Sulfonación de ésteres metílicos derivados del aceite de palma

Sulfonation with sulfur trioxide (SO3) of methyl esters produced by a transesterification of hydrogenated palm stearin, was studied in the present research. The generation of sulfur trioxide (SO3), by heating, stirring and bubbling nitrogen on oleum, helped establish the conditions for processing. Through gas chromatography and infrared spectroscopy, raw materials were characterized; and with volumetric titrations, the percentage of active substance (Hyamina 1622) and sulfuric acid content in the product were determined, oil-free through drawings with petroleum ether, and coloring was also determined in a spectrophotometer (420 nm). Recommendations were developed from the standpoint of the process used to identify the main variables for the functionality of the sulfonation plant to a scaling-level pilot. The flow of liquid reactant, the molar ratio SO3/methyl ester, the mole fraction of SO3 (or the percentage by volume) in the sulfonante gaseous flow, and the temperature process are the variables that have a more decisive influence on the conversion and properties of the product. En la presente investigación se estudió la sulfonación con trióxido de azufre (SO3) de ésteres metílicos fabricados mediante una transesterificación de la estearina hidrogenada de palma. La generación del agente sulfonante (SO3) mediante calentamiento, agitación y burbujeo de nitrógeno sobre óleum permitió establecer las condiciones de procesamiento. La materia prima se caracterizó mediante cromatografía de gases y espectroscopia infrarroja, y a través de titulaciones volumétricas se determinó el porcentaje de materia activa (Hyamina 1622) y del ácido sulfúrico contenido en el producto. Se determinaron el aceite libre mediante extracciones con éter de petróleo, y la coloración mediante espectrofotometría (420 nm). Se sugieren valores de las condiciones de proceso con miras a un escalamiento piloto. Las variables que tienen una influencia más determinante sobre las propiedades finales del producto son: el caudal de reactante líquido, la razón molar SO3/metiléster, la fracción molar de SO3 (o el porcentaje volumétrico) en la corriente sulfonante, la temperatura del proceso.  

Minimal residual disease evaluation by flow cytometry is a complementary tool to cytogenetics for treatment decisions in acute myeloid leukaemia

For PETHEMA Programa para el Estudio de la Terapéutica en Hemopatías Malignas Cooperative Study Group.The clinical utility of minimal residual disease (MRD) analysis in acute myeloid leukaemia (AML) is not yet defined. We analysed the prognostic impact of MRD level at complete remision after induction therapy using multiparameter flow cytometry in 306 non-APL AML patients. First, we validated the prognostic value of MRD-thresholds we have previously proposed (≥0.1%; ≥0.01-0.1%; and <0.01), with a 5-year RFS of 38%, 50% and 71%, respectively (p = 0.002). Cytogenetics is the most relevant prognosis factor in AML, however intermediate risk cytogenetics represent a grey zone that require other biomarkers for risk stratification, and we show that MRD evaluation discriminate three prognostic subgroups (p = 0.03). Also, MRD assessments yielded relevant information on favourable and adverse cytogenetics, since patients with favourable cytogenetics and high MRD levels have poor prognosis and patients with adverse cytogenetics but undetectable MRD overcomes the adverse prognosis. Interestingly, in patients with intermediate or high MRD levels, intensification with transplant improved the outcome as compared with chemotherapy, while the type of intensification therapy did not influenced the outcome of patients with low MRD levels. Multivariate analysis revealed age, MRD and cytogenetics as independent variables. Moreover, a scoring system, easy in clinical practice, was generated based on MRD level and cytogenetics.This work was supported in part by Spanish grants from Fondo de Investigación Sanitaria-ISCIII (FIS 00/0023-03, PI12/02321), DGCYT (SAF 94- 0308, SAF2001-1687), Conserjería de Educación de Castilla y León (HUS416A12), and Red Temática de Investigación Cooperativa en Cáncer (RTICC-ISCIII) (RD12/0036/0069).Peer Reviewe

Semiótica, la pasión del conocimiento. Interpretación e interacciones de la cultura.

