Propuesta de un modelo de minería circular a partir de datos hidrogeoquímicos asociados a escombreras de la faja pirítica ibérica (SW España)

info:eu-repo/semantics/publishedVersio

Caracterización hidrogeoquímica de efluentes de escombreras en el grupo minero la Zarza-Perruna

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Estudio hidroquímico de los embalses afectados por procesos de drenaje ácido de mina en la faja pirítica ibérica

info:eu-repo/semantics/publishedVersio

Are Cu isotopes a useful tool to trace metal sources and processes in acid mine drainage (AMD) context?

In the South-West Europe (Iberian Pyrite Belt), acid mine drainage (AMD) processes are especially problematic because they affect the environmental quality of watersheds, restricting the use of surface water. Recent studies have shown that Cu isotopes are fractionated during the oxidative dissolution of primary sulfide minerals and could be used to trace metal cycling. However the chemistry of Cu in such environment is complex because Cu is redistributed within numerous secondary minerals and strongly dependent on the hydroclimatic conditions that control key parameters (pH, redox conditions). Finally, it remains difficult to compare the various field studies and deliver some strong general tendencies because of these changing conditions. For these reasons, concerted studies on Cu isotopes fractionation in waters impacted by AMD may help to reveal the sources and transport pathways of this important pollutant. To address this issue, we used a representative scenario of strong contamination by AMD in the Iberian Pyrite Belt (SW Spain), the Cobica River. The aim of our study is to measure the Cu isotopes signature in the waters (river, mine lake, water draining waste) of the small Cobica River system (Huelva, Spain), sampled during a short period (8 h) to avoid any change in the hydro-climatic conditions. This provided an instantaneous image of the isotopic Cu signature in a small mining systems and helped us to constrain both the processes affecting Cu isotopes and their use a potential tracer of metals in contaminated environments.This work was supported by the french national programme EC2CO Biohefect/Ecodyn//Dril/MicrobiEen (INSU/CNRS, France), the Paul Sabatier University (France) and the Department of Mining, Mechanical, Energetic and Construction Engineering of the University of Huelva (Spain)

Development and Validation of a Model to Predict Severe Hospital-Acquired Acute Kidney Injury in Non-Critically Ill Patients

Lesión renal aguda; Registros electrónicos de datos de salud; Adquirido en el hospitalLesió renal aguda; Registres electrònics de dades de salut; Adquirit a l'HospitalAcute kidney injury; Electronic health data records; Hospital-acquiredBackground. The current models developed to predict hospital-acquired AKI (HA-AKI) in non-critically ill fail to identify the patients at risk of severe HA-AKI stage 3. Objective. To develop and externally validate a model to predict the individual probability of developing HA-AKI stage 3 through the integration of electronic health databases. Methods. Study set: 165,893 non-critically ill hospitalized patients. Using stepwise logistic regression analyses, including demography, chronic comorbidities, and exposure to risk factors prior to AKI detection, we developed a multivariate model to predict HA-AKI stage 3. This model was then externally validated in 43,569 non-critical patients admitted to the validation center. Results. The incidence of HA-AKI stage 3 in the study set was 0.6%. Among chronic comorbidities, the highest odds ratios were conferred by ischemic heart disease, ischemic cerebrovascular disease, chronic congestive heart failure, chronic obstructive pulmonary disease, chronic kidney disease and liver disease. Among acute complications, the highest odd ratios were associated with acute respiratory failure, major surgery and exposure to nephrotoxic drugs. The model showed an AUC of 0.906 (95% CI 0.904 to 0.908), a sensitivity of 89.1 (95% CI 87.0–91.0) and a specificity of 80.5 (95% CI 80.2–80.7) to predict HA-AKI stage 3, but tended to overestimate the risk at low-risk categories with an adequate goodness-of-fit for all risk categories (Chi2: 16.4, p: 0.034). In the validation set, incidence of HA-AKI stage 3 was 0.62%. The model showed an AUC of 0.861 (95% CI 0.859–0.863), a sensitivity of 83.0 (95% CI 80.5–85.3) and a specificity of 76.5 (95% CI 76.2–76.8) to predict HA-AKI stage 3 with an adequate goodness of fit for all risk categories (Chi2: 15.42, p: 0.052). Conclusions. Our study provides a model that can be used in clinical practice to obtain an accurate dynamic assessment of the individual risk of HA-AKI stage 3 along the hospital stay period in non-critically ill patients.This research received no external funding

