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1.
Chemosphere ; 358: 142222, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38714249

RESUMO

In this study, neural networks and support vector regression (SVR) were employed to predict the degradation over three pharmaceutically active compounds (PhACs): Ibuprofen (IBP), diclofenac (DCF), and caffeine (CAF) within a stirred reactor featuring a flotation cell with two non-concentric ultraviolet lamps. A total of 438 datapoints were collected from published works and distributed into 70% training and 30% test datasets while cross-validation was utilized to assess the training reliability. The models incorporated 15 input variables concerning reaction kinetics, molecular properties, hydrodynamic information, presence of radiation, and catalytic properties. It was observed that the Support Vector Regression (SVR) presented a poor performance as the ε hyperparameter ignored large error over low concentration levels. Meanwhile, the Artificial Neural Networks (ANN) model was able to provide rough estimations on the expected degradation of the pollutants without requiring information regarding reaction rate constants. The multi-objective optimization analysis suggested a leading role due to ozone kinetic for a rapid degradation of the contaminants and most of the results required intensification with hydrogen peroxide and Fenton process. Although both models were affected by accuracy limitations, this work provided a lightweight model to evaluate different Advanced Oxidation Processes (AOPs) by providing general information regarding the process operational conditions as well as know molecular and catalytic properties.


Assuntos
Diclofenaco , Peróxido de Hidrogênio , Ibuprofeno , Aprendizado de Máquina , Redes Neurais de Computação , Diclofenaco/química , Peróxido de Hidrogênio/química , Ibuprofeno/química , Cinética , Poluentes Químicos da Água/química , Poluentes Químicos da Água/análise , Cafeína/química , Oxirredução , Preparações Farmacêuticas/química , Preparações Farmacêuticas/análise , Ozônio/química , Máquina de Vetores de Suporte , Análise Custo-Benefício , Raios Ultravioleta , Catálise , Fotólise
2.
Front Endocrinol (Lausanne) ; 15: 1350154, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38577571

RESUMO

Introduction: Progesterone-primed cycles effectively suppress the pituitary LH surge during ovarian stimulation in oocyte donors and in the infertile population. Particularly in oocyte donors, the use of synthetic progesterone (progestins) has been explored in prospective clinical trials, showing mixed results. This trial was designed to determine whether the use of micronized natural progesterone is as effective as the GnRH-antagonist protocol in terms of the number of mature oocytes (MII) retrieved in oocyte donation cycles as a primary outcome, and it also aims to explore the corresponding results in recipients as a secondary outcome. Methods: We propose a prospective, open-label, non-inferiority clinical trial to compare a novel approach for oocyte donors with a control group, which follows the standard ovarian stimulation protocol used in our institution. A total of 150 donors (75 in each group) will be recruited and randomized using a computer algorithm. After obtaining informed consent, participants will be randomly assigned to one of two ovarian stimulation protocols: either the standard GnRH antagonist or the oral micronized natural progesterone protocol. Both groups will receive recombinant gonadotropins tailored to their antral follicle count and prior donation experiences, if any. The primary outcome is the number of mature metaphase II (MII) oocytes. Secondary measures include treatment duration, pregnancy outcomes in recipients, as well as the economic cost per MII oocyte obtained in each treatment regimen. Analyses for the primary outcome will be conducted in both the intention-to-treat (ITT) and per-protocol (PP) populations. Each donor can participate only once during the recruitment period. The estimated duration of the study is six months for the primary outcome and 15 months for the secondary outcomes. Discussion: The outcomes of this trial have the potential to inform evidence-based adjustments in the management of ovarian stimulation protocols for oocyte donors. Clinical trial registration: ClinicalTrials.gov, identifier, NCT05954962.


