Diagnosis of light chain cast nephropathy through immunostaining of the urine: Perfecting the "liquid biopsy".

Light chain (LC) cast nephropathy is the main cause of kidney injury and an important determinant of poor survival in patients with multiple myeloma (MM). It is usually suspected when an MM patient with elevated serum concentration of free LC presents kidney failure, but it often requires confirmation by kidney biopsy. We report the case of a 73-year-old woman who presented with fatigue, weight loss, and constipation. Laboratory exams revealed anemia, hypercalcemia, and kidney failure. Urine sediment analysis demonstrated irregular crystalline "waxy type" casts. With the hypothesis of LC cast nephropathy, immunostaining of the urine sediment was performed. The analysis revealed several rectangular and irregular casts with intense and bright stain for λ LCs only. A myelogram was performed, showing extensive occupation of the bone marrow by plasma cells; and immunofixation in urine and serum revealed monoclonal IgG-λ component, confirming the diagnosis of IgG-λ MM. This case highlights the potential utility of the urine sediment analysis and immuno-staining as a reliable non-invasive alternative method for diagnosis of cast nephropathy in patients with monoclonal gammopathies.

Los difíciles deberes de cuarentena. De lo obligado al deseo. Algunas reflexiones sobre los efectos subjetivos de la cuarentena y la educación virtual / The quarantine´s difficult duties. From the obligation to the desire. Some reflections on the subjective effects of quarantine and virtual education / Les difficiles devoirs de la quarantaine. De l'obligation au désir. Quelques réflexions sur les effets subjectifs de la quarantaine et de l'éducation virtuelle / Os difíceis deveres da quarentena. Da obrigação ao desejo. Algumas reflexões sobre os efeitos subjetivos da quarentena e da educação virtual

La situación mundial de pandemia COVID-19 y las medidas de aislamiento, supusieron la ruptura de muchas de las certezas que sostenían el mundo tal como lo conocíamos. Estos grandes cambios en la vida cotidiana, como en la institución escolar, pusieron aún más de manifiesto las altas exigencias que recaen en los niños, en los pedidos de adaptación. Reducido a las "tareas", lo educativo emerge como un nuevo imperativo, que si se sostiene desde el mero cumplimiento de las demandas anula el deseo, dando como resultado manifestaciones de angustia, desgano y malestar. La tarea desligada de la pulsión vivificante de la escuela se vuelve exceso. El desafío de la clínica y de la vida actual en general, parece debatirse en la posibilidad singular de pasar de lo obligado, al deseo. O mejor aún, el desafío de pasar "de lo obligado al deseo"… a lo deseante(AU)

The global COVID-19 pandemic situation and the isolation meassures meant the rupture of many of the certainties that sustained the world as we knew it. These great changes in the daily life, as in the school institution,exposed even more the high demands that fall on children, in the requests for adaptation. Reduced to the "tasks", the education emerges as a new imperative, that if it is sustained in the mere fulfillment of the demands, it annuls the desire, resulting in manifestations of anguish, apathy and discomfort. The task detached from the school's vital impulse becomes an excess. The challenge of the clinic and of current life in general, seems to be debated in the singular possibility of going from the obligatory, to the desire. Or better yet, the challenge of going "from the obligation to the desire" ... to the desiring posture(AU)

La situation mondiale de la pandémie de COVID-19 et les mesures d'isolement ont entraîné la ruptura de bon nombre des certitudes qui soutenaient le monde tel que nous le connaissions. Ces grands changements dans la vie quotidienne, comme dans l'institution scolaire, ont rendu encore plus évidentes les exigences élevées imposées aux enfants, dans les demandes d'adaptation. Réduit à des "tâches", l'éducation apparaît comme un nouvel impératif qui, s'il est soutenu par la simple satisfaction des exigences, annule le désir, entraînant des manifestations d'angoisse, de réticence et d'inconfort. La tâche détachée de l'impulsion vivifiante de l'école devient un excès. L'enjeu de la clinique et de la vie actuelle en général, semble se débattre dans la possibilité singulière de passer de l'obligatoire, au désir. Ou mieux encore, le défi de passer "du forcé au désir"… au désirant(AU)

