Uterine devascularization

Uterine devascularization is a valuable alternative to hysterectomy or internal iliac arteries ligation in case of otherwise intractable obstetrical haemorrhage. Has a higher success rate as compared to that of internal iliac arteries ligation. Can be dealt with, vaginally or through abdomen, in this case may be employed curatively or preventively

On-line carbon dots synthesis using flow injection analysis. Application to aluminium determination in water samples

An on-line synthesis of CDots is proposed for the first time, using the flow injection analysis (FIA) technique, which was coupled, in a single system, to the analytical determination of aluminium in water samples. The nanoparticles were obtained from the carbonization of glucose and iron(III) in an acidic medium, and their photoluminescence increased in the presence of aluminium ions. Under optimal experimental conditions, the proposed method has shown an acceptable linearity range –between 0.04 and 3.0 mg L−1 (R2 = 0.9999) – and a detection limit of 0.007 mg L−1. The analysis of drinking water and groundwater samples showed good accuracy (recoveries ranged between 91 – 113%) and RSD% < 13. The on-line system exhibited a high sample throughput (36 h−1), since no incubation time was required.Financial support from Universidad Nacional del Sur (PGI 24/Q099 and 24/Q123, CONICET 11220200102603CO, CONICET 11220200103198CO and the ANPCyT PICT-2019-04458 (2021-2023) is gratefully acknowledged. This research was part of the Ph.D. thesis of Damian Uriarte, which was supported by a doctoral grant funded by Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). M. Garrido and C.E. Domini wish to thank CONICET

Analysis of metals and phosphorus in biodiesel B100 from different feedstock using a Flow Blurring® multinebulizer in inductively coupled plasma-optical emission spectrometry

A simple and fast method for determining the content of Na, K, Ca, Mg, P, and 20 heavy metals in biodiesel samples with inductively coupled plasma optical emission spectrometry (ICP OES) using a two-nozzle Flow Blurring® multinebulizer prototype and on-line internal standard calibration, are proposed. The biodiesel samples were produced from different feedstock such as sunflower, corn, soybean and grape seed oils, via a base catalyst transesterification. The analysis was carried out without any sample pretreatment. The standards and samples were introduced through one of the multinebulizer nozzles, while the aqueous solution containing yttrium as an internal standard was introduced through the second nozzle. Thus, the spectral interferences were compensated and the formation of carbon deposits on the ICP torch was prevented. The determination coefficients (R2) were greater than 0.99 for the studied analytes, in the range 0.21–14.75 mg kg−1. Short-term and long-term precisions were estimated as relative standard deviation. These were acceptable, their values being lower than 10%. The LOQ for major components such as Ca, K, Mg, Na, and P, were within a range between 4.9 ng g−1 for Mg (279.553 nm) and 531.1 ng g−1 for Na (588.995 nm), and for the other 20 minor components they were within a range between 1.1 ng g−1 for Ba (455.403 nm) and 2913.9 ng g−1 for Pb (220.353 nm). Recovery values ranged between 95% and 106%.The authors gratefully acknowledge Universidad Nacional del Sur (UNS) and Instituto de Química del Sur – Universidad Nacional del Sur – Consejo Nacional de Investigaciones Científicas y Técnicas (INQUISUR-UNS-CONICET) from Argentina for the financial support. FDAO acknowledges Universidad de Alicante (UA) for his short visit fellowship. Ministerio de Asuntos Exteriores y de Cooperación (MAEC) and Dirección de Relaciones Culturales y Científicas (AECID) from Spain for the financial support. The authors wish to thank the Spanish Government (CTQ2011-23968) for the financial support

Working length transfer in the endodontic clinical practice: A comparative study

8The present paper evaluated the accuracy of two different methods for transferring working length (WL) between manual endodontic instruments and nickel–titanium (NiTi) shaping files. Thirty root canals of extracted permanent teeth were used. Root canals were divided according to canal length (CL) and canal curvature (CC). The reference cusp and the root end were flattened to provide reproducible and accurate measurements. During shaping, the WL measurements were obtained with manual k-files (KF) and transferred to WaveOne (W1) NiTi reciprocating files using the traditional method with the endodontic ruler (method I) and an alternative clinical procedure based on the comparison of the instruments side by side from tip to shank (method II). For each file and each tested method, two measures were taken by two examiners using Rhino (ver. 4.0, McNeel, Seattle, WA, USA) software for a total of 360 (30 × 3 × 2 × 2) measures. Analysis of variance was performed by taking the difference in length (Delta WL, DWL) between files used for the same canal. The difference between methods I and II for WL transfer was found to be statistically significant (df = 1; F = 71.52; p < 0.001). The DWL absolute values obtained with method II were found to be closer to 0 mm (i.e., same length as corresponding KF) than those obtained with method I. Both CL (df = 2; F = 1.27; p = 0.300) and CC (df = 1; F = 2.22; p = 0.149) did not significantly influence WL measurements. With respect to WL transfer, method II seemed to better preserve the correct WL transfer between instruments during the clinical endodontic procedures.openopenMario Alovisi; Mario Dioguardi; Massimo Carossa; Giuseppe Troiano; Maria Chiara Domini; Davide Salvatore Paolino; Giorgio Chiandussi; Elio BeruttiAlovisi, Mario; Dioguardi, Mario; Carossa, Massimo; Troiano, Giuseppe; Chiara Domini, Maria; Paolino, DAVIDE SALVATORE; Chiandussi, Giorgio; Berutti, Eli

Reversed-phase dispersive liquid–liquid microextraction for elemental analysis of gasoline by inductively coupled plasma optical emission spectrometry

In this work a green and fast sample preparation method based on reversed-phase dispersive liquid–liquid microextraction (RP-DLLME) was developed for the separation and preconcentration of several elements (i.e., Ag, As, Ba, Cd, Cr, Cu, Hg, Mn, Mo, Ni, Pb, S, Se, Sn and V) in gasoline samples before determination by Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES). The extraction procedure was carried out in a reverse mode, since a small volume of the aqueous phase (i.e., 8 M HCl) is used to extract a relatively high volume of the organic phase (i.e., gasoline sample). Unlike conventional DLLME, in RP-DLLME the analytes were extracted from the organic phase into the aqueous phase. The experimental conditions for the microextraction procedure were: 5 g of sample, 8 M HCl as the extractant phase, mechanical agitation by vortex as the dispersion system, 115 μL of extractant volume, and 2 min extraction and 5 min centrifugation time. Under optimized extraction conditions the enrichment factor ranged between 3 and 53, and the limits of detection ranged between 0.02 and 50 μg kg−1. The proposed analytical method was validated and successfully used to analyze three gasoline samples. All gasoline samples were spiked at 100 μg kg−1 for all analytes, except sulfur (in this case at 1000 μg kg−1), obtaining recovery and RSD values within the range of 88–109% and 2–9%, respectively.The authors would like to thank the Regional Government of Valencia (Spain) (PROMETEO/2018/087) for the financial support, Agilent Technologies Inc. for the loan of the ICP-OES spectrometer, and Ingeniatrics for the OneNeb® provided. Financial support from Universidad Nacional del Sur is gratefully acknowledged. A. S. Lorenzetti, E. Vidal and C. E. Domini wish to thank Consejo Nacional de Investigaciones Científicas y Técnicas for the financial support received. The authors extend their appreciation to the Ministry of Science, Innovation and Universities for granting the Spanish Network of Excellence in Sample Preparation (RED2018-102522-T). This article is based upon work from the Sample Preparation Study Group and Network, supported by the Division of Analytical Chemistry of the European Chemical Society

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112