Available design codes provide formulations to evaluate the maximum spacing between the cracks, which then is used to calculate the crack width in concrete structures. This paper discusses the ...parameters controlling the crack spacing and develops an experimental test program on a set of industrial-scale reinforced concrete elements cast with self-healing concretes to be tested under flexural actions. This study provides a wide picture of the limits of maximum, minimum, and average spacing occurring in the beams. A comparison is highlighted between the calculated and experimentally evaluated measures. It was observed that the provisions given in Eurocode 2 and Model code 2010 present a good approach for the calculation, always with a small degree of overestimation for concrete without fibres. On the other hand, the values calculated using recommendations from NFP 18-710, the overestimation is higher. The influence of loading levels seems to not affect the number of cracks with an increase in concrete cover. The experimentally evaluated ranges to relate maximum and minimum spacing with the average value in a loaded region are given. No influence of using self-healing agents was detected.
Introduction Family psychoeducation is an effective intervention extensively used in the treatment of mental disorders. Objectives To examine the efficacy of group psychoeducation in anxious and ...depressive symptoms in relatives of patients with addictive behaviours. To investigate satisfaction levels in relatives. Methods Seventy relatives of 53 outpatients were included into group psychoeducation between January and July 2012. This 8 session structured psychoeducational group is designed as follows: 1.5 hours every 3 weeks. To assess psychopathological symptoms, we used the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI), at baseline and at the end of the follow-up period. Family satisfaction levels were assessed by using the Visual Analogue Scale (VAS). Results 59% of relatives were men, and mean age was 55 years. 45% of the patients had a cocaine dependence disorder, 34% alcohol dependence disorder, and 93% co-dependence disorders. 74% had a dual diagnosis (Psychosis, affective disorders, or personality disorders). 90% had psychosocial stress (60% moderate or severe). Anxious symptoms were found in 30% of the relatives, being psychic anxiety most common in women than in men. Furthermore, depressive symptoms were found in 30% of relatives (mild:30%; moderate:25%, severe:15%). Women were more likely to have moderate-severe depression and men mild-depression disorders. After 8 sessions, mean satisfaction levels assessed by EVA Scale were 9.2 Conclusions Statistically significant gender differences in anxious and depressive symptoms were found in relatives. Satisfaction levels were higher than expected, and a significant reduction in anxiety and depression was found after the group psychoeducation.
Introduction In recent years, special attention has been paid to the quality of life in dual psychotic patients. Objectives To study quality of life in psychotic patients with co-occurring substance ...use recently treated with long-acting injectable paliperidone palmitate (PPLAI) in monotherapy. Method An open-label, non-interventional, observational study was carried out in 42 dual psychotic outpatients who were recently treated with PPLAI in monotherapy. At baseline, main demographic and clinical variables were recorded. The Health Status Questionnaire (SF-36) was assessed at the time of the study inclusion, and after 3 and 6 months. Thirty-five patients completed the study. Results 81% were men, and mean age was 39 years. 31% had an alcohol dependence disorder, 26% opiates, 24% cocaine, 14% cannabis, and 100% nicotine dependence. 95% had co-dependence substance use disorders. 38% per cent were diagnosed as having an unspecified psychosis, 36% schizophrenia, 57% Axis II and 55% III disorders. 29% were previously treated with oral antipsychotics, and 71% received long-acting injectable risperidone (RLAI). 83% were treated with other non-psychopharmacological drugs. After 6 months of treatment, higher scores were found in the following SF-36 items: Vitality (31 vs.77), social functioning (48 vs.85), mental health (49 vs 78), health subjective perception (45 vs.70), and health improvement (65 vs.87). Transaminase levels did not change after treatment. Mean PPLAI dosage at baseline: 111.18 mg; mean dosage at 6 months: 132.86. Conclusions High psychopathological and organic comorbidity was found. Quality of life improved after 6 months of treatment. PPLAI 100 mg was the most common prescribed dosage.
Introduction Group psychoeducation is an effective psychotherapy in the treatment of addictive behaviours. Objectives To evaluate the efficacy of group psychoeducation on quality of life in relatives ...of dual diagnosed patients. To investigate the impact of group psychoeducation on treatment compliance. Method A case-control study was conducted between January 2012 and July 2012. Case group: seventy relatives and 53 patients included into an 8 session systematic psychoeducational group designed as follows: 1.5 hours every 3 weeks. The control group was formed by 53 patients who did not participate in psychoeducation during the same period. To assess quality of life in relatives, we used the Health Status Questionnaire (SF-36). Attendance rates for appointments were recorded in patients from both groups. Results At baseline, relatives had poor outcomes in quality of life (Vitality: 49.8; emotional role: 49.3; mental health: 51.8, and general health perception: 54.9). Psychoeducated, as compared to control group relatives, had significantly better outcomes in quality of life (Vitality 71.0; emotional role 82.6; mental health 72.6, and general health perception 66.5). When compared to the control group, mean psychiatric appointments were higher in patients whose relatives were psychoeducated (8.2 vs.3.6). Conclusions Our findings suggest that psychoeducation can improve quality of life in relatives of patients with addictive behaviours. Attendance rates for appointments were higher in patients whose relatives were psychoeducated.
