Res ; 250: 121045, 2024 Feb 15.
Article in English | MEDLINE | ID: mdl-38159537

ABSTRACT

Lactate is among the top-ten-biobased products. It occurs naturally as D- or L-isomer and as a racemic mixture (DL-lactate). Generally, lactate with a high optical purity is more valuable. In searching for suitable renewable feedstocks for lactate production, unutilized organic waste streams are increasingly coming into focus. Here, we investigated acid whey, which is a lactose-rich byproduct of yogurt production, that represents a considerable environmental footprint for the dairy industry. We investigated the steering of the lactate-isomer composition in a continuous and open culture system (HRT = 0.6 d) at different pH values (pH 5.0 vs. pH 6.5) and process temperatures (38°C to 50°C). The process startup was achieved by autoinoculation. At a pH of 5.0 and a temperature of 47°C-50°C, exclusive D-lactate production occurred because of the dominance of Lactobacillus spp. (> 95% of relative abundance). The highest volumetric D-lactate production rate of 722 ± 94.6 mmol C L-1 d-1 (0.90 ± 0.12 g L-1 h-1), yielding 0.93 ± 0.15 mmol C mmol C-1, was achieved at a pH of 5.0 and a temperature of 44°C (n = 18). At a pH of 6.5 and a temperature of 44°C, we found a mixture of DL-lactate (average D-to-L-lactate production rate ratio of 1.69 ± 0.90), which correlated with a high abundance of Streptococcus spp. and Enterococcus spp. However, exclusive L-lactate production could not be achieved. Our results show that for the continuous conversion of lactose-rich dairy waste streams, the pH was a critical process parameter to control the yield of lactate isomers by influencing the composition of the microbiota. In contrast, temperature adjustments allowed the improvement of bioprocess kinetics.


Subject(s)
Lactic Acid , Microbiota , Fermentation , Temperature , Lactose , Hydrogen-Ion Concentration
3.
Dis Esophagus ; 37(4)2024 Apr 02.
Article in English | MEDLINE | ID: mdl-38117958

ABSTRACT

There is little information on the degree of concordance between the results obtained using the Chicago 3.0 (CCv3.0) and Chicago 4.0 (CCv4.0) protocols to interpret high-resolution manometry (HRM) seeking to determine the value provided by the new swallowing maneuvers included in the last protocol. This is a study of diagnostic tests, evaluating concordance by consistency between the results obtained by the CCv3.0 and CCv4.0 protocols, in patients undergoing HRM. Concordance was assessed with the kappa test. Bland-Altman scatter plots, and Lin's correlation-concordance coefficient (CCC) were used to assess the agreement between IRP measured with swallows in the supine and seated position or with solid swallows. One hundred thirty-two patients were included (65% women, age 53 ± 17 years). The most frequent HRM indication was dysphagia (46.1%). Type I was the most common type of gastroesophageal junction. The most frequent CCv4.0 diagnoses were normal esophageal motility (68.9%), achalasia (15.5%), and ineffective esophageal motility (IEM; 5.3%). The agreement between the results was substantial (Kappa 0.77 ± 0.05), with a total agreement of 87.9%. Diagnostic reclassification occurred in 12.1%, from IEM in CCv3.0 to normal esophageal motility in CCv4.0. Similarly, there was a high level of agreement between the IRP measured in the supine compared to the seated position (CCC0.92) and with solid swallows (CCC0.96). In conclusion, the CCv4.0 protocol presents a high concordance compared to CCv3.0. In the majority of manometric diagnoses there is no reclassification of patients with provocation tests. However, the more restrictive criteria of CCv4.0 achieve a better reclassification of patients with IEM.


Subject(s)
Deglutition Disorders , Esophageal Achalasia , Esophageal Motility Disorders , Humans , Female , Adult , Middle Aged , Aged , Male , Esophageal Motility Disorders/diagnosis , Chicago , Esophageal Achalasia/diagnosis , Deglutition Disorders/diagnosis , Deglutition Disorders/etiology , Manometry/methods
4.
Front Psychiatry ; 14: 1222972, 2023.
Article in English | MEDLINE | ID: mdl-37645639

