Influence of a Static Magnetic Field on the ⟨100⟩ Growth Rates of Sodium Chlorate Crystals from Aqueous Solution.

The results of the study of the influence of a static magnetic field of 55 ± 3 mT on the growth rates of diamagnetic sodium chlorate crystals in the direction ⟨100⟩ will be presented. Two groups of experiments were performed in the same solution supersaturation range of 0.89-1.78%, the first in zero field conditions, and the second in an applied magnetic field. The results show that crystals nucleated and grown in a static magnetic field have higher mean growth rates in the ⟨100⟩ direction than crystals in a zero field. Also, X-ray analyses suggest that crystals nucleated and grown in a magnetic field may have a higher lattice constant. Possible mechanisms and possible reasons for these phenomena are discussed.

Coexistence of Different Growth Mechanisms of Sodium Chlorate under the Same Experimental Conditions.

Dependence of growth rates of {100} sodium chlorate crystal faces on solution supersaturation in the range of 0.44-1.32% was analyzed. It has been shown that the growth rate dispersion does not have a consequence only in the growth parameter differences predicted by specific crystal growth theory but that individual crystal faces may grow with different mechanisms under the same experimental conditions. The majority of the observed {100} sodium chlorate crystal faces grew in accordance with the power law R ∼ σ n , whereas approximately one-third of them grew in accordance with BCF or Chernov's theories. Possible reasons for this as well as for the coexistence of crystal faces, which grew with different mechanisms under the same conditions, have been discussed.

'Real-life' report on the management of chronic GvHD in the Gruppo Italiano Trapianto Midollo Osseo (GITMO).

Several guidelines have been published about management of chronic GvHD (cGvHD), but the clinical practice still remains demanding. The Gruppo Italiano Trapianto di Midollo Osseo (GITMO) has planned a prospective observational study on cGvHD, supported by a dedicated software, including the updated recommendations. In view of this study, two surveys have been conducted, focusing the management of cGvHD and ancillary therapy in cGvHD, to address the current 'real life' situation. The two surveys were sent to all 57 GITMO centers, performing allografting in Italy; the response rate was 57% and 66% of the interviewed centers, respectively. The first survey showed a great disparity especially regarding steroid-refractory cGvHD, although extracorporeal photo-apheresis resulted as the most indicated treatment in this setting. Another challenging issue was the strategy for tapering steroid: our survey showed a great variance, and this disagreement could be a real bias in evaluating outcomes in prospective studies. As for the second survey, the results suggest that the ancillary treatments are not standardized in many centers. All responding centers reported a strong need to standardize management of cGvHD and to participate in prospective trials. Before starting observational and/or interventional studies, a detailed knowledge of current practice should be encouraged.

State of the art of produced water treatment.

Produced water (PW) is the wastewater generated when water from underground reservoirs is brought to the surface during oil or gas extraction. PW is generated in large amounts and has a complex composition, containing various toxic organic and inorganic compounds. PW is currently treated in conventional trains that include phase separators, decanters, cyclones and coarse filters in order to comply with existing regulation for discharge. These treatment trains do not achieve more restrictive limitations related to the reuse of the effluent (reinjection into extraction wells) or other beneficial uses (e.g., irrigation). Therefore, and to prevent environmental pollution, further polishing processes need to be carried out. Characterization of the PW to determine major constituents is the first step to select the optimum treatment for PW, coupled with environmental factors, economic considerations, and local regulatory framework. This review tries to provide an overview of different treatments that are being applied to polish this type of effluents. These technologies include membranes, physical, biological, thermal or chemical treatments, where special emphasis has been made on advanced oxidation processes due to the advantages offered by these processes. Commercial treatments, based on the combination, modification and improvement of simpler treatments, were also discussed.

Serum cystatin C and microalbuminuria in the detection of vascular and renal damage in early stages.

