Metallic impurities in the Cu-fraction of Ni targets prepared from NiCl2 solutions

Introduction Copper-64 is an emerging radionuclide with applications in PET molecular imaging and/or internal therapy and it is typically produced by proton irradiation of isotopically enriched 64Ni electrodeposited on a suitable backing substrate. We recently reported a simple and efficient method for the preparation of nickel targets from electrolytic solutions of nickel chloride and boric acid [1]. Herein we report our recent research work on the analysis of metallic impurities in the copper-fraction of the radiochemical separation process. Material and Methods Nickel targets were prepared and processed as previously reported [1]. Briefly, the bath solution was composed of a mixture of natural NiCl2. 6H2O (135 mg/ml) and H3BO3 (15 mg/ml) and Ni was electrodeposited using a gold disk as cathode and a platinum wire as anode. The plating process was carried out at room temperature using 2 ml of bath solution (pH = 3.7) and a constant current density of 60 mA/cm2 for 1 hour. The unirradiated Ni targets were dissolved in 1–2 ml of concentrated (10M) HCl at 90 oC. After complete dissolution of the Ni layer, water was added to dilute the acid to 6M, and the solution was transferred onto a chromatographic column containing AG 1-X8 resin equilibrated with 6M HCl. The Ni , Co and Cu isotopes were separated by using the well-known chromatography of the chloro-complexes. The sample-fractions containing the Cu isotopes (15 ml, 0.1M HCl) were collected in plastic centrifuge tubes previously soaked in 1M HNO3 and rinsed with Milli-Q water (18 MΩ cm). Impurities of B, Co, Ni, Cu and Zn in these samples were determined by inductively coupled plasma-mass spectroscopy (ICP-MS) at the Department of Geosciences (Laboratory of Isotopic Studies) of the National University. Results and Conclusions The mass of Ni deposited in 1 h was 25.0 ± 1.0 mg (n = 3) and the current efficiency was > 75 % in all cases. The pH of the electrolytic solution tended to decrease along the electrodeposition process (3.71.6). The results of ICP-MS analysis of the Cu-fractions from the cold chromatography separation runs are shown in FIG. 1. We were particularly interested in the boron impurities as H3BO3 is used as buffer for electrodeposition of the Ni targets. Except for the Ni impurities that were deter-mined to be in the range of ppm (mg/l), all other analyzed metallic impurities were found to be in the range of ppb (µg/l), including boron. The Co, Ni, Cu and Zn impurities determined in the Cu-fraction in this work using Ni targets electrode-posited from a NiCl2 acidic solution, are in the same order of magnitude compared with that obtained when using targets prepared from an alkaline solution [2], with the advantage of the simplicity of the electrodeposition method from NiCl2 solutions, as the target material is already recovered in the chemical form of NiCl2, enabling a simpler, one step process to prepare a new plating solution when using enriched 64Ni target material for the production of 64Cu

Origen y razones del consumo de psicofármacos y analgésicos en la población general.

Se investiga en este trabajo el origen y razones del consumo de psicofármacos y analgésicos en una comunidad de Cantabria. El 2,6± 1% de los varones y el 10,7 ±2% de las mujeres consumen psicofármacos, siendo para ambos sexos los porcentajes de consumo de analgésicos significativamente más altos (varones = 6,5 ± 2 %; mujeres = 16,4 ± 3 %). Distintos factores como el sexo femenino o la presencia de enfermedad física o psíquica incrementan de forma significativa el consumo de dichos fármacos. Se observó, sin embargo, que la presencia de enfermedad psíquica (medida mediante el sistema PSECA TEGO-ID) se asociaba a tratamiento psicofarmacológico sólo en un reducido número de casos. Es más, en aquellos cuadros depresivos o psicóticos que recibían tratamiento farmacológico, éste solía pertenecer al grupo de las benzodiacepinas. Se evidenció además en nuestro estudio una clara interacción entre factores psicosociales y los modos o formas de consumo definidos como "auto-consumo" o "consumo bajo control médico ". Dicha interacción demuestra la existencia de perfiles sociodemográficos específicos para cada uno de dichos modos de consumo

Origen y razones del consumo de psicofármacos y analgésicos en la población general.

