Free microvascular tissue transfer for the reconstruction of midfacial defects in oncological patients

This study reviews our experience with free microvascular tissue transfer for the repair of midfacial defects in surgical oncology. From 2000 to 2008, eight patients with maxillectomy defects were immediately reconstructed using free flaps. Their clinical charts were retrospectively reviewed to record demographic data, ablative and reconstructive procedures, complications and outcome. Free tissue transfer was successful in all patients, giving an overall success rate of 100%. The mean follow-up time was 4 to 101 months (mr: 43.8). Three patients died from the disease giving a patient mortality of 30%, while five patients are alive, free of disease and back to their normal daily activities. The restoration of function and improvement of patients? quality of life was a common feature in all our reconstructions. The development of free tissue transfer has made surgical treatment of oncological patients with maxillectomy defects previously considered inoperable possible, improving at the same time their quality of life

El Tratado de Lisboa y la armonización del derecho penal material: realidad y propuestas

Desde la creación de las Comunidades Europeas, en los años cincuenta, y de la Unión Europea, posteriormente, hasta nuestros días, el mecanismo europeo está evolucionando continuamente, demostrando, gradualmente, interés por cubrir todos los ámbitos que pueden garantizar la prosperidad y el progreso de los Estados miembros y el bienestar de los ciudadanos europeos. Dentro de estos dominios, y con importancia especial, se encuentran los elementos de la seguridad y justicia interior junto con el principio de la libertad. La cooperación judicial en materia penal, dentro de la cual se localiza la armonización de la normativa del Derecho Penal material o sustantivo, como se denomina; en ciertas materias delictivas, empezando como una especie de cooperación intergubernamental, con características que atendían con prioridad a la cooperación en el contexto internacional, más que al mecanismo de integración del contexto de la Unión, progresivamente ha llegado a formar una de las piedras angulares para la consecución de un espacio de libertad, seguridad y justicia en el territorio de la Unión. Con la entrada en vigor del Tratado de Lisboa, y la supresión de los pilares, la materia ha pasado a formar parte del Tratado de Funcionamiento de la Unión Europea, conociendo uno de los avances más importantes para su progreso: su integración paulatina en el marco de la Unión. La armonización del Derecho Penal material se pretende a través del artículo 83 ap. 1 del TFUE, constituyendo uno de los factores básicos de la cooperación judicial en el ámbito penal y el consecutivo logro de un espacio de libertad, seguridad y justicia. No obstante, dicho Tratado, aunque propone y diseña supuestamente la integración completa de la cooperación judicial en materia penal, incluye varias excepciones y particularidades que obstaculizan claramente la integración completa de la materia y la armonización del Derecho Penal Sustantivo. Examinando, la evolución de la cooperación judicial en el ámbito penal dentro del marco de la Unión, desde los orígenes de la Comunidad Económica Europea hasta el Tratado de Lisboa y la situación actual y a su vez, el panorama de cada una de las materias delictivas que incluye el artículo 83 ap. 1 del TFUE, se demuestra que, lejos de las proclamaciones realizadas después de la entrada en vigor del Tratado de Lisboa, la armonización propuesta por el mismo, en cuanto a estas materias, hasta hoy en día, no se ha logrado

Targeted and non-targeted liquid chromatography-mass spectrometric workflows for identification of transformation products of emerging pollutants in the aquatic environment

Identification of transformation products (TPs) of emerging pollutants is challenging, due to the vast number of compounds, mostly unknown, the complexity of the matrices and their often low concentrations, requiring highly selective, highly sensitive techniques.Wecompile background information on biotic and abiotic formation of TPs and analytical developments over the past five years. We present a database of biotic or abiotic TPs compiled fromthose identified in recent years.We discuss mass spectrometric (MS) techniques and workflows for target, suspect and non-target screening of TPs with emphasis on liquid chromatography coupled to MS (LC-MS). Both low- and high-resolution (HR) mass analyzers have been applied, but HR-MS is the technique of choice, due to its high confirmatory capabilities, derived fromthe high resolving power and the mass accuracy in MS and MS/MS modes, and the sophisticated software developed

Η γυναικεία επιχειρηματικότητα ως συντελεστής ενίσχυσης της ανταγωνιστικότητας της Ελλάδας