Assuntos
Antagonistas de Hormônios , Progesterona , Feminino , Humanos , Gravidez , Hormônio Liberador de Gonadotropina , Antagonistas de Hormônios/uso terapêutico , Indução da Ovulação/métodos , Progestinas , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
Farm. comunitarios (Internet) ; 16(2): 5-13, Abr. 2024. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-232403

RESUMO

La enfermedad renal crónica (ERC) es la presencia de alteraciones de estructura o función renal con consecuencias para la salud. Suele considerarse cuando el filtrado glomerular estimado (FGe) baja de 60 ml/min/1,73m2. Su progresión lleva al tratamiento renal sustitutivo (diálisis o trasplante) cuando baja de 15 ml/min/1,73m2. El cribado en poblaciones de riesgo ha demostrado ser coste-efectivo. El objetivo de este trabajo es hacer un cribado de ERC en farmacia comunitaria y en esta publicación exponemos la metodología de forma detallada y justificada.Metodología: los farmacéuticos de las farmacias comunitarias participantes seleccionan pacientes que cumplan criterios de inclusión y no de exclusión. Se les mide la creatinina mediante punción en el dedo y se calcula el FGe con la fórmula CKD-EPI. Si es menor de un determinado valor, que depende de la edad, se deriva al médico de atención primaria.Resultados: 141 de un total de 200 farmacias participaron en el estudio. 2.116 pacientes fueron reclutados y hubo una pérdida de 116 pacientes, alcanzando un tamaño muestral final de 2.000 pacientes.Discusión: El protocolo ha sido implementado con éxito por los farmacéuticos comunitarios y ha tenido una excelente acogida por parte de los usuarios de la farmacia comunitaria. El ajuste por edad de los puntos de corte para FGe aporta un filtro adicional novedoso, con el objetivo de no sobrecargar los centros de atención primaria con potenciales derivaciones de falsos positivos. La confirmación del diagnóstico queda sujeta a la comunicación voluntaria por parte del paciente al farmacéutico.(AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Insuficiência Renal Crônica/diagnóstico , Programas de Rastreamento , Farmacêuticos , Farmácias , Creatinina/sangue , Epidemiologia Descritiva , Consentimento Livre e Esclarecido , Fatores de Risco
4.
Mar Pollut Bull ; 201: 116225, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38460435

RESUMO

The Huelva estuary is formed by the common mouths of the Odiel and Tinto Rivers, and inside this ecosystem is the biosphere reserve of the Odiel saltmarshes. This ecosystem has been historically affected by acid mine drainage (AMD) and by releases of pollutants from five phosphoric acid industrial plants and phosphogypsum (PG) waste stacks located in the area. This study carried out a comprehensive assessment of the environmental impact of the biosphere reserve of the Odiel saltmarshes. To this end, it was necessary to find a suitable sedimentary background (Piedras River in our case). To quantify this impact, several pollution indexes were used. According to the values reached by the indexes, this impact was classified as "serious" pollution for most trace elements, excepting the deepest layers, and "low-moderate" pollution for the 238U-series radionuclides, while no pollution for the 232Th-series and 40K radionuclides was found as expected.


Assuntos
Ecossistema , Poluentes Químicos da Água , Estuários , Resíduos Industriais/análise , Rios , Radioisótopos , Espanha , Monitoramento Ambiental , Poluentes Químicos da Água/análise
5.
Rev Esp Anestesiol Reanim (Engl Ed) ; 71(2): 90-111, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38309642

RESUMO

INTRODUCTION AND OBJECTIVES: Sedation is used in intensive care units (ICU) to improve comfort and tolerance during mechanical ventilation, invasive interventions, and nursing care. In recent years, the use of inhalation anaesthetics for this purpose has increased. Our objective was to obtain and summarise the best evidence on inhaled sedation in adult patients in the ICU, and use this to help physicians choose the most appropriate approach in terms of the impact of sedation on clinical outcomes and the risk-benefit of the chosen strategy. METHODOLOGY: Given the overall lack of literature and scientific evidence on various aspects of inhaled sedation in the ICU, we decided to use a Delphi method to achieve consensus among a group of 17 expert panellists. The processes was conducted over a 12-month period between 2022 and 2023, and followed the recommendations of the CREDES guidelines. RESULTS: The results of the Delphi survey form the basis of these 39 recommendations - 23 with a strong consensus and 15 with a weak consensus. CONCLUSION: The use of inhaled sedation in the ICU is a reliable and appropriate option in a wide variety of clinical scenarios. However, there are numerous aspects of the technique that require further study.


