Background
Cytoreductive surgery (CRS) and administration of hyperthermic intraperitoneal chemotherapy (HIPEC) have shown their efficacy in multiple malignancies and also could offer a prognostic ...benefit for patients with advanced ovarian cancer.
Methods
A prospective, single-center, parallel-group, randomized phase 3 clinical trial analyzed patients with a diagnosis of carcinomatosis from ovarian cancer treated with neoadjuvant systemic chemotherapy (NACT). In this trial, 71 patients were randomized to receive CRS alone (36 patients) or CRS with HIPEC (35 patients) using cisplatin (75 mg/m
2
for 60 min at 42 °C). The primary end point was disease-free survival (DFS). Overall survival (OS), morbidity, and quality of life (QoL) were the secondary end points.
Results
During a median follow-up period of 32 months, the median DFS was 12 months in the control group (CRS) and 18 months in the experimental group (CRS and HIPEC). The findings showed HIPEC to be an independent protective factor against the development of recurrence (hazard ratio HR, 0.12, 95 % confidence interval CI, 0.02–0.89;
p
= 0.038). The median OS was 45 months in the control group and 52 months in the experimental group. The respective morbidity rates for any grade (1 to 5) were respectively 58.3 % and 45.7 % (
p
> 0.05), with a mortality rates of 2.8 % and 2.9 % (
p
> 0.05). In the dimensions evaluated, CRS with or without HIPEC had no impact on QoL.
Conclusions
For patients who had advanced ovarian cancer treated with NACT, CRS and HIPEC was associated with better DFS and OS, but without a difference in postoperative morbidity, mortality, or in the QoL evaluation.
This work tries to evaluate road transport usage in Lanzarote Island and its implications for sustainable tourism development. The methodology followed here is the ecological footprint indicator. Its ...evaluation is based on projections of trip matrix estimated for Lanzarote Island. This study allows us to determine, in an approximate way, the environmental impact (that is, the contribution to climate change) of car usage on the island. Besides, it permits to extract some important conclusions about the trade-off existing between the need of individual mobility and tourism development in Lanzarote Island.
Current public transport supply on the Island of Lanzarote is clearly insufficient, and opportunities to substitute private automobiles are extremely limited, for residents and tourists alike. ...Therefore, this paper analyzes the possibility of introducing a tourist bus service to connect Lanzarote’s main tourist attractions, and it also focuses on a move towards public transport by tourists to reduce the CO2 emitted by excessive private car usage. This work assesses the impact of road transport in accessing tourist activities on Lanzarote Island and its implications for sustainable tourism development. The evaluation is based on the volume of CO2 emissions for the current tourist mobility model on the island and an alternative option such as a tourist bus route. The methodology employed here is the application of a geographical information system (GIS). The study analyzes how to manage the impact of road access to tourist sites through the implementation of a new tourist bus line. The study seeks to evaluate the design of a new bus to deliver tourists to key tourist activities on Lanzarote Island. A GIS-T algorithm is used to compare the level of CO2 emissions from the current tourist mobility model versus the implementation of a new touristic bus. The levels of pollution produced by the present system and the tourist route are compared, and different levels of demand for the new circuit are considered. We conclude that in order to reduce the current levels of emissions by around 15%, some 19.4% of the tourists that currently use hire cars would have to switch to the new tourist bus service.
Introducción. La embolia paradójica es un evento trombótico originado en la circulación venosa, que se manifiesta como embolismo arterial por medio de un defecto anatómico a nivel cardíaco o ...pulmonar. Se asocia principalmente a eventos cerebrovasculares, aunque se han encontrado casos de infarto agudo de miocardio, infarto renal y otros eventos isquémicos. Caso clínico. Paciente de 47 años, quien consultó por cuadro de dolor abdominal, que requirió manejo quirúrgico de urgencia, donde identificaron isquemia intestinal importante. Los estudios adicionales hallaron déficit de proteína S y persistencia de foramen oval permeable. Resultados. La presencia de trombosis arterial se conoce como trombosis de sitios inusuales y requiere de estudios para descartar trombofilias asociadas u otros estados protrombóticos. El déficit de proteína S es una trombofilia infrecuente, la cual se asocia en la vida adulta a eventos trombóticos de origen venoso. En presencia de defectos anatómicos, como un foramen oval permeable, puede progresar a embolia arterial, configurando un cuadro de embolismo paradójico. La estratificación de estos pacientes requiere imágenes que demuestran el defecto mencionado, así como el posible origen de los émbolos. El manejo se basa en anticoagulación plena, manejo de soporte, resolver las manifestaciones trombóticas existentes y un cierre temprano del defecto anatómico. Conclusiones. El embolismo paradójico debe sospecharse en caso de trombosis de sitios inusuales. Requiere de un estudio exhaustivo con imágenes y su manejo debe basarse en anticoagulación y cierre del defecto.
