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result(s) for
"Benavides, Roberto"
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Systematic Management of Postoperative Enterocutaneous Fistulas: Factors Related to Outcomes
by
Luque-de-Leon, Enrique
,
Blanco-Benavides, Roberto
,
Mier, Juan
in
Abdominal Surgery
,
Adolescent
,
Adult
2008
Background
Most enterocutaneous fistulas are postoperative in origin. Sepsis, malnutrition, and hydroelectrolytic deficit are still the most important complications to which patients with postoperative enterocutaneous fistulas (PEF) are exposed. Knowledge of prognostic factors related to specific outcomes is essential for therapeutic decision-making processes.
Methods
We reviewed files of all consecutive patients with PEF treated in our hospital during a 10-year period. Our aim was to identify factors related to spontaneous closure, need for operative treatment, and mortality. Univariate and multivariate analyses were performed.
Results
A total of 174 patients were treated. The most frequent site of origin was the small bowel (90 patients: 48 jejunal, and 42 ileal), followed in frequency by the colon (50 patients). Postoperative enterocutaneous fistula closure was achieved in 151 patients (86%), being spontaneous in 65 (37%) and surgical in 86 (49%). Factors that significantly precluded spontaneous closure were jejunal site, multiple fistulas, sepsis, high output, and hydroelectrolytic deficit at diagnosis or referral. Origin of PEF at our hospital was the only factor significantly associated with spontaneous closure. The most frequent operative indication was PEF persistence without sepsis. Factors significantly associated with the need for operative treatment were high output, jejunal site, and multiple fistulas. Closure was achieved in 84% of patients who underwent operation. A total of 23 patients died (13%). Factors associated with mortality were serum albumin <3.0 g/dl (at diagnosis or referral), high output, hydroelectrolytic deficit, multiple fistulas, jejunal site, sepsis, and a complex fistulous tract.
Conclusions
In spite of advances in management of PEF, the associated morbidity and mortality remain high. Among several variables influencing outcome, our multivariate analysis disclosed high output, jejunal site, multiple fistulas, and sepsis as independent adverse factors related to non-spontaneous closure, need for operative treatment, and/or death.
Journal Article
Synthesis and characterization of tetrazole-derived solid polymeric electrolytes
by
Da Silva Paula, Marcos Marques
,
Magnago, Rachel Faverzani
,
Francisco-Vieira, Luana
in
Alkylation
,
Batteries
,
Characterization and Evaluation of Materials
2024
In this work, N-alkylated tetrazole copolymers were prepared to produce the solid polymeric electrolytes StVTz-82, StVTz-82:4C, StVTz-82:6C, StVTz-82:8C and StVTz-82:sultone. The chemical structure was confirmed by FTIR, H NMR, C NMR and GPC. GPC thermal analysis showed that the membranes are thermally stable up to 160 °C. DSC was used to evaluate the structural effect on the Tg value. Water absorption (WU) and ion exchange capacity (IEC) were conducted for all electrolytes. We observed a decrease in the elastic modulus with the introduction of side alkyl chains linked to the tetrazole heterocycle. The ionic conductivity of these materials was studied by electrochemical impedance spectroscopy. We observed that the StVTz-82 and StVTz-82:sultone copolymers, in hydrated conditions and at room temperature, are the ones that present the best conductivity values 2.09 and 9.78 mS. cm, respectively. Relating to the hydration number (λ), the StVTz-82:sultone electrolyte has a higher λ value. It also has sulfonic acid group, which has a lower pKa value (~ 1.9) then tetrazole (~ 4.50). From the point of view of mechanical properties, the StVTz-82:sultone electrolyte has a rigidity modulus intermediate to that of StVTz-82, which is more rigid, and StVTz-82:8C, which is the most flexible. These characteristics provide suitable properties for use of StVTz-82:sultone as a solid electrolyte for power generation devices such as fuel cells and batteries.
Journal Article
Giant Parathyroid Adenoma-Associated Fracture, Not All Lytic Bone Lesions are Cancer: A Case-Based Review
by
Román-González, Alejandro
,
Agámez-Gómez, Jose E.