ABSTRACT

Suicide is a complex and multifaceted public health issue that affects individuals from all walks of life, including healthcare professionals such as physicians. According to research, physicians have a higher risk of suicide compared to the general population, with an estimated suicide rate that is two to three times greater than that of the general population. Suicide in physicians can have devastating consequences, not only for the individual but also for their patients and colleagues. The factors contributing to suicide in physicians are numerous and often interrelated. Physicians are exposed to numerous stressors in their daily lives, including long work hours, high workload, burnout, and exposure to traumatic events. These stressors can lead to mental health problems such as depression, anxiety, and substance use disorders, which in turn can increase the risk of suicide. In addition to work-related stressors, personal factors such as relationship problems, financial stress, and a history of mental health problems can also contribute to suicide risk in physicians. Stigma and shame around seeking help for mental health issues may also prevent physicians from seeking treatment, exacerbating the problem. Understanding the complex factors that contribute to suicide in physicians is crucial for developing effective prevention strategies. For this reason, it is necessary to know the behavior of this phenomenon and the factors associated with a higher risk of suicide in this population. However, taking into account that different regions of the world vary in socioeconomic, cultural, professional, occupational, and health attributes, it is to be expected that the behavior of these risk factors will also be heterogeneous. At present, it is presumed that there is a significant gap in the evidence, due to a predominance of evidence on this topic from high-income countries. Considering the importance of having a comprehensive understanding of the risk factors for suicide in the medical population and possible strategies to mitigate this condition, the aim of this review is to analyze the most recent evidence on these factors, and to assess the quality of the evidence and gaps that need to be studied further.

5.
Article in English | LILACS-Express | LILACS | ID: biblio-1535914

ABSTRACT

Introduction: Limited information is available regarding the clinical and manometric characteristics of different subtypes of achalasia. This study aims to describe these characteristics in patients treated at a prominent hospital in Colombia. Methods: This descriptive observational study included patients diagnosed with achalasia using high-resolution esophageal manometry at Hospital Universitario San Ignacio in Bogotá, Colombia, between 2016 and 2020. We documented the clinical manifestations, manometric findings, treatment approaches, and response to treatment based on the subtype of achalasia. Results: A total of 87 patients were enrolled, with a median age of 51 years, and 56.4% of them were female. The majority had type II achalasia (78.1%), followed by type I (16%) and type III (5.7%). All patients presented with dysphagia, 40.2% experienced chest pain, and 27.6% had gastroesophageal reflux. The clinical parameters, including integrated relaxation pressure value (IRP; median: 24 mmHg, interquartile range [IQR]: 19-33), upper esophageal sphincter pressure (UES; median: 63 mmHg, IQR: 46-98), and lower esophageal sphincter pressure (LES; median: 34 mm Hg, IQR: 26-45), were similar across the different subtypes. Esophageal clearance was incomplete in all patients. Among the 35 patients who received intervention, Heller's myotomy was the most commonly employed procedure (68.5%), followed by esophageal dilation (28.6%). All patients experienced symptomatic improvement, with a median pre-treatment Eckardt score of 5 (IQR: 5-6) and a post-treatment score of 1 (IQR: 1-2). Conclusions: Type II achalasia is the most prevalent subtype. The clinical and manometric findings, as well as treatment response, exhibit similarities among the different subtypes of achalasia. In Colombia, the outcomes of this condition align with those reported in other parts of the world.


Introducción: existe información limitada sobre las características clínicas y manométricas de los diferentes subtipos de acalasia. Este estudio describe dichas características en pacientes manejados en un hospital de referencia en Colombia. Método: estudio descriptivo observacional que incluye a pacientes con diagnóstico de acalasia por manometría esofágica de alta resolución manejados en el Hospital Universitario San Ignacio de Bogotá, Colombia, entre 2016 y 2020. Se describen las manifestaciones clínicas, hallazgos manométricos, tratamiento utilizado y respuesta al mismo según el subtipo de acalasia. Resultados: se incluyeron a 87 pacientes (mediana de edad: 51 años, 56,4% mujeres). La mayoría de tipo II (78,1%), seguido por tipo I (16%) y tipo III (5,7%). Todos presentaron disfagia, 40,2% dolor torácico y 27,6% reflujo gastroesofágico. La clínica y los valores del integral de presión de relajación (IRP; mediana: 24 mm Hg, rango intercuartílico [RIC]: 19-33), presión del esfínter esofágico superior (EES; mediana: 63 mm Hg, RIC: 46-98) y presión del esfínter esofágico inferior (EEI; mediana: 34 mm Hg, RIC: 26-45) fueron similares en los diferentes subtipos. El aclaramiento esofágico fue incompleto en todos los pacientes. Entre 35 pacientes que recibieron manejo intervencionista, la miotomía de Heller fue la intervención más utilizada (68,5%), seguido por la dilatación esofágica (28,6%). La totalidad de estos pacientes presentó una mejoría sintomática con la mediana de Eckardt pretratamiento de 5 (RIC: 5-6) y postratamiento de 1 (RIC: 1-2). Conclusiones: la acalasia tipo II es la más común. La clínica y los hallazgos manométricos y respuesta a tratamiento son similares entre los subtipos de acalasia. En Colombia, esta entidad se comporta de forma similar a lo reportado en otras partes del mundo.