As the skin is the main protective organ of the body, it is exposed to wounds or injuries which carry out a healing process during a period of approximately 15 days depending on the severity of the ...injury. In the present research, the development of chitosan-based hydrogels loaded with silver nanoparticles and calendula extract (Ch-AgNPs-Ce) was proposed. This can be used to fulfill the hemostatic, anti-infective, antibacterial, healing and anti-inflammatory functions through controlled release of the nanoparticles and calendula extract in substitution of commonly used drugs. The physical properties of the silver nanoparticles were analyzed by UV–visible spectroscopy, scanning and transmission electron microscopy, showing a size between 50 and 100 nm. The antibacterial properties were evaluated by the agar well diffusion method. Antimicrobial testing of the hydrogels showed that the inclusion of silver nanoparticles provides concentration-dependent antibacterial behavior against E. coli and S. aureus. The healing properties of the system were tested in two diabetic patients to whom said hydrogels were placed, obtaining a positive curative result after a few weeks. Therefore, it can be concluded that Ch-AgNPs-Ce hydrogels can achieve healing in chronic or exposed wounds after a period of time which can be used in alternative treatments in patients with poor healing capacity.
The high morbidity and mortality of hepatocellular carcinoma (HCC) has encouraged the search for new biomarkers to be used alongside alpha-foetoprotein (AFP) and imaging tests. The aim of this study ...was to evaluate the clinical contribution of protein induced by vitamin K absence or antagonist-II (PIVKA-II) for HCC monitoring after liver transplantation (LT) and compare it with AFP, a routinely used tumour marker. A total of 46 HCC patients (Milan criteria) were enrolled in this study. Serum levels of PIVKA-II and AFP were measured before and after transplantation. Clinical features were determined for all the patients that were included. Significant correlations were found between PIVKA-II expression levels and some clinicopathological features, such as tumour size and number of pre-transplant transarterial chemoembolizations (TACEs). Serum levels of PIVKA-II and AFP decreased significantly after LT and increased in patients with tumour recurrence. Serum PIVKA-II levels may play an important role in predicting disease severity. Furthermore, monitoring PIVKA-II levels in HCC transplant recipients reflects the tumor early recurrence after transplantation and could be used, complementing AFP and imaging tests, as a novel biomarker of this pathology.
Developing environmentally friendly building materials with low environmental impacts is receiving more attention nowadays to face the global challenges of climate change; building insulation ...materials made from agricultural waste can be used for their low environmental impact and to generate responsible supplies that utilize natural resources adequately. The study aims to assess a panel made from rice husk using the pulping method. An experimental design established the proportion of rice husk, the percentage of additive (NaOH concentration), boiling time and blending time. Taguchi’s method was applied to investigate the effect on density and thermal conductivity; the final panel with optimum conditions was morphologically analyzed using scanning electron microscopy (SEM); the thermal behavior was studied by thermogravimetric analysis (TGA); fire reaction and smoldering behavior were analyzed; and characterization in water absorption and acoustic absorption performances were established. The results show thermal conductivity values between 0.037 and 0.042 W/mK, a smoldering velocity of 3.40 mm/min, and a good acoustic absorption coefficient in octave frequency bands between 125 Hz and 4 kHz greater than 0.7. These characteristics are competitive with other insulating bio-based materials available on the market. This study employed chemicals utilized by other biomaterials for the pulping process and in flame retardants. However, it is important to investigate natural treatments or those with a diminished environmental impact.
Background
It is important to find out what would be the level of acceptance of xenotransplantation in society, especially in populations where there are preclinical trials. The Latin‐American ...population is growing in Spain, given the cultural, religious, and language similarities. Objectives: (i) to analyze attitude toward xenotransplantation in the population born in Latin America and now residing in Spain; and (ii) to establish the variables that affect this attitude.
Method
A sample of Latin‐American residents in Spain was obtained randomly in 2010 and stratified by the respondent's nationality (n = 1.314). Attitude was evaluated using a validated questionnaire (PCID—XenoTx Rios), which was completed anonymously and self‐administered. Statistical analysis: Student's t‐test, the Chi‐squared test, Fisher's exact test, and logistic regression analysis.
Results
The questionnaire completion rate was 89% (n = 1.165). If it was assumed that xenotransplanted organs functioned as well as human ones, 40% were in favor, 19% against, and 41% undecided. This attitude is related to: age (P = 0.003); sex (P = 0.002); level of education (P < 0.001); descendents (P = 0.003); country of origin (P < 0.001); participation in voluntary prosocial activities (P = 0.006); having spoken about donation and transplantation within the family (P < 0.001); a partner's favorable attitude toward transplantation (P < 0.001); previous experience of donation and/or transplantation (P < 0.001); a belief that one might need a transplant in the future (P < 0.001); and a favorable attitude toward human donation, both deceased as well as living (P < 0.001). In the multivariate analysis, the following variables continue to feature as independent variables: age (older: Odds Ratio = 1.041); sex (male: OR = 1.579); level of education (university: OR = 2.770); descendents (none: OR = 2.386); a partner's attitude toward transplantation (favorable: OR = 2.262); attitude toward deceased organ donation (favorable: OR = 1.587); previous experience of donation and/or transplantation (OR = 1.519); a belief that one might need a transplant in the future (OR = 1.675); and attitude toward related living donation (in favor: OR = 4.405).
Conclusions
Latin Americans who usually reside in Spain have a more negative attitude toward xenotransplantation than the native Spanish population, and their attitude is affected by many psychosocial factors, mainly related to previous attitude toward the different types of human organ donation.
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