Introduction Long-acting atypical antipsychotics have been widely used in the treatment of substance use disorders and comorbid psychosis. Objectives To investigate the impact of long-acting ...injectable paliperidone palmitate (PPLAI) on craving and satisfaction levels in dual psychotic patients. Methods An open-label, non-interventional, prospective study was conducted in 42 dual psychotic outpatients who received PPLAI in monotherapy. Craving and satisfaction levels in patients and relatives were assessed by using the Visual Analogue Scale (VAS). We used the Clinical Global Impression Scale (CGI) to assess clinical severity and global improvement, and the GAF scale to assess global functioning. 35 patients completed the study and underwent a systematic assessment at baseline and after 3 and 6 months. Results After 6 months of treatment, mean craving scores decreased in patients treated with PPLAI when compared to baseline scores (4.9 vs 2.3). Mean satisfaction levels in dual psychotic patients increased (6.0 vs 9.1), and satisfaction levels in their relatives improved after 6 months (5.2 vs 9.5). Patients receiving PPLAI showed a statistically significant decrease in consumption relapses, had lower scores in CGI for clinical severity (CGISI), higher scores in global improvement (CGI-GI), and higher scores in global functioning. Conclusions After 6 months of PPLAI treatment, psychotic patients with substance use had lower craving levels. Satisfaction levels were higher in patients and their relatives. Consumption relapses decrease and patients had higher scores in global functioning.
Introduction The efficacy of long-acting injectable antipsychotics in dual schizophrenia patients has been well established. Objectives To investigate the efficacy of long-acting injectable ...paliperidone palmitate(PPLAI) in the psychopathology of dual psychotic patients. To examine the tolerability profile of PPLAI in dual psychosis. Method An open-label, non-interventional, prospective study was conducted in 42 dual psychotic outpatients who received PPLAI in monotherapy. We used the Brief Psychiatric Rating Scale (BPRS) to assess psychotic symptoms and the Udvalg für Kliniske Undersogelser Scale (UKU) to evaluate treatment tolerability, at baseline, and after 3 and 6 months of treatment. Prolactin levels were also determined at the time of the study inclusion and after 6 months. Results Thirty-five patients were included into the study. After 6 months of treatment, patients receiving PPLAI showed a significant improvement in positive symptoms (disorganisation, suspiciousness), negative symptoms (emotional withdrawal, motor retardation, blunted affect and confusion), affective symptoms (somatic concern, anxiety and depression) and in motor symptoms (unco-operativeness, excitement). When compared to the 3rd month assessment, after 6 months, statistically significant differences were found in items 4,11,14,17 and 18. Patients receiving PPLAI had lower rates of side effects assessed by UKU Scale (asthenia, sedation, failing memory, tension, insomnia, rigidity, tremor, weight gain and sexual dysfunction). Baseline prolactin levels ranged 11–122 (mean:38), at 6 months: 20–136 (mean:38.4). Conclusions After 6 months, patients receiving PPLAI had lower psychotic symptoms, a decrease in side effects, and a significant improvement in global functioning. No changes in prolactin levels were found.
Purpose
The hallmark of Primary immunodeficiencies (PID) is unusual infection, although other immunological non-infectious manifestations such as autoimmunity, allergy and cancer are often present. ...Most published reports focus on one disease or defect groups, so that a global prevalence of non-infectious manifestations of PID is hard to find. We aimed to describe the clinical features of our pediatric patients with PID, as well as the frequency and evolution of allergy, cancer and autoimmunity.
Methods
We reviewed all the available charts of patients being followed for PID from 1991 to the spring of 2012 at the National Institute of Pediatrics, Mexico City, to describe their demographic, clinical and laboratory features. Their diagnoses were established by pediatric immunologists in accordance to ESID criteria, including routine immunological workup and specialized diagnostic assays. We divided patients by decade of diagnosis to analyze their survival curves.
