Recurrent gastric lactobezoar in an infant

Lactobezoars are a type of bezoar composed of undigested milk and mucus. The aetiology is likely multifactorial, being classically described in association with pre-term, low-birth weight infants fed with hyperconcentrated formula. The authors present a case of lactobezoar recurrence in a pre-term infant with oesophageal atresia. To our knowledge, this is the first report of recurrence of lactobezoar.info:eu-repo/semantics/publishedVersio

Study of non-equilibrium effects and thermal properties of heavy ion collisions using a covariant approach

Non-equilibrium effects are studied using a full Lorentz-invariant formalism. Our analysis shows that in reactions considered here, no global or local equilibrium is reached. The heavier masses are found to be equilibrated more than the lighter systems. The local temperature is extracted using hot Thomas Fermi formalism generalized for the case of two interpenetrating pieces of nuclear matter. The temperature is found to vary linearly with bombarding energy and impact parameter whereas it is nearly independent of the mass of the colliding nuclei. This indicates that the study of temperature with medium size nuclei is also reliable. The maximum temperatures obtained in our approach are in a nice agreement with earlier calculations of other approaches. A simple parametrization of maximal temperature as a function of the bombarding energy is also given.Comment: LaTex-file, 17 pages, 8 figures (available upon request), Journal of Physics G20 (1994) 181

Instability of insular tree communities in an Amazonian mega-dam is driven by impaired recruitment and altered species composition

Mega-dams create highly fragmented archipelagos, affecting biodiversity and ecosystem functioning in remnant forest isolates. This study assessed the long-term impact of dam-induced fragmentation on insular tropical tree communities, with the aim of generating robust recommendations to mitigate some of the detrimental biodiversity impacts associated with future dam development. We inventoried adult and sapling trees across 89 permanent plots, located on 36 islands and in three mainland continuous forest sites in the Balbina Dam, Brazilian Amazon. We examined differences in recruitment, structure, and composition of sapling and adult tree communities, in relation to plot-, patch- and landscape-scale attributes including area, isolation, and fire severity. Islands harboured significantly lower sapling (mean ± 95% CI 48.6 ± 3.8) and adult (5 ± 0.2) tree densities per 0.01 ha, than nearby mainland continuous forest (saplings, 65.7 ± 7.5; adults, 5.6 ± 0.3). Insular sapling and adult tree communities were more dissimilar than in mainland sites, and species compositions showed a directional shift away from mainland forests, induced by fire severity, island area, and isolation. Insular sapling recruitment declined with increasing fire severity; tree communities with higher community-weighted mean wood density showed the greatest recruitment declines. Our results suggest that insular tree communities are unstable, with rare species becoming extinction-prone due to reduced tree recruitment and density on islands, potentially leading to future losses in biodiversity and ecosystem functioning across Balbina's >3,500 reservoir islands. Policy implications. In Balbina, fire and reduced habitat area and connectivity were drivers of tree community decay after only 28 years of insularization, despite strict protection provided by the ~940,000 ha Uatumã Biological Reserve. Given that many dams are planned for lowland, moderately undulating Amazonia, we recommend that dam development strategy explicitly considers (a) dam location, aiming to minimize creation of small (<10 ha) and isolated islands, (b) maintaining reservoir water levels during droughts to reduce fire risk, and (c) including aggregate island area in environmental impact and offset calculations. Ideally, we recommend that alternatives to hydropower be sought in lowland tropical regions, due to the far-reaching biodiversity losses and ecosystem disruption caused by river impoundment

Cyclohexanedione as the negative electrode reaction for organic redox flow batteries

The electrochemical reduction and oxidation of cyclohexanedione is evaluated for the first time as the negative electrode reaction in an organic redox flow battery. Electrochemical characterization indicates that the redox reaction of cyclohexanedione is a proton-coupled electron transfer process with quasi-reversible behavior in acidic media (pH 2 M) and exhibit reduction process with up to 4 electrons transferred

