Eliminación/Degradación de Triazinas Mediante Biorreactor de Membrana con Post-Tratamiento de Ozonización

The aim of the research was to evaluate the removal of micropollutants in a combined system MBR + ozonation. The research was carried out in a MBR scale laboratory plant which was fed with synthetic wastewater, doped with simazine (SIM), atrazine (ATZ) and terbutilazine (TBZ). The MBR operational conditions were: hydraulic retention time (HRT) of 20 h, organic loading rate (OLR) of 0.23 KgCOD/KgSSV·day, sludge retention time (SRT) of 30 d, and flux of 5.5 LMH. Two ozone doses were tested: low dose (16 mg O3/L) and high dose (45 mg O3/L). The removal eficiency of organic matter was 96%. For the studied triazines, low biodegradation effiencies were reached by biological treatment (MBR): 57%, 53% and 63% for SIM, ATZ and TBZ, respectively. The complementary treatment of ozonation improved the quality  of the effluents. At low ozonation dose the overall removal efficiencies increased to 95%, 92% and 96% for SIM, ATZ and TBZ, respectively. At high ozonization dose the overall removal efficiencies were 98%, 97% and 97 % for SIM, ATZ and TBZ, respectively, percentages slightly higher than those obtained at low dose. The results showed the combination of MBR + O3 is effective to remove micropollutants from wastewater, contributing to the preservation of a good ecological state of water bodies.Keywords: Bioreactor, Membrane, Ozone, Triazines, Herbicides

Relación de la calidad de vida profesional y el burnout en médicos de atención primaria

ObjetivoConocer la relación, si es que la hay, entre la calidad de vida profesional (CVP) y burnout de facultativos de atención primaria.DiseñoEstudio transversal mediante cuestionario CVP-35 y MBI (Maslach Burnout Inventory), por correo postal.ÁmbitoTres centros urbanos y 3 zonas de atención rural. Participó un total de 131 profesionalesMedicionesDel CVP-35 se obtienen puntuaciones que van de 0 (mínimo) a 10 (máximo). El cuestionario Maslach clasifica en nivel alto, medio y bajo de cada dimensión.ResultadosContestó a la encuesta el 71,7%. La edad media era de 44 años y la media de tarjetas sanitarias, 1.339. El número de consultas/día fue de 37; en cuanto las visitas domiciliarias, realizaban una diaria. El valor medio de la CVP fue de 4,48 (intervalo de confianza [IC] del 95%, 4,08-4,88). La percepción de la demanda tuvo una puntuación de 5,9 (IC del 95%, 5,6-6,1); la motivación intrínseca del profesional se situó en 6,5 (IC del 95%, 6,2-6,7) y el apoyo de los directivos en 3,8 (IC del 95%, 3,6-4,1). En cuanto al cuestionario MBI, se observó una despersonalización alta en el 54,3%, cansancio emocional alto en un 56,2% y realización personal alta en el 9,3%. La correlación mayor fue entre las demandas en el puesto y el cansancio emocional (r=0,6; p<0,0001), la motivación intrínseca y la realización personal (r=0,46; p<0,0001) y la calidad de vida profesional frente al cansancio emocional (r=−0,4; p<0,0005).ConclusionesLa CVP y el burnout miden dimensiones diferentes pero relacionadas. Por tanto, su utilidad es diferente en función de los objetivos. Con estos instrumentos se pueden identificar elementos clave de la gestión de personas que pueden mejorar la calidad de vida profesional.ObjectiveTo know the relationship, if this exists, between the quality of professional life (CPL) and the burnout of primary health care staff.DesignTransversal study employing CVP-35 test and MBI (Maslach Burnout Inventory), both sent by postmail.Setting3 urban centers and 3 rural centers. Total: 131 professionals.MeasuresIn the CVP-35 test, scores from 0 (minimum) to 100 (maximum) are obtained. Maslach categorised each dimension into high, medium and low level.Results71.7% answered. Medium age 44 years, average of 1339 sanitary cards. The number of visits/day was 37, home visits 1 per day. The CVP average was 4.48 (95% CI, 4.08-4.88). The damage perception in the post 5.9 (95% CI, 5.6-6.1); the professional intrinsic motivation 6.5 (95% CI, 6.2-6.7), and the manager support 3.8 (95% CI, 3.6-4.1). MBI: high depersonalization 54.3%, emotional exhaustion (r=0.6; P<.0001), intrinsic motivation, and personal accomplishment (r=0.46; P<.0001) and profesional quality of life front emotional fatigue (r= −0.4; P<.0005).ConclusionsCPL and burnout measure different but related dimensions. Therefore, its utility is dependent on the objectives. Target elements, which can improve the quality of professional life, can be identified from these tools

