Assessment of a wide array of contaminants of emerging concern in a Mediterranean water basin (Guadalhorce river, Spain): Motivations for an improvement of water management and pollutants surveillance.

This study investigates the occurrence and distribution of 185 organic contaminants (regulated pollutants and contaminants of emerging concern; CECs) in surface and groundwater of the Guadalhorce River basin (southern Spain) providing the most detailed dataset regarding organic pollution presented so far in this area. Up to 63 contaminants were detected in a monitoring campaign conducted in March 2016. Most contaminants were detected more frequently in surface water where they generally present higher concentrations suggesting the prevalence of wastewater discharges into streams as the main pollutant sources. In general, hydrophobic CECs presented the highest frequencies of detection and concentrations, which can be a consequence of several factors: (1) hydrophobic compounds show a higher retardation factor, which result, along with a continuous contaminant input, in a widespread and homogeneous distribution. In contrast, hydrophilic contaminants are more easily transported by water flows towards the lower basin and potentially accumulate as driven by groundwater flow and because of low renewal rates in the detrital aquifers caused by re-pumping and irrigation return flows in agricultural lands; (2) hydrophobic CECs studied in this research are mainly personal care products and organophosphate esters flame retardants and plasticizers, which are present in many different products and are used in large amounts; Also, (3) use of biosolids (reclaimed sewer sludge) as fertilizer for crops is potentially an additional diffuse source of organic pollutants in the study area contributing to a widespread distribution, especially for hydrophobic compounds. Obtained results highlight the need to better define the potential risk of non-regulated contaminants in water resources as well as the great impact of untreated wastewater discharges.

Application of ATAD technology for digesting sewage sludge in small towns: Operation and costs.

In an economic context marked by increasing energy costs and stricter legislation regarding the landfill disposal of wastewater treatment plant (WWTP) sewage sludge, and where biomethanization is difficult to implement in small WWTPs, an efficient alternative is required to manage this polluting waste. This study shows that autothermal thermophilic aerobic digestion (ATAD) is a feasible technique for treating sewage sludge in small- and medium-sized towns. The experiments were carried out at pilot scale on a cyclical basis and in continuous mode for nine months. The main results showed an optimal hydraulic retention time of 7 days, which led to an organic matter removal of 34%. The sanitized sludge meets the microbial quality standards for agronomic application set out in the proposed European sewage sludge directive. An economic assessment for the operation of ATAD technology was carried out, showing a treatment cost of €6.5/ton for dewatered sludge.

Documento de recomendaciones para el diagnóstico y tratamiento de la enfermedad pulmonar obstructiva crónica en Andalucía / No disponible

La Enfermedad Pulmonar Obstructiva Crónica (EPOC) se define como una enfermedad respiratoria, caracterizada esencialmente por una limitación crónica al flujo aéreo, que no es totalmente reversible y que, en nuestro medio, se relaciona fundamentalmente con el consumo de tabaco. La EPOC se caracteriza también por la presencia de agudizaciones y comorbilidades que contribuyen a la gravedad en algunos pacientes. La EPOC es una enfermedad muy prevalente y en España afecta al 10,2% de la población entre los 40 y 80 años, con un gran impacto en la calidad de vida de pacientes y cuidadores y un importante consumo de recursos económicos y sanitarios. En la actualidad, la EPOC es la cuarta causa de muerte a nivel mundial, por detrás de la cardiopatía isquémica, los accidentes cerebrovasculares y las infecciones de las vías respiratorias inferiores. El diagnóstico de la EPOC se basa en la exposición a un factor de riesgo, habitualmente el tabaco (≥10 paquetes-año), en un paciente mayor de 35 años en presencia de síntomas (disnea, tos y/o expectoración) y confirmación del patrón obstructivo en la espirometría tras broncodilatador con una relación FEV1 /FVC < 0,70 en fase estable de la enfermedad. Pese a todos los esfuerzos realizados, la EPOC sigue teniendo un elevado infradiagnóstico (73%) que es mayor en mujeres que en hombres. La EPOC es una enfermedad muy heterogénea, por lo que es necesario realizar una correcta caracterización clínica que nos permita identificar grupos homogéneos de pacientes que se puedan beneficiar de una intervención terapéutica específica e incluso personalizada. Las sociedades científicas aquí representadas han trabajado para elaborar unas recomendaciones, basadas en la evidencia científica actual, para el diagnóstico y tratamiento de la EPOC en Atención Primaria y Neumología en Andalucía, con una visión adaptada a la práctica clínica en la vida real

No disponible

Factores de riesgo para la infección en prótesis de rodilla, incluyendo la fractura intraoperatoria y la trombosis venosa profunda, no descritos previamente / Risk factors for infection in total knee artrhoplasty, including previously unreported intraoperative fracture and deep venous thrombosis