Assuntos
Anestesia , Anestésicos Inalatórios , Adulto , Humanos , Hipnóticos e Sedativos , Unidades de Terapia Intensiva , Respiração Artificial
6.
Radiother Oncol ; 190: 110024, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37995851

RESUMO

OBJECTIVES: To evaluate the predictive factors for biochemical failure and distant metastases in a prospective cohort of patients with localized prostate cancer treated with the combination of HDR BT and EBRT. METHODS AND MATERIALS: Patients with intermediate (IR) or high-risk (HR) prostate adenocarcinoma received a single fraction of HDR of 15 Gy combined with RT of 37.5 Gy in 15 fractions. ADT duration was used depending on risk-group. Descriptive analyses were performed. Univariate and multivariate Hazard Ratios were obtained. Finally, the Kaplan-Meier model was used to describe the survival of the events of interest. RESULTS: 309 patients were treated prospectively (199 were IR and 110 HR). Median age was 72 years; 58.3 % were MRI stage ≤ T2c, 34.1 % T3a and 7.6 % T3b; ISUP-grade 1-3 in 78.9 % and ISUP 4-5 in 21.1 %. 71.8 % of patients had ≤ 50 % positive-cores in biopsy and 28.2 % had > 50 %. Median pre-treatment PSA was 9.9 ng/mL. After a median follow-up of 88 months, 41 patients presented biochemical failure and 18 developed distant metastases. Multivariate cox-regression analyses found that MR-T3b Stage (HR 3.88, p = 0.001) and ADT use (HR 3.99, p = 0.03) were the only predictive factors for biochemical failure and the number of positive cores (>50 %) the only independent predictive factor of distant metastases (HR 4.36, p = 0.002). CONCLUSIONS: Patients with mpMRI evidence of invasion of the SV and involvement of more than 50% of the cores in the prostate biopsy are patients with a higher risk of presenting a biochemical recurrence or developing metastasis due to their prostate cancer, respectively.


Assuntos
Braquiterapia , Neoplasias da Próstata , Masculino , Humanos , Idoso , Braquiterapia/métodos , Estudos Prospectivos , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/radioterapia , Antagonistas de Androgênios/uso terapêutico , Androgênios/uso terapêutico , Antígeno Prostático Específico/análise , Dosagem Radioterapêutica , Imageamento por Ressonância Magnética , Estudos Retrospectivos
7.
Rev. esp. anestesiol. reanim ; 70(10): 561-568, Dic. 2023. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-228132

RESUMO

Antecedentes y objetivo: Los pacientes con infección por SARS-CoV-2 pueden presentar afectación cardiovascular, incluyendo miocarditis, arritmias y prolongación del intervalo QT. Nuestro objetivo fue evaluar el impacto de la COVID-19 y su tratamiento en la repolarización ventricular y el desarrollo de arritmias en pacientes críticos. Material y métodos: Estudio de cohortes retrospectivo de pacientes críticos con infección confirmada por SARS-CoV-2 durante un periodo de 3meses. Se registraron los datos clínicos relevantes y el tratamiento específico administrado para la COVID-19. Se consideró QTc prolongado cuando medía ≥460ms en mujeres y ≥450ms en hombres. Se registró la incidencia y el tipo de arritmias durante el mismo periodo. Resultados: Se evaluaron 77 pacientes con una edad media de 62±13años: 20 mujeres y 57 hombres. El 60% de los pacientes eran hipertensos, el 52% presentaban un IMC>30 y el 70% desarrollaron fracaso renal agudo durante el ingreso. El 56% de los pacientes presentaron prolongación del QTc. El 44% presentaron algún tipo de arritmia durante su estancia en la UCI, siendo en el 21% arritmias auriculares. La mortalidad global fue del 53%, sin diferencias entre los pacientes con o sin QTc prolongado. Conclusiones: En nuestra serie, una elevada proporción de pacientes críticos con COVID-19 han presentado QTc prolongado y arritmias. Los factores implicados se han relacionado con la elevación de biomarcadores cardiacos, la propia afectación miocárdica del virus y la medicación concomitante recibida en la UCI.(AU)


