The Miniaturized Electron pRoton Telescope, MERiT, is a low‐mass, low‐power, compact instrument using an innovative combination of particle detectors, sensor electronics, and onboard processing. ...MERiT is flying on the Compact Radiation belt Explorer, CeREs, a 3U CubeSat launched into a low earth orbit of 500‐km altitude and inclination of 85° on 16 December 2018. The primary and secondary science goals of CeREs are to investigate electron microbursts and to study solar particles. MERiT comprises a stack of solid state detectors (SSD) behind space facing avalanche photo diodes (APDs) surrounded by W‐Al shielding to reduce side‐penetrating particle background. The APD‐SSD combination enables measurement of electrons from 5 to 200 keV and 1 to 8 MeV; protons from 200–400 keV and 7–100 MeV in differential channels with energy resolution ΔE/E≈30% for both electrons and protons. MERiT measures microbursts with a high time resolution ranging from 4 to 16 ms and solar particles with a cadence of 1 s. MERiT energy channels and cadences are software configurable via algorithms and lookup tables residing on a field‐programmable gate array. The lookup tables can be changed via ground commands. MERiT geometry factor is 31 sq.cm‐sr and optimized to measure microbursts with the instrument viewing the local zenith in orbit. MERiT enables investigation of dynamical processes of radiation belt electron energization and loss, solar electron and proton transport, and their access to the Earth's polar caps. We describe the MERiT sensor design, calibration, operational modes, data products, and science goals.
A case of a massive gastrointestinal bleeding secondary to a between esophagus and aberrant right subclavian artery (arteria lusoria) is presented, treated first with haemostatic clips and later with ...a Sengstaken-Blakemore tube and endovascular stent. A brief literary review is done.
Successful gallstone ileus treatment by endoscopy Guerro Moya, Andrea; Couto Wörner, Ignacio; Alonso Aguirre, Pedro Antonio
Revista española de enfermedades digestivas,
12/2022, Letnik:
114, Številka:
12
Journal Article
Recenzirano
Odprti dostop
We present the case of a 73-year-old woman who was admitted to hospital with a 6-day history of complete constipation, abdominal pain and vomiting. An abdominal CT scan is performed that shows a ...large colonic dilatation. In the sigmoid colon identifying a 43x20mm gallstone impaction and a solution of continuity between the gallbladder and the hepatic flexure with pneumobilia associated. Because the obstruction is located at the sigmoid colon, it was decided to perform an urgent colonoscopy. During the endoscopy, the gallstone was observed, which was successfully extracted using a Roth Net. The surrounding mucosa showed signs of mucosal damage and an extensive decubitus ulcer. After endoscopy, the patient presented resolution of the obstructive condition. During her admission, surgery was performed to resection the cholecystocolic fistula, cholecystectomy, and primary closure of the colon. However, the patient presented a torpid evolution with ascending colon perforation and necrotizing fasciitis in the surgical wound, finally dying of abdominal septic shock.
It is now recognized that the white adipose tissue (WAT) produces a variety of bioactive peptides, collectively termed “adipokines”. Alteration of WAT mass in obesity or lipoatrophy, affects the ...production of most adipose secreted factors. Since both conditions are associated with multiple metabolic disorders and increased risk of cardiovascular diseases, the idea has emerged that WAT could be instrumental in these complications, by virtue of its secreted factors. Several adipokines are increased in the obese state and have been implicated in hypertension (angiotensinogen), impaired fibrinolysis (PAI-1) and insulin resistance (ASP, TNFα, IL-6, resistin). Conversely, leptin and adiponectin both exert an insulin-sensitizing effect, at least in part, by favoring tissue fatty-acid oxidation through activation of AMP-activated kinase. In obesity, insulin resistance has been linked to leptin resistance and decreased plasma adiponectin. In lipoatrophic mice, where leptin and adiponectin circulating levels are low, administration of the two adipokines synergistically reverses insulin resistance. Leptin and adiponectin also have distinct properties: leptin, as a long-term integrative signal of energy store and adiponectin, as a potent anti-atherogenic agent. The thiazolidinedione anti-diabetic drugs increase endogenous adiponectin production in rodents and humans, supporting the idea that the development of new drugs targeting adipokines might represent a promising therapeutic approach to protect obese patients from insulin resistance and atherosclerosis.
