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In this work, a pilot biobed was built up to treat pesticide-contaminated wastewaters discharged from a formulation plant. The pre-treated wastewater was spiked with additional pesticides in order to simulate a scenario of higher contamination: glyphosate, atrazine, imidacloprid, prometryn and carbendazim were added to reach a final Total Organic Carbon (TOC) concentration of 70 mg L-1. An Intermediate Bulk Container (IBC) was filled with a biomixture of soil and foxtail millet stubble (50:50% v v-1), and 200 l of the wastewater was added to the system recycling tank. The recirculation to the IBC was established for 12 h. After that (Day 0), the recirculation was turned on during the assay only to maintain the moisture for 180 days. Biomixture and wastewater samples were taken periodically to analyse pesticides and phytotoxicity in both matrices. In addition, hydrolytic and phenoloxidase activities, total bacteria and yeast and fungi communities were determined in the biomixture. The designed pilot scale biobed allowed to treat wastewaters with high concentration of pesticides reaching a complete removal of glyphosate, AMPA, atrazine, carbendazim and prometryn at 180 days. A good degradation percentage of the recalcitrant imidacloprid was achieved (60%) and the biomixture showed enough biological activity to continue treating additional wastewater. The root elongation index from the germination test showed low toxicity on day 180 both in biomixture and wastewater. The millet stubble resulted an appropriate lignocellulosic material to be used in biobeds to treat a wide variety of pesticides. The application of the seed germination test proved to be a low cost and simple tool to determine the end point of the process.
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Plaguicidas , Contaminantes del Suelo , Biodegradación Ambiental , Plaguicidas/análisis , Suelo , Aguas ResidualesRESUMEN
BACKGROUND: After appendectomy due to complicated acute appendicitis (CAA), there are some alternatives as antibiotic scheme: ciprofloxacin/metronidazole; as well as monoscheme based on carbapenems: ertapenem, meropenem, and imipenem. AIM: This study aims to prove the efficacy of carbapenems versus ciprofloxacin/metronidazole in CAA post-operative management in terms of preventing complications during post-operative period and decreasing hospital stay. MATERIALS AND METHODS: This was an observational, analytical, longitudinal, and prospective cohort study (March 2014-November 2016). Patients were classified into two groups, according to the prescribed antibiotic scheme: some carbapenems or ciprofloxacin/metronidazole. RESULTS: Ninety-eight patients were enrolled. There was an requirement for antibiotic therapy rotation only in the ciprofloxacin/metronidazole (7/49, 14.3%; p = 0.004). Carbapenems reached a mean hospital stay of 4.45 days, in contrast with ciprofloxacin/metronidazole, 8.29 days (p = 0.020). In post-surgical follow-up, there were more cases of curative resolution in the group in the carbapenems group (35/49 vs. 15/49 p < 0.001) as well as a greater number of cases with some late infection in the ciprofloxacin/metronidazole group (1/49 vs. 10/49, p = 0.010). CONCLUSION: In the post-operative management of CAA, carbapenems represent an important indication to be considered as first-line antibiotic therapy.
ANTECEDENTES: Tras la cirugía por apendicitis aguda complicada existen varias alternativas de esquema antibiótico, entre las que destacan ciprofloxacino/metronidazol, o bien monoterapia con algún carbapenémico, como ertapenem, meropenem e imipenem. OBJETIVO: Determinar la eficacia de los carbapenémicos en comparación con ciprofloxacino/metronidazol en el manejo posquirúrgico de la apendicitis aguda complicada, en términos de prevención de complicaciones durante el posoperatorio y de reducción de la estancia hospitalaria. MÉTODO: Estudio observacional, analítico, longitudinal, prospectivo y de cohorte, de marzo de 2014 a noviembre de 2016. Los pacientes fueron clasificados en dos grupos según el esquema antibiótico prescrito: un carbapenémico o ciprofloxacino/metronidazol. RESULTADOS: Se seleccionaron 98 pacientes. Solo hubo necesidad de rotación de antibiótico en el grupo de ciprofloxacino/metronidazol (7 de 49, 14.3%; p = 0.004). En el grupo de carbapenémico, la media de estancia hospitalaria fue de 4.45 días, y en el grupo de ciprofloxacino/metronidazol fue de 8.29 días (p = 0.020). En el seguimiento posquirúrgico hubo más casos de resolución curativa en el grupo de carbapenémico (35 de 49 vs. 15 de 49; p < 0.001), así como un mayor número de casos con alguna infección tardía en el grupo de ciprofloxacino/metronidazol (1 de 49 vs. 10 de 49; p < 0.001). CONCLUSIÓN: En el manejo posquirúrgico de la apendicitis aguda complicada, los carbapenémicos representan una importante indicación que debe considerarse como antibioticoterapia de primera línea.
