Vascular risk factors in primary open angle glaucoma

To determine whether cardiovascular risk factors distribution differ between primary open-angle glaucoma (POAG) and control subjects. To assess the strength of this association in POAG. To analyze the most frequent pathology in this group of patients for a better selection of medical treatment. METHODS: Observational cross-sectional study in patients with a diagnosis of POAG. Fifty glaucoma patients were selected with consecutive sampling between those who had been admitted to an tertiary hospital by any reason and compared with fifty admitted to the same hospital patients without POAG diagnosis in the same period of time. The variables age, sex, the reason for admission to hospital classified by diagnosis related group (DRG) and diagnostic mayor criteria (DMC), treatment for glaucoma, stroke, diabetes mellitus, high blood pressure, ischaemic cardiopathy, Raynaud phenomenon, low blood pressure, hypercholesterolemia and tobacco were investigated. RESULTS: An association was found between POAG and stroke (prevalence ratio=2.16;CI al 95%=1.01-2.20; p=0.074*), low blood pressure (prevalence ratio=5; CI=1.14-2.63; p=0.092*) and high blood pressure (prevalence ratio=1.35; p=0.16) but it didn't reach to the statistical level of signification. No association with the remaining variables was found with this size sample. The most frequent reason for hospital admission in the study group were respiratory and circulatory system disease. Circulatory (24 y 22% respectively)with the pneumonia the most frequent DRG (10%). In the control group, the most frequent reason were circulatory and respiratory system disease (24 y 16% respectively). The chronic obstructive airway disease (COAD) was the most frequent DRG in this group (6%). The vascular risk factors most frequently found in both of the groups was high blood pressure (54 and 40% ) and the stroke (26-12%). The medical glaucoma treatment in these patients were the beta-blockers only (24.3%) or in association (18.9%). CONCLUSIONS: POAG is associated with stroke and blood pressure variations (high and low). The respiratory (pneumonia and COAD) and circulatory system diseases (congestive heart failure-CHF- and ischaemic cardiopathy) are the most frequently mortality cause in this group of patients. The most frequent medical therapy used for glaucoma are the beta-blockers which are contraindicated in COAD and CHF patients

Complicaciones en la evolución de los hemangiomas y malformaciones vasculares

The differentiation of haemangiomas and vascular malformations is histological, clinical and prognostic. Although the majority of haemangiomas evolve towards spontaneous resolution, as many as 10% of cases can develop complications with ulceration, pain and haemorrhaging. Besides, the localisation of haemangiomas in the head and neck, next to vital structures, can compromise their functions. Hence, compression of the airway might be a vital emergency. Periorbital haemangiomas can give rise to amblyopia due to sensory deprivation or due to a restrictive strabismus. Lumbosacral haemangiomas must be studied with Nuclear Magnetic Resonance because of their frequent association with alterations in the midline at the level of the spine, anus, genitals or kidneys. Amongst visceral haemangiomas, hepatic haemangiomas are the most serious due to their association with congestive cardiac insufficiency. The association of extensive facial haemangiomas with anomalies of the central nervous system, vascular, cardiac, ocular and sternal anomalies, is denominated PHACE syndrome and is frequently complicated by mental deficiency, convulsions or ictus. Vascular malformations of trigeminal localisation are associated in up to 15% of cases with glaucoma or choroidal or leptomeningeal haemangiomas (Sturge- Weber syndrome). Combined vascular malformations localised in the extremities can become complicated with thrombophlebitis, regional osteolysis and even distant thromboembolisms (Klippel-Treneaunay Syndrome). On the other hand, there is a coagulopathy due to consumption (Kassabach-Merrit Syndrome) that can complicate some vascular tumours such as the Kaposiform haemangioendothelioma and the tufted angioma. Finally, the complications of the treatments employed are reviewed

Stratégies d'élimination de l'azote d'un effluent urbain dans un réacteur discontinu séquentiel (SBR)