Introduction and objective: Patients with SARS-CoV-2 infection may present cardiovascular involvement including myocarditis, arrhythmias and QT interval prolongation. Our objective was to evaluate the impact of COVID-19 and its treatment on ventricular repolarization and development of arrhythmias in critically ill patients. Material and methods: Retrospective cohort study of critically ill COVID-19 patients during a 3-month period in whom at least one ECG was available. Relevant clinical data and specific treatment administered for COVID-19 were recorded. Prolonged QTc was considered prolonged when it measured ≥460ms in women and ≥450ms in men. The incidence and type of arrhythmias during the same period were recorded. Results: A total of 77 patients with a mean age of 62±13years, 20 women and 57 men, were evaluated. Sixty percent of the patients were hypertensive, 52% had a BMI>30, and 70% developed acute renal failure during admission. Some 56% of the patients presented QTc prolongation. Forty-four percent presented some type of arrhythmia during their stay in the ICU, 21% of which were atrial arrhythmias. Overall mortality was 53%, with no differences between patients with or without prolonged QTc. Conclusions: In our series, a high proportion of critical patients with COVID-19 presented prolonged QTc and arrhythmias. The factors involved have been related to the elevation of cardiac biomarkers, the myocardial involvement of the virus and concomitant medication received in the ICU.(AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Síndrome do QT Longo , /tratamento farmacológico , Arritmias Cardíacas/tratamento farmacológico , Estudos de Coortes , Síndrome do QT Longo/epidemiologia , Estudos Retrospectivos , /complicações
8.
RSC Adv ; 13(43): 29819-29829, 2023 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-37829715

RESUMO

Developing borophene films with good structural stability on non-metallic substrates to maximize their potential in photosensitivity, gas detection, photothermia, energy storage, and deformation detection, among others has been challenging in recent years. Herein, we succeeded in the pulsed laser deposition of multilayered borophene films on Si (100) with ß12 or χ3 bonding by tuning the mean kinetic energy in the plasma during the deposition process. Raman and X-ray photoelectron spectroscopies confirm ß12 and χ3 bonding in the films. Borophene films with ß12 bonding were obtained by tuning a high mean kinetic energy in the plasma, while borophene with χ3 bonding required a relatively low mean kinetic energy. Atomic force microscopy (AFM) micrographs revealed a granular and directional growth of the multilayered borophene films following the linear atomic terraces from the (100) silicon substrate. AFM nanofriction was used to access the borophene surfaces and to reveal the pull-off force and friction coefficient of the films where the surface oxide showed a significant contribution. To summarize, we show that it is possible to deposit multilayered borophene thin films with different bondings by tuning the mean kinetic energy during pulsed laser deposition. The characterization of the plasma during borophene deposition accompanies our findings, providing support for the changes in kinetic energy.

9.
Rev Esp Anestesiol Reanim (Engl Ed) ; 70(10): 561-568, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37717632

RESUMO

INTRODUCTION: Patients with SARS-CoV-2 infection may present cardiovascular involvement including myocarditis, arrhythmias and QT interval prolongation. Our objective was to evaluate the impact of COVID-19 and its treatment on ventricular repolarization and development of arrhythmias in critically ill patients. METHODS: Retrospective cohort study of critically ill COVID-19 patients during a 3-month period in whom at least one ECG was available. Relevant clinical data and specific treatment administered for COVID-19 were recorded. Prolonged QTc was considered prolonged when it measured ≥ 460 ms in women and ≥450 ms in men. The incidence and type of arrhythmias during the same period were recorded. RESULTS: A total of 77 patients with a mean age of 62 ±â€¯13 years, 20 women and 57 men, were evaluated. Sixty percent of the patients were hypertensive, 52% had a BMI > 30, and 70% developed acute renal failure during admission. Some 56% of the patients presented QTc prolongation. Forty-four percent presented some type of arrhythmia during their stay in the ICU, 21% of which were atrial arrhythmias. Overall mortality was 53%, with no differences between patients with or without prolonged QTc. CONCLUSIONS: In our series, a high proportion of critical patients with COVID-19 presented prolonged QTc and arrhythmias. The factors involved have been related to the elevation of cardiac biomarkers, the myocardial involvement of the virus and concomitant medication received in the ICU.