BACKGROUND: The aim of this study was to assess serum cystatin C and urinary albumin in the early detection of impairment in cardiovascular and renal function. MATERIAL ANS METHODS: Cystatin C was quantified in sera from healthy people, moreover, cystatin C was quantified in a group of patients diagnosed with chronic kidney disease for predicting a measured glomerular filtration rate <60 ml/min/1.73 m2. Finally serum cystatin C and microalbuminuria were measured in patients with increasing of risk of impairment in cardiovascular and renal function (hypertension, diabetes and hyperlipidemia). RESULTS: When the serum cystatin C was quantified in a group of risk, we observe as when being increased the cystatin C, the values of the glomerular filtration rate decreased (p <0.05), the cystatin values C were increased when increasing the age of the patients (p <0.05) and cystatin C values higher than 0.95 mg/l were not observed in patient smaller than 50 years old. In the group of risk, serum cystatin C was high regarding to the values obtained in healthy people in 27.6%, microalbuminuria in the 20.3% and both parameters were high in the 14.4% of patients with a glomerular filtration rate >90 ml/min/1.73 m2, while in patients with a glomerular filtration rate 60-90 ml/min/1.73 m2, cystatin C was high in the 51.7% and the microalbuminuria only in the 6.4%. CONCLUSIONS: Determinations of serum cystatin C associated to the quantification of urinary albumin in patients with cardiovascular risk can optimize the early detection of vascular and renal damage. Cystatin C can show vascular and renal damage in patients without urinary albumin.

Cistatina C sérica y microalbuminuria en la detección del daño vascular y renal en estadios precoces, en pacientes de riesgo sin enfermedad renal crónica / Serum cystatin C and microalbuminuria in the detection of early-stage vascular and renal damage, in at-risk patients without chronic kidney disease

Objetivo: Evaluar la cistatina C sérica y la microalbuminuria en la detección precoz de las alteraciones vasculares y renales. Material y método: La cistatina C sérica fue cuantificada en suero de un grupo de personas sanas y en un grupo de pacientes con enfermedad renal crónica para establecer un valor de cistatina C a partir del cual se pueda predecir un filtrado glomerular <60 ml/min/1.73 m2. Finalmente, la cistatina C sérica y la microalbuminuria fueron cuantificadas en pacientes con un incremento del riesgo de daño vascular y renal (hipertensión, diabetes e hiperlipemia). Resultados: Cuando la cistatina C sérica fue cuantificada en un grupo de riesgo, observamos cómo al aumentar los valores de cistatina C disminuían los valores del filtrado glomerular (p <0,05), que los valores de cistatina C se incrementaban al aumentar la edad de los pacientes (p <0,05) y cómo valores de cistatina C superiores a 0,95 mg/l no se observaron en pacientes con edad inferior a 50 años. En los pacientes del grupo de riesgo con un filtrado glomerular >90 ml/min/1,73 m2, la cistatina C sérica estaba elevada en un 27,6% con respecto a los valores obtenidos en personas sanas; existía microalbuminuria en un 20,3% y elevación de ambos parámetros en un 14,4%. Con valores de filtrado glomerular 60-90 ml/min/1,73 m2, la cistatina C estaba elevada en un 51,7%, la microalbuminuria en un 6,4% y ambos parámetros en un 23,8%. Conclusiones: Determinaciones de cistatina C sérica asociadas a la cuantificación de microalbuminuria en pacientes con riesgo pueden mejorar la detección del daño vascular y renal en estadios precoces. La cistatina C puede poner de manifiesto el daño vascular y renal precoz incluso en pacientes sin microalbuminuria (AU)

Background: The aim of this study was to assess serum cystatin C and urinary albumin in the early detection of impairment in cardiovascular and renal function. Material ans methods: Cystatin C was quantified in sera from healthy people, moreover, cystatin C was quantified in a group of patients diagnosed with chronic kidney disease for predicting a measured glomerular filtration rate <60 ml/min/1.73 m2. Finally serum cystatin C and microalbuminuria were measured in patients with increasing of risk of impairment in cardiovascular and renal function (hypertension, diabetes and hyperlipidemia). Results: When the serum cystatin C was quantified in a group of risk, we observe as when being increased the cystatin C, the values of the glomerular filtration rate decreased (p <0.05), the cistatina values C were increased when increasing the age of the patients (p <0.05) and cystatin C values higher than 0.95 mg/l were not observed in patient smaller than 50 years old. In the group of risk, serum cystatin C was high regarding to the values obtained in healthy people in 27.6%, microalbuminuria in the 20.3% and both parameters were high in the 14.4% of patients with a glomerular filtration rate >90 ml/min/1.73 m2, while in patients with a glomerular filtration rate 60-90 ml/min/1.73 m2, cystatin C was high in the 51.7% and the microalbuminuria only in the 6.4%. Conclusions: Determinations of serum cystatin C associated to the quantification of urinary albumin in patients with cardiovascular risk can optimize the early detection of vascular and renal damage. Cystatin C can show vascular and renal damage in patients without urinary albumin (AU)

Off-label use of rituximab in 196 patients with severe, refractory systemic autoimmune diseases.