El documento aquí expuesto está inspirado por diversas voces y construido por varias manos. Así que sus páginas transitan entre la polisemia y la polifonía, que emergen con la lectura de las interpretaciones semióticas que aquí se encuentran. Cada uno de los artículos, seleccionados por un grupo de especialistas que colaboraron de manera generosa con esta actualización, recoge la experiencia y el conocimiento de los autores que trabajan en esta disciplina; a la vez, constituye una aporte sólido y valioso para quienes están interesados en conocer los avances alcanzados por la semiótica en Colombia, un país donde la Asociación de Estudios en Semiótica se esfuerza de manera permanente por la consolidación de estos estudios

SARS-CoV-2 Infection in Multiple Sclerosis

To understand COVID-19 characteristics in people with multiple sclerosis (MS) and identify high-risk individuals due to their immunocompromised state resulting from the use of disease-modifying treatments. Retrospective and multicenter registry in patients with MS with suspected or confirmed COVID-19 diagnosis and available disease course (mild = ambulatory; severe = hospitalization; and critical = intensive care unit/death). Cases were analyzed for associations between MS characteristics and COVID-19 course and for identifying risk factors for a fatal outcome. Of the 326 patients analyzed, 120 were cases confirmed by real-time PCR, 34 by a serologic test, and 205 were suspected. Sixty-nine patients (21.3%) developed severe infection, 10 (3%) critical, and 7 (2.1%) died. Ambulatory patients were higher in relapsing MS forms, treated with injectables and oral first-line agents, whereas more severe cases were observed in patients on pulsed immunosuppressors and critical cases among patients with no therapy. Severe and critical infections were more likely to affect older males with comorbidities, with progressive MS forms, a longer disease course, and higher disability. Fifteen of 33 patients treated with rituximab were hospitalized. Four deceased patients have progressive MS, 5 were not receiving MS therapy, and 2 were treated (natalizumab and rituximab). Multivariate analysis showed age (OR 1.09, 95% CI, 1.04-1.17) as the only independent risk factor for a fatal outcome. This study has not demonstrated the presumed critical role of MS therapy in the course of COVID-19 but evidenced that people with MS with advanced age and disease, in progressive course, and those who are more disabled have a higher probability of severe and even fatal diseas

Effects of intubation timing in patients with COVID-19 throughout the four waves of the pandemic : a matched analysis

The primary aim of our study was to investigate the association between intubation timing and hospital mortality in critically ill patients with COVID-19-associated respiratory failure. We also analysed both the impact of such timing throughout the first four pandemic waves and the influence of prior non-invasive respiratory support on outcomes. This is a secondary analysis of a multicentre, observational and prospective cohort study that included all consecutive patients undergoing invasive mechanical ventilation due to COVID-19 from across 58 Spanish intensive care units (ICU) participating in the CIBERESUCICOVID project. The study period was between 29 February 2020 and 31 August 2021. Early intubation was defined as that occurring within the first 24 h of intensive care unit (ICU) admission. Propensity score (PS) matching was used to achieve balance across baseline variables between the early intubation cohort and those patients who were intubated after the first 24 h of ICU admission. Differences in outcomes between early and delayed intubation were also assessed. We performed sensitivity analyses to consider a different timepoint (48 h from ICU admission) for early and delayed intubation. Of the 2725 patients who received invasive mechanical ventilation, a total of 614 matched patients were included in the analysis (307 for each group). In the unmatched population, there were no differences in mortality between the early and delayed groups. After PS matching, patients with delayed intubation presented higher hospital mortality (27.3% versus 37.1%, p =0.01), ICU mortality (25.7% versus 36.1%, p=0.007) and 90-day mortality (30.9% versus 40.2%, p=0.02) when compared to the early intubation group. Very similar findings were observed when we used a 48-hour timepoint for early or delayed intubation. The use of early intubation decreased after the first wave of the pandemic (72%, 49%, 46% and 45% in the first, second, third and fourth wave, respectively; first versus second, third and fourth waves p<0.001). In both the main and sensitivity analyses, hospital mortality was lower in patients receiving high-flow nasal cannula (n=294) who were intubated earlier. The subgroup of patients undergoing NIV (n=214) before intubation showed higher mortality when delayed intubation was set as that occurring after 48 h from ICU admission, but not when after 24 h. In patients with COVID-19 requiring invasive mechanical ventilation, delayed intubation was associated with a higher risk of hospital mortality. The use of early intubation significantly decreased throughout the course of the pandemic. Benefits of such an approach occurred more notably in patients who had received high-flow nasal cannul