Objetivo. Describir los factores de riesgo estadísticamente significativos para la infección periprotésica tardía (PJI, «prosthetic joint infection») en rodilla. Material y método. Estudio observacional y retrospectivo mediante comparación de series de casos y controles. Se han analizado todos los factores de riesgo descritos en la literatura. Casos: 32 prótesis de rodilla infectadas diagnosticadas consecutivamente. Controles: 100 pacientes seleccionados aleatoriamente, intervenidos quirúrgicamente en el mismo servicio de un hospital general universitario durante el mismo período de tiempo, sin signo alguno de infección a lo largo de todo el seguimiento. Comparaciones estadísticas: Pearson para variables cualitativas y ANOVA para cuantitativas. Resultados. Los siguientes hechos son significativamente más frecuentes (p < 0,05) en la serie de casos infectados: Preoperatorios Cirugía previa en la rodilla, terapia corticoidea, tratamiento con inmunosupresores, y artritis inflamatoria. Intraoperatorios. Tiempo quirúrgico excesivo, profilaxis antibiótica inadecuada, fractura periprotésica intraoperatoria. Postoperatorios Secreción persistente tras 10 días, hematoma palpable profundo, necesidad de nueva cirugía, trombosis venosa profunda en extremidades inferiores. Infecciones a distancia Cutánea, sepsis generalizada, urinaria, neumonía, abdominal. Discusión y conclusiones. Esta es la primera descripción de una fractura intraoperatoria y de una trombosis venosa profunda como hechos significativamente más frecuentes en las prótesis de rodilla con infección tardía. Asimismo se confirma la significación de otros factores de riesgo previamente descritos (AU)

Purpose. To carry out a statistical analysis on the significant risk factors for deep late infection (prosthetic joint infection, PJI) in patients with a knee arthroplasty (TKA). Methods. A retrospective observational case-control study was conducted on a case series of 32 consecutive knee infections, using an analysis of all the risk factors reported in the literature. A control series of 100 randomly selected patients operated in the same Department of a University General Hospital during the same period of time, with no sign of deep infection in their knee arthroplasty during follow-up. Statistical comparisons were made using Pearson for qualitative and ANOVA for quantitative variables. Results. The significant (p > 0 .05) factors found in the series were: Preoperative previous knee surgery, glucocorticoids, immunosuppressants, inflammatory arthritis. Intraoperative. prolonged surgical time, inadequate antibiotic prophylaxis, intraoperative fractures. Postoperative secretion of the wound longer than 10 days, deep palpable haematoma, need for a new surgery, and deep venous thrombosis in lower limbs. Distant infections cutaneous, generalized sepsis, urinary tract, pneumonia, abdominal. Conclusions. This is the first report of intraoperative fractures and deep venous thrombosis as significantly more frequent factors in infected TKAs. Other previously described risk factors for TKA PJI are also confirmed (AU)

[Risk factors for infection in total knee artrhoplasty, including previously unreported intraoperative fracture and deep venous thrombosis]. / Factores de riesgo para la infección en prótesis de rodilla, incluyendo la fractura intraoperatoria y la trombosis venosa profunda, no descritos previamente.

PURPOSE: To carry out a statistical analysis on the significant risk factors for deep late infection (prosthetic joint infection, PJI) in patients with a knee arthroplasty (TKA). METHODS: A retrospective observational case-control study was conducted on a case series of 32 consecutive knee infections, using an analysis of all the risk factors reported in the literature. A control series of 100 randomly selected patients operated in the same Department of a University General Hospital during the same period of time, with no sign of deep infection in their knee arthroplasty during follow-up. Statistical comparisons were made using Pearson for qualitative and ANOVA for quantitative variables. RESULTS: The significant (p>0.05) factors found in the series were: Preoperative previous knee surgery, glucocorticoids, immunosuppressants, inflammatory arthritis. INTRAOPERATIVE: prolonged surgical time, inadequate antibiotic prophylaxis, intraoperative fractures. Postoperative secretion of the wound longer than 10 days, deep palpable haematoma, need for a new surgery, and deep venous thrombosis in lower limbs. Distant infections cutaneous, generalized sepsis, urinary tract, pneumonia, abdominal. CONCLUSIONS: This is the first report of intraoperative fractures and deep venous thrombosis as significantly more frequent factors in infected TKAs. Other previously described risk factors for TKA PJI are also confirmed.

Scaling in complex systems: a link between the dynamics of networks and growing interfaces.