Cómo la pandemia del COVID-19 afectó emocional y económicamente a los actores de teatro en Miraflores de Lima, Perú

La pandemia por COVID 19 afectó a muchos sectores como la educación, la salud, el entretenimiento, entre otros. En consecuencia, las actividades laborales se suspendieron parcial o totalmente. En consecuencia, muchas actividades culturales han sido clausuradas indefinidamente. Entre ellas se encuentra el teatro, cuyo nivel de presencialidad es imprescindible para su desarrollo. Este problema se extiende aún más si se considera la falta de apoyo a esta actividad en algunos países como Perú

The Prevention of Postmenopausal Osteoporotic Fractures: Results of the Health Technology Assessment of a New Antiosteoporotic Drug

Objective. The Health Technology Assessment (HTA) approach was applied to denosumab in the prevention of osteoporotic fractures in postmenopausal women. Method. Epidemiological, clinical, technical, economic, organizational, and ethical aspects were considered. Medical electronic databases were accessed to evaluate osteoporosis epidemiology and therapeutical approaches. A budget impact and a cost-effectiveness analyses were performed to assess economic implications. Clinical benefits and patient needs were considered with respect to organizational and ethical evaluation. Results. In Italy around four millions women are affected by osteoporosis and have a higher risk for fractures with 70,000 women being hospitalized every year. Bisphosphonates and strontium ranelate are recommended as first line treatment for the prevention of osteoporotic fractures. Denosumab is effective in reducing vertebral, nonvertebral, and hip/femoral fractures with an advantage of being administered subcutaneously every six months. The budget impact analysis estimated a reduction in costs for the National Health Service with the introduction of denosumab. Furthermore, the economic analysis demonstrated that denosumab is cost-effective in comparison to oral bisphosphonates and strontium ranelate. Denosumab can be administered in outpatients by involving General Practitioners in the management. Ethical evaluation is positive because of its efficacy and compliance. Conclusion. Denosumab could add value in the prevention of osteoporotic fractures

Papel de las diatomeas como indicadores del grado de afección de embalses receptores de AMD: influencia del PH en el modo de ocurrencia

Este trabajo se basa en el estudio de 23 embalses ubicados en la Faja Pirítica Ibérica para llevar a cabo una clasificación ambiental basada en las comunidades de Diatomeas, con especial interés en aquellas acidófilas o ácido tolerantes, para definer la relación de estas comunidades con la físico-química de las aguas. Para ello, la distribución de diatomeas bentónicas se ha caracterizado, en particular en relación con el pH del medio, que ha permitido entender el papel de las diatomeas como indicadores de AMD en los embalses. Los resultados obtenidos confirmaron que las comunidades de diatomeas responden a variaciones en el pH y que el análisis cluster refleja los cambios en las comunidades de los embalses. Se verificó una relación de dependencia entre la abundancia y la distribución de las especies en relación con el pH del agua.Twenty three reservoirs located in the Iberian Pyrite Belt were studied in order to carry out an environmental assessment based on the communities of Diatoms, with special interest in those that present an acidophilic or acid-tolerant profile and to define the relation of these communities with the physical-chemical characteristics of the water. For this purpose, the distribution of benthic diatoms has been studied, in particular in relation to the pH of the medium, which has allowed. understanding the role of diatoms as indicators of AMD in the reservoirs. The obtained results confirmed that the diatom communities respond to variations in pH and that the cluster analysis reflects those changes in the communities of the reservoirs. A relationship of dependence between the abundance and distribution of the species under study with respect to the pH of the water was verified.info:eu-repo/semantics/publishedVersio