6.
J Environ Manage ; 337: 117734, 2023 Jul 01.
Article in English | MEDLINE | ID: mdl-36996548

ABSTRACT

Drinking water may undergo spatiotemporal changes in quality as it leaves the treatment plant and enters the distribution system. This variability means that not all consumers receive water of the same quality. Monitoring water quality in distribution networks makes it possible to verify the compliance of current regulations and reduce consumption risks associated with water quality degradation. An inaccurate interpretation of the spatiotemporal variability of water quality affects the selection of monitoring locations and the sampling frequency, which may conceal problems with the water quality and increase consumers' risk. This paper presents a chronological and critical review of the literature on the evolution, benefits and limitations of methodologies for the optimization of water quality degradation monitoring in water distribution systems supplied by surface sources. This review compares the different methodologies and examines the types of approaches, optimization objectives, variables, and types of spatial and temporal analysis, as well as the main advantages and limitations. A cost-benefit analysis was conducted to assess applicability in different-sized municipalities (small, medium and large). Future research recommendations for optimal water quality monitoring in distribution networks are also provided.


Subject(s)
Drinking Water , Water Quality , Water Supply , Environmental Monitoring/methods , Seasons
7.
Int J Gynecol Cancer ; 32(12): 1497-1504, 2022 12 05.
Article in English | MEDLINE | ID: mdl-36351746

ABSTRACT

OBJECTIVE: To assess the incidence of peritoneal carcinomatosis in patients undergoing minimally invasive or open radical hysterectomy for cervical cancer. METHODS: The MEDLINE (accessed through Ovid), Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Clinical Trials, and Scopus databases were searched for articles published from inception up to April 2022. Articles published in English were considered. The included studies reported on patients with International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IA-IIA squamous cell carcinoma, adenocarcinoma, and/or adenosquamous carcinoma of the cervix who underwent primary surgery. Studies had to report at least one case of peritoneal carcinomatosis as a recurrence pattern, and only studies comparing recurrence after minimally invasive surgery versus open surgery were considered. Variables of interest were manually extracted into a standardized electronic database. This study was registered in PROSPERO (CRD42022325068). RESULTS: The initial search identified 518 articles. After the removal of the duplicate entries from the initial search, two authors independently reviewed the titles and abstracts of the remaining 453 articles. Finally, 78 articles were selected for full-text evaluation; 22 articles (a total of 7626 patients) were included in the analysis-one randomized controlled trial and 21 observational retrospective studies. The most common histology was squamous cell carcinoma in 60.9%, and the tumor size was <4 cm in 92.8% of patients. Peritoneal carcinomatosis pattern represented 22.2% of recurrences in the minimally invasive surgery approach versus 8.8% in open surgery, accounting for 15.5% of all recurrences. The meta-analysis of observational studies revealed a statistically significant higher risk of peritoneal carcinomatosis after minimally invasive surgery (OR 1.90, 95% CI 1.32 to 2.74, p<0.05). CONCLUSION: Minimally invasive surgery is associated with a statistically significant higher risk of peritoneal carcinomatosis after radical hysterectomy for cervical cancer compared with open surgery.


Subject(s)
Carcinoma, Squamous Cell , Peritoneal Neoplasms , Uterine Cervical Neoplasms , Pregnancy , Female , Humans , Uterine Cervical Neoplasms/surgery , Uterine Cervical Neoplasms/pathology , Retrospective Studies , Peritoneal Neoplasms/surgery , Peritoneal Neoplasms/pathology , Hysterectomy/adverse effects , Carcinoma, Squamous Cell/pathology , Minimally Invasive Surgical Procedures/adverse effects , Recurrence , Neoplasm Staging , Randomized Controlled Trials as Topic
9.
Rev. colomb. gastroenterol ; 36(2): 212-217, abr.-jun. 2021. tab
Article in English, Spanish | LILACS | ID: biblio-1289301