A situação global da pandemia COVID-19 e as medidas de isolamento significaram o colapso de muitas das certezas que sustentavam o mundo como o conhecíamos. Essas grandes mudanças no cotidiano, como na instituição escolar, tornaram ainda mais evidentes as altas demandas das crianças, nas solicitações de adaptação. Reduzido a "tarefas", o educativo surge como um novo imperativo, que se sustentado a partir do mero cumprimento das demandas, anula o desejo, resultando em manifestações de angústia, relutância e desconforto. A tarefa separada do impulso vivificador da escola torna-se um excesso. O desafio da clínica e da vida atual em geral, parece ser debatido na possibilidade singular de passar do obrigatório ao desejo. Ou melhor, o desafio de ir "do forçado a desejar"... ao desejante(AU)

Prevención en la transmisión de Coronavirus-19: ¿qué tan preparado está el personal de salud en Chile?

Background: COVID-19 is highly transmissible, thus requiring strict measures to prevent its propagation. Aim: To report a survey about self-reported adherence to recommendations aimed to reduce the transmission of COVID-19, among health care personnel. Material and Methods: A cross-sectional survey among health professionals about adherence to recommendations to prevent COVID-19 transmission was carried out in a public hospital in Chile. The survey had 11 questions and was developed using Delphi methodology, according to the recommendations of the World Health Organization and the Centers for Disease Control. Results: The survey was answered by 137 of 155 invited workers. Hand washing, use of personal protection equipment, use of the elbow or tissue to sneeze, out-of-hospital hand washing and exclusive use of the uniform in the hospital, had an adherence of over 90%. The adherence to face touching avoidance during working hours, and face mask use in the public areas, was over 50%. No statistical differences were observed between gender or professionals. Conclusions: The adherence reported by health care workers was adequate in most of the evaluated recommendations.

[Adherence to COVID-19 trasmission prevention measures among health care workers]. / Prevención en la transmisión de Coronavirus-19: ¿qué tan preparado está el personal de salud en Chile?

BACKGROUND: COVID-19 is highly transmissible, thus requiring strict measures to prevent its propagation. AIM: To report a survey about self-reported adherence to recommendations aimed to reduce the transmission of COVID-19, among health care personnel. MATERIAL AND METHODS: A cross-sectional survey among health professionals about adherence to recommendations to prevent COVID-19 transmission was carried out in a public hospital in Chile. The survey had 11 questions and was developed using Delphi methodology, according to the recommendations of the World Health Organization and the Centers for Disease Control. RESULTS: The survey was answered by 137 of 155 invited workers. Hand washing, use of personal protection equipment, use of the elbow or tissue to sneeze, out-of-hospital hand washing and exclusive use of the uniform in the hospital, had an adherence of over 90%. The adherence to face touching avoidance during working hours, and face mask use in the public areas, was over 50%. No statistical differences were observed between gender or professionals. CONCLUSIONS: The adherence reported by health care workers was adequate in most of the evaluated recommendations.

Atención de los pacientes con trauma grave durante los primeros días: evolución entre la urgencia, el pabellón y la unidad de cuidados intensivos / Features of patients with trauma admitted to an emergency room of a general hospital