Assuntos
COVID-19 , Síndrome do QT Longo , Masculino , Humanos , Feminino , Pessoa de Meia-Idade , Idoso , COVID-19/complicações , COVID-19/epidemiologia , Estudos de Coortes , Estudos Retrospectivos , Estado Terminal , Pandemias , Prevalência , SARS-CoV-2 , Síndrome do QT Longo/epidemiologia , Síndrome do QT Longo/complicações , Arritmias Cardíacas/epidemiologia , Arritmias Cardíacas/etiologia
10.
Fitoterapia ; 169: 105602, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37423501

RESUMO

Tabernaemontana arborea (Apocynaceae) is a Mexican tree species known to contain ibogan type alkaloids. This study aimed at determining central nervous system-related activities of an alkaloid extract obtained from the root bark of T. arborea. A gas chromatography-mass spectrometry (GC-MS) analysis was performed to describe the alkaloid profile of the extract. A wide dosing range (0.1 to 56.2 mg/kg) of this extract was evaluated in different murine models. Electrical brain activity was examined by electroencephalography (EEG). The extract's effects on motor coordination, ambulatory activity, and memory were analyzed based on the rotarod, open field (OFT), and object recognition tests (ORT), respectively. Antidepressant and antinociceptive activities were determined using the forced swimming test (FST) and the formalin assay, respectively. In order to elucidate the underlying mechanisms of action, the 5-HT1A receptor antagonist WAY100635 (1 mg/kg) or the opioid receptor antagonist naloxone (1 mg/kg) was included in the latter experiments. GC-MS analysis (µg/mg extract) confirmed the presence of the monoterpenoid indole alkaloids (MIAs) voacangine (207.00), ibogaine (106.33), vobasine (72.81), coronaridine (30.72), and ibogamine (24.2) as principal constituents of the extract, which exhibited dose- and receptor-dependent antidepressant (0.1 to 1 mg/kg; 5-HT1A) and antinociceptive (30 and 56.2 mg/kg; opioid) effects, without altering motor coordination, ambulatory activity, and memory. EEG indicated CNS depressant activity at high doses (30 and 56.2 mg/kg). The root bark of T. arborea contains a mixture of alkaloids that may hold therapeutic value in pain relief and the treatment of psychiatric diseases without causing neurotoxic activity at effective doses.


Assuntos
Antineoplásicos , Alcaloides de Triptamina e Secologanina , Tabernaemontana , Animais , Camundongos , Tabernaemontana/química , Modelos Animais de Doenças , Estrutura Molecular , Extratos Vegetais/farmacologia , Extratos Vegetais/química , Sistema Nervoso Central , Analgésicos/farmacologia , Transmissão Sináptica
11.
J Assist Reprod Genet ; 40(7): 1755-1763, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37171739

RESUMO

PURPOSE: To identify novel genetic variants responsible for meiotic embryonic aneuploidy. METHODS: A prospective observational cohort study that included 29 couples who underwent trophectoderm biopsies from 127 embryos and performed whole-exome sequencing (WES) between November 2019 and March 2022. Patients were divided into two groups according to the expected embryo aneuploidy rate based on maternal age. RESULTS: After variant filtering in the WES analysis of 58 patients/donors, five heterozygous variants were identified in female partners from the study group that had an impact on embryo aneuploidy. Additionally, a slowdown in embryo development and a decrease in the number of blastocysts available for biopsy were observed in the study group embryos. CONCLUSION: This study has identified new candidate genes and variants not previously associated with meiotic embryo aneuploidy, but which are involved in important biological processes related to cell division and chromosome segregation. WES may be an efficient tool to identify patients with a higher-than-expected risk of embryo aneuploidy based on maternal age and allow for individualized genetic counselling prior to treatment.