ABSTRACT

Resumen Introducción: La enfermedad por reflujo gastroesofágico (ERGE) refractaria puede conducir a complicaciones potenciales como la esofagitis persistente, estenosis esofágica, anillo de Schatzki y esófago de Barrett. Este estudio describe la motilidad en pacientes con ERGE refractaria y su relación con síntomas esofágicos. Método: Se realizó un estudio observacional analítico a partir de una cohorte retrospectiva en pacientes con diagnóstico de ERGE refractaria y síntomas esofágicos a quienes se les realizó manometría esofágica de alta resolución más impedanciometría. Se describen las características clínicas y demográficas, y la asociación entre los trastornos manométricos y los síntomas esofágicos. Resultados: Se incluyeron 133 pacientes (edad promedio: 54,1 ± 12,5 años). La pirosis y regurgitación (69,2 %) y la disfagia esofágica (13,5 %) fueron los síntomas más comunes. La motilidad normal (75,2 %), el aclaramiento completo del bolo (75,2 %) y la motilidad esofágica inefectiva (MEI) (18 %) fueron los hallazgos manométricos más frecuentes. La unión gastroesofágica tipos II y IIIb estuvieron presentes en el 35,3% y 33,8 % de los casos, respectivamente. La aperistalsis (3,8 %) y el esófago en martillo neumático (Jackhammer; 0,8 %) fueron infrecuentes. El aclaramiento incompleto del bolo se asoció con disfagia esofágica (p = 0,038) y a MEI (p = 0,008). Ningún síntoma esofágico se relacionó significativamente con trastornos de motilidad. Conclusiones: Los resultados de nuestro estudio sugieren que los trastornos de motilidad son infrecuentes en los pacientes con ERGE refractaria. Adicionalmente, sugieren que la presencia de alteraciones de motilidad esofágica no se relaciona con la presencia de síntomas esofágicos y, por tanto, que el tipo de síntoma presentado no permite predecir la existencia de dichos trastornos.


Abstract Introduction: Refractory gastroesophageal reflux disease (GERD) can lead to potential complications such as persistent esophagitis, esophageal stricture, Schatzki ring, and Barrett's esophagus. This study describes motility in patients with refractory GERD, and its association with esophageal symptoms. Materials and methods: An analytical observational study was carried out in a retrospective cohort of patients diagnosed with refractory GERD and esophageal symptoms who underwent high-resolution esophageal manometry and impedance testing. Clinical characteristics, demographics, and the association between motility disorders and esophageal symptoms are described. Results: 133 patients were included (mean age 54.1 ± 12.5 years). Heartburn and regurgitation (69.2%), and esophageal dysphagia (13.5%) were the most common symptoms. Normal motility (75.2%), complete bolus clearance (75.2%), and ineffective esophageal motility (IEM) (18%) were the most frequent manometric findings. Type II and IIIb gastroesophageal junction were observed in 35.3% and 33.8% of the cases, respectively. Esophageal aperistalsis (3.8%) and Jackhammer esophagus (0.8%) were rare findings. Incomplete bolus clearance was associated with esophageal dysphagia (p=0.038) and IEM (p=0.008). No esophageal symptoms were significantly related to motility disorders. Conclusions: The results of the present study suggest that motility disorders are rare in patients with refractory GERD. They also suggest that esophageal motility disorders are not associated with the presence of esophageal symptoms and, therefore, the type of symptom experienced does not allow predicting the existence of such disorders.


Subject(s)
Humans , Male , Female , Esophageal Motility Disorders , Deglutition Disorders , Gastroesophageal Reflux , Esophagitis , Manometry , Patients , Association , Barrett Esophagus , Esophageal Stenosis
10.
Rev. cienc. salud (Bogotá) ; 19(3): 1-15, 2021. graf, tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1367507

ABSTRACT

Introducción: las caídas intrahospitalarias están dentro de las prioridades nacionales e internacionales en cuanto a calidad asistencial. Aunque se reconocen elementos intrínsecos y extrínsecos al paciente con la presencia de caídas, en Colombia existe poca evidencia al respecto. El objetivo es caracterizar las caídas de pacientes ocurridas entre 2013 y 2016, y sus factores asociados en un hospital de alta complejidad de Bogotá (Colombia). Materiales y métodos: estudio observacional retrospectivo basado en el registro de caídas que ocurrieron en el periodo de análisis en un hospital de alta complejidad. Se utilizó estadística descriptiva y análisis de regresión logística binaria. Resultados: de 951 caídas que ocurrieron entre 2013 y 2016, el 63.1 % se clasificó como eventos adversos. Según la gravedad, el 54.2 % fue "moderado" y "severo". De la muestra de pacientes, el 53.0 % fue hombres, el 65.5 % tenía 65 o más años (mediana = 71 años; mínimo = 16 años y máximo = 98 años), el 23.2 % tenía alguna enfermedad del sistema circulatorio. Se asoció con un mayor riesgo para una caída que culmina en evento adverso: ser mujer (ic95 %; or= 1.08-1.87), el turno laboral noche (ic95 % = 1.09-2.03) y las especialidades clínicas (ic95 % = 1.36-4.84) y quirúrgicas (ic95 % = 1.14-4.46). Conclusión: las caídas de pacientes son un evento adverso importante de intervenir en las instituciones hospitalarias. Se identificaron elementos intrínsecos, principalmente la edad, y extrínsecos, el turno laboral y la especialidad médica, relacionados con la probabilidad de generar un daño en el paciente ante una caída