The "O3E" program: raising awareness on natural hazards

Earthquakes may be traumatic events and as many other environmental emergencies, like storm or floods, may cause more damages than expected when who experiences the phenomena does not know how to behave in the fall. Provided that it is always not feasible to rely on prediction when dealing with earthquakes or extreme meteorological events, preparedness proves to be an efficient (and certainly the most recommendable and cheap) way to face emergencies. Education and training are thus two ingredients to help citizens to perceive the scientific information formerly confined in the laboratories, in particular in the domain of the environmental risk. The “O3E” innovative program (European Observatory for Education and Environment) is established after 10 years (1997-2007) of regional and national original programs (“Sismos of the Schools”), and from Italian and Swiss experiences concerning environment tools for education. The project, that is a cooperation between France, Italy and Switzerland, is born to promote a responsible behaviour of citizens in front of the evolution of a society where scientific information is promptly available. ARGAL (Agency for Geological Risk in the Latin Arc) operates the administrative and technical coordination. The objective of this program is to create a school network in the Alpine and Mediterranean areas equipped with environmental sensors of an educational vocation. The data on the movement of the ground (seismometers), the temperatures and precipitations (weather stations), the flows of rivers (hydrogeology) recorded in the schools and processed by the students are collected on dedicated servers and then made available through internet to the entire educational community. This network “O3E”, once installed, is the starting point of activities. Indeed, various general objectives are pursued: - To promote the applied sciences and new technologies. - To put in network the actors of Education and formation. - To develop the sense of the autonomy and the responsibility in the young people. - To reinforce and develop relationships with regional partners of the educational and university fields. - To support a rational awakening for the prevention of the natural risks that can make the difference during the event in terms of safety. With these premises, the “O3E” experience sets up a permanent educational network of citizens in the Alpine and Mediterranean areas, building an exchange of knowledge on natural risks prevention.PublishedAix en Provence5.9. Formazione e informazioneope

Pronóstico de la insuficiencia cardíaca aguda basado en datos clínicos de congestión