OBJECTIVES: To analyse the safety and efficacy of the off-label use of rituximab in patients with severe, refractory systemic autoimmune diseases. METHODS: In 2006, the Study Group on Autoimmune Diseases of the Spanish Society of Internal Medicine created the BIOGEAS project, a multicenter study devoted to collecting data on the use of biological agents in adult patients with systemic autoimmune diseases refractory to standard therapies (failure of at least two immunosuppressive agents). RESULTS: One hundred and ninety-six patients with systemic autoimmune diseases treated with rituximab have been included in the Registry (158 women and 38 men, mean age 43 years). Systemic autoimmune diseases included systemic lupus erythematosus (107 cases), inflammatory myopathies (20 cases), ANCA-related vasculitides (19 cases), Sjögren's syndrome (15 cases) and other diseases (35 cases). A therapeutic response was evaluable in 194 cases: 99 (51%) achieved a complete response, 51 (26%) a partial response and 44 (23%) were classified as non-responders. After a mean follow-up of 27.56+/-1.32 months, 44 (29%) out of the 150 responders patients relapsed. There were 40 adverse events reported in 33 (16%) of the 196 patients. The most frequent adverse events were infections, with 24 episodes being described in 19 patients. Thirteen (7%) patients died, mainly due to disease progression (7 cases) and infection (3 cases). CONCLUSIONS: Although not yet licensed for this use, rituximab is currently used to treat severe, refractory systemic autoimmune diseases, with the most favourable results being observed in Sjögren's syndrome, inflammatory myopathies, systemic lupus erythematosus and cryoglobulinemia.

[Intermediate care units. Health care consequences in a reference hospital]. / Unidades de Cuidados Intermedios. Consecuencias asistenciales en un hospital de referencia.

INTRODUCTION: Intermediate Care Units are forms to provide health care services to potentially critical patients that allow for improved cost-benefit ratio of the care offered by Intensive Medicine Departments. OBJECTIVE: Analyze heart care repercussion that the permanent opening of this type of unit had in a reference teaching center. DESIGN: Prospective. PERIOD: From the beginning of 2003 to the end of 2005. SCOPE: Intensive Medicine Department (IMD), with teaching accreditation, which has 15 conventional ICU beds and 4 intermediate care beds. PATIENTS AND METHODS: Analysis of demographic data (gender and age, type of patient, and origin or admission), of severity (SAPS 2), prognosis (MPM II 0 and SAPS2) and health care burden (NEMS) in 3,392 consecutive admissions to IMD. Specific analysis of the stay and mortality (intra- and post ICU). RESULTS: Permanent opening of an intermediate care unit is associated with an increase of patients seen by the IMD and makes it possible to clearly identify two different types of patients according to the site linked to the cause of the admission. The patients seen in the Intermediate Care Unit have a shorter stay, less seriousness, greater survival prognosis and less care burden. However, the initiation of this service does not decrease the interval of total mortality (intra+post- ICU). CONCLUSION: Initiating an intermediate care unit depending on an IMD increases its health care capacity and that of the center it gives service to without affecting global mortality.

Unidades de Cuidados Intermedios. Consecuencias asistenciales en un hospital de referencia / Intermediate care units. Health careconsequences in a reference hospital

Introducción. Las Unidades de Cuidados Intermedios constituyen formas de prestación asistencial a pacientes potencialmente críticos que permiten mejorar la relación coste-beneficio de la asistencia ofertada por los Servicios de Medicina Intensiva (SMI). Objetivo. Analizar la repercusión asistencial que en un centro docente de referencia ha tenido la apertura estable de una Unidad de este tipo. Diseño. Prospectivo. Período. Desde el inicio de 2003 a finales de 2005. Ámbito. Servicio de Medicina Intensiva, con acreditación docente, dotado de 15 camas de Unidad de Cuidados Intensivos (UCI) convencional y 4 camas de cuidados intermedios. Pacientes y método. Análisis, en 3.392 ingresos consecutivos en el SMI de datos demográficos (sexo y edad, tipo de paciente y procedencia del ingreso), de gravedad (SAPS 2), pronóstico (MPM II 0 y SAPS 2) y carga asistencial (NEMS). Análisis específico de la estancia y de la mortalidad (intra y post UCI). Resultados. La apertura estable de una Unidad de Cuidados Intermedios se asocia con un incremento de pacientes atendidos por el SMI, y permite identificar claramente dos tipos distintos de pacientes conforme la ubicación ligada a la causa de ingreso. Los pacientes atendidos en la Unidad de Cuidados Intermedios tienen una menor estancia, una menor gravedad, un mejor pronóstico de supervivencia y una menor carga asistencial. Sin embargo, la puesta en marcha de esta prestación no disminuye el intervalo de mortalidad total (intra + post UCI). Conclusión. La puesta en marcha de una Unidad de Cuidados Intermedios dependiente de un SMI incrementa la capacidad asistencial del mismo y del centro al que presta servicio sin afectar a la mortalidad global

