Non-invasive diagnostic and prognostic evaluation of liver cirrhosis and portal hypertension.

Cirrhosis is the final stage of most of chronic liver diseases, and is almost invariably complicated by portal hypertension, which is the most important cause of morbidity and mortality in these patients. This review will focus on the non-invasive methods currently used in clinical practice for diagnosing liver cirrhosis and portal hypertension. The first-line techniques include physical examination, laboratory parameters, transient elastography and Doppler-US. More sophisticated imaging methods which are less commonly employed are CT scan and MRI, and new technologies which are currently under evaluation are MR elastography and acoustic radiation force imaging (ARFI). Even if none of them can replace the invasive measurement of hepatic venous pressure gradient and the endoscopic screening of gastroesophageal varices, they notably facilitate the clinical management of patients with cirrhosis and portal hypertension, and provide valuable prognostic information.

Evaluation of subsidies programs to sell green cars: Impact on prices, quantities and efficiency

During the recent period of economic crisis, many countries have introduced scrappage schemes to boost the sale and production of vehicles, particularly of vehicles designed to pollute less. In this paper, we analyze the impact of a particular scheme in Spain (Plan2000E) on vehicle prices and sales figures as well as on the reduction of polluting emissions from vehicles on the road. We considered the introduction of this scheme an exogenous policy change and because we could distinguish a control group (non-subsidized vehicles) and a treatment group (subsidized vehicles), before and after the introduction of the Plan, we were able to carry out our analysis as a quasi-natural experiment. Our study reveals that manufacturers increased vehicle prices by the same amount they were granted through the Plan (1,000 €). In terms of sales, econometric estimations revealed an increase of almost 5% as a result of the implementation of the Plan. With regard to environmental efficiency, we compared the costs (inverted quantity of money) and the benefits of the program (reductions in polluting emissions and additional fiscal revenues) and found that the Plan would only be beneficial if it boosted demand by at least 30%.

Evaluation of detection methods for Virus, Viroids and Phytoplasmas affecting pear and apple

The RT-PCR technique for the detection of apple stem grooving virus (ASGV), apple stem pitting virus (ASPV), apple chlorotic leaf spot virus (ACLSV), apple mosaic virus (ApMV) and pear blister canker viroid (PBCV) was evaluated for health control of fruit plants from nurseries. The technique was evaluated in purified RNA and crude extracts and also in phloem collected in autumn and from young spring shoots. The results obtained for phytoplasma detection with ribosomal and non-ribosomal primers are also presented.

CO2 wedged hepatic venography in the evaluation of portal hypertension.

BACKGROUND/AIMS/METHODS During hepatic vein catheterisation, in addition to measurement of hepatic venous pressure gradient (HVPG), iodine wedged retrograde portography can be easily obtained. However, it rarely allows correct visualisation of the portal vein. Recently, CO2 has been suggested to allow better angiographic demonstration of the portal vein than iodine. In this study we investigated the efficacy of CO2 compared with iodinated contrast medium for portal vein imaging and its role in the evaluation of portal hypertension in a series of 100 patients undergoing hepatic vein catheterisation, 71 of whom had liver cirrhosis. RESULTS In the overall series, CO2 venography was markedly superior to iodine, allowing correct visualisation of the different segments of the portal venous system. In addition, CO2, but not iodine, visualised portal-systemic collaterals in 34 patients. In cirrhosis, non-visualisation of the portal vein on CO2 venography occurred in 11 cases; four had portal vein thrombosis and five had communications between different hepatic veins. Among non-cirrhotics, lack of portal vein visualisation had a 90% sensitivity, 88% specificity, 94% negative predictive value, and 83% positive predictive value in the diagnosis of pre-sinusoidal portal hypertension. CONCLUSIONS Visualisation of the venous portal system by CO2 venography is markedly superior to iodine. The use of CO2 wedged portography is a useful and safe complementary procedure during hepatic vein catheterisation which may help to detect portal thrombosis. Also, lack of demonstration of the portal vein in non-cirrhotic patients strongly suggests the presence of pre-sinusoidal portal hypertension.

Evaluation of reclamation technologies for wastewater reuse

Reclamation and reuse of wastewater require the use of tools that minimize risks to health and natural ecosystems. There are various types of such tools, among which HACCP (hazardanalysis and critical control points) and barrier systems are gainingimportance. The research reported here aims to determine andevaluate the most efficient combinations of different treatmentsystems—barriers—for the reclamation of secondary effluentsfrom urban sewage treatment plants, and for obtaining water ofsufficient quality for reuse in accordance with existing legislation,in which water disinfection has become one of the keys tocompliance. Several conventional and non-conventional reclamationtechnologies are evaluated. The results lead us to recommendtreatment lines for the different reclaimed water uses established inthe Spanish legislation.