Mecanismos inductores y vías de la apoptosis en la diarrea vírica bovina

La apoptosis es una forma de muerte celular inducida por una gran variedad de estímulos, considerada como el resultado final de una cascada en la que intervienen una serie de enzimas denominadas caspasas, inducidas tanto por estímulos externos como internos. Entre éstas destacan las denominadas caspasas iniciadoras (2, 8, 9 y 10) y las caspasas ejecutoras o efectoras (3, 6 y 7). Existen dos vías principales reguladoras de la apoptosis: la vía extrínseca, inducida y mediada por receptores, la cual se inicia cuando un ligando apropiado se une a receptores de muerte localizados en la superficie celular, de modo que estas uniones ligando-receptor hacen que los dominios de muerte celular intracelulares y su unión a ciertas proteínas del citosol activen a las caspasas iniciadoras de esta vía (pe: caspasa 8), y la vía intrínseca o mitocondrial, gobernada por proteínas de la familia del Bcl-2 que agrupa un grupo de moléculas involucradas en la permeabilidad de la mitocondria, pudiéndose distinguir entre moléculas anti-apoptóticas y pro-apoptóticas. El desequilibrio en la expresión de estas moléculas incrementa la permeabilidad de la membrana mitocondrial, favoreciendo la liberación de proteínas al citosol y la activación de las caspasas iniciadora de esta vía (pe: caspasa 9). Una vez activadas las caspasas iniciadoras, éstas ejercerán su actividad proteolítica sobre las denominadas caspasas efectoras o ejecutoras (3, 6 y 7), las cuales, una vez activadas ejecutarán la muerte de forma irreversible. Junto a aspectos generales relacionados con los mecanismos y vías de la apoptosis, en este trabajo se abordan aspectos relacionados con dichos mecanismos en el transcurso de la diarrea vírica bovina, donde la apoptosis parece ser la responsable de la depleción linfoide y la leucopenia que caracterizan a esta enfermedad

Acumulación de Ag, Cu y Ni en sedimentos en una cuenca semiárida como sub-producto de la mina de oro El Triunfo, Baja California Sur, México

The dispersal of Ag, Cu, and Ni in mine wastes (tailings and ash) was studied from the source of an abandoned gold mine at El Triunfo (Baja California Sur, Mexico) to the adjacent coast of the Pacific Ocean. The highest contamination levels of the studied elements were measured in one sample of the tailings (Ag: 247 mg kg-1; Cu: 1660 mg kg-1; Ni: 111 mg kg-1). Horizontal and vertical distributions of these elements were obtained from the analysis of surface sediments, tailings, a test pit, a sediment core, and dunes. The background levels of these elements were estimated from independent methods. Then, these regional background level calculations were used to determine the normalised enrichment factors (NEFs). Relatively high NEF values (averages of Ag, Cu, and Ni were 24.0, 3.0, and 1.4, respectively) indicated that the area close to the mine waste zone (up to about 18 km from the source area) was moderately to severely polluted. Moderate to null pollution (average NEFs of Ag, Cu, and Ni were 7, 2 and 1, respectively) was interpreted for the area at about 18-49 km from the mine waste zone. Vertical distributions of the elements in sediments of the overbank, the test pit in the mine zone, and the sediment core (at the discharge of the main arroyo Hondo–Las Gallinas–El Carrizal), also revealed enrichment of Ag, Cu, and Ni relative to the surface sediments. This study indicated that historic and contemporary contamination continues to impact the fluvial environment.Se estudió la dispersión de Ag, Cu, y Ni, en desechos mineros (jales y cenizas) desde su origen en la mina de oro abandonada de El Triunfo (Baja California Sur, México) hasta su desembocadura en la costa adyacente al Océano Pacífico. Los mayores niveles de la contaminación de los elementos estudiados se presentan en los jales (Ag: 247 mg kg-1; Cu: 1660 mg kg-1; Ni: 111 mg kg-1). Se obtuvieron distribuciones horizontales y verticales de estos elementos a partir de los análisis de sedimentos superficiales, de deterun jale, de un pozo de ensayo, de un testigo y en las dunas adyacentes a la desembocadura del arroyo. Los niveles de fondo fueron calculados considerando varios métodos independientes. Luego, con estos cálculos de niveles de fondo se determinaron los Factores de Enriquecimiento Normalizados (NEFs). Los valores relativamente altos de NEF (promedios de Ag, Cu and Ni de 24.0, 3.0 y 1.4, respectivamente) indicaron que el área situada cerca de la zona minera (aproximadamente 18 km de los desechos mineros abandonados) se encuentra de moderada a severamente contaminada. Una contaminación moderada a nula (NEFs promedio de Ag, Cu y Ni: 7, 2 y 1, respectivamente) fue determinada en el área comprendida entre los 18 y los 49 km medidos desde el distrito minero. Las distribuciones verticales de los elementos en los sedimentos de los jales y el pozo de ensayo en la zona minera, así como en el testigo analizado en la desembocadura del arroyo principal (Arroyo Hondo – Las Gallinas – El Carrizal), muestran mayor enriquecimiento de Ag, Cu y Ni, que los sedimentos superficiales adyacentes. Este estudio indica que la contaminación histórica y contemporánea está impactando el ambiente fluvial