Background: Trauma is the main cause of death among people aged 5 to 44 years. Aim: To describe features, treatment and evolution of trauma patients admitted to an emergency room. Material and Methods: Adult patients admitted in the emergency department of a public hospital due to severe trauma were studied and followed during their hospital stay. Results: We included 114 patients aged 40 ± 17 years (78%men) with an injury severity score of 21 ± 11. Trauma was penetrating in 43%. Traumatic brain injury (TBI) was the most common diagnosis in 46%. In the emergency room, 8% had hypotension, 5% required vasopressors and 23% required mechanical ventilation. The initial lactate was 3.6 ± 2.9 mmol/L. Sixty-five patients (57%) required emergency surgery. The intraoperative lactate was 3 ± 1.7 mmol/L and 20% required vasopressors. Sixty-four patients (56%) were admitted to the ICU, with APACHEII and SOFA scores of 16 ± 8 and 5 ± 3, respectively. ICU lactate was 3.2±1.5 mmol/L. In the ICU 40% required vasopressors and 63% mechanical ventilation. Thirty two percent had coagulopathy, 43% received transfusions and 10% required massive transfusions. The hospital stay was 13 (6-32) days, being significantly longer in patients with TBI. ICU and hospital mortalities were 12.5 and 18.4% respectively. The only predictor for mortality was the APACHEII score (Hazard Ratio 1.18, 95% confidence intervals 1.03-1.36). Conclusions: APACHE score was a predictor of mortality in this group of patients.

Sulfonated and gamma-irradiated waste expanded polystyrene with iron oxide nanoparticles, for removal of indigo carmine dye in textile wastewater.

In this work, waste expanded polystyrene (WEPS) was irradiated with gamma rays, ranging doses from 100 kGy to 1,000 kGy. After irradiation, the WEPS had decrease on its glass transition temperature (Tg), as consequence of the scissions of its polymer chains. Then, the irradiated WEPS was sulfonated, and its degree of sulfonation (DS) was measured. The highest DS value, 46.6%, was obtained for an irradiation dose of 200 kGy. The sulfonated and irradiated polystyrene (denominated as iS-WEPS), was used as a support of iron oxide nanoparticles. Such composite system was denominated (FeO-NPs + iS-WEPS). The results show nanoparticle sizes of 31.5 nm containing 21.97% iron oxide. The composites followed a pseudo-second order model, with a maximum adsorption capacity of 20 mg/g, and an equilibrium time of 30 min, according to the Langmuir model. Moreover, the optimal conditions followed by the Fenton process were: pH = 3.2, H2O2 concentration = 0.32 mM/L, composite concentration (FeO-NPs + iS-WEPS) = 2 g/L, and a reaction time 20 min. Finally, 99% removal of indigo carmine dye was achieved, and a reduction of 83% of COD in textile wastewater.

[Features of patients with trauma admitted to an emergency room of a general hospital]. / Atención de los pacientes con trauma grave durante los primeros días: evolución entre la urgencia, el pabellón y la unidad de cuidados intensivos.

BACKGROUND: Trauma is the main cause of death among people aged 5 to 44 years. AIM: To describe features, treatment and evolution of trauma patients admitted to an emergency room. MATERIAL AND METHODS: Adult patients admitted in the emergency department of a public hospital due to severe trauma were studied and followed during their hospital stay. RESULTS: We included 114 patients aged 40 ± 17 years (78%men) with an injury severity score of 21 ± 11. Trauma was penetrating in 43%. Traumatic brain injury (TBI) was the most common diagnosis in 46%. In the emergency room, 8% had hypotension, 5% required vasopressors and 23% required mechanical ventilation. The initial lactate was 3.6 ± 2.9 mmol/L. Sixty-five patients (57%) required emergency surgery. The intraoperative lactate was 3 ± 1.7 mmol/L and 20% required vasopressors. Sixty-four patients (56%) were admitted to the ICU, with APACHEII and SOFA scores of 16 ± 8 and 5 ± 3, respectively. ICU lactate was 3.2±1.5 mmol/L. In the ICU 40% required vasopressors and 63% mechanical ventilation. Thirty two percent had coagulopathy, 43% received transfusions and 10% required massive transfusions. The hospital stay was 13 (6-32) days, being significantly longer in patients with TBI. ICU and hospital mortalities were 12.5 and 18.4% respectively. The only predictor for mortality was the APACHEII score (Hazard Ratio 1.18, 95% confidence intervals 1.03-1.36). CONCLUSIONS: APACHE score was a predictor of mortality in this group of patients.

Solvent effect in the polyethylene recovery from multilayer postconsumer aseptic packaging.