ECAMulticapa: Effectiveness of double-layered compression therapy for healing venous ulcers in primary care: a Study Protocol

Background: Chronic venous insufficiency, in its final stage can cause venous ulcers. Venous ulcers have a prevalence of 0.5 % to 0.8 % in the general population, and increases starting at 60 years of age. This condition often causes increased dependency in affected individuals, as well as a perceived reduced quality of life and family overload. Local Treating chronic venous ulcers has 2 components: topically healing the ulcer and controlling the venous insufficiency. There is evidence that compressive therapy favours the healing process of venous ulcers. The studies we have found suggest that the use of multilayer bandage systems is more effective than the use of bandages with a single component, these are mostly using in Spain. Multilayer compression bandages with 2 layers are equally effective in the healing process of chronic venous ulcers as 4-layer bandages and are better tolerated and preferenced by patients. More studies are needed to specifically compare the 2-layer bandages systems in the settings where these patients are usually treated. Method/design: Randomised, controlled, parallel, multicentre clinical trial, with 12 weeks of follow-up and blind evaluation of the response variable. The objective is to assess the efficacy of multilayer compression bandages (2 layers) compared with crepe bandages, based on the incidence of healed venous ulcers in individuals treated in primary care nursing consultations, at 12 weeks of follow-up. The study will include 216 individuals (108 per branch) with venous ulcers treated in primary care nursing consultations. The primary endpoint is complete healing at 12 weeks of follow-up. The secondary endpoints are the degree of healing (Resvech.2), quality of life (CCVUQ-e), adverse reactions related to the healing process. Prognosis and demographic variables are also recorder. Effectiveness analysis using Kaplan-Meier curves, a log-rank test and a Cox regression analysis. The analysis was performed by intention to treat. Discussion: The study results can contribute to improving the care and quality of life of patients with venous ulcers, decreasing healing times and healthcare expenditure and contributing to the consistent treatment of these lesions. Trial registration: This study has been recorded in the Clinical Trials.gov site with the code NCT02364921. 17 February 2015.This study was funded by PN of I + D + I 2013–2016 and the ISCIII – Subdirección General de Evaluación y Fomento de la Investigación and FEDER funds (PI13/01975). Ministerio de Economia y Competitividad

Axillary node metastasis from differentiated thyroid carcinoma with hürthle and signet ring cell differentiation. A case of disseminated thyroid cancer with peculiar histologic findings

<p>Abstract</p> <p>Background</p> <p>Differentiated thyroid cancer is usually associated with an excellent prognosis and indolent course. Distant metastases are rare events at the onset of thyroid cancer. Among these presentations, metastasis to the axillary lymph nodes is even more unusual: only few cases were previously reported in the literature; there has been no report of axillary lymph node metastasis from follicular thyroid carcinoma. Axillary lymph node metastasis generally arises in the context of disseminated disease and carries an ominous prognosis.</p> <p>Case presentation</p> <p>Here we present a case of axillary lymph node metastasis in the context of disseminated differentiated thyroid cancer. The patient underwent near total thyroidectomy and neck and axillary lymph node dissection. A histopathological diagnosis of poorly differentiated follicular carcinoma with "signet ring cells" and Hürthle cell features was established. The patient received radioactive iodine therapy and TSH suppression therapy. Subsequently his serum thyroglobulin level decreased to 44.000 ng/ml from over 100.000 ng/ml.</p> <p>Discussion and Conclusion</p> <p>Currently there are only few reported cases of axillary node metastases from thyroid cancer, and to our knowledge, this is the first report on axillary lymph node metastasis from follicular thyroid carcinoma. "Signet ring cell" is a morphologic feature shared by both benign and, more rarely, malignant follicular thyroid neoplasm, and it generally correlates with an arrest in folliculogenesis. Our case is one of the rare "signet ring cells" carcinomas so far described.</p