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OBJECTIVE: The objective of the study was to analyse the pregnancy rate after curettage, 1G (Endometrial resection) and 2G (Endometrial ablation) procedures in women with abnormal uterine bleeding (AUB-O,E,N) to evaluate the rate of pregnancy following these procedures and to improve pre and post-therapeutic women information. METHODS: This retrospective study analyzed data extracted from the French Hospital medical information database. All hospital stays with a diagnostic code for AUB and an appropriate surgical procedure coded between 2009 and 2015 were identified. A total of 109,884 women were included. Of these, 88,165 were followed up for 18 months, 80,054 for 24 months and 33,251 for 60 months. Outcomes were compared between second generation (2G) procedures, first-generation (1G) procedures (endometrial resection) and curettage. The rate of pregnancy was the primary end point. RESULTS: 7863 women underwent a 2G surgical procedure (7.2%), 39,935 a 1G procedure (36.3%) and 38,923 a curettage (35.4%). The mean age of the women was 46 years (IC.95: 36.7-52.5), with no difference in age between groups. The rate of pregnancy after 2G, 1G and curettage was respectively 13 (1.5%), 617 (10.1%) and 1025 (11.1%). The primary endpoint was significantly different between 2G and 1G and curettage (p<0.0001) CONCLUSION: 2G procedures result in lower risk of pregnancy without requiring specific training for surgeons. However, endometrial ablation cannot be considered as a sterilization method nor an effective contraceptive procedure. In the absence of sterilization of either partner, women should continue to use contraception whatever their age and menstrual status.
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Técnicas de Ablación Endometrial/efectos adversos , Resultado del Embarazo/epidemiología , Adulto , Técnicas de Ablación Endometrial/estadística & datos numéricos , Femenino , Francia/epidemiología , Humanos , Persona de Mediana Edad , Embarazo , Estudios Retrospectivos , Hemorragia Uterina/complicaciones , Hemorragia Uterina/epidemiología , Hemorragia Uterina/cirugíaRESUMEN
This work performed co-AD from the vinasse and filter cake (from 1G ethanol production) and deacetylation liquor (from the pretreatment of sugarcane straw for 2G ethanol production) in a semi-Continuous Stirred Tank Reactor (s-CSTR) aiming to provide optimum operational parameters for continuous CH4 production. Using filter cake as co-substrate may allow the reactor to operate throughout the year, as it is available in the sugarcane off-season, unlike vinasse. A comparison was made from the microbial community of the seed sludge and the reactor sludge when CH4 production stabilized. Lactate, butyrate, and propionate fermentation routes were denoted at the start-up of the s-CSTR, characterizing the acidogenic phase: the oxidation-reduction potential (ORP) values ranged from -800 to -100 mV. Once the methanogenesis was initiated, alkalizing addition was no longer needed as its demand by the microorganisms was supplied by the alkali characteristics of the deacetylation liquor. The gradual increase of the applied organic load rates (OLR) allowed stabilization of the methanogenesis from 3.20 gVS L-1 day-1: the highest CH4 yield (230 mLNCH4 g-1VS) and average organic matter removal efficiency (83% ± 13) was achieved at ORL of 4.16 gVS L-1 day-1. The microbial community changed along with the reactor operation, presenting different metabolic routes mainly due to the used lignocellulosic substrates. Bacteria from the syntrophic acetate oxidation (SAO) process coupled to hydrogenotrophic methanogenesis were predominant (~ 90% Methanoculleus) during the CH4 production stability. The overall results are useful as preliminary drivers in terms of visualizing the co-AD process in a sugarcane biorefinery integrated to scale. KEY POINTS: ⢠Integration of 1G2G sugarcane ethanol biorefinery from co-digestion of its residues. ⢠Biogas production from vinasse, filter cake, and deacetylation liquor in a semi-CSTR. ⢠Lignocellulosic substrates affected the biochemical routes and microbial community. ⢠Biomol confirmed the establishment of the thermophilic community from mesophilic sludge.
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Saccharum , Anaerobiosis , Biocombustibles , Reactores Biológicos , Digestión , MetanoRESUMEN
BACKGROUND: Matrix metalloproteinase (MMP) are involved in bone transformation at the extraction site postdental extraction. We examined the genetic association between single nucleotide polymorphisms of MMP-1 and continuous atrophy of edentulous mandible. METHODS: Buccal cells from 33 edentulous patients were collected using sterile wooden spatula and were suspended in 15 ml falcon tubes containing 1.5 ml of cell lysis buffer, without proteinase K. The cells were transported to the laboratory on ice and were stored at -20°C until being processed. RESULTS: Of the samples analyzed, 26 edentulous patients (78.8%) carried 2G allele, while 7 of them (21.2%) carried 1G allele. CONCLUSION: The patients with the alveolar bone resorption exhibited more of 2G allele while only 21.2% of them showed 1G allele, associated with excessive atrophy of edentulous mandible. This study may provide genetic background to identify susceptible individuals prone to develop jawbone atrophy after dental extraction.
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This work addresses the economic and environmental performance of integrated biorefineries based on sugarcane juice and residues. Four multiproduct scenarios were considered; two from sugar mills and the others from ethanol distilleries. They are integrated biorefineries producing first (1G) and second (2G) generation ethanol, sugar, molasses (for animal feed) and electricity in the context of Brazil. The scenarios were analysed and compared using techno-economic value-based approach and LCA methodology. The results show that the best economic configuration is provided by a scenario with largest ethanol production while the best environmental performance is presented by a scenario with full integration sugar - 1G2G ethanol production.