Migration of liquid silicone, an emerging contraindication of neuraxial anesthesia

La aplicación ilegal de productos como silicona líquida o biopolímeros en procedimientos de aumento de glúteos está generando múltiples complicaciones con gran impacto negativo para la salud tanto a corto como a largo plazo. La migración de polímeros a la región sacra y lumbar representa una importante limitación para la realización de procedimientos de anestesia neuroaxial. Esta migración de silicona es impredecible a través del tejido superficial, la cual está ampliamente descrita en la literatura. Los procedimientos anestésicos caudal, espi-nal y epidural podrían atravesar los silicomas en la fascia del tejido y contaminar el neuroeje con sustancias con alta capacidad de generar inflamación, edema y necrosis de tejidos. Con el fin de aumentar la seguridad de los procedimientos anestésicos neuroaxiales y evitar el riesgo potencial de dispersión y contaminación del neuroeje, es necesario descartar esta complicación o considerar una contraindicación emergente en estos procedimientos anestésicos.The illegal use of liquid silicone products or biopolymers in gluteal augmentation procedures is giving rise to multiple complications, with a significant negative health impact, both in the short and long-term. The migration of polymers to the sacral and lumbar region represents a major limitation to conducting neuraxial anesthesia procedures. This silicon migration is unpredictable through the superficial tissue as is widely described in the literature. Caudal, spinal and epidural anesthesia may cross the silicone in the fascia and contaminate the neural axis with substances that are highly capable of causing inflammation, edema and tissue necrosis. In order to improve the safety of neuraxial anesthetic procedures and avoid the potential risk of dissemination and contamination of the neural axis, this complication must be ruled out, or be considered an emerging contraindication for these anesthetic procedures

Respuesta de la comunidad fitoplanctónica a experimentos de eutrofización artificial realizados en la represa la fe, el retiro, antioquia, colombia

Se probó el efecto de la adición de nitrógeno (nitrato de potasio) en tres concentraciones [0 μg.l-1 (No), 500 μg.l-1 (N1), y 1000 μg.l-1 (N2)] y de la adición de fósforo (fosfato ácido de potasio) en cuatro concentraciones [0μg.l-1 (Po), 10 μg.l-1 (P1), 50 μg.l-1 (P2) y 100 μg.l-1 (P3)] a muestras de agua superficial de la presa del embalse, las que se colocaron en bolsas plásticas de 2 litros. Se consideraron doce tratamientos. Las muestras de agua fueron colectadas el 6 de junio de 2001, incubadas en la superficie durante 14 días. Los resultados fueron sometidos a análisis exploratorio y a un andeva factorial del tipo 3 x 4. Las variables de respuesta fueron la biomasa fitoplanctónica, la razón de pigmentos y la concentración de material particulado. Con excepción de los cuatro primeros tratamientos, hubo incrementos de biomasa fitoplanctónica en todos los demás. El andeva efectuado para los datos de clorofila transformados logarítmicamente mostró diferencias significativas para el factor nitrógeno (α = 0.0290); en los tratamientos sin nitrógeno no hubo clorofila. Ni para el factor fósforo (α = 0.9536) ni para la interacción doble (α = 0.7598) el andeva halló diferencias significativas en la concentración de clorofila. Para la razón de pigmentos el andeva realizado no mostró significancia estadística para ninguno de los factores analizados. El andeva efectuado para el material particulado mostró diferencias significativas para el factor fósforo (α = 0.0398) y para la interacción doble (α = 0.0162), mas no para el factor nitrógeno (α = 0.0607). Los mayores valores medios se presentaron en los tratamientos donde estaban presentes los dos nutrientes, siendo el más alto aquel en que los dos nutrientes tenían las mayores concentraciones (N2P3). El incrementó significativo de la biomasa fitoplanctónica en las bolsas con nitrato lleva a concluir que, para el día de la experimentación en la zona limnética del embalse La Fe fue el nitrógeno y no el fósforo el nutriente limitante. En los tratamientos en los que ambos nutrientes estuvieron presentes, el aumento de la concentración de clorofila no fue el más pronunciado. El material total suspendido no constituyó el mejor criterio para la evaluación de los efectos del enriquecimiento en la comunidad fitoplanctónica, pues no se eliminó una fuente adicional de material particulado: el zooplancton, el cual en la represa es bastante abundante