,
Ribero, Marcel E.
in
Adenoma
,
Arthritis
,
Biopsy
2022
Introduction. Due to the early diagnosis of primary hyperparathyroidism the musculoskeletal manifestations of this disease are becoming less frequent. When this disease manifests secondary to a giant adenoma, it presents with more aggressive symptoms and can have important repercussions such as the hungry bone syndrome after parathyroidectomy. There are few reported cases of hyperparathyroidism secondary to a giant adenoma in the literature, as the presence of a brown tumor is often misinterpreted as a metastatic lesion from an unknown primary tumor. Methods. We describe a case and performed a literature review to identify all case reports. A literature search was carried out on PubMed/MEDLINE and EMBASE bibliographic databases. All available studies from May 2009 to May 2021 were included. Data were tabulated, and outcomes were cumulatively analyzed. Results. Twenty-four cases of primary hyperparathyroidism due to giant adenoma have been described; the majority were women, with a mean age of 52 years. They presented with heterogeneous symptoms such as palpable nodules (45%), bone pain (33%), brown tumor (12.5%), asymptomatic (12.5%), metabolic profile with a mean calcemia of 13.8 mg/dL, PTH 1109 ng/L, and mean tumor weight of 47.24 g. Conclusion. Primary hyperparathyroidism due to giant adenoma increases the risk of developing potentially serious postoperative complications such as hungry bone syndrome. This implies the need of implementing preventive measures comprising administration of intravenous zoledronic acid and early supplementation of oral calcium to prevent complications after resection.
Journal Article
Global variability in seawater Mg:Ca and Sr:Ca ratios in the modern ocean
by
Ashjian, Carin
,
Sanchez-Leal, Ricardo
,
Tseng, Li-Chun
in
"Earth, Atmospheric, and Planetary Sciences"
,
Alkalinity
,
Archives & records
2020
Seawater Mg:Ca and Sr:Ca ratios are biogeochemical parameters reflecting the Earth–ocean–atmosphere dynamic exchange of elements. The ratios’ dependence on the environment and organisms’ biology facilitates their application in marine sciences. Here, we present a measured single-laboratory dataset, combined with previous data, to test the assumption of limited seawater Mg:Ca and Sr:Ca variability across marine environments globally. High variability was found in open-ocean upwelling and polar regions, shelves/neritic and river-influenced areas, where seawater Mg:Ca and Sr:Ca ratios range from ∼4.40 to 6.40 mmol:mol and ∼6.95 to 9.80 mmol:mol, respectively. Open-ocean seawater Mg:Ca is semi-conservative (∼4.90 to 5.30 mol:mol), while Sr:Ca is more variable and nonconservative (∼7.70 to 8.80 mmol:mol); both ratios are nonconservative in coastal seas. Further, the Ca, Mg, and Sr elemental fluxes are connected to large total alkalinity deviations from International Association for the Physical Sciences of the Oceans (IAPSO) standard values. Because there is significant modern seawater Mg:Ca and Sr:Ca ratios variability across marine environments we cannot absolutely assume that fossil archives using taxa-specific proxies reflect true global seawater chemistry but rather taxa- and process-specific ecosystem variations, reflecting regional conditions. This variability could reconcile secular seawater Mg:Ca and Sr:Ca ratio reconstructions using different taxa and techniques by assuming an error of 1 to 1.50 mol:mol, and 1 to 1.90 mmol:mol, respectively. The modern ratios’ variability is similar to the reconstructed rise over 20 Ma (Neogene Period), nurturing the question of semi-nonconservative behavior of Ca, Mg, and Sr over modern Earth geological history with an overlooked environmental effect.
Journal Article
Effects of the Addition of Transition Metals on Cast Al–Cu Alloys
by
Lamas-Martínez, Ramón
,
Garza-Montes-de-Oca, Nelson F
,
Haro-Rodríguez, Sergio
in
Alloys
,
Aluminum base alloys
,
Atmospheric corrosion
2024
This work reports the studies conducted to characterize the microstructure and strength of Al–Cu alloys cast with various additions of Ti, V and Zr as these elements form stable particles of the Al3M type that are able to enhance their strength. The alloys were melted at 760 °C and poured into steel moulds. The solidification and cooling of the alloys was studied with the aid of a modified Scheil–Gulliver model. The volume fraction of D022 and D023 particles at the end of solidification was used to evaluate the strengthening by Orowan’s mechanism. Microstructural studies revealed the presence of particles of the Al3M type made of Ti, V and Zr. The difference in strength of the different alloys is attributed to Al3M precipitates.