We consider growing interfaces as dynamical networks whose nodes are the discrete points of the interface and the edges the physical interactions among them. We map the points of the interface formed at each time into a graph by means of a visibility algorithm. As the corresponding interfaces grow, their visibility graphs change over time. We show that the visibility graphs are all scale free for each time. We use the variance of the node degrees as a measure of the dynamical properties of these graphs. This magnitude reveals an unexpected scaling behaviour of these graphs in both the number of nodes and time. This enables to define three robust exponents that characterize any type of dynamics with more detail than the classical scaling analysis applied directly to the physical interfaces. To check the feasibility of this approach we study and classify six different dynamical processes and estimate their critical exponents. We conclude that the dynamics of physical systems far from equilibrium can be determined by its corresponding visibility network. Indeed, this methodology is able to discern among dynamical processes that hitherto have been classified in the same universality class according to the scaling analysis of their interfaces.

Cage-like effect in Au-Pt nanoparticle synthesis in microemulsions: a simulation study.

The different distributions of metals in bimetallic nanoparticles synthesized in microemulsions were studied by computer simulation. The simulations demonstrated that if the difference between the reduction potentials of both metals is about 0.15-0.3 V, the compartmentalization of the reaction media causes the accumulation of slower reduction reactants in the microemulsions droplets, which favours the chemical reaction like a cage effect: increasing the local concentration of the slower reduction metal salt gives rise to a faster reduction, so the differences in reduction rates of both metals are attenuated. A more coincidental reduction of both metals deeply affects the nanoparticle structure, causing a better mixed alloy. This effect will be more pronounced when the concentration is higher and the intermicellar exchange rate is faster. This means that for any fixed microemulsion the nanoparticle structure can be modified by changing the reactant concentration: the core can be enriched in the faster reduction metal by lower concentrations, and the shell can be enriched in the slower metal by higher concentrations. Based on these observations, this study suggests a route to help experimentalists better create nanoparticles with a pre-defined structure.

Valoración de la satisfacción de usuarios de consulta de Enfermería en Centros de Salud a partir de indicadores de calidad técnicos y de comunicación / Evaluation of user satisfaction of nursing consultation in health centers based on quality and technical communication indicators

Objetivos: Medir la satisfacción relacionada con aspectos técnicos y comunicativos de los usuarios de consulta de Enfermería en Atención Primaria. Métodos: Estudio descriptivo realizado con pacientes usuarios del Servicio de Enfermería de los Centros de Salud (CCSS) de Córdoba y provincia. Los pacientes fueron entrevistados utilizando dos tipos de preguntas, cerradas y abiertas que recogían sus opiniones y satisfacción en dominios comunicacionales como la relación enfermera-paciente, la información recibida o el tiempo empleado; así como los procedimientos utilizados. Análisis descriptivo e inferencial (Test de Ji-cuadrado; p<0,05). Las preguntas abiertas se agruparon en categorías en un proceso de análisis cualitativo que implicó a dos investigadoras independientes. Resultados: Participaron 335 pacientes. Se obtuvo un 76,5% de satisfacción en las respuestas cerradas respecto a los procedimientos utilizados en la sala de curas, sin embargo el 26,1% de los pacientes planteo alguna sugerencia o propuesta de cambio en las respuestas abiertas. Al 89,1% de satisfacción en información recibida en respuestas cerradas, el 16,1% hizo sugerencias de cambio en las respuestas abiertas. En cuanto a la relación enfermera paciente, los resultados fueron: un 94,2% mostraba satisfacción frente a un 7,5% que planteó sugerencias en preguntas abiertas; en referencia al tiempo empleado la satisfacción oscilo del 88,5% al 16,8%. Conclusiones: La mayoría de los pacientes que consultaron con Enfermería en los Centros de Salud mostraron satisfacción con la atención recibida, si bien les gustaría participar más en la toma de decisiones(AU)

Objectives: To measure the satisfaction related to communication and technical aspects of the users of nursing consultation in Primary Care. Material and methods: Descriptive study conducted with patients using the nursing service Health Centers. After consultation with the staff, the patients were interviewed using two types of open and closed questions that assessed their views and satisfaction with some communication domains. Frequency distributions and exploring the differences between the two measures were explored using descriptive and inferential analysis (chi-square test, P <0.05). Open-ended questions were grouped into categories in a process of qualitative analysis involving two researchers independently. Results: 335 patients participated, 76.5% was obtained of the closed-ended satisfaction regarding the procedures used in the treatment room, and however, 26.1% of patients won’t have any suggestions or proposed changes in the open responses. To 89.1% of satisfaction with information received in closed responses, 16.1% made suggestions for change in the open answers. As the nurse patient, the results were 94.2% showed satisfaction, compared to 7.5% which raised suggestions on open questions, and time used the ratio was 88.5% vs. 16.8%. Discussion and Conclusions: Most patients who consult with nurses in health centers showed satisfaction with care received, however they would like to participate more in decision making(AU)