Se investiga en este trabajo el origen y razones del consumo de psicofármacos y analgésicos en una comunidad de Cantabria. El 2,6± 1% de los varones y el 10,7 ±2% de las mujeres consumen psicofármacos, siendo para ambos sexos los porcentajes de consumo de analgésicos significativamente más altos (varones = 6,5 ± 2 %; mujeres = 16,4 ± 3 %). Distintos factores como el sexo femenino o la presencia de enfermedad física o psíquica incrementan de forma significativa el consumo de dichos fármacos. Se observó, sin embargo, que la presencia de enfermedad psíquica (medida mediante el sistema PSECA TEGO-ID) se asociaba a tratamiento psicofarmacológico sólo en un reducido número de casos. Es más, en aquellos cuadros depresivos o psicóticos que recibían tratamiento farmacológico, éste solía pertenecer al grupo de las benzodiacepinas. Se evidenció además en nuestro estudio una clara interacción entre factores psicosociales y los modos o formas de consumo definidos como "auto-consumo" o "consumo bajo control médico ". Dicha interacción demuestra la existencia de perfiles sociodemográficos específicos para cada uno de dichos modos de consumo

Research Priorities for Neglected Infectious Diseases in Latin America and the Caribbean Region

Dujardin, J. C. et al. 5 p.-1 tab.Global priorities for research in neglected infectious diseases (NIDs) can be assessed in different ways, but it is important to realize that regional priorities may significantly differ one from another. The region of Latin America and the Caribbean (LAC) is—along with Africa and Asia—more affected by NIDs than other regions of the world. Some of the Latin American NIDs are common to other continents, while others are very specific or disproportionately affect the Latin American region [1– 3] (Table 1). Because of its huge ecological diversity, ongoing environmental changes, and massive migrations, LAC is also a catalyst for the (re-)emergence and spreading of NIDs, both inside and outside the subcontinent. Following a colloquium on NIDs in LAC held in Lima, Peru, between 12 and 14 November 2009, a thematic workshop was organized with the support of the European Commission (EC). It involved 29 scientists (16 from the Americas, two from the Democratic Republic of Congo and India, respectively, and nine from Europe) working on different NIDs and representing several research areas from basic to applied. This report summarizes the consensus comments of the expert group after oral and written consultation. It is envisaged that this document should stimulate a debate within the scientific community and serve as a recommendation for future actions by international or regional funding agencies in the area of NIDs in LACThis work was supported by the Directorate-General for Development Cooperation of the Belgian Government (framework agreement 03, project 95502) and the European CommissionPeer reviewe

Anticoagulant selection in relation to the SAMe-TT2R2 score in patients with atrial fibrillation. the GLORIA-AF registry

