Abstract Craniosynostosis refers to a great number of deformities associated with the premature fusion of cranial sutures. There are several types of synostoses, depending on the number of sutures ...affected and the involved regions. Surgery is indicated for functional and esthetic reasons. Although many surgical techniques have been described, the decision of the type of operation to be performed and the time of the procedure should be based on three pillars: the patient's clinical and tomographic features as well as social and demographic aspects; the expertise of the treating surgeons; and the resources available at the craniofacial center. The patient's outcome will be directly related to a structured management protocol, implemented by a multidisciplinary team, in which all team members should speak the same language. The main objective of this article is to describe the management protocol developed at a public tertiary level medical institution in Mexico.
Ballistic efficiency and cost are the main considerations in the design of lightweight armors. Metallic materials have the drawback of their high density. Mixed armors, of ceramic tiles backed by a ...metallic plate, are an efficient shield against low and medium caliber projectiles since they combine the light weight and high resistance of a ceramic with the ductility of a metal. The drawback is their high cost. The authors developed a new material composed of ceramic particles and a polymeric matrix. It fills the gap between metallic and ceramic materials and could be interesting for applications in which weight is not the primary concern and cost benefits are welcome. A model of the mechanical behavior of this composite is presented in this paper, implemented in a numerical code and validated by experimental results.
The effect of two sources of Se, selenized yeast (Se-Y) and sodium selenite, added to total mixed rations (TMR) fed to cows on Se milk content and distribution in milk components was studied on three ...farms for 6 weeks. The maximal increase in milk Se was attained with Se-Y supplemented at 0.3 μg g-1. The effect was immediate, with an increase of 9 μg L-1 being observed after only 5 days, and remained steady until the last sample at day 40 of Se supplementation. Se distribution in milk components was constant, 53.6, 42.6, and 9.3% in whey, casein, and fat, respectively, and was unaffected by the form of supplementation. The effect of the level of Se-Y supplementation on milk Se was studied on two farms. Increasing dietary Se-Y from 0 to 0.5 μg g-1 elevated milk Se content from 20 to 39 μg L-1. Se-enriched cow's milk at different levels can be produced by varying dietary Se supplementation in the form of selenized yeast. Keywords: Selenium; cow's milk; selenium distribution; selenium supplementation; HGAAS
In 2017, the ECO Foundation (Excellence and Quality in Oncology) completed the EIO-50 project to learn about the diagnostic and treatment criteria of opioid-induced constipation (OIC) in cancer ...patients. The EIO-Praxis project was designed as a continuation of EIO-50, to learn about the current clinical practice of oncology professionals for the management of patients with OIC (process, follow-up and results).
77 health care professionals (HCP) from oncology units participated in the study. Each investigator collected information from 10 medical records of cancer patients who received OIC treatment, with a total of 770 records. In each center, 6 indicators of its structure were collected and the completion of a questionnaire with 15 questions regarding patient’s follow-up and treatment process was conducted.
According to healthcare professionals (HCP), an average proportion of 47.5% of cancer patients received treatment with opioids. From these, an average of 44.9% developed OIC. 51.9% of the investigators didn’t follow any guidelines for the management of patients with OIC. The mean age of the patients of the study was 61.6 years old. The mean duration of opioid treatment was 4.9 months, with an average time of 16.5 days from the start of opioid treatment to the appearance of the first symptoms of OIC. Only in 55.1% of the patients, the presence of functional constipation before starting opioid treatment was assessed. Patients of the study presented the following Rome IV criteria symptoms: 82.6% reduced bowel frequency, 52.9% fewer than three spontaneous bowel movements per week, 54.4% development or worsening of straining and stool consistency (54.2%). The majority of the patients were treated with laxatives (76.0%). Oral Peripherally Active µ-Opioid Receptor Antagonist (PAMORA) was also used in 54.8% of the patients.
Despite new guidelines for the management of constipation in cancer patients were published in 2018, the management of OIC is still insufficient. After laxative failures, the use of PAMORA drugs should be taken into consideration for the management of OIC.
ECO Foundation.
Kyowa Kirin.
E. Aranda Aguilar: Advisory / Consultancy: Amgen; Advisory / Consultancy: Bayer; Advisory / Consultancy: Celgene; Advisory / Consultancy: Merck; Advisory / Consultancy: Roche; Advisory / Consultancy: Sanofi. J. Garcia Foncillas: Advisory / Consultancy, Travel / Accommodation / Expenses: Roche; Advisory / Consultancy: Bayer; Advisory / Consultancy, Travel / Accommodation / Expenses: Sanofi; Research grant / Funding (institution): Merck. E. Diaz Rubio: Advisory / Consultancy, Research grant / Funding (institution): Amgen; Advisory / Consultancy: Bayer; Advisory / Consultancy: Genomica; Advisory / Consultancy, Speaker Bureau / Expert testimony: Servier; Advisory / Consultancy, Research grant / Funding (institution): Merck Serono; Speaker Bureau / Expert testimony: MSD; Research grant / Funding (institution): Roche; Research grant / Funding (institution): AstraZeneca; Research grant / Funding (institution): Sysmex. R. López: Shareholder / Stockholder / Stock options, Licensing / Royalties: Nasasbiotech; Shareholder / Stockholder / Stock options: Mtrap Inc; Advisory / Consultancy, Research grant / Funding (institution), Travel / Accommodation / Expenses: Roche; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy, Research grant / Funding (institution): Merck; Advisory / Consultancy: MSD; Advisory / Consultancy: Bayer; Advisory / Consultancy, Travel / Accommodation / Expenses: BMS; Advisory / Consultancy: Novartis; Advisory / Consultancy: Janssen; Advisory / Consultancy: Lilly; Advisory / Consultancy: Pfizer; Travel / Accommodation / Expenses: PharmaMar; Travel / Accommodation / Expenses: Pierre Fabre. All other authors have declared no conflicts of interest.
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