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Antibacterianos/uso terapéutico , Apendicectomía , Apendicitis/tratamiento farmacológico , Carbapenémicos/uso terapéutico , Ciprofloxacina/uso terapéutico , Metronidazol/uso terapéutico , Adulto , Anciano , Antibacterianos/administración & dosificación , Profilaxis Antibiótica , Apendicitis/complicaciones , Apendicitis/epidemiología , Apendicitis/cirugía , Ciprofloxacina/administración & dosificación , Comorbilidad , Quimioterapia Combinada , Ecuador/epidemiología , Urgencias Médicas , Femenino , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Metronidazol/administración & dosificación , Persona de Mediana Edad , Complicaciones Posoperatorias/prevención & control , Estudios Prospectivos , Sepsis/tratamiento farmacológico , Sepsis/etiología , Adulto JovenRESUMEN
Background: Intestinal malrotation is a rare congenital anomaly. In adults is very difficult to recognize due to the lack of symptoms. Diagnosis is usually incidental during surgical procedures or at autopsy. Aim: To review the occurrence and recognition of uneventful intestinal malrotation discovered during regular cases of bariatric surgeries. Methods: Were retrospectively reviewed the medical registry of 20,000 cases undergoing bariatric surgery, from January 2002 to January 2016, looking for the occurrence of intestinal malrotation and consequences in the intraoperative technique and immediate evolution of the patients. Results: Five cases (0,025%) of intestinal malrotation were found. All of them were males, aging 45, 49, 37,52 and 39 years; BMI 35, 42, 49, 47 and 52 kg/m2, all of them with a past medical history of morbid obesity. The patient with BMI 35 kg/m2 suffered from type 2 diabetes also. All procedures were completed by laparoscopic approach, with no conversions. In one patient was not possible to move the jejunum to the upper abdomen in order to establish the gastrojejunostomy and a sleeve gastrectomy was performed. In another patient was not possible to fully recognize the anatomy due to bowel adhesions and a single anastomosis gastric bypass was preferred. No leaks or bleeding were identified. There were no perioperative complications. All patients were discharged 72 h after the procedure and no immediate 30-day complications were reported. Conclusion: Patients with malrotation can successfully undergo laparoscopic bariatric surgery. May be necessary changes in the surgical original strategy regarding the malrotation. Surgeons must check full abdominal anatomical condition prior to start the division of the stomach.
Racional: Má-rotação intestinal é rara anomalia congênita em adultos de difícil reconhecimento devido à falta de sintomas. O diagnóstico é feito geralmente incidentalmente durante procedimentos cirúrgicos ou durante autópsia. Objetivo: Verificar a ocorrência e reconhecimento não eventual da má-rotação intestinal durante operações bariátricas sequenciais. Métodos: Retrospectivamente foram analisados os prontuários médicos de 20.000 casos de operações bariátricas de janeiro 2002 a janeiro de 2016, procurando por ocorrência de má-rotação intestinal, sua interferência na técnica operatória aplicada e a evolução imediata no pós-operatório. Resultados: Foram encontrados cinco casos (0.025%) de má-rotação intestinal em homens com idades de 37, 39, 45, 49 e 52 anos e IMC de 35, 42, 49, 47 e 52 kg/m2. O paciente com IMC de 35 kg/m2 também sofria de diabete melito tipo 2. Todos os procedimentos foram realizados através de laparoscopia, sem conversões. Em um paciente não foi possível mover o jejuno para o abdome superior a fim de realizar gastrojejunostomia; foi, então, realizada gastrectomia vertical. Em outro paciente, não foi possível reconhecer totalmente a anatomia devido às aderências intestinais e foi decidido realizar bypass gástrico com anastomose única. Nenhum vazamento ou sangramento foi identificado. Não houve nenhuma complicação pós-operatória. Todos os pacientes foram liberados 72 h após o procedimento e nenhuma complicação foi notificada nos primeiros 30 dias. Conclusão: A cirurgia bariátrica laparoscópica pode ser realizada com sucesso em pacientes com má-rotação. Mudanças talvez sejam necessárias com relação à anomalia. Os cirurgiões devem verificar toda a condição anatômica abdominal antes de iniciar a secção gástrica.
