Integración arquitectónica de colectores solares térmicos cerámicos para clima mediterráneo

The work presented here aims to demonstrate the technical, architectural and energy viability of solar thermal collectors made with ceramic materials and the Mediterranean climate suitable for the production of domestic hot water (DHW) and for heating systems in buildings. The design of a ceramic shell formed by panels collectors and panels no sensors, which are part of the same building system that is capable of responding to the basic requirements of a building envelope and capture solar energy is proposed. Ceramics considerably reduced the final cost of the sensor system and offers the new system a variety of compositional and chromatic since, with reduced performance compared to a conventional metallic collector, can occupy the entire surface of front and get a high degree of architectural integration. A tool for assessing the new ceramic solar collector has been defined from a multi-criteria perspective: economic, environmental and social. The tool enables the comparison of the ceramic solar collector with solar collectors on the market under different climatic and demand conditions.El trabajo aquí presentado se orienta a demostrar la viabilidad técnica, arquitectónica y energética de colectores solares térmicos realizados con materiales cerámicos y adecuados al clima mediterráneo para la producción de agua caliente sanitaria (ACS) y de calefacción en edificios. Se propone el diseño de una envolvente cerámica formada por paneles captadores y paneles no captadores, que forman parte de un mismo sistema constructivo que es capaz de dar respuesta a los requerimientos básicos de un cerramiento exterior y de captar la energía solar. La cerámica consigue reducir considerablemente el coste final del sistema captador y ofrece al nuevo sistema una gran variedad de juego compositivo y cromático dado que, con un menor rendimiento frente al de un colector convencional metálico, puede ocupar toda la superficie de fachada y obtener un elevado grado de integración arquitectónica. También se ha definido una herramienta que permite evaluar el sistema de captación solar térmica cerámico desde un punto de vista multicriterio, económico, ambiental y social, para compararlo con los sistemas de captación solar térmica comerciales bajo distintas condiciones climáticas y de demanda

Association between necropsy evidence of disseminated intravascular coagulation and hemostatic variables before death in horses with colic

Background: Disseminated intravascular coagulation (DIC) is frequent in horses with severe gastrointestinal disorders. Postmortem studies have found fibrin microthrombi in tissues of these horses, but studies relating these histopathological findings with antemortem hemostatic data are lacking. Hypothesis: Antemortem classification of coagulopathy is related to the presence and severity of fibrin deposits observed postmortem in horses with severe gastrointestinal disorders. Animals: Antemortem hemostatic profile data and postmortem tissue samples (kidney, lung, liver) from 48 horses with colic. Methods: Tissue samples were stained with phosphotungstic acid hematoxylin and immunohistochemical methods for histological examination. A fibrin score (grades 0-4) was assigned for each technique, tissue and horse, as well as the presence or absence of DIC at postmortem examination. D-dimer concentration, prothrombin time (PT), activated partial thromboplastin time (aPTT), and antithrombin (AT) activity, as well as the clinicopathological evidence of coagulopathy, were determined from plasma samples collected 0-24 hours before death or euthanasia. Histologic and clinicopathologic data from the same horses were compared retrospectively. Results: No association was found between antemortem classification of coagulopathy and postmortem diagnosis of DIC based on tissue fibrin deposition. None of the hemostatic parameters was significantly different between horses with or without postmortem diagnosis of DIC. There was no association between horses with fibrin in tissues or different cut-offs for D-dimer concentration and postmortem evidence of DIC. Conclusions and Clinical Importance: Abnormalities of the routine clotting profile, including D-dimer concentration, were not useful in predicting histologic evidence of DIC at necropsy in horses with severe gastrointestinal disorders

Association of admission plasma D-Dimer concentration with diagnosis and outcome in horses with colic

Background: Coagulopathies detected in horses with gastrointestinal problems seem to be associated with poor outcome. Plasma D-Dimer concentration is a sensitive test for assessing coagulopathies. Hypothesis: Plasma D-Dimer concentration tested on admission is related to diagnosis and outcome in horses with colic. Animals: Four hundred and ninety three horses referred for evaluation of abdominal pain. Methods: Prospective observational clinical study. Horses were grouped according to diagnosis (medical and surgical intestinal obstructions, ischemic disorders with and without intestinal resection, enteritis, peritonitis), outcome (survivors, nonsurvivors), and number of coagulopathies (normal profile, 1 or 2 coagulopathies, subclinical disseminated intravascular coagulation [DIC]). Blood samples were collected on admission and plasma D-Dimer concentration, clotting times (PT and aPTT), and antithrombin activity were determined. Positive likelihood ratios (LR1) were calculated for evaluation of D-Dimer cut-off values, which were later tested in a logistic regression model. Results: Horses with enteritis or peritonitis had significantly (P o .001) higher plasma D-Dimer concentrations and more severe coagulopathies on admission than horses with other diagnoses. Nonsurvivors also had significantly (P o .001) higher plasma D-Dimer concentrations at presentation than did survivors, and those horses with subclinical DIC on presentation had an odds ratio (OR) 8.6 (95% confidence interval [CI], 3.3-22.5, P o .001) for nonsurvival. Finally, D-Dimer concentrations 44,000 ng/mL had a LR1 of 5.9 and an OR 8.8 (95% CI, 4.5-17.1, Po .001) for nonsurvival. Conclusion and Clinical Importance: Plasma D-Dimer concentration measured on admission can be used to facilitate diagnosis and outcome prediction in horses with colic. A potential cut-off value for nonsurvival was found at approximately 4,000 ng/m