CXCL12 is displayed by rheumatoid endothelial cells through its basic amino-terminal motif on heparan sulfate proteoglycans

The chemokine CXCL12 (also known as stromal cell-derived factor, SDF-1) is constitutively expressed by stromal resident cells and is involved in the homeostatic and inflammatory traffic of leukocytes. Binding of CXCL12 to glycosaminoglycans on endothelial cells (ECs) is supposed to be relevant to the regulation of leukocyte diapedesis and neoangiogenesis during inflammatory responses. To improve our understanding of the relevance of this process to rheumatoid arthritis (RA), we have studied the mechanisms of presentation of exogenous CXCL12 by cultured RA ECs. RA synovial tissues had higher levels of CXCL12 on the endothelium than osteoarthritis (OA) tissues; in both, CXCL12 colocalized to heparan sulfate proteoglycans (HSPGs) and high endothelial venules. In cultured RA ECs, exogenous CXCL12α was able to bind in a CXCR4-independent manner to surface HSPGs. Desulfation of RA EC HSPGs by pretreatment with sodium chlorate, or by replacing in a synthetic CXCL12α the residues Lys24 and Lys27 by Ser (CXCL12α-K2427S), decreased or abrogated the ability of the chemokine to bind to RA ECs. Ex vivo, synovial ECs from patients with either OA or RA displayed a higher CXCL12-binding capacity than human umbilical vein ECs (HUVECs), and in HUVECs the binding of CXCL12 was increased on exposure to tumor necrosis factor-α or lymphotoxin-α(1)β(2). Our findings indicate that CXCL12 binds to HSPGs on ECs of RA synovium. The phenomenon relates to the interaction of HSPGs with a CXCL12 domain with net positive surface charge located in the first β strand, which encompasses a canonical BXBB HSPG-binding motif. Furthermore, we show that the attachment of CXCL12 to HSPGs is upregulated by inflammatory cytokines. Both the upregulation of a constitutive chemokine during chronic inflammation and the HSPG-dependent immobilization of CXCL12 in EC surfaces are potential sites for therapeutic intervention

Planeación de la Expansión de la Transmisión con Reforzamiento de la red a partir de la evaluación de la confiabilidad

One of the main factors for transmission expansion is established from various criteria as the minimization of inversion, operation or both, criteria’s of reliability in generation, in transmission system or the composite system. In this paper the static transmission expansion planning (TEP) is solved, the problem is formulated by Mix Integer Programming (MIP). And is solved in two sequential phases: first phase the TEP is solved by GAMS and the second phase assess the reliability of the optimum expansion plan and new lines are added with the finality of reduce the reliability indices to a defined value or zero. The principal contribution of this work is the implementation of the interface Matlab-GAMS to solve the TEP considering the reliability assessment. To show the effectiveness of the methodology 6 nodes Garver system and 12 nodes Scandinavian system are used. Key Word —Expansion, Planning, Transmission, ReliabilityUno de los principales factores para la planeación de la transmisión se establece a partir de diversos criterios como la minimización de los costos de inversión, operación o ambos, además de criterios de confiabilidad en la generación, en el sistema de transmisión o en el sistema compuesto generación-transmisión. En este trabajo se resuelve el problema de expansión de la transmisión (PET) estático, el problema de expansión es formulado mediante Programación Entera Mixta (MIP, Mix Integer Programming). El problema se resuelve en dos fases secuenciales: la primera fase resuelve el PET mediante GAMS la segunda fase evalúa la confiabilidad del plan de expansión óptimo y se adicionan nuevas líneas a fin de reducir los índices de confiabilidad hasta un valor definido o cero. La principal aportación en este trabajo es la implementación en Matlab-GAMS para la solución al PET considerando la evaluación de la confiablidad. Para mostrar la efectividad de la metodología se utiliza el sistema de 6 nodos de Garver y el sistema escandinavo de 12 nodos.