Polyethylene films were separated and recovered from polyethylene-aluminum composites derived from recycling multilayer postconsumer aseptic packaging. A brief study about the separation process by dissolving PE-aluminum (PE-Al) composites into a series of organic solvents with a combination of time and temperature is presented. Through this procedure, 56% polyethylene is recovered from this kind of composites in optimized conditions. DSC and TGA studies were performed to determine the thermal stability of recovered polyethylene films and to establish a comparison with a PE reference commercial product, demonstrating that recovered polyethylene films kept their thermal properties.

Covalently Bonded Chitosan on Graphene Oxide via Redox Reaction.

Carbon nanostructures have played an important role in creating a new field of materials based on carbon. Chemical modification of carbon nanostructures through grafting has been a successful step to improve dispersion and compatibility in solvents, with biomolecules and polymers to form nanocomposites. In this sense carbohydrates such as chitosan are extremely valuable because their functional groups play an important role in diversifying the applications of carbon nanomaterials. This paper reports the covalent attachment of chitosan onto graphene oxide, taking advantage of this carbohydrate at the nanometric level. Grafting is an innovative route to modify properties of graphene, a two-dimensional nanometric arrangement, which is one of the most novel and promising nanostructures. Chitosan grafting was achieved by redox reaction using different temperature conditions that impact on the morphology and features of graphene oxide sheets. Transmission Electron Microscopy, Fourier Transform Infrared, Raman and Energy Dispersive spectroscopies were used to study the surface of chitosan-grafted-graphene oxide. Results show a successful modification indicated by the functional groups found in the grafted material. Dispersions of chitosan-grafted-graphene oxide samples in water and hexane revealed different behavior due to the chemical groups attached to the graphene oxide sheet.

Effects on the Thermo-Mechanical and Crystallinity Properties of Nylon 6,6 Electrospun Fibres Reinforced with One Dimensional (1D) and Two Dimensional (2D) Carbon.

Electrospun one dimensional (1D) and two dimensional (2D) carbon based polymer nanocomposites are studied in order to determine the effect provided by the two differently structured nanofillers on crystallinity and thermo-mechanical properties of the nanofibres. The nanomaterials studied are pristine carbon nanotubes, oxidised carbon nanotubes, reduced graphene oxide and graphene oxide. Functional groups associated with the order structure of the polymers are analysed by infrared and Raman spectroscopies; the morphology is studied by scanning electron microscopy and the crystallinity properties are investigated by differential scanning calorimetry and X-ray diffraction. Differences in crystallisation behaviour between 1D and 2D carbon based nanofibres are shown by their crystallinity degree and their crystal sizes. The nanocomposite crystal sizes perpendicular to the plane (100) decrease with nanofiller content in all cases. The crystallinity trend and crystal sizes are in accordance with storage modulus response. The results also suggest that functionalisation favours interfacial bonding and dispersion of the nanomaterials within the polymer matrix. As a consequence the number of nucleating sites increases which in turn decreases the crystal size in the nanocomposites. These features explain the improved thermo-mechanical properties in the nanocomposites.

Processed wastewater sludge for improvement of mechanical properties of concretes.

Two problems are addressed simultaneously. One is the utilisation of sludge from the treatment of wastewater. The other is the modification of the mechanical properties of concrete. The sludge was subjected to two series of treatments. In one series, coagulants were used, including ferrous sulphate, aluminium sulphate or aluminium polyhydroxychloride. In the other series, an electrochemical treatment was applied with several starting values of pH. Then, concretes consisting of a cement matrix, silica sand, marble and one of the sludges were developed. Specimens without sludge were prepared for comparison. Curing times and aggregate concentrations were varied. The compressive strength, compressive strain at yield point, and static and dynamic elastic moduli were determined. Diagrams of the compressive strength and compressive strain at the yield point as a function of time passed through the minima as a function of time for concretes containing sludge; therefore, the presence of sludge has beneficial effects on the long term properties. Some morphological changes caused by the presence of sludge are seen in scanning electron microscopy. A way of utilising sludge is thus provided together with a way to improve the compressive strain at yield point of concrete.