Le traitement des effluents urbains par réacteurs discontinus séquentiels (SBR : Sequencing Batch Reactor) constitue une solution alternative aux traitements par systèmes à boue activée en effectuant le traitement du carbone, la séparation liquide solide et l'élimination des nutriments au sein d'un bassin unique grâce à une gestion adéquate des cycles temporels de réaction. L'alternance de phases aérées et anoxiques suivie d'une période de décantation conduit en théorie à l'élimination quasi totale des ions nitrate formés lors de la phase de nitrification aérobie. Cependant, selon la charge appliquée, le carbone totalement dégradé lors de la phase préliminaire d'aération ne peut servir de source de carbone pour la dénitrification exogène.Afin d'accélérer la dénitrification, plusieurs solutions sont possibles : l'une consiste à allonger la deuxième phase d'anoxie suffisamment longtemps pour traiter les ions nitrate résiduels au cours d'un processus de dénitrification endogène, l'autre à diminuer le temps de réaction aérobie tout en augmentant la fréquence des séquences aérobie/anoxie afin de conserver du carbone résiduel lors de la dénitrification. Une troisième solution réside dans l'ajout d'une source de carbone exogène suite à l'étape de nitrification de manière à permettre une assimilation plus rapide et plus efficace des ions nitrate formés (dénitrification exogène).L'article compare les résultats d'abattement sur le carbone et l'azote d'une eau usée urbaine en utilisant les trois types de fonctionnement. Il en résulte la définition d'une stratégie globale de contrôle du procédé, chacun des scénarii pouvant être privilégié en fonction de la qualité de l'effluent de départ et des contraintes de traitement.Wastewater treatment by a Sequencing Batch Reactor (SBR) provides an alternative solution to activated sludge treatment, by carrying out carbon treatment, liquid-solid separation and nutrient removal in a single tank, thanks to the appropriate management of the temporal reaction cycles. Alternating the aeration and anoxic phases, followed by a decantation period, leads, in theory, to the almost total removal of nitrate ions formed during the aerobic nitrification phase. However, depending on the applied load, the carbon that is totally degraded during the preliminary aeration phase, cannot be used as a source of carbon for exogenic denitrification.Several solutions are possible in order to accelerate denitrification: one consists of lengthening sufficiently the second anoxic phase to treat the residual nitrate ions during the endogenous denitrification process; another strategy involves reducing the aerobic reaction time, while increasing the frequency of aerobic/anoxic sequences in order to preserve residual carbon during denitrification. A third solution lies in the addition of a source of exogenic carbon after the nitrification stage, to allow a quicker and more efficient assimilation of the nitrate ions that are formed (exogenic denitrification). This article compares the results of reducing carbon and nitrogen in wastewater, using three types of operation.The cycle of reference has been established starting from previous bibliographical results (WUN JERN and DROSTE, 1989) and simulations using the model ASM1 (HENZE et al., 1986). It consists of an anoxic feeding, followed by an anoxic phase, then an aerobic phase and another anoxic phase. The cycle ends by the settling and decanting phases. The lengths of these different phases are: 1 h, 0.5 h, 4.5 h, 3.25 h, 1 h, 1 h. This reference cycle, carried out at the laboratory, leads to the elimination of 90% of the Chemical Oxygen Demand (COD), 95% of the Biological Oxygen Demand (BOD5) and more than 80% of total nitrogen, i.e. with residual concentrations of 60 mg×L-1 for the Dissolved Organic Carbon (DOC), 5 mg×L-1 for the Biological Oxygen Demand, and 10 mg×L-1 for total nitrogen. These results are comparable with those in the literature (IRVINE et al., 1987, MELCER et al., 1987, YANG et al., 1999).The results obtained during the reference cycle enabled us to reach a rate of total nitrogen removal of 85% and a global nitrogen concentration in the effluent of 11 mg×L-1. Nitrification and denitrification rates yielded values of 0.8 mg N-NH4+×gMVS-1 ×h-1 and 0.8 mg N-NO3 -×gMVS-1×h-1 respectively. Total nitrogen removal was not completely achieved because of the lack of available carbon. This lack of carbon favours endogenic denitrification, characterized by a slow denitrification rate 0.8 mg N-NO3 -×mgMVS-1×h-1, compared to exogenic denitrification characterized by a higher nitrogen reduction rate (about 2 mg N-NO3 -×mgMVS-1 ×h-1). This fact was experimentally confirmed with carbon addition in the form of acetate at the beginning of the second anoxic phase. In this case, carbon addition significantly improves the denitrification rate compared to the same experiment without exogenic carbon addition: 2 mg N-NO3 -×mgMVS-1 ×h-1 versus 0.8 mg N-NO3 -×mgMVS-1 ×h-1. However, this method raises operating costs for the process.In order to reach complete nitrogen removal without the addition of synthetic carbon, it is possible to increase the anoxic phase time scale from 3 hours to 15 hours. Although the results in term of carbon and nitrogen removal are satisfactory when the anoxia phase is lengthened, the concentration in the discharged effluent is 0.33 mg total N×L-1, and thus this technique decreases the productivity of the SBR. The feeding cycles of a biological reactor being variable, a regulation based on the use of the evolution of the pH, or the redox potential, can be considered (PAVELJ et al., 2001; ANDREOTTOLA et al., 2001). This regulation would make it possible to adapt the duration of the phases of anoxia to the necessary treatment.To overcome this drawback, a possible approach consists in replacing the aerobic / anoxic phase in the reference cycle by five aerobic / anoxic phases during the same time. Unfortunately, this method leads to a decrease in nitrogen removal and in the nitrification rate, compared to classical cycle (65% versus 85%, and 0.4 mg N-NO3 - ×mgMVS-1 ×h-1 versus 0.8 mg N-NO3 -×mgMVS-1 ×h-1, respectively). The nitrification rate is, in this case, half that obtained in the reference cycle, probably due to delays related to the induction of nitrification and denitrification. This strategy, consisting of increasing the aeration / no aeration frequency, has to be optimized in term of nitrification and denitrification ratios.A better solution from the economic and productivity points of view is the addition of wastewater at the beginning of anoxic phase. This strategy implies the modification of the cycle. First, after the anoxic feeding, an aerobic phase allows carbon and nitrogen oxidation. In order to supply an available carbon source for exogenic denitrifcation, a second feeding is introduced at the beginning of the second anoxic phase. This addition also contains ammonium ions and implies new nitrification and denitrification steps. This last denitrification phase is then endogenic.Carbon addition in the form of wastewater leads to an improvement in nitrogen removal. The exogenic denitrification rate is twice the value for endogenous denitrification for the same cycle of operation (1.6 mg N-NO3 -×gMVS-1 ×h-1 versus 0.9 mg N-NO3 -×gMVS-1 ×h-1 respectively). This strategy yields a final concentration of 3 mg N×L-1 and the nitrification and denitrification rates are similar to those of the traditional processes.In conclusion, the addition of synthetic carbon in the form of acetate must be preserved as a means of acting quickly in the event of dysfunction (that can be detected by monitoring the redox potential or the pH), although this technique significantly increases the cost of operation. Although the best economic solution to improve denitrification is carbon addition in the form of wastewater, other strategies can be undertaken according to the goals of the treatment process. When the wastewater load is sufficiently weak (night period), the endogenous phase of denitrification can be lengthened. In the event of an important load, carbon addition (in synthetic form or as waste water) makes it possible to eliminate the nitrate ions exogenically