Aim: The SAMe-TT2R2 score helps identify patients with atrial fibrillation (AF) likely to have poor anticoagulation control during anticoagulation with vitamin K antagonists (VKA) and those with scores >2 might be better managed with a target-specific oral anticoagulant (NOAC). We hypothesized that in clinical practice, VKAs may be prescribed less frequently to patients with AF and SAMe-TT2R2 scores >2 than to patients with lower scores. Methods and results: We analyzed the Phase III dataset of the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF), a large, global, prospective global registry of patients with newly diagnosed AF and ≥1 stroke risk factor. We compared baseline clinical characteristics and antithrombotic prescriptions to determine the probability of the VKA prescription among anticoagulated patients with the baseline SAMe-TT2R2 score >2 and ≤ 2. Among 17,465 anticoagulated patients with AF, 4,828 (27.6%) patients were prescribed VKA and 12,637 (72.4%) patients an NOAC: 11,884 (68.0%) patients had SAMe-TT2R2 scores 0-2 and 5,581 (32.0%) patients had scores >2. The proportion of patients prescribed VKA was 28.0% among patients with SAMe-TT2R2 scores >2 and 27.5% in those with scores ≤2. Conclusions: The lack of a clear association between the SAMe-TT2R2 score and anticoagulant selection may be attributed to the relative efficacy and safety profiles between NOACs and VKAs as well as to the absence of trial evidence that an SAMe-TT2R2-guided strategy for the selection of the type of anticoagulation in NVAF patients has an impact on clinical outcomes of efficacy and safety. The latter hypothesis is currently being tested in a randomized controlled trial. Clinical trial registration: URL: https://www.clinicaltrials.gov//Unique identifier: NCT01937377, NCT01468701, and NCT01671007

Anti-tumour necrosis factor discontinuation in inflammatory bowel disease patients in remission: study protocol of a prospective, multicentre, randomized clinical trial

Background: Patients with inflammatory bowel disease who achieve remission with anti-tumour necrosis factor (anti-TNF) drugs may have treatment withdrawn due to safety concerns and cost considerations, but there is a lack of prospective, controlled data investigating this strategy. The primary study aim is to compare the rates of clinical remission at 1?year in patients who discontinue anti-TNF treatment versus those who continue treatment. Methods: This is an ongoing, prospective, double-blind, multicentre, randomized, placebo-controlled study in patients with Crohn?s disease or ulcerative colitis who have achieved clinical remission for ?6?months with an anti-TNF treatment and an immunosuppressant. Patients are being randomized 1:1 to discontinue anti-TNF therapy or continue therapy. Randomization stratifies patients by the type of inflammatory bowel disease and drug (infliximab versus adalimumab) at study inclusion. The primary endpoint of the study is sustained clinical remission at 1?year. Other endpoints include endoscopic and radiological activity, patient-reported outcomes (quality of life, work productivity), safety and predictive factors for relapse. The required sample size is 194 patients. In addition to the main analysis (discontinuation versus continuation), subanalyses will include stratification by type of inflammatory bowel disease, phenotype and previous treatment. Biological samples will be obtained to identify factors predictive of relapse after treatment withdrawal. Results: Enrolment began in 2016, and the study is expected to end in 2020. Conclusions: This study will contribute prospective, controlled data on outcomes and predictors of relapse in patients with inflammatory bowel disease after withdrawal of anti-TNF agents following achievement of clinical remission. Clinical trial reference number: EudraCT 2015-001410-1

Research priorities for neglected infectious diseases in Latin America and the Caribbean Region

Global priorities for research in neglected infectious diseases (NIDs) can be assessed in different ways, but it is important to realize that regional priorities may significantly differ one from another. The region of Latin America and the Caribbean (LAC) is—along with Africa and Asia—more affected by NIDs than other regions of the world. Some of the Latin American NIDs are common to other continents, while others are very specific or disproportionately affect the Latin American region [1– 3] (Table 1). Because of its huge ecological diversity, ongoing environmental changes, and massive migrations, LAC is also a catalyst for the (re-)emergence and spreading of NIDs, both inside and outside the subcontinent. Following a colloquium on NIDs in LAC held in Lima, Peru, between 12 and 14 November 2009, a thematic workshop was organized with the support of the European Commission (EC). It involved 29 scientists (16 from the Americas, two from the Democratic Republic of Congo and India, respectively, and nine from Europe) working on different NIDs and representing several research areas from basic to applied. This report summarizes the consensus comments of the expert group after oral and written consultation. It is envisaged that this document should stimulate a debate within the scientific community and serve as a recommendation for future actions by international or regional funding agencies in the area of NIDs in LAC. (Párrafo extraído del texto a modo de resumen)Facultad de Ciencias Médica

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

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