Introduction:Intrahospitalary falls are among the national and international priorities in terms of quality of care. Although several intrinsic and extrinsic elements associated with patient falls have been recog-nized, information and evidence on these elements are lacking in Colombia. Thus, we aimed to charac-terize the falls of patients and their associated factors in a high-complexity hospital in Bogotá, Colombia between 2013 and 2016. Materials and methods:A retrospective observational study based on the data obtained from the registry of falls that occurred during the study period in a high-complexity hospital in Bogotá, Colombia was carried out. Descriptive statistical analysis and binary logistic regression analysis were performed. Results:Of the 951 falls that occurred between 2013 and 2016, 63.1% were classified as adverse events. According to the severity of falls, 54.2% falls were "moderate" and "severe." According to the demographic characteristics, 53.0% patients were men, 65.5% were ≥65 years old (median: 71 years, minimum: 16 years, maximum: 98 years), and 23.2% had circulatory diseases. The following factors were found to be associated with an increased risk for a fall that culminated in an adverse event: being a woman (95% ci = 1.08­1.87), night shift (95% ci; or = 1.09­2.03), and clinical (95% ci = 1.36­4.84) and sur-gical specialties (95% ci = 1.14­4.46). Conclusion: Patient falls are important adverse events that require intervention in hospital institutions. Intrinsic elements (mainly age) and extrinsic elements (work shift and medical specialty) were identified to cause harm to the patient in the event of a fall


Introdução: as quedas intra-hospitalares estão entre as prioridades nacionais e internacionais quanto àqualidade do atendimento. Embora sejam reconhecidos elementos intrínsecos e extrínsecos ao paciente com a frequência de quedas, na Colômbia há poucas evidências a esse respeito. O objetivo é caracterizar as quedas de pacientes ocorridas entre 2013 e 2016 e seus fatores associados em um hospital de alta complexidade em Bogotá (Colômbia). Materiais e métodos: estudo observacional retrospectivo baseado no registro das quedas ocorridas no período de análise em um hospital de alta complexidade. Foram utilizadas estatística descritiva e análise de regressão logística binária. Resultados: das 951 quedas ocor-ridas entre 2013 e 2016, 63.1% foram classificadas como eventos adversos. De acordo com a gravidade, 54.2% foram "moderadas" e "graves". Da amostra de pacientes, 53.0% eram homens, 65.5% tinham 65 anos ou mais (mediana = 71 anos; mínimo = 16 anos e máximo = 98 anos), 23.2% apresentavam alguma doença do aparelho circulatório. Foi associado a um maior risco de queda que culmina em um evento adverso: ser mulher (ic 95%; or = 1.08-1.87), turno noturno de trabalho (ic 95% = 1.09-2.03) e as especia-lidades clínica (95% ic = 1.36-4.84) e cirúrgica (ic 95% = 1.14-4.46). Conclusão: as quedas de pacientes são um importante evento adverso para intervenção nas instituições hospitalares. Foram identificados ele-mentos intrínsecos, principalmente a idade, e elementos extrínsecos, turno de trabalho e especialidade médica, relacionados à probabilidade de causar dano ao paciente em caso de queda


Subject(s)
Humans , Accidental Falls , Quality of Health Care , Unified Health System , Risk Factors , Morbidity , Colombia , Patient Safety , Patient Harm , Hospitals
11.
Matern Child Health J ; 24(11): 1376-1386, 2020 Nov.
Article in English | MEDLINE | ID: mdl-32815078