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ABSTRACT Background: Intestinal malrotation is a rare congenital anomaly. In adults is very difficult to recognize due to the lack of symptoms. Diagnosis is usually incidental during surgical procedures or at autopsy. Aim: To review the occurrence and recognition of uneventful intestinal malrotation discovered during regular cases of bariatric surgeries. Methods: Were retrospectively reviewed the medical registry of 20,000 cases undergoing bariatric surgery, from January 2002 to January 2016, looking for the occurrence of intestinal malrotation and consequences in the intraoperative technique and immediate evolution of the patients. Results: Five cases (0,025%) of intestinal malrotation were found. All of them were males, aging 45, 49, 37,52 and 39 years; BMI 35, 42, 49, 47 and 52 kg/m2, all of them with a past medical history of morbid obesity. The patient with BMI 35 kg/m2 suffered from type 2 diabetes also. All procedures were completed by laparoscopic approach, with no conversions. In one patient was not possible to move the jejunum to the upper abdomen in order to establish the gastrojejunostomy and a sleeve gastrectomy was performed. In another patient was not possible to fully recognize the anatomy due to bowel adhesions and a single anastomosis gastric bypass was preferred. No leaks or bleeding were identified. There were no perioperative complications. All patients were discharged 72 h after the procedure and no immediate 30-day complications were reported. Conclusion: Patients with malrotation can successfully undergo laparoscopic bariatric surgery. May be necessary changes in the surgical original strategy regarding the malrotation. Surgeons must check full abdominal anatomical condition prior to start the division of the stomach.
RESUMO Racional: Má-rotação intestinal é rara anomalia congênita em adultos de difícil reconhecimento devido à falta de sintomas. O diagnóstico é feito geralmente incidentalmente durante procedimentos cirúrgicos ou durante autópsia. Objetivo: Verificar a ocorrência e reconhecimento não eventual da má-rotação intestinal durante operações bariátricas sequenciais. Método: Retrospectivamente foram analisados os prontuários médicos de 20.000 casos de operações bariátricas de janeiro 2002 a janeiro de 2016, procurando por ocorrência de má-rotação intestinal, sua interferência na técnica operatória aplicada e a evolução imediata no pós-operatório. Resultados: Foram encontrados cinco casos (0.025%) de má-rotação intestinal em homens com idades de 37, 39, 45, 49 e 52 anos e IMC de 35, 42, 49, 47 e 52 kg/m2. O paciente com IMC de 35 kg/m2 também sofria de diabete melito tipo 2. Todos os procedimentos foram realizados através de laparoscopia, sem conversões. Em um paciente não foi possível mover o jejuno para o abdome superior a fim de realizar gastrojejunostomia; foi, então, realizada gastrectomia vertical. Em outro paciente, não foi possível reconhecer totalmente a anatomia devido às aderências intestinais e foi decidido realizar bypass gástrico com anastomose única. Nenhum vazamento ou sangramento foi identificado. Não houve nenhuma complicação pós-operatória. Todos os pacientes foram liberados 72 h após o procedimento e nenhuma complicação foi notificada nos primeiros 30 dias. Conclusões: A cirurgia bariátrica laparoscópica pode ser realizada com sucesso em pacientes com má-rotação. Mudanças talvez sejam necessárias com relação à anomalia. Os cirurgiões devem verificar toda a condição anatômica abdominal antes de iniciar a secção gástrica.
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OBJECTIVE: The human auditory system acquires environmental information under sound stimuli faster than visual or touch systems, which in turn, allows for faster human responses to such stimuli. It also complements senses such as sight, where direct line-of-view is necessary to identify objects, in the environment recognition process. This work focuses on implementing human reaction to sound stimuli and environment recognition on assistive robotic devices, such as robotic wheelchairs or robotized cars. These vehicles need environment information to ensure safe navigation. APPROACH: In the field of environment recognition, range sensors (such as LiDAR and ultrasonic systems) and artificial vision devices are widely used; however, these sensors depend on environment constraints (such as lighting variability or color of objects), and sound can provide important information for the characterization of an environment. In this work, we propose a sound-based approach to enhance the environment recognition process, mainly for cases that compromise human integrity, according to the International Classification of Functioning (ICF). Our proposal is based on a neural network implementation that is able to classify up to 15 different environments, each selected according to the ICF considerations on environment factors in the community-based physical activities of people with disabilities. MAIN RESULTS: The accuracy rates in environment classification ranges from 84% to 93%. This classification is later used to constrain assistive vehicle navigation in order to protect the user during daily activities. This work also includes real-time outdoor experimentation (performed on an assistive vehicle) by seven volunteers with different disabilities (but without cognitive impairment and experienced in the use of wheelchairs), statistical validation, comparison with previously published work, and a discussion section where the pros and cons of our system are evaluated. SIGNIFICANCE: The proposed sound-based system is very efficient at providing general descriptions of the environment. Such descriptions are focused on vulnerable situations described by the ICF. The volunteers answered a questionnaire regarding the importance of constraining the vehicle velocities in risky environments, showing that all the volunteers felt comfortable with the system and its performance.