Η διπλωματική διερευνά τη γυναικεία επιχειρηματικότητα στην Ελλάδα και κατά πόσο δύναται να αποτελέσει εργαλείο, ώστε η χώρα να αναπτύξει περισσότερο την ανταγωνιστικότητά της. Αναλύονται εκτενώς τα χρηματοδοτικά εργαλεία καθώς και οι συντελεστές που συνιστούν το Εθνικό Διαμάντι, ώστε η χώρα να αποκτήσει βιώσιμο ανταγωνιστικό πλεονέκτημα. Τέλος παρουσιάζεται ποσοτική έρευνα που έγινε σε δείγμα με συγκεκριμένα χαρακτηριστικά και παρουσιάζονται οι προτάσεις.This thesis analyzes the contribution of the Greek female entrepreneurship to the competitiveness of the country. An extended report for the finance sector and its accelerators is going to be delivered. Following there will be an analysis of the factors which constitute the so called "National Diamond" providing the country with sustainable competitive advantage. To conclude, there is going to be a presentation of a research finding; targeted a specific group of people and lastly proposals from the study are going to be laid out

Advanced Technologies for Oral Controlled Release: Cyclodextrins for oral controlled release

Cyclodextrins (CDs) are used in oral pharmaceutical formulations, by means of inclusion complexes formation, with the following advantages for the drugs: (1) solubility, dissolution rate, stability and bioavailability enhancement; (2) to modify the drug release site and/or time profile; and (3) to reduce or prevent gastrointestinal side effects and unpleasant smell or taste, to prevent drug-drug or drug-additive interactions, or even to convert oil and liquid drugs into microcrystalline or amorphous powders. A more recent trend focuses on the use of CDs as nanocarriers, a strategy that aims to design versatile delivery systems that can encapsulate drugs with better physicochemical properties for oral delivery. Thus, the aim of this work was to review the applications of the CDs and their hydrophilic derivatives on the solubility enhancement of poorly water soluble drugs in order to increase their dissolution rate and get immediate release, as well as their ability to control (to prolong or to delay) the release of drugs from solid dosage forms, either as complexes with the hydrophilic (e.g. as osmotic pumps) and/ or hydrophobic CDs. New controlled delivery systems based on nanotechonology carriers (nanoparticles and conjugates) have also been reviewed

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Kinetic study on the degradation of indomethacin in alkaline aqueous solutions by derivative ultraviolet spectrophotometry

A fourth-order derivative method for monitoring a degradation product is proposed for the kinetic investigation of the alkaline hydrolysis of indomethacin, where indomethacin co-exists with its degradation products. A second-order derivative approach for monitoring the parent compound itself was also examined but showed limitations. Detection limits for the second-and fourth-order derivative methods, defined as b + 3sb, are 4 × 10-6 and 2 × 10-6 mol dm-3, respectively. In this work the kinetic investigation of the alkaline hydrolysis of indomethacin was carried out at pH levels of 8.0, 9.0 and 10.0. Two sets of recovery studies, in order to calculate one substance in the presence of the other, gave us 104.0 ± 0.3% and 96.8 ± 9.7% (for the second-order derivatization) and 100.9 ± 0.9% and 101.4 ± 1.5% (for the fourth-order derivative approach) showing that only the latter method can be considered free of interference and is analytically useful. Accelerated studies at higher temperatures have been employed that enable rapid prediction of the long-term stability of this drug at pH 8.0 (90 °C), 9.0 (35, 40 and 45 °C) and 10.0 (20, 26 and 30 °C). At pH 9.0 and 10.0 enough data were produced to draw Arrhenius plots and calculate the activation energies for drug decomposition: Ea = 17 ± 1 kcal mol-1 (1 cal = 4.184 J) and 14 ± 1 kcal mol-1, respectively. Kinetic results for kobs and t1/2 at room temperature (25 °C) were estimated from the Arrhenius plots: kobs = 7.7 × 10-4 min-1 and t1/2 = 900 min at pH 9.0 and kobs = 7.3 × 10-3 min-1 and t1/2 = 95 min at pH 10.0. Measurements of absorbance at a wavelength of 360 nm in the zero-order spectrum of indomethacin were included in our study for the purpose of comparison, as well as literature results