Planeación de la Expansión de la Transmisión con Reforzamiento de la red a partir de la evaluación de la confiabilidad

One of the main factors for transmission expansion is established from various criteria as the minimization of inversion, operation or both, criteria’s of reliability in generation, in transmission system or the composite system. In this paper the static transmission expansion planning (TEP) is solved, the problem is formulated by Mix Integer Programming (MIP). And is solved in two sequential phases: first phase the TEP is solved by GAMS and the second phase assess the reliability of the optimum expansion plan and new lines are added with the finality of reduce the reliability indices to a defined value or zero. The principal contribution of this work is the implementation of the interface Matlab-GAMS to solve the TEP considering the reliability assessment. To show the effectiveness of the methodology 6 nodes Garver system and 12 nodes Scandinavian system are used. Key Word —Expansion, Planning, Transmission, ReliabilityUno de los principales factores para la planeación de la transmisión se establece a partir de diversos criterios como la minimización de los costos de inversión, operación o ambos, además de criterios de confiabilidad en la generación, en el sistema de transmisión o en el sistema compuesto generación-transmisión. En este trabajo se resuelve el problema de expansión de la transmisión (PET) estático, el problema de expansión es formulado mediante Programación Entera Mixta (MIP, Mix Integer Programming). El problema se resuelve en dos fases secuenciales: la primera fase resuelve el PET mediante GAMS la segunda fase evalúa la confiabilidad del plan de expansión óptimo y se adicionan nuevas líneas a fin de reducir los índices de confiabilidad hasta un valor definido o cero. La principal aportación en este trabajo es la implementación en Matlab-GAMS para la solución al PET considerando la evaluación de la confiablidad. Para mostrar la efectividad de la metodología se utiliza el sistema de 6 nodos de Garver y el sistema escandinavo de 12 nodos.

Cobalt Metal-Organic Framework based on two dinuclear secondary building units for electrocatalytic oxygen evolution

The synthesis of a new microporous metal-organic framework (MOF) based on two secondary building units, with dinuclear cobalt centers, has been developed. The employment of a well-defined cobalt cluster results in an unusual topology of the Co2-MOF, where one of the cobalt centers has three open coordination positions, which has no precedent in MOF materials based on cobalt. Adsorption isotherms have revealed that Co2-MOF is in the range of best CO2 adsorbents among the carbon materials, with very high CO2/CH4 selectivity. On the other hand, dispersion of Co2-MOF in an alcoholic solution of Nafion gives rise to a composite (Co2-MOF@Nafion) with great resistance to hydrolysis in aqueous media and good adherence to graphite electrodes. In fact, it exhibits high electrocatalytic activity and robustness for the oxygen evolution reaction (OER), with a turnover frequency number value superior to those reported for similar electrocatalysts. Overall, this work has provided the basis for the rational design of new cobalt OER catalysts and related materials employing well-defined metal clusters as directing agents of the MOF structure

Cobalt metal-organic framework based on layered double nanosheets for enhanced electrocatalytic water oxidation in neutral media

A new cobalt metal-organic framework (2D-Co-MOF) based on well-defined layered double cores that are strongly connected by intermolecular bonds has been developed. Its 3D structure is held together by π-π stacking interactions between the labile pyridine ligands of the nanosheets. In aqueous solution, the axial pyridine ligands are exchanged by water molecules, producing a delamination of the material, where the individual double nanosheets preserve their structure. The original 3D layered structure can be restored by a solvothermal process with pyridine, so that the material shows a "memory effect" during the delamination-pillarization process. Electrochemical activation of a 2D-Co-MOF@Nafion-modified graphite electrode in aqueous solution improves the ionic migration and electron transfer across the film and promotes the formation of the electrocatalytically active cobalt species for the oxygen evolution reaction (OER). The so-activated 2D-Co-MOF@Nafion composite exhibits an outstanding electrocatalytic performance for the OER at neutral pH, with a TOF value (0.034 s-1 at an overpotential of 400 mV) and robustness superior to those reported for similar electrocatalysts under similar conditions. The particular topology of the delaminated nanosheets, with quite distant cobalt centers, precludes the direct coupling between the electrocatalytically active centers of the same sheet. On the other hand, the increase in ionic migration across the film during the electrochemical activation stage rules out the intersheet coupling between active cobalt centers, as this scenario would impair electrolyte permeation. Altogether, the most plausible mechanism for the O-O bond formation is the water nucleophilic attack to single Co(IV)-oxo or Co(III)-oxyl centers. Its high electrochemical efficiency suggests that the presence of nitrogen-containing aromatic equatorial ligands facilitates the water nucleophilic attack, as in the case of the highly efficient cobalt porphyrins

Socioeconomic determinants of sarcopenic obesity and frail obesity in community-dwelling older adults: The Seniors-ENRICA Study