Assuntos
Diagnóstico Pré-Implantação , Gravidez , Humanos , Feminino , Estudos Prospectivos , Sequenciamento do Exoma , Aneuploidia , Idade Materna , Blastocisto , Testes Genéticos
12.
Radiography (Lond) ; 29(3): 668-674, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-37148708

RESUMO

INTRODUCTION: This work presents a prospective analysis of the key aspects involved in the Spanish radiographer's perception of the weaknesses of the current educational curriculum in terms of teaching staff's qualifications and composition in the clinical training and core subjects. The goal is to show clinical training and professional's perception of the teaching quality and to characterise the weakness detected within the context of the European radiographer's academic system. METHODS: The perception of the quality of the training received by the professionals was collected through an anonymous survey. A total of 758 valid responses were received, and were analysed to three hypotheses: the variability of the teachers' qualifications in the core subjects, the variability in terms of internships time carried out by the students, and assessment about teaching quality of the teachers. RESULTS: The results prove there is a huge variability and little academic affinity of the teachers' degrees with the core subjects. On the other hand, the results shows there is a scarcity of clinical training hours in Spain, especially compared to European standards. It was demonstrated that teachers with a specific radiographer degree obtained the best scores. CONCLUSION: It is mandatory to adjust the criteria for selecting clinical imaging teachers to improve the teaching quality in Spain and increase the clinical training period of the Spanish radiographers to match their European counterparts. IMPLICATION FOR PRACTICE: Improving the training of Spanish radiographers will contribute to standardising the training quality of the whole European profession.


Assuntos
Currículo , Estudantes , Humanos , Inquéritos e Questionários , Espanha , Competência Clínica
14.
Zootaxa ; 5239(3): 431-441, 2023 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-37045089

RESUMO

Archanara neurica (Hübner, 1808) is recorded for the first time from the Iberian Peninsula. The Iberian population represent a link between central European, including French, and Moroccan populations. Male internal genitalia are comparatively described. DNA barcode is presented and compared with those of the other European Archanara, Lenisa and Globia species, formerly considered congeneric. An analysis based on the COI mitochondrial gene provisionally supports the morphologically proposed statement that recognize the three mentioned taxa at the generic level.


Assuntos
Lepidópteros , Mariposas , Masculino , Animais , Código de Barras de DNA Taxonômico , Europa (Continente) , DNA , Genitália Masculina , Genitália
15.
Circ Cardiovasc Imaging ; 16(4): e014963, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-37071717

RESUMO

BACKGROUND: The relation between ventricular arrhythmia and fibrosis in mitral valve prolapse (MVP) is reported, but underlying valve-induced mechanisms remain unknown. We evaluated the association between abnormal MVP-related mechanics and myocardial fibrosis, and their association with arrhythmia. METHODS: We studied 113 patients with MVP with both echocardiogram and gadolinium cardiac magnetic resonance imaging for myocardial fibrosis. Two-dimensional and speckle-tracking echocardiography evaluated mitral regurgitation, superior leaflet and papillary muscle displacement with associated exaggerated basal myocardial systolic curling, and myocardial longitudinal strain. Follow-up assessed arrhythmic events (nonsustained or sustained ventricular tachycardia or ventricular fibrillation). RESULTS: Myocardial fibrosis was observed in 43 patients with MVP, predominantly in the basal-midventricular inferior-lateral wall and papillary muscles. Patients with MVP with fibrosis had greater mitral regurgitation, prolapse, and superior papillary muscle displacement with basal curling and more impaired inferior-posterior basal strain than those without fibrosis (P<0.001). An abnormal strain pattern with distinct peaks pre-end-systole and post-end-systole in inferior-lateral wall was frequent in patients with fibrosis (81 versus 26%, P<0.001) but absent in patients without MVP with basal inferior-lateral wall fibrosis (n=20). During median follow-up of 1008 days, 36 of 87 patients with MVP with >6-month follow-up developed ventricular arrhythmias associated (univariable) with fibrosis, greater prolapse, mitral annular disjunction, and double-peak strain. In multivariable analysis, double-peak strain showed incremental risk of arrhythmia over fibrosis. CONCLUSIONS: Basal inferior-posterior myocardial fibrosis in MVP is associated with abnormal MVP-related myocardial mechanics, which are potentially associated with ventricular arrhythmia. These associations suggest pathophysiological links between MVP-related mechanical abnormalities and myocardial fibrosis, which also may relate to ventricular arrhythmia and offer potential imaging markers of increased arrhythmic risk.