Educación y actividad intraempresarial en egresados universitarios colombianos

This article analyzes entrepreneurship education from the perspective of curricular courses, extracurricular activities, and postgraduate or continuing education in universities; and seeks to contribute to the theoretical evidence of the positive relationship between intrapreneurial activity and education in Colombian universities. For this purpose, a descriptive, correlational and non-experimental study has used contingency tables and a binomial logistic regression model with 3,152 graduates of various undergraduate degree programs from 120 universities. The findings suggest that taking entrepreneurship courses, participating in extracurricular activities, and having additional training after undergraduate degree studies increases the probability of being an intrapreneur. However, the probability is not significant if the graduate participated simultaneously in curricular and extracurricular activities. Post-undergraduate training is the one with the highest odd ratio in the model.El artículo analiza la educación emprendedora en los cursos curriculares, las actividades extracurriculares y la formación de posgrado o continua en universidades, y busca aportar evidencia de la relación positiva entre actividad intraempresarial y educación en egresados de universidades colombianas. Para ello, se llevó a cabo un estudio descriptivo, correlacional y no experimental, a través de tablas de contingencia y un modelo de regresión logística binomial, con 3.152 egresados de diversos programas de pregrado de 120 universidades. Los hallazgos sugieren que el hecho de haber cursado asignaturas curriculares de emprendimiento, participar en actividades extracurriculares y tener formación adicional después del pregrado aumenta la probabilidad de que un egresado sea intraempresario. No obstante, la probabilidad no es significativa si el egresado participó, de manera simultánea, tanto en actividades curriculares como en extracurriculares. La formación posterior al pregrado es la que presenta un odd ratio mayor en el modelo

Carbapenem-resistant Citrobacter spp. isolated in Spain from 2013 to 2015 produced a variety of carbapenemases including VIM-1, OXA-48, KPC-2, NDM-1 and VIM-2

Objectives: There is little information about carbapenemase-producing (CP) Citrobacter spp.We studied the molecular epidemiology and microbiological features of CP Citrobacter spp. isolates collected in Spain (2013-15). Methods: In total, 119 isolates suspected of being CP by the EUCAST screening cut-off values were analysed. Carbapenemases and ESBLs were characterized using PCR and sequencing. The genetic relationship among Citrobacter freundii isolates was studied by PFGE. Results: Of the 119 isolates, 63 (52.9%) produced carbapenemases, of which 37 (58.7%) produced VIM-1, 20 (31.7%) produced OXA-48, 12 (19%) produced KPC-2, 2 (3.2%) produced NDM-1 and 1 (1.6%) produced VIM- 2; 9 C. freundii isolates co-produced VIM-1 plus OXA-48. Fourteen isolates (22.2%) also carried ESBLs: 8 CTX-M-9 plus SHV-12, 2 CTX-M-9, 2 SHV-12 and 2 CTX-M-15. Fifty-seven isolates (90.5%) were C. freundii, 4 (6.3%) were Citrobacter koseri, 1 (1.6%) was Citrobacter amalonaticus and 1 (1.6%) was Citrobacter braakii. By EUCAST breakpoints, eight (12.7%) of the CP isolates were susceptible to the four carbapenems tested. In the 53 CP C. freundii analysed by PFGE, a total of 44 different band patterns were observed. Four PFGE clusters were identified: cluster 1 included eight isolates co-producing VIM-1 and OXA-48; blaVIM-1 was carried in a class 1 integron (intI-blaVIM-1 - aacA4-dfrB1-aadA1-catB2-qacE¿1/sul1) and blaOXA-48 was carried in a Tn1999.2 transposon. Conclusions: We observed the clonal and polyclonal spread of CP Citrobacter spp. across several Spanish geographical areas. Four species of Citrobacter spp. produced up to five carbapenemase types, including coproduction of VIM-1 plus OXA-48. Some CP Citrobacter spp. isolates were susceptible to the four carbapenems tested, a finding with potential clinical implications