Low-molecular-weight heparin dosage in newborn foals

Background: Heparin is used in humans as prophylaxis of hypercoagulable states and disseminated intravascular coagulation (DIC). However, babies need a higher heparin dose than do adults. Septic neonate foals are at high risk of hypercoagulable state and DIC, and there is limited objective information about heparin dose for equine neonates. Objective: To assess whether neonate foals require higher dosages of low-molecular-weight heparin (LMWH) than adults. Animals: Eighteen healthy and 11 septic neonate foals. Methods: Experimental and clinical studies. Firstly, healthy foals were randomly distributed in 2 groups, 1 receiving 50 IU/ kg SC of dalteparin and the 2nd group receiving 100 IU/kg SC of dalteparin, once daily for 3 days. Blood samples were collected before and 3, 6, 27, and 51 hours after the 1st LMWH administration. Plasma antifactor-Xa activity was measured, together with hemostatic and hematologic parameters used to assess the risk of bleeding. Subsequently, septic foals were treated blindly either with placebo (saline) or 100 IU/kg of dalteparin for 3 days. Plasma antifactor-Xa activity and other hemostatic parameters were determined before and after treatment. Results: Plasma antifactor-Xa activity in healthy foals was below prophylactic activity when using the adult dosage (50 IU/ kg), whereas prophylactic activities were achieved when using the double dosage (100 IU/kg). No hemorrhagic events and erythrocyte-related complications were observed with either dosage. In the clinical study, only 4/6 septic foals had plasma antifactor-Xa activity adequate for prophylaxis. Conclusions and Clinical Importance: Equine neonates require higher dosages of LMWH compared with adults to reach prophylactic heparinemia

The management of acute venous thromboembolism in clinical practice. Results from the European PREFER in VTE Registry

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries. Consecutive patients with acute VTE were documented and followed up over 12 months. PREFER in VTE included 3,455 patients with a mean age of 60.8 ± 17.0 years. Overall, 53.0 % were male. The majority of patients were assessed in the hospital setting as inpatients or outpatients (78.5 %). The diagnosis was deep-vein thrombosis (DVT) in 59.5 % and pulmonary embolism (PE) in 40.5 %. The most common comorbidities were the various types of cardiovascular disease (excluding hypertension; 45.5 %), hypertension (42.3 %) and dyslipidaemia (21.1 %). Following the index VTE, a large proportion of patients received initial therapy with heparin (73.2 %), almost half received a vitamin K antagonist (48.7 %) and nearly a quarter received a DOAC (24.5 %). Almost a quarter of all presentations were for recurrent VTE, with >80 % of previous episodes having occurred more than 12 months prior to baseline. In conclusion, PREFER in VTE has provided contemporary insights into VTE patients and their real-world management, including their baseline characteristics, risk factors, disease history, symptoms and signs, initial therapy and outcomes

Uveal inflammation in septic newborn foals.

BACKGROUND: Septicemia in humans is described as a leading cause of uveitis, which eventually can induce blindness. HYPOTHESIS/OBJECTIVES: Uveal inflammatory findings could be related to sepsis severity in newborn foals and might be used as an indirect indicator for survival. ANIMALS: Seventy-four septic foals, 54 nonseptic foals, and 42 healthy foals. METHODS: Prospective observational clinical study. A detailed blinded, ophthalmic examination was performed by boarded ophthalmologists on all admitted newborn foals. Foals were grouped as septic (when blood culture resulted positive or the sepsis score was > or =14), nonseptic, and controls. Based on blood culture results, the septic group was subdivided into bacteremic and nonbacteremic foals. RESULTS: Blood culture was performed in 62/74 septic foals, from which 35 (56%) were bacteremic and 27 (44%) were non-bacteremic. Anterior uveitis was diagnosed in a significantly (P < .005) higher number of septic/bacteremic foals (14/35, 40%) than in septic/nonbacteremic foals (5/27, 19%), nonseptic foals (4/54, 7%), and control foals (0%). Anterior chamber fibrin was only observed in 4/14 (29%) septic/bacteremic foals with anterior uveitis. Anterior uveitis was also associated with posterior uveitis in 6/35 (19%) septic/bacteremic foals. The diagnosis of uveitis was related to nonsurvival (P = .001, odds ratio = 6.2, 95% confidence interval = 2.1-18.2). CONCLUSIONS AND CLINICAL IMPORTANCE: Anterior uveitis is highly prevalent in septic newborn foals, especially in those with a positive blood culture, and it should be considered as a survival prognostic factor