Assuntos
Insuficiência da Valva Mitral , Prolapso da Valva Mitral , Humanos , Prolapso da Valva Mitral/complicações , Prolapso da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/etiologia , Insuficiência da Valva Mitral/complicações , Arritmias Cardíacas/etiologia , Arritmias Cardíacas/complicações , Músculos Papilares/diagnóstico por imagem , Fibrose , Prolapso
16.
Neurología (Barc., Ed. impr.) ; 38(3): 181-187, abril 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-218080

RESUMO

Introducción: Se denomina síndrome de Terson (ST) a cualquier tipo de hemorragia intraocular (HIO), identificada en pacientes con patología aguda intracraneal. El ST parece estar relacionado con la gravedad clínica en la hemorragia subaracnoidea (HSA), pero en pacientes con trauma craneoencefálico (TCE) y hemorragia intracerebral (HIC), su asociación está por definir. Diseñamos este estudio para evaluar el rendimiento de la ecografía ocular (EO) y su utilidad en la práctica clínica.Materiales y métodosRealizamos un estudio observacional prospectivo, unicéntrico en pacientes neurocríticos. Analizamos los casos con respecto a los controles, identificados con oftalmoscopia indirecta (OI), y por EO. Determinamos las características diagnósticas de la EO. Hicimos un análisis multivariante para determinar asociaciones clínicamente relevantes.ResultadosSe incluyeron 91 pacientes con diagnósticos de HIC (41,76%), HSA (29,67%) y TCE (28,57%). El ST fue identificado por EO en ocho pacientes (8,79%) y en 24 pacientes (24,37%) por OI. La mortalidad ajustada para los pacientes con ST tuvo una OR 4,15 con IC 95% (1,52 - 11,33). Todos los pacientes con ST identificados por EO presentaron una escala de coma de Glasgow < 9 y tuvieron un riesgo elevado de precisar craniectomía descompresiva, una OR 9,84 (1,64 - 59). La EO alcanzó una sensibilidad global de 30,43%, una especificidad del 98,53%, con una precisión diagnóstica de 81,32. Para la detección de la hemorragia vítrea, una sensibilidad y especificidad del 87,5 y 98,5%, respectivamente.ConclusionesEl ST diagnosticado por EO discrimina pacientes neurocríticos de extrema gravedad que pueden requerir el máximo escalón terapéutico y es un factor independiente de mortalidad intrahospitalaria. (AU)


Introduction: Terson syndrome (TS) is defined as any intraocular haemorrhage identified in patients with acute intracranial pathology. TS appears to be associated with clinical severity in patients with subarachnoid haemorrhage (SAH), but the association is yet to be defined in patients with traumatic brain injury (TBI) and intracerebral haemorrhage (ICH). This study aimed to evaluate the diagnostic performance of ocular ultrasound (OU) and its usefulness in clinical practice.Material and methodsWe performed an observational, prospective, single-centre study of neurocritical care patients. We analysed cases and controls, defined according to indirect ophthalmoscopy (IO) and OU findings. We determined the diagnostic characteristics of OU. A multivariate analysis was performed to identify clinically relevant associations.ResultsThe sample included 91 patients diagnosed with ICH (41.76%), SAH (29.67%), and TBI (28.57%). TS was identified by OU in 8 patients (8.79%) and by IO in 24 (24.37%). The adjusted mortality rate in patients with TS showed an odds ratio (OR) of 4.15 (95% confidence interval [CI], 1.52-11.33). All patients with TS detected by OU presented Glasgow Coma Scale scores < 9, with an elevated risk of needing decompressive craniectomy (OR: 9.84; 95% CI, 1.64-59). OU presented an overall sensitivity of 30.43%, specificity of 98.53%, and diagnostic accuracy of 81.32%. For the detection of vitreous haemorrhage, sensitivity and specificity were 87.5% and 98.5%, respectively.ConclusionsOU diagnosis of TS identifies extremely critical patients, who may require the highest level of care; TS is an independent risk factor for in-hospital mortality. (AU)


Assuntos
Humanos , Lesões Encefálicas Traumáticas , Hemorragia Subaracnóidea , Hemorragia Cerebral , Hemorragia Ocular , Ultrassonografia
18.
J Hazard Mater ; 447: 130782, 2023 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-36641853