Introduction. Intermediate Care Units are forms to provide health care services to potentially critical patients that allow for improved cost-benefit ratio of the care offered by Intensive Medicine Departments. Objective. Analyze heart care repercussion that the permanent opening of this type of unit had in a reference teaching center. Design. Prospective. Period. From the beginning of 2003 to the end of 2005. Scope. Intensive Medicine Department (IMD), with teaching accreditation, which has 15 conventional ICU beds and 4 intermediate care beds. Patients and methods. Analysis of demographic data (gender and age, type of patient, and origin or admission), of severity (SAPS 2), prognosis (MPM II 0 and SAPS2) and health care burden (NEMS) in 3,392 consecutive admissions to IMD. Specific analysis of the stay and mortality (intra- and post ICU). Results. Permanent opening of an intermediate care unit is associated with an increase of patients seen by the IMD and makes it possible to clearly identify two different types of patients according to the site linked to the cause of the admission. The patients seen in the Intermediate Care Unit have a shorter stay, less seriousness, greater survival prognosis and less care burden. However, the initiation of this service does not decrease the interval of total mortality (intra + post- ICU). Conclusion. Initiating an intermediate care unit depending on an IMD increases its health care capacity and that of the center it gives service to without affecting global mortality

Malaria vectors in the Bioko Island (Equatorial Guinea): estimation of vector dynamics and transmission intensities.

The current study was performed on the Bioko Island (Equatorial Guinea) with the aim of establishing a rapid assessment technique for mapping malaria risk and measuring vector densities. Human bait collection, tent traps, light traps, indoor resting collection, and window exit traps were used to collect Anopheles gambiae s.s. and Anopheles funestus, the two anopheline species involved in malaria transmission in this island. Capture data were used to compare differences in the behavior and vectorial capacity of An. gambiae s.s. and An. funestus. Differences in the two species of mosquitoes were found in relation to the season and trapping methods used. Entomological inoculation rates (EIR) for Plasmodium falciparum were calculated using a polymerase chain reaction (PCR) test with individual anopheline mosquitoes from human bait collections in two villages during the dry and rainy seasons. P. falciparum sporozoites were detected from both dissected heads/thorax and abdomens of both species.

Semi-nested, multiplex polymerase chain reaction for detection of human malaria parasites and evidence of Plasmodium vivax infection in Equatorial Guinea.

A semi-nested, multiplex polymerase chain reaction (PCR) based on the amplification of the sequences of the 18S small subunit ribosomal RNA (ssrRNA) gene was tested in a field trial in Equatorial Guinea (a hyperendemic focus of malaria in west central Africa). The method uses a primary PCR amplification reaction with a universal reverse primer and two forward primers specific for the genus Plasmodium and to mammals (the mammalian-specific primer was included as a positive control to distinguish uninfected cases from inhibition of the PCR). The second amplification is carried out with the same Plasmodium genus-specific forward primer and four specific reverse primers for each human Plasmodium species. The PCR amplified products are differentiated by fragment size after electrophoresis on a 2% agarose gel. Four villages from three regions of the island of Bioko (Equatorial Guinea) and two suspected Plasmodium vivax-P. ovale infections from the hospital of Malabo were tested by microscopy and PCR. The PCR method showed greater sensitivity and specificity than microscopic examination and confirmed the existence of a focus of P. vivax infections in Equatorial Guinea suspected by microscopic examination. It also provided evidence of several mixed infections, mainly P. falciparum and P. malariae, the two predominant species causing malaria in Equatorial Guinea.