Journal Article
Jelly biomass sinking speed reveals a fast carbon export mechanism
by
de Jesus Mendes, Pedro
,
Jones, Bethan M.
,
Cartes, Joan E.
in
Animal and plant ecology
,
Animal, plant and microbial ecology
,
Biological and medical sciences
2013
Sinking of gelatinous zooplankton biomass is an important component of the biological pump removing carbon from the upper ocean. The export efficiency, e.g., how much biomass reaches the ocean interior sequestering carbon, is poorly known because of the absence of reliable sinking speed data. We measured sinking rates of gelatinous particulate organic matter (jelly-POM) from different species of scyphozoans, ctenophores, thaliaceans, and pteropods, both in the field and in the laboratory in vertical columns filled with seawater using high-quality video. Using these data, we determined taxon-specific jelly-POM export efficiencies using equations that integrate biomass decay rate, seawater temperature, and sinking speed. Two depth scenarios in several environments were considered, with jelly-POM sinking from 200 and 600 m in temperate, tropical, and polar regions. Jelly-POM sank on average between 850 and 1500 m d−1 (salps: 800–1200 m d−1; ctenophores: 1200–1500 m d−1; scyphozoans: 1000–1100 m d−1; pyrosomes: 1300 m d−1). High latitudes represent a fast-sinking and low-remineralization corridor, regardless of species. In tropical and temperate regions, significant decomposition takes place above 1500 m unless jelly-POM sinks below the permanent thermocline. Sinking jelly-POM sequesters carbon to the deep ocean faster than anticipated, and should be incorporated into biogeochemical and modeling studies to provide more realistic quantification of export via the biological carbon pump worldwide.
Journal Article
Erasmus Syndrome, An Autoimmunity Paradox: A Case Report and Literature Review
by
Cardona Palacio, Alejandro
,
Arango, Alejandro
,
Villa-Pérez, Simon
in
Antibodies
,
Antigens
,
Dyspnea
2025
Erasmus syndrome (ES) is a rare condition characterized by the link between crystalline silica exposure, with or without silicosis, and systemic sclerosis (SSc). Although first noted over a century ago, its underlying mechanisms remain unclear. However, it is indistinguishable from idiopathic SSc in the general population. Its clinical presentation is heterogeneous, depending on the affected systems, with notable features, including skin fibrosis, microstomia, telangiectasia, Raynaud's phenomenon, arthralgia, and interstitial lung disease. Currently, there is no unified consensus on its treatment; however, organ-specific therapy is a reasonable approach. We report the case of a 43-year-old miner diagnosed with diffuse cutaneous SSc, where ES was diagnosed after an exhaustive history was taken, occupational exposure was characterized, differential diagnoses were excluded, and radiological and histopathological evidence of pulmonary silicosis was presented.
Journal Article
Enfermedad renal crónica en mujeres embarazadas
by
Victor Leal Martínez
,
Rodrigo Daza Arnedo
,
Robles, María Monterrosa
in
Creatinine
,
diálisis
,
Hemodialysis
2021
La enfermedad renal crónica (ERC), definida como una alteración estructural o funcional renal que persiste por más de 3 meses con o sin deterioro de la función renal o como un filtrado glomerular (FG) < 60 mL/min/1,73 m 2 sin otros signos de enfermedad renal, es una condición prevalente en la población general; sin embargo, no es tan frecuente en mujeres embarazadas. A pesar de su baja frecuencia en gestantes, el antecedente de enfermedad renal se asocia con peores desenlaces maternos y fetales cuando se presenta ERC. Las fórmulas estándar (CKD-EPI, Cockroft-Gault y MDRD) utilizadas para determinar la tasa de filtrado glomerular en población no obstétrica tienen poca precisión en las embarazadas debido a que subestiman la función renal en aproximadamente un 20%. Ante esto, el aclaramiento de creatinina medido utilizando recolecciones de orina de 24 horas y la estimación de creatinina sérica que se correlaciona estrechamente con el aclaramiento de inulina (estándar de oro) son opciones que pueden utilizarse durante el embarazo. Asimismo, el reconocimiento temprano de la enfermedad, la optimización de las estrategias de nefroprotección, el evitar las drogas nefrotóxicas y la instauración de un tratamiento específico para la etiología garantizan una mayor sobrevida y un menor número de complicaciones derivadas de la enfermedad renal.