RESUMO

The spatiotemporal evolution of both U and Th isotopes in a mine effluent highly polluted by acid mine drainage (AMD) was evaluated. The acidic tributary, which born from the outflows of an abandoned sulfide mine, flows into the Odiel River. AMD comprises an important source of natural radionuclides, presenting concentrations of 238U and 232Th, two and four orders of magnitude higher, respectively, than the background values of surface continental waters. These natural radionuclides behave conservatively along the mine effluent (pH < 2.5) throughout the hydrological year. Under AMD conditions uranium is in the hexavalent state U(VI) and the main dissolved species are uranyl sulfate complexes. The polluted tributary has a significant impact on the Odiel River acidifying its waters during the low flow season and increasing up to one order of magnitude the activity concentrations of U and Th isotopes. U presented a conservative behavior in the Odiel River during the low flow season (pH ≈ 3), however it is removed from the liquid phase in the wet season (pH ≈ 6), probably due its coprecipitation/adsorption onto Al-phases. Th shows a high sensitivity to small increases of pH, and it is strongly coprecipitated/adsorbed with or onto Fe-oxyhydroxydizes in the river.

19.
Neurologia (Engl Ed) ; 38(3): 181-187, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35305963

RESUMO

INTRODUCTION: Terson syndrome (TS) is defined as any intraocular haemorrhage identified in patients with acute intracranial pathology. TS appears to be associated with clinical severity in patients with subarachnoid haemorrhage (SAH), but the association is yet to be defined in patients with traumatic brain injury (TBI) and intracerebral haemorrhage (ICH). This study aimed to evaluate the diagnostic performance of ocular ultrasound (OU) and its usefulness in clinical practice. MATERIAL AND METHODS: We performed an observational, prospective, single-centre study of neurocritical care patients. We analysed cases and controls, defined according to indirect ophthalmoscopy (IO) and OU findings. We determined the diagnostic characteristics of OU. A multivariate analysis was performed to identify clinically relevant associations. RESULTS: The sample included 91 patients diagnosed with ICH (41.76%), SAH (29.67%), and TBI (28.57%). TS was identified by OU in 8 patients (8.79%) and by IO in 24 (24.37%). The adjusted mortality rate in patients with TS showed an odds ratio (OR) of 4.15 (95% confidence interval [CI], 1.52-11.33). All patients with TS detected by OU presented Glasgow Coma Scale scores < 9, with an elevated risk of needing decompressive craniectomy (OR: 9.84; 95% CI, 1.64-59). OU presented an overall sensitivity of 30.43%, specificity of 98.53%, and diagnostic accuracy of 81.32%. For the detection of vitreous haemorrhage, sensitivity and specificity were 87.5% and 98.5%, respectively. CONCLUSIONS: OU diagnosis of TS identifies extremely critical patients, who may require the highest level of care; TS is an independent risk factor for in-hospital mortality.


Assuntos
Hemorragia Subaracnóidea , Hemorragia Vítrea , Humanos , Hemorragia Cerebral , Estudos Prospectivos , Fatores de Risco , Hemorragia Subaracnóidea/diagnóstico por imagem , Hemorragia Vítrea/diagnóstico por imagem , Hemorragia Vítrea/complicações
20.
J Phys Chem Lett ; 14(1): 24-31, 2023 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-36562987

RESUMO

An open-loop control scheme of molecular fragmentation based on transient molecular alignment combined with single-photon ionization induced by a short-wavelength free electron laser (FEL) is demonstrated for the acetylene cation. Photoelectron spectra are recorded, complementing the ion yield measurements, to demonstrate that such control is the consequence of changes in the electronic response with molecular orientation relative to the ionizing field. We show that stable C2H2+ cations are mainly produced when the molecules are parallel or nearly parallel to the FEL polarization, while the hydrogen fragmentation channel (C2H2+ → C2H+ + H) predominates when the molecule is perpendicular to that direction, thus allowing one to distinguish between the two photochemical processes. The experimental findings are supported by state-of-the art theoretical calculations.

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