A proposal to establish indicators for the evaluation of municipal councils' socio-cultural policies

How can municipal sociocultural policies stimulate and promote community empowerment, civic creativity or social cohesion? What objectives should be proposed at the municipal level to promote processes of sociocultural community development? How can we identify local needs in order to stimulate community development processes? In response to these questions, our paper proposes a creative solution: indicators to evaluate sociocultural policies. The proposal will enable us to obtain information about our own reality and, at the same time, contribute to producing changes and to outlining possible de intervention strategies for local administrations. The proposal describes a system of creative, flexible and rigourous indicators intended for municipal technicians and politicians interested in evaluating their sociocultural actions and strategies. We present the result of a research process whose methods included validation of the indicators by experts and technicians in or related to sociocultural community development, and the application of this system based on a case study of a Spanish municipality. Among the proposed indicators specific consideration is given to the support of local creators and the promotion of civic creativity, as well as the use, the creation and the articulation of sociocultural activities as strategies to contribute to cultural and civic diversity

Evaluation of a pharmacist intervention on patients initiating pharmacological treatment for depression: a randomized controlled superiority trial

Major depression is associated with high burden, disability and costs. Non-adherence limits the effectiveness of antidepressants. Community pharmacists (CP) are in a privileged position to help patients cope with antidepressant treatment. The aim of the study was to evaluate the impact of a CP intervention on primary care patients who had initiated antidepressant treatment. Newly diagnosed primary care patients were randomised to usual care (UC) (92) or pharmacist intervention (87). Patients were followed up at 6 months and evaluated three times (Baseline, and at 3 and 6 months). Outcome measurements included clinical severity of depression (PHQ-9), health-related quality of life (HRQOL) (Euroqol-5D) and satisfaction with pharmacy care. Adherence was continuously registered from the computerised pharmacy records. Non-adherence was defined as refilling less than 80% of doses or having a medication-free gap of more than 1 month. Patients in the intervention group were more likely to remain adherent at 3 and 6 months follow-up but the difference was not statistically significant. Patients in the intervention group showed greater statistically significant improvement in HRQOL compared with UC patients both in the main analysis and PP analyses. No statistically significant differences were observed in clinical symptoms or satisfaction with the pharmacy service. The results of our study indicate that a brief intervention in community pharmacies does not improve depressed patients' adherence or clinical symptoms. This intervention helped patients to improve their HRQOL, which is an overall measure of patient status.

Experimental evaluation of anonymous protocols under the JXTA middleware

JXTA is a peer-to-peer (P2P) middleware whichhas undergone successive iterations through its 10 years of history, slowly incorporating a security baseline that may cater to different applications and services. However, in order to appeal to a broader set of secure scenarios, it would be interesting to take into consideration more advanced capabilities, such as anonymity.There are several proposals on anonymous protocols that can be applied in the context of a P2P network, but it is necessary to be able to choose the right one given each application¿s needs. In this paper, we provide an experimental evaluation of two relevant protocols, each one belonging to a different category of approaches to anonymity: unimessage and split message. Webase our analysis on two scenarios, with stable and non-stable peers, and three metrics: round trip-time (RTT), node processing time and reliability.

The use of non-animal alternatives in the safety evaluations of cosmetics ingredients by the Scientific Committee on Consumer Safety (SCCS)

In Europe, the safety evaluation of cosmetics is based on the safety evaluation of each individual ingredient. Article 3 of the Cosmetics Regulation specifies that a cosmetic product made available on the market is to be safe for human health when used normally or under reasonably foreseeable conditions. For substances that cause some concern with respect to human health (e.g. colorants, preservatives, UV-filters), safety is evaluated at the Commission level by a scientific committee, presently called the Scientific Committee on Consumer Safety (SCCS). According to the Cosmetics Regulations, in the EU, the marketing of cosmetics products and their ingredients that have been tested on animals for most of their human health effects, including acute toxicity, is prohibited. Nevertheless, any study dating from before this prohibition took effect is accepted for the safety assessment of cosmetics ingredients. The in vitro methods reported in the dossiers summited to the SCCS are here evaluated from the published reports issued by the scientific committee of the Directorate General of Health and Consumers (DG SANCO); responsible for the safety of cosmetics ingredients. The number of studies submitted to the SCCS that do not involve animals is still low and in general the safety of cosmetics ingredients is based on in vivo studies performed before the prohibition.