Acute heart failure; Congestion; Emergency departments; MortalityInsuficiència cardíaca aguda; Congestió; Serveis d'urgències; MortalitatInsuficiencia cardiaca aguda; Congestión; Servicios de urgencias; MortalidadBackground and objectives: This work aims to assess whether symptoms/signs of congestion in patients with acute heart failure (AHF) evaluated in hospital emergency departments (HED) allows for predicting short-term progress. Patients and methods: The study group comprised consecutive patients diagnosed with AHF in 45 HED from EAHFE Registry. We collected clinical variables of systemic congestion (edema in the lower extremities, jugular vein distention, hepatomegaly) and pulmonary congestion (dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, and pulmonary crackles) and analysed their individual and group association with all-cause 30-day of mortality crudely and adjusted for differences between groups. Results: We analysed 18,120 patients (median = 83 years, interquartile range [IQR] = 76-88; women = 55.7%). Of them, 44.6% had > 3 congestive symptoms/signs. Individually, the 30-day adjusted risk of death increased 14% for jugular vein distention (hazard ratio [HR] = 1.14, 95% confidence interval [95%CI] = 1.01-1.28) and 96% for dyspnea on exertion (HR = 1.96, 95% CI = 1.55-2.49). Assessed jointly, the risk progressively increased with the number of symptoms/signs present; compared to patients without symptoms/signs of congestion, the risk increased by 109%, 123 %, and 156% in patients with 1-2, 3-5, and 6-7 symptoms/signs, respectively. These associations did not show interaction with the final disposition of the patient after their emergency care (discharge/hospitalization) with the exception of edema in the lower extremities, which had a better prognosis in discharged patients (HR = 0.66, 95% CI = 0.49-0.89) than hospitalised patients (HR = 1.01, 95% CI = 0.65-1.57; interaction p < 0.001). Conclusion: The presence of a greater number of congestive symptoms/signs was associated with greater all-cause 30-day mortality. Individually, jugular vein distention and dyspnea on exertion were associated with higher short-term mortality.Antecedentes y objetivos: : Evaluar si los síntomas/signos de congestión en pacientes con insuficiencia cardíaca aguda (ICA) atendidos en los servicios de urgencias hospitalarios (SUH) permiten predecir la evolución a corto plazo. Pacientes y métodos: Pacientes consecutivos diagnosticados de ICA en 45 SUH del Registro EAHFE. Recogimos variables clínicas de congestión sistémica (edemas en miembros inferiores, ingurgitación yugular, hepatomegalia) y pulmonar (disnea de esfuerzo, disnea paroxística nocturna, ortopnea y crepitantes pulmonares) analizando su asociación con la mortalidad por cualquier causa a 30 días, de forma cruda y ajustada por diferencias entre grupos. Resultados: Analizamos 18.120 pacientes (mediana = 83 anos, ˜ rango intercuartil [RIC] = 76---88; mujeres = 55,7%). El 44,6% presentaba >3 síntomas/signos congestivos. Individualmente, el riesgo ajustado de muerte a 30 días se incrementó un 14% para la existencia de ingurgitación yugular (hazard ratio [HR] = 1,14, intervalo de confianza al 95% [IC95%] = 1,01−1,28) y un 96% para la disnea de esfuerzo (HR = 1,96, IC95% = 1,55−2,49). Valorados conjuntamente, el riesgo se incrementó progresivamente con el número de síntomas/signos presentes; así, respecto a los pacientes sin síntomas/signos de congestión, el riesgo incrementó un 109%, 123% y 156% en pacientes con 1---2, 3---5 y 6---7 síntomas/signos respectivamente. Estas asociaciones no mostraron interacción con la disposición final del paciente tras su atención en Urgencias (alta/hospitalización), con excepción de edemas en extremidades inferiores, que tuvieron mejor pronóstico en pacientes dados de alta (HR = 0,66, IC95% = 0,49−0,89) que en los hospitalizados (HR = 1,01, IC95% = 0,65−1,57; p interacción <0,001). Conclusión: La presencia de mayor número de síntomas/signos congestivos se asoció a una mayor mortalidad de cualquier causa a los 30 días. Individualmente, la ingurgitación yugular y la disnea de esfuerzo se asocian a mayor mortalidad a corto plazo

Switching from natalizumab to fingolimod: an observational study

Background – Multiple sclerosis patients who discontinue using natalizumab are at risk of a rebound in disease activity. However, the optimal alternative therapy is not currently known. Aims of the study – We report on clinical and MRI data and patient safety in a group of relapsing–remitting multiple sclerosis patients who tested seropositive for the JC virus and who have switched from natalizumab to fingolimod because of concerns regarding PML risks. Methods – The test for JC virus antibodies was performed in 18 relapsing–remitting multiple sclerosis patients who were being treated with natalizumab for more than 1 year. Eight seropositive patients switched to fingolimod while the seronegative patients continued with natalizumab. Results – After switching to fingolimod, five of eight patients (63%) experienced clinical relapses, and MRI activity was detected in six of eight patients (75%). Neither clinical relapses nor MRI activity was observed in the patients who continued with natalizumab. No serious adverse effects were detected. Conclusions – Natalizumab is an effective treatment for relapsing–remitting multiple sclerosis, but its discontinuation continues to be a complex problem. All of the therapies tried thus far, including fingolimod, have been unable to control the reactivation of the disease. Further studies addressing alternative therapies after natalizumab discontinuation are necessary

Association of patients' geographic origins with viral hepatitis co-infection patterns, Spain

To determine if hepatitis C virus seropositivity and active hepatitis B virus infection in HIV-positive patients vary with patients' geographic origins, we studied co-infections in HIV-seropositive adults. Active hepatitis B infection was more prevalent in persons from Africa, and hepatitis C seropositivity was more common in persons from eastern Europe.Ministerio de Sanidad. Instituto de Salud Carlos II