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Automóviles , Biomimética/instrumentación , Redes Neurales de la Computación , Reconocimiento de Normas Patrones Automatizadas/métodos , Espectrografía del Sonido/métodos , Silla de Ruedas , Percepción Auditiva , Biomimética/métodos , Diseño de Equipo , Análisis de Falla de Equipo , Humanos , Sistemas Hombre-Máquina , Reproducibilidad de los Resultados , Robótica , Sensibilidad y EspecificidadRESUMEN
A simplified mathematical model to describe the oxidative degradation of glyphosate employing hydrogen peroxide and UV radiation was developed based on a sequence of predominant reactions. The kinetics obtained include all the required significant variables. Consequently, not only were concentration dependencies examined but also the influence of a detailed spatial description of the radiation field was included as part of the modeling. The kinetic parameters were obtained by comparing the simulation concentrations obtained with the model with the experimental values gathered in the laboratory reactor, employing a multiparameter non-linear regression analysis. In addition, the potential of the H2O2/UV process for treating water polluted with a commercial formulation, which was the glyphosate monoisopropylamine salt plus some additives, was studied. The glyphosate and TOC (total organic carbon) conversions reached were close to 80% and 70% respectively at 12 h (0.66 h actual exposure to radiation). It has been shown that a simple reaction scheme for the degradation of glyphosate acid and glyphosate isopropylamine salt from a commercial formulation can represent with good accuracy the performance of both reacting systems. In addition, the degradation procedure allowed a clear reduction of the toxicity of the glyphosate in the formulation over Vibrio fischeri at the end of the experiments. For this reason, reaching complete mineralization might not be necessary.
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The H(2)O(2)/UVC process was applied to the photodegradation of a commercial formulation of glyphosate in water. Two organisms (Vibrio fischeri bacteria and Rhinella arenarum tadpoles) were used to investigate the toxicity of glyphosate in samples M(1,) M(2), and M(3) following different photodegradation reaction times (120, 240 and 360 min, respectively) that had differing amounts of residual H(2)O(2). Subsamples of M(1), M(2), and M(3) were then used to create samples M(1,E), M(2,E) and M(3,E) in which the H(2)O(2) had been removed. Acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) activities were measured in tadpoles to determine possible sub-lethal effects. In V. fischeri, M(1,E), which was collected early in the photodegradation process, caused 52% inhibition, while M(3,E), which was collected at the end of the photodegradation process, caused only 17% inhibition. Survival of tadpoles was 100% in samples M(2), M(3), and in M(1,E), M(2,E) and M(3,E). The lowest percentages of enzymatic inhibition were observed in samples without removal of H(2)O(2): 13.96% (AChE) and 16% (BChE) for M(2), and 24.12% (AChE) and 13.83% (BChE) for M(3). These results show the efficiency of the H(2)O(2)/UVC process in reducing the toxicity of water or wastewater polluted by commercial formulations of glyphosate. According to the ecotoxicity assays, the conditions corresponding to M(2) (11 ± 1 mg a.e. L(-1) glyphosate and 11 ± 1 mg L(-1) H(2)O(2)) could be used as a final point for glyphosate treatment with the H(2)O(2)/UV process.
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Aliivibrio fischeri/efectos de los fármacos , Bufo arenarum/crecimiento & desarrollo , Monitoreo del Ambiente/métodos , Restauración y Remediación Ambiental/métodos , Glicina/análogos & derivados , Herbicidas/química , Larva/efectos de los fármacos , Animales , Bioensayo , Glicina/química , Glicina/toxicidad , Herbicidas/toxicidad , Peróxido de Hidrógeno/química , Larva/crecimiento & desarrollo , Oxidación-Reducción/efectos de la radiación , Fotólisis , Rayos Ultravioleta , Contaminantes Químicos del Agua/química , Contaminantes Químicos del Agua/toxicidad , GlifosatoRESUMEN
Kierkegaard inscreve a repetição no cerne da experiência filosófica. O novo conceito difere da reminiscência e da rememoração. Na repetição uma temporalidade outra se anuncia: não é um passado que retorna como representação mas o acontecimento de algo que, tendo sido, se eterniza no instante atual. A repetição se experimenta de modos diversos nos três planos que se imbricam na existência: o estético, o ético e o religioso. É na esfera da liberdade que ela se realiza como verdade. A partir de Kierkegaard, a repetição é da ordem do ato cujo princípio é a impossibilidade da própria repetição
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La poca frecuencia con que se realiza el diagnóstico pre-operatorio de los hematomas retroperitoneales en los pacientes traumatizados, la diversidad de criterios terapéuicos que existen y la escasa bibliografía de que disponemos, no motivaron a realizar este trabajo para contribuir a precisar los datos que pudieron llevarnos a lograr el diagnóstico precoz de esta lesión(AU)