Information on the association between socioeconomic status (SES) throughout life and sarcopenic obesity is scarce, whereas no study has been focused on the association between SES and frail obesity. This analysis estimated the prevalence of sarcopenic obesity and frail obesity, and their associations with SES in older adults. Data were collected in 2012 from 1,765 non-institutionalized individuals aged ≥65 participating in the Seniors-ENRICA study in Spain, by using standardized techniques and equipment. SES throughout life was evaluated with the father's occupation, participant's educational level, former own occupation, and current poor housing condition. Overall, 17.2% of participants had sarcopenic obesity, and 4.0% frail obesity. No association was found between SES and sarcopenic obesity. In contrast, the prevalence of frail obesity was higher in those with lower education, having worked in manual job, and currently having poor housing condition. Having ≥1 social disadvantages throughout life was associated with higher prevalence of frail obesity. The prevalence of this disorder increased by 1.49 (95% CI: 1.21-1.85) times for each social disadvantage added. The OR (95% CI) of frail obesity was 3.13 (1.71-5.7) for those having 3 or 4 vs. 0 or 1 social disadvantages, implying a more complex process beginning early in life.Data collection was funded by the following grants: PI13/0288; PI14/0009; PI16/01460; PI16/01512; and PI16/00609 (State Secretary of R+D and FEDER/FSE). BM-F was supported by a CIBERCV contract, RFP-T was supported by the National Government of Ecuador through the National Institution of Higher Education, Science, Technology and Innovation-SENESCYT, and ML research activity is funded by Agencia Aragonesa para la Investigación y el Desarrollo (ARAID

Pathogenicity island cag, vacA and IS605 genotypes in Mexican strains of Helicobacter pylori associated with peptic ulcers

<p>Abstract</p> <p>Background</p> <p><it>Helicobacter pylori </it>is associated with chronic gastritis, peptic ulcers, and gastric cancer. Two major virulence factors of <it>H. pylori </it>have been described: the pathogenicity island <it>cag </it>(<it>cag </it>PAI) and the vacuolating cytotoxin gene (<it>vacA</it>). Virtually all strains have a copy of <it>vacA</it>, but its genotype varies. The <it>cag </it>PAI is a region of 32 genes in which the insertion of IS<it>605 </it>elements in its middle region has been associated with partial or total deletions of it that have generated strains with varying virulence. Accordingly, the aim of this work was to determine the <it>cag </it>PAI integrity<it>, vacA </it>genotype and IS<it>605 </it>status in groups of isolates from Mexican patients with non-peptic ulcers (NPU), non-bleeding peptic ulcers (NBPU), and bleeding peptic ulcers (BPU).</p> <p>Methods</p> <p>The <it>cag </it>PAI integrity was performed by detection of eleven targeted genes along this locus using dot blot hybridization and PCR assays. The <it>vacA </it>allelic, <it>cag </it>PAI genotype 1 and IS<it>605 </it>status were determined by PCR analysis.</p> <p>Results</p> <p>Groups of 16-17 isolates (n = 50) from two patients with NPU, NBPU, and BPU, respectively, were studied. 90% (45/50) of the isolates harbored a complete <it>cag </it>PAI. Three BPU isolates lacked the <it>cag </it>PAI, and two of the NBPU had an incomplete <it>cag </it>PAI: the first isolate was negative for three of its genes, including deletion of the <it>cagA </it>gene, whereas the second did not have the <it>cagM </it>gene. Most of the strains (76%) had the <it>vacA </it>s1b/m1 genotype; meanwhile the IS<it>605 </it>was not present within the <it>cag </it>PAI of any strain but was detected elsewhere in the genome of 8% (4/50).</p> <p>Conclusion</p> <p>The patients had highly virulent strains since the most of them possessed a complete <it>cag </it>PAI and had a <it>vacA </it>s1b/m1 genotype. All the isolates presented the <it>cag </it>PAI without any IS<it>605 </it>insertion (genotype 1). Combined <it>vacA </it>genotypes showed that 1 NPU, 2 NBPU, and 1 BPU patients (66.6%) had a mixed infection; coexistence of <it>H. pylori </it>strains with different <it>cag </it>PAI status was observed in 1 NBPU and 2 BPU (50%) of the patients, but only two of these patients (NBPU and BPU) had different <it>vacA </it>genotypes.</p