Results
There were 168 charts available, from which we excluded one duplicate and six equivocal diagnoses. We studied the charts of 161 PID patients (68 % male, 86 % alive), mostly from the center of the country, with a positive family history in 27 % and known consanguinity in 11 %. Eighty percent of the patients were diagnosed during the last decade. Current median age was 124 months; median age at onset of infections, 12 months; median age at diagnosis, 52 months; median age at death, 67.5 months. Severe infection and bleeding were the cause of 22 deaths. Eighty-six percent of all patients had at least one infection, while non-infectious manifestations had a global prevalence of 36 %, namely: autoimmunity 19 %, allergies 17 %, and cancer 2.4 %. Survival curves were not significantly different when compared by decade of diagnosis.
Conclusions
Compared to other registry reports, we found a lower prevalence of antibody defects, and of associated allergy and cancer. We could only locate two isolated IgA deficiencies and four cases of cancer among our PID patients. Although antibody defects are the most prevalent group (30 %), the distribution we found is similar to that reported in Iran, Kuwait, Egypt and Taiwan, with a close 27 % share for phagocyte defects, and 26 % for the formerly called “well-defined” syndromes. Of note, autoimmune and inflammatory complications are high among our patients with chronic granulomatous disease, as has been reported in both the United States and Japan, but not in Europe.
Fundamento: la utilización de mallas en la cirugía herniaria alcanzó su mayor popularidad a partir de los años 80. En el año 2007, en la Clínica Multiperfil de Luanda, Angola, se diseñó una nueva ...variante de colocación de la malla que cumple con todos los principios de la cirugía herniaria, basada en la oclusión del anillo herniario y el refuerzo de la pared del canal. En el año 2009 se introduce la técnica en el Hospital Enrique Cabrera en La Habana. Objetivo: mostrar los resultados de la aplicación de la técnica del cono extendido en el tratamiento de la hernia inguinal en el Hospital Docente Enrique Cabrera. Métodos: se realizó un estudio de serie de casos en 100 pacientes, en los cuales se operaron 110 hernias mediante una técnica protésica denominada cono extendido, durante los años 2009 al 2013 en el Hospital Enrique Cabrera de La Habana. Se utilizó la clasificación de Gilbert modificada por Rutkow y Robbin. Se analizó: edad, sexo, localización de la hernia, grado de la hernia según la clasificación de Gilbert, complicaciones e índice de recidivas. Resultados: hubo un predominó el sexo masculino. La localización más frecuente fue la región inguinal izquierda. Predominaron las hernias clasificadas como grado III según la clasificación de Gilbert. Hubo 15 complicaciones menores y hasta el momento no han ocurrido recidivas. Conclusiones: la técnica del cono extendido es una técnica segura y otra opción para el tratamiento de pacientes que presenten hernias inguinales del grado III, IV y VI de la clasificación de Gilbert modificada por Rutkow y Robbins.
Background: the use of meshes for hernia repair reached its greatest popularity in the 1980´s. In 2007, a new mesh placement technique was designed in the Multiprofile Clinic in Luanda, Angola, which ...meets all the requirements of hernia surgery, consisting in the occlusion of the hernia ring and reinforcement of the canal wall. In 2009 this procedure was introduced into the Enrique Cabrera Hospital in Havana.
Objective: to show the results of the extended cone technique in the treatment of inguinal hernia in the Enrique Cabrera Teaching Hospital.
Methods: a case series study was conducted in 100 patients in whom 110 hernias were operated using a prosthetic technique called extended cone, at the Enrique Cabrera Hospital in Havana between 2009 and 2013. Gilbert’s classification modified by Robbin and Rutkow was applied. The variables analyzed were age, sex, location of the hernia, type of hernia according to Gilbert’s classification, complications and recurrence rate.
Results: male patients predominated. The most frequent location was the left inguinal region. Type III hernias according to Gilbert’s classification were the most common. There were 15 minor complications and there have been no recurrences thus far.
Conclusions: the proposed technique is a safe procedure and another option for the treatment of patients with type III, IV and VI hernias according to Gilbert’s classification modified by Rutkow and Robbins.
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The reaction of derivatives of 3-acetyl-
d-glucal, 3-acetyl-
l-rhamnal, 3-acetyl-
d-galactal, and 3-acetyl-
d-lactal with sodium benzenesulfinate in acid medium catalyzed by HgSO
4 ...afforded diastereoisomeric mixtures of the corresponding 2,3-dideoxy-3-(phenylsulfonyl)-hexopyranoses through a Ferrier rearrangement. The anomeric alkoxyl radical fragmentation of these γ-hydroxy sulfones using the system (diacetoxyiodo)benzene and iodine gave vinyl sulfones with structures of 1,2-dideoxy-4-
O-formyl-2-(phenylsulfonyl)-pent-1-enitol and configurations
d-
erythro,
l-
erythro, and
d-
threo at the two stereogenic centers.