Colombian consensus recommendations for diagnosis, management and treatment of the infection by SARS-COV-2/ COVID-19 in health care facilities - Recommendations from expert´s group based and informed on evidence

La Asociación Colombiana de Infectología (ACIN) y el Instituto de Evaluación de Nuevas Tecnologías de la Salud (IETS) conformó un grupo de trabajo para desarrollar recomendaciones informadas y basadas en evidencia, por consenso de expertos para la atención, diagnóstico y manejo de casos de Covid 19. Estas guías son dirigidas al personal de salud y buscar dar recomendaciones en los ámbitos de la atención en salud de los casos de Covid-19, en el contexto nacional de Colombia

Formación de la conciencia moral de los estudiantes de la Vuad Centro de Atención Universitaria Duitama

The investigation is an attempt to get to formulate a proposal for the formation of the moral conscience in the students of Superior Education. In many means one speculates on the lack of commitment and responsibility of the people, perhaps reason why nowadays it has been wanted to denominate the �absence of values�, but it will be the this reason, or something much more deep, that would be not to have formed the conscience, therefore, are not possible to be demonstrated values in that conscience does not have of what it does. It is one first approach of this thematic one with students of remote Education, this, because every greater time is wanted to be giving to the investigation a validation, in the diverse atmospheres in which the Education can be carried out. The methodology that is used is the one of the reflective critical action, looking for with them to construct a valid proposal from a reality it makes specific and in own contexts in which the education exercise is carried out learning.La investigación es un intento por llegar a formular una propuesta para la formación de la conciencia moral en los estudiantes de Educación Superior. En muchos medios se especula sobre la falta de compromiso y responsabilidad de las personas, tal vez por lo que hoy en día se ha querido denominar la �ausencia de valores�, pero será éste el motivo, o algo mucho más profundo, que sería el no tener formada la conciencia, por tanto, no se pueden evidenciar valores en quien no tiene conciencia de aquello que hace. Es una primera aproximación de esta temática con estudiantes de Educación a Distancia, esto, porque se quiere ir dando a la investigación una validación cada vez mayor, en los diversos ambientes en los cuales se puede llevar a cabo la educación. La metodología que se utiliza es la de la acción crítica reflexiva, buscando con ellos construir una propuesta válida desde una realidad concreta y en contextos propios en los cuales se lleva a cabo el ejercicio de enseñanza aprendizaje