ABSTRACT

OBJECTIVE: To analyze municipal- and individual-level factors related to the prevalence of teenage pregnancy in Colombia during 2015. METHODS: We analyzed 660,767 births registers, of which 21.5% recorded adolescent women. At an individual level, marital status, educational level, area of residence, and access to health services were included in the analysis. At the contextual level, Colombian municipal socioeconomic characteristics and proxies of violence and poverty were analyzed. A multilevel logistic regression model was generated with a Markov Chain Monte Carlo estimation method using 100,000 simulations in MLwiN 2.32 software. RESULTS: Multilevel modeling revealed an increased risk of teenage pregnancy in municipalities with the highest numbers of people expelled by forced displacement (OR 1.21; CI 95%, 1.13-1.29) and with unsatisfied basic needs (OR 1.09; CI 95%, 1.02-1.17). At an individual level, the majority of the teenage women were unmarried and/or had an unstable partnership, a low level of educational, a subsidized health regimen, and resided in the municipal seat. CONCLUSIONS: Municipal contextual variables related to poverty, violence, and social inequity contribute to an increase in teenage pregnancy in Colombia. At the individual level, marital status, educational level, and area of residence is associated with teenage pregnancy. It is therefore imperative to include municipal contextual characteristics in the design of the national political agenda.


Subject(s)
Pregnancy in Adolescence/prevention & control , Pregnancy in Adolescence/psychology , Adolescent , Child , Colombia , Female , Geographic Mapping , Housing , Humans , Logistic Models , Multilevel Analysis , Pregnancy , Pregnancy in Adolescence/statistics & numerical data , Prevalence , Qualitative Research , Socioeconomic Factors , Young Adult
12.
Rev. colomb. gastroenterol ; 34(4): 404-410, oct.-dic. 2019. graf
Article in Spanish | LILACS | ID: biblio-1092968

ABSTRACT

Resumen La manometría anorrectal es la técnica más utilizada para evaluar la función anorrectal y así detectar las anormalidades funcionales del esfínter anal y de coordinación anorrectal. En nuestro laboratorio de fisiología realizamos aproximadamente 15 estudios de manometría anorrectal de alta resolución a la semana, por lo que consideramos que es de vital importancia realizarlo de forma adecuada y tener una correcta interpretación. Mediante este artículo deseamos compartir nuestro protocolo de realización de manometría anorrectal de alta resolución con base en la literatura más relevante.


Abstract Anorectal manometry is the most commonly used technique to evaluate anorectal functioning and coordination and detect functional abnormalities of the anal sphincter. In our physiology laboratory we perform approximately 15 high resolution anorectal manometry studies each week. We consider that proper performance and correct interpretation are vitally important. We want to share our high resolution anorectal manometry protocol based on the most relevant literature through this article.


Subject(s)
Humans , Anal Canal , Physiology , Manometry , Literature
13.
Rev. colomb. gastroenterol ; 34(4): 411-415, oct.-dic. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1092969

ABSTRACT

Resumen La manometría anorrectal de alta resolución es una prueba diagnóstica utilizada para los trastornos motores y sensitivos anorrectales. Consta de una medición del tono basal y de contracción anal; también valora la maniobra de pujo, reflejo rectoanal inhibitorio (RIAR) y parámetros sensitivos rectales. La interpretación convencional de la manometría anorrectal se enfoca en describir aisladamente la región anatómica disfuncional. Sin embargo, con la clasificación de Londres se busca estandarizar el informe de estos resultados, agrupándolos en trastornos mayores, menores y hallazgos no concluyentes, similar a la clasificación de Chicago para trastornos motores esofágicos.


Abstract High resolution anorectal manometry is a diagnostic test, used for anorectal motor and sensory disorders. It consists of measurement of basal tone, anal contraction and squeeze, the rectoanal inhibitory reflex (RAIR), and rectal sensory parameters. The conventional interpretation of anorectal manometry focuses on describing the dysfunctional anatomical region in isolation. However, the London classification seeks to standardize the report of these results, grouping them into major, minor and inconclusive findings in a manner similar to the Chicago classification for esophageal motor disorders.