Journal Article
Global variability in seawater Mg:Ca and Sr:Ca ratios in the modern ocean
2020
Seawater Mg:Ca and Sr:Ca ratios are biogeochemical parameters reflecting the Earth–ocean–atmosphere dynamic exchange of elements. The ratios’ dependence on the environment and organisms’ biology facilitates their application in marine sciences. Here, we present a measured single-laboratory dataset, combined with previous data, to test the assumption of limited seawater Mg:Ca and Sr:Ca variability across marine environments globally. High variability was found in open-ocean upwelling and polar regions, shelves/neritic and river-influenced areas, where seawater Mg:Ca and Sr:Ca ratios range from ∼4.40 to 6.40 mmol:mol and ∼6.95 to 9.80 mmol:mol, respectively. Open-ocean seawater Mg:Ca is semiconservative (∼4.90 to 5.30 mol:mol), while Sr:Ca is more variable and nonconservative (∼7.70 to 8.80 mmol:mol); both ratios are nonconservative in coastal seas. Further, the Ca, Mg, and Sr elemental fluxes are connected to large total alkalinity deviations from International Association for the Physical Sciences of the Oceans (IAPSO) standard values. Because there is significant modern seawater Mg:Ca and Sr:Ca ratios variability across marine environments we cannot absolutely assume that fossil archives using taxa-specific proxies reflect true global seawater chemistry but rather taxa- and process-specific ecosystem variations, reflecting regional conditions. This variability could reconcile secular seawater Mg:Ca and Sr:Ca ratio reconstructions using different taxa and techniques by assuming an error of 1 to 1.50 mol:mol, and 1 to 1.90 mmol:mol, respectively. The modern ratios’ variability is similar to the reconstructed rise over 20 Ma (Neogene Period), nurturing the question of semi-nonconservative behavior of Ca, Mg, and Sr over modern Earth geological history with an overlooked environmental effect.
Journal Article
Global variability in seawater Mg:Ca and Sr:Ca ratios in the modern ocean
Seawater Mg:Ca and Sr:Ca ratios are biogeochemical parameters reflecting the Earth–ocean–atmosphere dynamic exchange of elements. The ratios’ dependence on the environment and organisms' biology facilitates their application in marine sciences. Here, we present a measured single-laboratory dataset, combined with previous data, to test the assumption of limited seawater Mg:Ca and Sr:Ca variability across marine environments globally. High variability was found in open-ocean upwelling and polar regions, shelves/neritic and river-influenced areas, where seawater Mg:Ca and Sr:Ca ratios range from ∼4.40 to 6.40 mmol:mol and ∼6.95 to 9.80 mmol:mol, respectively. Open-ocean seawater Mg:Ca is semiconservative (∼4.90 to 5.30 mol:mol), while Sr:Ca is more variable and nonconservative (∼7.70 to 8.80 mmol:mol); both ratios are nonconservative in coastal seas. Further, the Ca, Mg, and Sr elemental fluxes are connected to large total alkalinity deviations from International Association for the Physical Sciences of the Oceans (IAPSO) standard values. Because there is significant modern seawater Mg:Ca and Sr:Ca ratios variability across marine environments we cannot absolutely assume that fossil archives using taxa-specific proxies reflect true global seawater chemistry but rather taxa- and process-specific ecosystem variations, reflecting regional conditions. This variability could reconcile secular seawater Mg:Ca and Sr:Ca ratio reconstructions using different taxa and techniques by assuming an error of 1 to 1.50 mol:mol, and 1 to 1.90 mmol:mol, respectively. The modern ratios’ variability is similar to the reconstructed rise over 20 Ma (Neogene Period), nurturing the question of seminonconservative behavior of Ca, Mg, and Sr over modern Earth geological history with an overlooked environmental effect.
Journal Article