Obtaining and Characterization of Highly Crystalline Recycled Graphites from Different Types of Spent Batteries.

Spent batteries recycling is an important way to obtain low-cost graphite. Nevertheless, the obtaining of crystalline graphite with a rather low density of defects is required for many applications. In the present work, high-quality graphites have been obtained from different kinds of spent batteries. Black masses from spent alkaline batteries (batteries black masses, BBM), and lithium-ion batteries from smartphones (smartphone black masses, SBM) and electric and/or hybrid vehicles (lithium-ion black masses, LBM) were used as starting materials. A hydrometallurgical process was then used to obtain recycled graphites by acidic leaching. Different leaching conditions were used depending on the type of the initial black mass. The final solids were characterized by a wide set of complementary techniques. The performance as Li ion batteries anode of the sample with better structural quality was assessed.

Femtosecond Double-Pulse Laser Ablation and Deposition of Co-Doped ZnS Thin Films.

Nanostructured thin films of Co-doped zinc sulfide were synthesized through femtosecond pulsed laser deposition. The scheme involved ablation of physically mixed Co and ZnS with pairs of ultrashort pulses separated in time in the 0-300 ps range. In situ monitorization of the deposition process was carried out through a simultaneous reflectivity measurement. The crystallinity of generated nanoparticles and the inclusion of Co in the ZnS lattice is demonstrated by transmission electron microscopy and energy dispersive X-ray microanalysis (TEM-EDX) characterization. Surface morphology, Raman response, and photoluminescence of the films have also been assessed. The role of interpulse temporal separation is most visible in the thickness of the films obtained at the same total fluence, with much thicker films deposited with short delays than with individual uncoupled pulses. The proportion of Co in the synthesized doped ZnS nanoparticles is found to be substantially lower than the original proportion, and practically independent on interpulse delay.

Análisis comparativo de indicadores de eficiencia en cirugía mayor ambulatoria / Comparative analysis of efficiency indicators in ambulatory surgery

Objetivo: Buscar elementos comparativos para el control de calidad en unidades de cirugía mayor ambulatoria (CMA). Método: Estudio descriptivo comparativo del índice de ambulatorización (IA) y el índice de sustitución (IS) en el Servicio de Cirugía del Hospital Santa Cristina, de Madrid (España), respecto a indicadores clave (IC) del Sistema Nacional de Salud (SNS). Resultados: Se analizaron 7817 procedimientos de CMA (entre 2006 y 2014) y se obtuvo un IA anual medio del 54%, superior (p <0,0001) al IC «Porcentaje de ambulatorización quirúrgica». Igualmente, la ambulatorización herniaria (media 72%) superó al IC nacional (p <0,0001), mientras que el IS «Hemorroidectomía» (media 33,6%) fue claramente inferior (p <0,0001). Conclusiones: Los IC del SNS son útiles y han permitido determinar un buen desarrollo en la ambulatorización global y de hernia, existiendo oportunidades de mejora en hemorroidectomía. Debe cuidarse su recogida, sin incluir cirugías menores, y su utilidad aumentaría si se ofrecieran datos desglosados por especialidades y complejidad

Objective: To find comparative elements for quality control in major ambulatory surgery (MAS) units. Method: Descriptive and comparative study of the Ambulatory Care Index (AI) and Substitution Index (SI) in the Santa Cristina Hospital Surgery Service (Madrid, Spain) compared to Key Indicators (KI) of the National Health Service (NHS). Results: 7,817 MAS procedures (between 2006 and 2014) were analysed. The average annual AI was 54%, higher (p <0.0001) than «ambulatory surgery» KI. The hernia outpatient procedures (average 72%) were also superior to the national KI (p <0.0001), but ambulatory haemorrhoidectomy (average 33.6%) was clearly lower (p <0.0001). Conclusions: KI of the NHS are useful and allow to establish a proper development in the global AI and hernia outpatient surgery with opportunities for improvement in haemorrhoidectomy. Their collection should be careful, not including minor surgeries. Also, their usefulness could be increased if data was broken down by speciality and by complexity

[Comparative analysis of efficiency indicators in ambulatory surgery]. / Análisis comparativo de indicadores de eficiencia en cirugía mayor ambulatoria.

OBJECTIVE: To find comparative elements for quality control in major ambulatory surgery (MAS) units. METHOD: Descriptive and comparative study of the Ambulatory Care Index (AI) and Substitution Index (SI) in the Santa Cristina Hospital Surgery Service (Madrid, Spain) compared to Key Indicators (KI) of the National Health Service (NHS). RESULTS: 7,817 MAS procedures (between 2006 and 2014) were analysed. The average annual AI was 54%, higher (p <0.0001) than «ambulatory surgery¼ KI. The hernia outpatient procedures (average 72%) were also superior to the national KI (p <0.0001), but ambulatory haemorrhoidectomy (average 33.6%) was clearly lower (p <0.0001). CONCLUSIONS: KI of the NHS are useful and allow to establish a proper development in the global AI and hernia outpatient surgery with opportunities for improvement in haemorrhoidectomy. Their collection should be careful, not including minor surgeries. Also, their usefulness could be increased if data was broken down by speciality and by complexity.