Subject(s)
Humans , Sensation Disorders , Research Report , Motor Disorders , Manometry , Reference Standards
14.
Water Sci Technol ; 78(5-6): 1115-1128, 2018 Oct.
Article in English | MEDLINE | ID: mdl-30339536

ABSTRACT

The bio-flocculants used in this study were synthesised by the Mannich reaction, which includes three reagents: a substrate (tannin extracts of Acacia, Quebracho, and Castanea), formaldehyde, and an amine derivative (ethanolamine, diethanolamine, ammonium chloride). Nine natural flocculants were prepared by combining extracts and amines; these products were evaluated in three different wastewater samples in two experimental phases. In phase I, five physicochemical parameters were analysed. From the data obtained, a multivariate, completely randomised design (CRD-Manava) was used, with a factorial arrangement and mean plots. In phase II, the three bio-flocculants with the most statistically significant responses and their mixtures were examined, evaluating 14 biological and physicochemical parameters. Statistical analysis was guided in this phase by CRD blocks, finding a significant removal in the physicochemical parameters analysed in the different types of wastewater and obtaining removal rates between 50 and 90%, depending on the parameter. At the end of both phases, the bio-flocculants acacia-ammonium chloride and quebracho-diethanolamine were the most efficient in the removal of turbidity (34-99%), true colour (93-100%) and total solids (12-99%). In addition, the natural flocculants showed low mutagenicity index (MI: 0.33-0.93) compared to aluminium sulphate (MI: 4.87-8.81).


Subject(s)
Acacia/chemistry , Tannins/chemistry , Wastewater/chemistry , Water Purification/methods , Alum Compounds , Flocculation , Waste Disposal, Fluid , Water Pollutants, Chemical
15.
São Paulo; s.n; fev. 2015. 92 p. tab, ilus, graf.
Thesis in Portuguese | Index Psychology - Theses | ID: pte-63835

ABSTRACT

Existe ampla evidência do nível de seletividade exibido por macacos-prego (Sapajus sp) em situações de escolha de ferramentas para a quebra de frutos encapsulados; indicando que as características dos martelos (material, peso e distância de transporte), assim como as características físicas próprias dos indivíduos, afetam a eficiência do na quebra e determinam o processo individual de tomada de decisões no uso de ferramentas. Considerando a predição de que também é provável que a eficiência na quebra seja dependente do controle do macaco sobre a pedra e do ângulo de impacto; o presente trabalho teve como objetivo avaliar experimentalmente se a forma das ferramentas afeta a eficiência na quebra e é levada em consideração pelos macacos-prego, na hora de escolher as ferramentas a serem usadas. Para tal, testamos a escolha de pedras por cinco macacos-prego semilivres usuários de ferramentas - fazendo uso de pedras artificiais e realizando tentativas discretas de escolha com participação livre dos indivíduos - através de um delineamento fatorial de medidas repetidas com oito condições experimentais, correspondentes às possíveis combinações de três variáveis independentes em dois níveis: forma dos martelos (possibilidades de pegada e superfície potencial de contato), peso (leve e pesado) e distância de transporte exigida (perto e longe das bigornas). Avaliamos a seletividade exibida, os comportamentos manipulativos exploratórios e a proficiência natural de quebra de cada sujeito, visando elucidar os fatores determinantes do processo de escolha de ferramentas para a quebra de frutos. Os resultados apontam preferência dos macacos-prego pelos martelos que fornecem maior eficiência, pedras com maior possibilidade de pegada e maior superfície potencial de contato no golpe, aumentando os benefícios e diminuindo os custos do uso. Não encontramos um efeito evidente das variáveis de custo (peso e distância de transporte) sobre a preferência pelas características da forma,...(AU)


Evidences point out that capuchin monkeys select stone tools for nut cracking based on the physical characteristics of tools (material, weight, transporting distance) in relation to their own physical characteristics (size, weight), and that selectivity seems to affect the efficiency of nut cracking, determining individual decision making in tool use. Considering the prediction that nut crack efficiency is affected by individual control, the stone and the impact angle; this study aimed to evaluate experimentally if the tools shape affect nut crack efficiency, and if this is considered in individual tool selection. We tested the choices of five semi-free individuals using artificial designed tools in eight different experimental conditions, manipulating hammers weight, shape and distance to the anvil, to determine the factors involved in tool selection process for nut cracking. The results shows the monkeys prefer hammers that increase cracking nut efficiency, with more holding possibility, and higher potential contact surface in the bites. There was no evidence for effect of variables related with costs (hammer weight and transporting distance) on the shape preference, and there was no relation between preferences in experimental conditions and engage or efficiency in baseline. We found that the capuchin monkeys based their tool choices in visual characteristics and exhibit manipulative exploratory behaviors that allow them to gain information about the tools shape to make choices...(AU)