Sulfonación de ésteres metílicos derivados del aceite de palma

Sulfonation with sulfur trioxide (SO3) of methyl esters produced by a transesterification of hydrogenated palm stearin, was studied in the present research. The generation of sulfur trioxide (SO3), by heating, stirring and bubbling nitrogen on oleum, helped establish the conditions for processing. Through gas chromatography and infrared spectroscopy, raw materials were characterized; and with volumetric titrations, the percentage of active substance (Hyamina 1622) and sulfuric acid content in the product were determined, oil-free through drawings with petroleum ether, and coloring was also determined in a spectrophotometer (420 nm). Recommendations were developed from the standpoint of the process used to identify the main variables for the functionality of the sulfonation plant to a scaling-level pilot. The flow of liquid reactant, the molar ratio SO3/methyl ester, the mole fraction of SO3 (or the percentage by volume) in the sulfonante gaseous flow, and the temperature process are the variables that have a more decisive influence on the conversion and properties of the product. En la presente investigación se estudió la sulfonación con trióxido de azufre (SO3) de ésteres metílicos fabricados mediante una transesterificación de la estearina hidrogenada de palma. La generación del agente sulfonante (SO3) mediante calentamiento, agitación y burbujeo de nitrógeno sobre óleum permitió establecer las condiciones de procesamiento. La materia prima se caracterizó mediante cromatografía de gases y espectroscopia infrarroja, y a través de titulaciones volumétricas se determinó el porcentaje de materia activa (Hyamina 1622) y del ácido sulfúrico contenido en el producto. Se determinaron el aceite libre mediante extracciones con éter de petróleo, y la coloración mediante espectrofotometría (420 nm). Se sugieren valores de las condiciones de proceso con miras a un escalamiento piloto. Las variables que tienen una influencia más determinante sobre las propiedades finales del producto son: el caudal de reactante líquido, la razón molar SO3/metiléster, la fracción molar de SO3 (o el porcentaje volumétrico) en la corriente sulfonante, la temperatura del proceso.  

Caracterización clínica de pacientes con cirrosis hepática en el Hospital Militar Docente Dr. Mario Muñoz, de Matanzas Clinical characterization of patients with liver cirrhosis in the Teaching Military Hospital Dr. Mario Muñoz, Matanzas

Introducción: la cirrosis hepática se caracteriza por una fase asintomática o compensada, seguida de una rápida progresión por el desarrollo de complicaciones o descompensada, lo que determina diferentes estadios evolutivos. Objetivo: caracterizar los pacientes cirróticos atendidos en el Servicio de Gastroenterología del Hospital Militar Docente Dr. Mario Muñoz Monroy, en el período comprendido entre enero de 2009 a diciembre de 2010. Métodos: se realizó un estudio descriptivo transversal. Se tuvieron en cuenta variables clínicas necesarias para clasificar los pacientes según las etapas contempladas en el consenso de Baveno IV. Se aplicaron procedimientos de la estadística descriptiva. Resultados: se estudiaron 41 pacientes, con predominio de masculinos (82,9 %), con edad promedio de 51,9 ± 9,2 años. La astenia fue el principal motivo de consulta en la fase compensada; los pacientes presentaron una enfermedad compensada en su gran mayoría, de acuerdo al estadio clínico de la enfermedad según criterios de Baveno IV Consenso Metodológico sobre Diagnóstico y Tratamiento de la Hipertensión Portal (56,1 %). Conclusiones: con la aplicación de los criterios del consenso de Baveno IV se logra la adecuada clasificación clínica del paciente cirrótico que permite una terapéutica oportuna en beneficio de estos.<br>Introduction: liver cirrhosis is characterized by an asymptomatic or compensated stage, followed by a fast progression for the development of complications or decompensated stage, determining different evolutionary stages. Objective: characterizing cirrhotic patients attended at the Gastroenterology Service of the Teaching Military Hospital Dr. Mario Muñoz Monroy, in the period from January 2009 to December 2010. Methods: We carried out a crossed descriptive study, taking into account clinical variables necessary to classify the patients according to the stages contemplated at Baveno IV Consensus. The procedures of the descriptive statistics were applied. Results: 41 patients were studied, with a predomination of the male ones (82,9 %), average age 51,9 ± 9,2 years. Asthenia was the main reason of the consultation in the compensated stage. Most of the patients presented the compensated disease taking into account the clinical stage of the disease according to Baveno VI Methodological Consensus on Diagnostic and Treatment of the Portal Hypertension (56,1 %). Conclusions: with the application of the Baveno IV consensus criteria we arrived to the adequate clinical classification of the cirrhotic patients allowing an opportune therapeutic on behalf of them