Prevalencia de hipertensión arterial en pacientes con insuficiencia renal crónica terminal en tratamiento hemodialítico: estudio multicéntrico / High Blood Pressure Prevalence in Patients with Terminal Chronic Renal Failure

Se realizó un estudio prospectivo multicéntrico de 169 pacientes con IRCT que recibían tratamiento hemodialítico en seis servicios de Nefrología de la región oriental del país, incluyéndose a todos los enfermos que llevaran al menos tres meses de tratamiento sustitutivo. El 78,7 por ciento eran hipertensos y de ellos, el 82 por ciento recibían tratamiento hipotensor, encontrándose controlados solamente el 31,2 por ciento. Se realizó una comparación entre los enfermos con y sin HTA, encontrándose que no hubo diferencia significativa entre ambos grupos en cuanto a edad, sexo, hábito de fumar, cumplimiento de la dieta, presencia de edema, conocimiento del peso seco, tipo de acceso vascular, presencia de síntomas relacionados con la HTA, duración del tratamiento y cifras de hematocrito...(AU)

A prospective multicenter study in 169 patients with hemodialysis treatment for terminal renal failure in six centers in the north east of the country was done. There was 78,7 percent of hypertensive patients, antihypertensive medication was given (82 percent of the patients) and only 31,2 percent of them were well controlled. A comparison between patients with and without high blood pressure was done. There was a significant difference between both groups taking into account age, sex, cigarette smoking, diet, edema presence, vascular access, symptoms related with hypertension, treatment duration and hematocrit. Only weight increment which was over 2 Kg had an statistical significance with high blood pressure. It was concluded that there was a high prevalence of hipertensive patients and the control of the disease was very low(AU)

Short-, mid- and long-term results of Larrad biliopancreatic diversion.

BACKGROUND: In an effort to reduce the complications of Scopinaro's biliopancreatic diversion (BPD), in 1989 we introduced the modification of lengthening the alimentary channel preserving most of the jejunum-ileum, by creating a short biliopancreatic limb (50 cm) and maintaining 50 cm of common limb (Larrad 50-50 BPD). METHODS: Of 343 patients who consecutively underwent Larrad 50-50 BPD surgery, 325, 194 and 65 patients were evaluated at 2, 5 and 10 years after surgery, respectively, in terms of surgical morbidity, mortality, metabolic sequelae and weight. Mean age was 41.2 years (range 17-62), mean initial weight 151.2 kg (range 97-260), and BMI was 52.2 kg/m2. Maximum follow-up was 120 months. RESULTS: Mortality was 0.87% and surgical morbidity 7.6%. There were no cases of suture dehiscence, peritonitis or stomal stenosis. Percent excess weight loss (%EWL) stabilized 2 years after surgery and at 10 years was 77.8 +/- 11.2% for morbidly obese patients and 63.2 +/- 11.8% for super-obese patients. The main complications were 43.8% clinical incisional hernia, 2.5% severe diarrhea, 10.8% mild diarrhea and 9.2% constipation. 30% experienced anemia and/or iron deficiency, and 3% required iron parenterally or lifelong zinc supplements. 28% showed preoperative PTH elevation and 30% vitamin D deficiency; these values postoperatively increased to 45% and 43% respectively. Both these alterations were resolved using supplements, although 12% needed increased doses of vitamin D. The incidence of severe hypoproteinemia was 0.29%. No patient required surgical reversal. When independently evaluated, failure rates in terms of insufficient weight loss were 9% at 5 years and 11.3% at 10 years for morbidly obese, and 12.2% and 14% for super-obese patients respectively. According to the BAROS questionnaire, 75% of surgery outcomes were excellent or very good, 18% good, 5% fair and 2% failures. CONCLUSIONS: After 2, 5 and 10 years, Larrad's BPD has offered excellent results in terms of weight loss and quality of life, a low rate of metabolic sequelae, including a hypoproteinemia rate < 0.5%, and a revision surgery rate 0%.

Evidencias científicas en el tratamiento de la hernia inguinal / Scientific evidence in the treatment of inguinal hernia

La hernia inguinal es una de las afecciones que más frecuentemente sufre el ser humano. En los últimos años ha pasado de ser considerada un tema poco importante a ser uno de los procesos mejor estudiados y donde la excelencia del tratamiento se ha convertido en el objetivo final. Hemos analizado la evolución histórica del tratamiento quirúrgico de la hernia inguinal, desde la etapa anatómica a la protésica, llegando finalmente a la vía laparoscópica. Las causas del cambio en el manejo de la hernia inguinal son factores profesionales, del paciente, tecnológicos y administrativos. Todos ellos, junto con la utilización de la medicina basada en la evidencia, pretenden encontrar la técnica quirúrgica ideal para el tratamiento del paciente y llegar a conseguir como fin último la excelencia del proceso terapéutico (AU)

Analysis of weight loss with the biliopancreatic diversion of Larrad: absolute failures or relative successes?

BACKGROUND: The authors studied whether morbidly obese patients who failed in stated weight loss criteria may be considered absolute failures or relative successes. METHODS: 75 morbidly obese patients underwent biliopancreatic diversion (BPD) of Larrad, with a 4/5 gastrectomy (residual gastric volume 150-200 ml), a biliopancreatic limb divided 50 cm distal to Treitz' ligament, a 50-cm common limb and an alimentary limb of nearly all the bowel length (500-600 cm). Every patient had a follow-up of 5 years. A percent excess weight loss (%EWL) < 50% was considered a "failure". We analyzed the post-surgical changes in the preoperative obesity-related problems in these patients and the causes of the weight loss failure. RESULTS: At 5 years after the BPD of Larrad, 9 patients (12%) had a %EWL < 50%, with a mean %EWL of 36 in these patients. Most of these failed patients were cured or improved of their preoperative illnesses. The 2 males were alcoholics, and 6 of the 7 females had an abnormal psychological examination. Comparing the "failed" patients with the successful group, there is a statistically significant influence (p < 0.01) of lack of satiety, unmarried status, housewife or unemployed. CONCLUSION: Patients judged as a failure by weight loss criteria after bariatric surgery should not be considered absolute failures, because most of their preoperative illnesses were cured or improved, improving their quality of life. Thus, they are "relative successes".