16.
Univ. sci ; 18(1): 51-63, ene.-abr. 2013. ilus, tab
Article in English | LILACS | ID: lil-677559

ABSTRACT

Se compararon química y microbiológicamente morterosde Bogotá, Villa de Leyva y Barichara. Las muestras seanalizaron por espectrometría de absorción y emisión atómica,espectroscopia infrarroja con transformada de Fourier,difracción de Rayos X, microscopía electrónica de barrido yespectroscopia por dispersión de energía. Se encontraron óxidosde silicio, aluminio, calcio, hierro, magnesio, yeso, weddellita,despuljosita, cuarzo, berlinita, carbonatos, mica, feldespatos,silicatos, sales de nitratos, sulfitos y compuestos orgánicos.A su vez, se hallaron partículas irregulares entre 10, 50 y 100µm y fibras de tipo orgánico de 20 µm. Se realizó el conteo deunidades formadoras de colonias por el método de dilucionespara identificar microorganismos fúngicos. Se identificaron lossiguientes géneros Aspergillus, Penicillium, Alternaria, Fusarium,Mucor y Syncephalastrum. La muestra de Bogotá presentó el mayornúmero de UFC/mL y el mayor porcentaje de humedad relativa.La concentración de hongos en esta muestra, a diferencia delas de Villa de Leyva y de Barichara, causó la degradación de lamayoría de los metales identificados. Esta comparación químicay microbiológica propone un plan eficaz de intervención paraeliminar y prevenir el biodeterioro en apoyo a la conservación deobras patrimoniales...


Mortars from Bogotá, Villa de Leyvaand Barichara were compared chemically andmicrobiologically. We analyzed the samples using atomicabsorption and emission spectrometry, Fourier-transforminfrared spectroscopy, X-ray diffraction, scanningelectron microscopy and energy dispersive spectroscopy.Oxides of silicon, aluminum, calcium, iron, magnesium,gypsum, weddellite, despujolsite, quartz, berlinite,carbonate, mica, feldspars, silicates, nitrate salts, sulfites,and organic compounds were identified. In addition,irregular particles between 10, 50 an 100 µm werefound, as well organic fibers of 20 µm. Was performeda CFU count using a dilution method to identify fungalmicroorganisms and found following genera Aspergillus,Penicillium, Alternaria, Fusarium, Mucor and Syncephalastrum.The mortar sample taken in Bogotá presented thehighest number of CFU/mL and the highest percentageof relative humidity. The concentration of fungi in thissample, unlike those from Villa de Leyva and Barichara,caused degradation in most of the metals identified.This chemical and microbiological comparison proposesan effective plan of action to eliminate and preventbiodeterioration in support of the conservation ofheritage constructions...


As amostras foram analisadas por espectrometria deemissão e espectroscopia de absorção atômica, infravermelhocom transformada de Fourier, difração de raios X, microscopiaeletrônica de varredura e espectroscopia de energia dispersiva.Foram identificados óxidos de silício, alumínio, cálcio, ferro,magnésio, gesso, weddellita, despuljosita, quartzo, berlinita,carbonato, mica, feldspato, silicatos, sais de nitratos, sulfitos, ecompostos orgânicos. Partículas irregulares entre os 10, 50 e 100µm foram encontradas bem como fibras de tipo orgânico de20 µm. Realizou-se uma contagem CFU usando um método dediluição para identificar microorganismos fúngicos e encontrousefungos dos gêneros Aspergillus, Penicillium, Alternaria, Fusarium,Mucor e Syncephalastrum. A amostra de Bogotá apresentou o maiornúmero de UFC/mL e umidade relativa do ar. A maior presençade fungos desta amostra, ao contrário das amostras da Villa deLeyva e Barichara, causou degradação na maioria dos metaisidentificados. Esta comparação química e microbiológica podesugerir um plano de ação eficaz para a eliminação e prevenção dabiodegradação e assim preservar obras patrimoniais.Departamento de Química, Facultad de Ciencias. PontificiaUniversidad Javeriana. Bogotá, D.C., Colombia.Departamento de Microbiología, Facultad de Ciencias. PontificiaUniversidad Javeriana. Bogotá, D.C., Colombia.Departamento de Biología, Facultad de Ciencias. PontificiaUniversidad Javeriana. Bogotá, D.C., Colombia.Departamento de Arquitectura, Facultad de Arquitectura y Diseño.Pontificia Javeriana. Bogotá, D.C., Colombia.Received: 15-12-2012 Accepted: 02-02-2013 Published on line: 28-02-2013 Edited by Alberto Acosta mUniversitas Scientiarum, Journal of the Faculty of Sciences, Pontificia Universidad Javeriana, is licensed under the Creative Commons 2.5 of Colombia: Attribution - Noncommercial - No Derivative...


Subject(s)
Biodegradation, Environmental , Microbiology/classification , Microbiology/history
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