Revistes publicades pels estudiants de medicina de la Universitat de Barcelona

Hem recollit o referenciat i estudiat vint-i-sis títols de revistes publicades o participades pels estudiants de medicina de la Universitat de Barcelona, amb la col·laboració en algunes ocasions d’algun professor. Aquestes publicacions, discontínues i de caràcter efímer, tenen un cert valor testimonial del moment i del grup que les van produir. Volem contribuir a revaluar aquestes publicacions estudiantils, que complementen el quadre històric del desenvolupament de la medicina acadèmica

Genetic analysis of beef fatty acid composition predicted by near-infrared spectroscopy

The aims of this study were 1) to inves- tigate the potential application of near-infrared spec- troscopy (NIRS) to predict intramuscular fat (IMF) and fatty acid (FA) composition of individual meat samples, 2) to estimate heritability of IMF and FA NIRS-based predictions, and 3) to assess the statisti- cal relevance of the genetic background of such predic- tions by using the Bayes factor (BF) procedure. Young Piemontese bulls (n = 1,298) were raised and fattened on 124 farms, and slaughtered at the same commercial abattoir. Intramuscular fat content and FA composi- tion were analyzed on a random subset of 148 samples of minced and homogenized longissimus thoracis mus- cle. Near-infrared spectroscopy spectra were collected on all samples (n = 1,298) in reflectance mode between 1,100 and 2,498 nm (every 2 nm) using fresh minced meat samples. Calibration models developed from the random subset of 148 samples were used to predict IMF and FA contents of the remaining 1,150 samples. Intra- muscular fat content and FA predictions were analyzed under a Bayesian univariate animal linear models, and the statistical relevance of heritability estimates was as

Diez años de selección de toros jóvenes en el centro de testaje de la raza Bruna dels Pirineus

publishedTomo I . Sección: Sistemas Ganaderos-Economía y Gestión. Sesión: Vacuno carne II. Ponencia nº