Facial Anthropometric Measurements and Principles - Overview and Implications for Aesthetic Treatments

Facial anatomy is highly individual in each patient. Anthropometric measurements can be a useful tool to objectively analyze individual facial anatomy to allow for better comparability before and after treatments to ultimately improve standardization of facial procedures, both nonsurgical and surgical. The aim of this study was to provide a comprehensive overview over clinically relevant and feasible facial anthropometric measurements and principles for aesthetic medicine. A literature review was conducted to describe the most important and clinically relevant anthropometric measurements and principles for both the entire face and for three aesthetically relevant facial regions: the periorbital region, the nose, and the perioral region. A multitude of different anthropometric measurements and principles have been described in the literature for both the overall facial appearance and specific facial regions. Certain generally accepted anthropometric principles and proportions need to be respected to achieve aesthetic and harmonious results. For the overall facial appearance, a focus on symmetry, certain proportions, facial angles, and indices has been described. Principles and measurements were also described for the periorbital region, the nose, and the perioral region. Although attractiveness and aesthetic perception are subjective, objective evaluation of facial surface anatomy via anthropometric measurements can improve pre- and postinterventional analysis of the face and help the treating physician to individualize treatments, both nonsurgical and surgical

Peritoneal bile acids concentration in adult horses with hepatic and gastrointestinal disorders

Background: Peritoneal bile acids concentration (PBAC) has not been previously reported in horses. A case of liver lobe torsion in which increased PBAC was detected prompted us to study PBAC in horses. Objectives: (a) To determine a reference range of PBAC in horses; (b) to compare PBAC from horses with either hepatic or gastrointestinal disease and healthy horses and (c) to assess the prognostic and diagnostic values of PBAC. Study design: Prospective case-control. Methods: Prospective observational clinical study. Bile acids concentrations were measured in both plasma and peritoneal fluid in selected clinical patients with hepatic or gastrointestinal disease (n = 108) and healthy horses (n = 11). Sixty-eight of 108 patients survived to hospital discharge, and the remaining 40 were nonsurvivors. Additionally, other haematological and biochemistry analyses were performed. Results: Sick horses were classified according to diagnosis into hepatic (n = 13), gastrointestinal (GI) obstructive (n = 48) and GI ischaemic-inflammatory (n = 47) groups. The hepatic group had significantly higher PBAC (6.8 [2.3-9.4]; median [IQR]) than the control (1.0 [0.6-1.5]) and GI obstructive groups (1.2 [0.8-1.7] µmol/L; P <.001). Moreover, the GI ischaemic-inflammatory group (3.3 [1.4-5.5]) also had significantly higher values than the control and GI obstructive groups (P <.001). Regarding outcome, the nonsurvivor group (n = 40) had significantly higher median PBAC value than the survivor group (n = 68, 4.1 [1.6-6.5] vs 1.3 [0.8-3]; P <.001). Main limitations: A higher number of horses with abdominal disease is required to confirm the clinical significance of these findings. Conclusions: PBAC may have a role in the diagnosis of hepatic and gastrointestinal disease and as a prognostic tool in horses with abdominal pain

Enteral fluid therapy in 108 horses with large colon impactions and dorsal displacements.

To assess the effect of enteral fluid therapy (EFT) in horses with colic, 78 adult horses with colon impactions and 30 with left dorsal colon displacements received an isotonic electrolyte solution via a nasogastric tube at a rate of 8 to 10 l every two hours until resolution of clinical signs. Clinical progression was monitored closely, and plasma biochemistry was evaluated before, during and after treatment. Volume of fluids, time to resolution, and outcome were also recorded. EFT was well tolerated by 102 of 108 horses and was an effective method to resolve 99 per cent of colon impactions and 83 per cent of displacements. For both groups, the mean (sd) time to resolution was 20.2 (5.2) hours and the volume of fluid administered was 118.6 (34.5) l. No relevant abnormalities were observed in most plasma biochemistry parameters during treatment, except for a mild haemodilution effect in 63 per cent of horses