Tissu adipeux et adipokines : pour le meilleur et pour le pire
Il est maintenant reconnu que le tissu adipeux blanc (TAB) produit une variété de peptides bioactifs, dénommés « adipokines ». Les altérations de la masse du TAB au cours de l'obésité ou des lipoatrophies affectent la production de la plupart des facteurs adipeux sécrétés. Dans la mesure où ces deux affections sont associées avec de multiples anomalies métaboliques et un risque cardiovasculaire accru, l'idée a émergé que le TAB participerait à ces complications, par l'intermédiaire de ses facteurs sécrétés. Plusieurs adipokines sont augmentées au cours de l'obésité et ont été impliquées dans l'hypertension (angiotensinogène), l'altération de la fibrinolyse (PAI-1) et l'insulinorésistance (ASP, TNFα, IL-6, résistine). Inversement, la leptine et l'adiponectine exercent un effet insulino-sensibilisant, au moins en partie en favorisant l'oxydation des acides gras par activation de l'AMP-activated kinase. Dans l'obésité, l'insulinorésistance a été reliée à une résistance à la leptine et une diminution de l'adiponectine plasmatique. Chez la souris lipoatrophique où les taux circulants de leptine et d'adiponectine sont bas, l'administration des deux adipokines lève de façon synergique l'insulinorésistance. Leptine et adiponectine ont aussi des propriétés distinctes : la leptine, comme signal intégrateur à long terme des stocks énergétiques, et l'adiponectine, comme puissant agent anti-athérogène. Les substances antidiabétiques de type thiazolidinedione augmente la production endogène d'adiponectine chez le rongeur et l'humain, en faveur de l'idée selon laquelle le développement de nouvelles molécules ciblant les adipokines pourrait offrir une approche thérapeutique séduisante pour la protection des obèses de l'insulinorésistance et de l'athérosclérose.
Enterococcus faecium is ranked worldwide as one of the top ten pathogens identified in healthcare-associated infections (HAI) and is classified as one of the high priority pathogens for research and ...development of new antibiotics worldwide. Due to molecular biology techniques' higher costs, the approach for identifying and controlling infectious diseases in developing countries has been based on clinical and epidemiological perspectives. Nevertheless, after an abrupt vancomycin-resistant Enterococcus faecium dissemination in the Méderi teaching hospital, ending up in an outbreak, further measures needed to be taken into consideration. The present study describes the vancomycin-resistant Enterococcus faecium pattern within Colombian's largest installed-bed capacity hospital in 2016.
Thirty-three vancomycin-resistant Enterococcus faecium isolates were recovered during a 5-month period in 2016. Multilocus variable-number tandem-repeat analysis was used for molecular typing to determine clonality amongst strains. A modified time-place-sequence algorithm was used to trace VREfm spread patterns during the outbreak period and estimate transmission routes.
Four clonal profiles were identified. Chronological clonal profile follow-up suggested a transitional spread from profile "A" to profile "B", returning to a higher prevalence of "A" by the end of the study. Antibiotic susceptibility indicated high-level vancomycin-resistance in most isolates frequently matching vanA gene identification.
Transmission analysis suggested cross-contamination via healthcare workers. Despite epidemiological control of the outbreak, post-outbreak isolates were still being identified as having outbreak-related clonal profile (A), indicating reduction but not eradication of this clonality. This study supports the use of combined molecular and epidemiological strategies in an approach to controlling infectious diseases. It contributes towards a more accurate evaluation of the effectiveness of the epidemiological measures taken regarding outbreak control and estimates the main cause related to the spread of this microorganism.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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