Effectiveness and safety of first-generation protease inhibitors in clinical practice: Hepatitis C virus patients with advanced fibrosis

AIM: To evaluates the effectiveness and safety of the first generation, NS3/4A protease inhibitors (PIs) in clinical practice against chronic C virus, especially in patients with advanced fibrosis. METHODS: Prospective study and non-experimental analysis of a multicentre cohort of 38 Spanish hospitals that includes patients with chronic hepatitis C genotype 1, treatment-nai¨ve (TN) or treatment-experienced (TE), who underwent triple therapy with the first generation NS3/4A protease inhibitors, boceprevir (BOC) and telaprevir (TVR), in combination with pegylated interferon and ribavirin. The patients were treatment in routine practice settings. Data on the study population and on adverse clinical and virologic effects were compiled during the treatment period and during follow up. RESULTS: One thousand and fifty seven patients were included, 405 (38%) were treated with BOC and 652 (62%) with TVR. Of this total, 30% (n = 319) were TN and the remaining were TE: 28% (n = 298) relapsers, 12% (n = 123) partial responders (PR), 25% (n = 260) null-responders (NR) and for 5% (n = 57) with prior response unknown. The rate of sustained virologic response (SVR) by intention-to-treatment (ITT) was greater in those treated with TVR (65%) than in those treated with BOC (52%) (P < 0.0001), whereas by modified intention-to-treatment (mITT) no were found significant differences. By degree of fibrosis, 56% of patients were F4 and the highest SVR rates were recorded in the non-F4 patients, both TN and TE. In the analysis by groups, the TN patients treated with TVR by ITT showed a higher SVR (P = 0.005). However, by mITT there were no significant differences between BOC and TVR. In the multivariate analysis by mITT, the significant SVR factors were relapsers, IL28B CC and non-F4; the type of treatment (BOC or TVR) was not significant. The lowest SVR values were presented by the F4-NR patients, treated with BOC (46%) or with TVR (45%). 28% of the patients interrupted the treatment, mainly by non-viral response (51%): this outcome was more frequent in the TE than in the TN patients (57% vs 40%, P = 0.01). With respect to severe haematological disorders, neutropaenia was more likely to affect the patients treated with BOC (33% vs 20%, P = 0.0001), and thrombocytopaenia and anaemia, the F4 patients (P = 0.000, P = 0.025, respectively). CONCLUSION: In a real clinical practice setting with a high proportion of patients with advanced fibrosis, effectiveness of first-generation PIs was high except for NR patients, with similar SVR rates being achieved by BOC and TVR

External validation of multidimensional prognostic indices (ADO, BODEx and DOSE) in a primary care international cohort (PROEPOC/COPD cohort)

Background: Due to the heterogeneous and systemic nature of the chronic obstructive pulmonary disease (COPD), the new guidelines are oriented toward individualized attention. Multidimensional scales could facilitate its proper clinical and prognostic assessment, but not all of them were validated in an international primary care cohort, different from the original ones used for model development. Therefore, our main aim is to assess the prognostic capacity of the ADO, BODEx and DOSE indices in primary care for predicting mortality in COPD patients and to validate the models obtained in subgroups of patients, classified by revised Global Initiative for Chronic Obstructive Lung Disease (2011) and updated Spanish Guideline (2014). Besides, we want to confirm that the prognostic capacity of all indices increases if the number of exacerbations is substituted by the interval between them and to assess the impact on health of the patient''s lifestyle, social network and adherence to treatment. Methods: Design: External validation of scales, open and prospective cohort study in primary care. Setting: 36 health centres in 6 European high, medium and low income countries. Subjects: 477 patients diagnosed with COPD, captured in clinical visit by their General Practitioner/Nurse. Predictors: Detailed patient history, exacerbations, lung function test and questionnaires at baseline. Outcomes: Exacerbations, all-cause mortality and specific mortality, within 5 years of recruitment. Analysis: Multivariate logistic regression and Cox regression will be used. Possible non-linear effect of the indices will be studied by using Structured Additive Regression models with penalised splines. Subsequently, we will assess different aspects of the regression models: discrimination, calibration and diagnostic precision. Clinical variables modulated in primary care and the interval between exacerbations will be considered and incorporated into the analysis. Discussion: The Research Agenda for General Practice/Family Medicine highlights that the evidence on predictive values of prognostic indices in primary care is scarce. A prospective cohort like that of PROEPOC/COPD provides good opportunities for research into COPD and make communication easier between family practitioners, nursing staff, pneumologists and other professionals, supporting a multi-disciplinary approach to the treatment of these patients. Trial registration:ISRCTN52402811. Date: 15/01/2015. Prospectively registered