LIQUID-PHASE MICROEXTRACTION FOR SIMULTANEOUS CHROMATOGRAPHIC ANALYSIS OF THREE ANTIDEPRESSANT DRUGS IN PLASMA

A method using Liquid Phase Microextraction for simultaneous detection of citalopram (CIT), paroxetine (PAR) and fluoxetine (FLU), using venlafaxine as internal standard, in plasma by high performance liquid chromatography with fluorescence detection was developed. The linearity was evaluated between 5.0 and 500 ng mL(-1) (r > 0.99) and the limit of quantification was 2.0, 3.0 and 5.0 ng mL-1 for CIT. PAR and FLU, respectively. Therefore, it can be applied to therapeutic drug monitoring, pharmacokinetics or bioavailability studies and its advantages are that it necessary relatively inexpensive equipment and sample preparation techniques.

New approach for power transformer protection based on intelligent hybrid systems

A power transformer needs continuous monitoring and fast protection as it is a very expensive piece of equipment and an essential element in an electrical power system. The most common protection technique used is the percentage differential logic, which provides discrimination between an internal fault and different operating conditions. Unfortunately, there are some operating conditions of power transformers that can mislead the conventional protection affecting the power system stability negatively. This study proposes the development of a new algorithm to improve the protection performance by using fuzzy logic, artificial neural networks and genetic algorithms. An electrical power system was modelled using Alternative Transients Program software to obtain the operational conditions and fault situations needed to test the algorithm developed, as well as a commercial differential relay. Results show improved reliability, as well as a fast response of the proposed technique when compared with conventional ones.

A Low Power CMOS Voltage Regulator for a Wireless Blood Pressure Biosensor

This paper describes a CMOS implementation of a linear voltage regulator (LVR) used to power up implanted physiological signal systems, as it is the case of a wireless blood pressure biosensor. The topology is based on a classical structure of a linear low-dropout regulator. The circuit is powered up from an RF link, thus characterizing a passive radio frequency identification (RFID) tag. The LVR was designed to meet important features such as low power consumption and small silicon area, without the need for any external discrete components. The low power operation represents an essential condition to avoid a high-energy RF link, thus minimizing the transmitted power and therefore minimizing the thermal effects on the patient's tissues. The project was implemented in a 0.35-mu m CMOS process, and the prototypes were tested to validate the overall performance. The LVR output is regulated at 1 V and supplies a maximum load current of 0.5 mA at 37 degrees C. The load regulation is 13 mV/mA, and the line regulation is 39 mV/V. The LVR total power consumption is 1.2 mW.

Hurdles at work: perceptions of hospital food handlers

Abstract Background Food handlers have a very important role in preventing food contamination during its preparation and distribution. This responsibility is even greater in hospitals, since a large number of patients have low immunity and consequently food contamination by pathogenic bacteria could be particularly harmful. Therefore, a good working environment and periodic training should be provided to food handlers by upper management. Methods This study is qualitative research by means of focus group and thematic content analysis methodologies to examine, in detail, the statements by food handlers working in the milk and specific-diet kitchens in a hospital to understand the problems they face in the workplace. Results We found that food handlers are aware of the role they play in restoring patients' health; they consider it important to offer a good-quality diet. However, according to their perceptions, a number of difficulties prevent them from reaching this aim. These include: upper management not prioritizing human and material resources to the dietetic services when making resource allocation decisions; a perception that upper management considers their work to be of lesser importance; delayed overtime payments; lack of periodic training; managers lacking administrative skills; insufficient dietitian staff assistants, leading to overwork, at the same time as there is an excess of dietitians; unhealthy environmental working conditions – high temperature, high humidity, loud and constant noise level, poor ventilation; lack of food, and kitchen utensils and equipment; and relationship conflicts with chief dieticians and co-workers. Conclusion From these findings, improvement in staff motivation could be achieved by considering non-financial incentives, such as improvement in working conditions and showing appreciation and respect through supervision, training and performance appraisal. Management action, such as investments in intermediary management so that managers have the capacity to provide supportive supervision, as well as better use of performance appraisal and access to training, may help overcome the identified problems.

Liquid-phase microextraction for simultaneous chromatographic analysis of three antidepressant drugs in plasma

A method using Liquid Phase Microextraction for simultaneous detection of citalopram (CIT), paroxetine (PAR) and fluoxetine (FLU), using venlafaxine as internal standard, in plasma by high performance liquid chromatography with fluorescence detection was developed. The linearity was evaluated between 5.0 and 500 ng mL-1 (r > 0.99) and the limit of quantification was 2.0, 3.0 and 5.0 ng mL-1 for CIT, PAR and FLU, respectively. Therefore, it can be applied to therapeutic drug monitoring, pharmacokinetics or bioavailability studies and its advantages are that it necessary relatively inexpensive equipment and sample preparation techniques.

Doppler-guided hemorrhoidal artery ligation with rectal mucopexy technique: initial evaluation of 42 cases

The treatment of hemorrhoidal disease (HD) by conventional hemorrhoidectomy is associated with significant morbidity, mainly represented by the postoperative pain and the late return to daily activities. Doppler-guided hemorrhoid artery ligation (DGHAL) is a minimal-invasive surgical treatment for HD that has been used as an alternative method in order to reduce these inconveniences. OBJECTIVE: To analyze the initial results of the DGHAL technique associated with rectal mucopexy in the treatment of HD. METHODS:Forty-two patients with stage I, III and IV hemorrhoids who were submitted to DGHAL were analyzed from December 2010 to August 2011. Eleven patients (26%) were stage II; 21 (50%), stage III; and 10 (24%), stage IV HD. All patients were operated by the same surgeon under spinal anesthesia and using the same equipment and technique to perform the procedure. The 42 patients underwent ligation of six arterial branches followed by rectal mucopexia by uninterrupted suture. Nine patients needed concomitant removal of perianal skin tag. In the postoperative, the following parameters were evaluated: pain, tenesmus, bleeding, itching, prolapse, mucus discharge and recurrence. The mean postoperative follow-up lasted four months (one to nine months). RESULTS: Tenesmus was the most common postoperative complaint for 85.7% of patients followed by pain, in 28.6%, perianal burning, in 12.3%, mucus discharge and perianal hematoma in 4.7%. Two patients had severe postoperative bleeding and required surgical haemostasis, one of which needed blood transfusion. Ninety-five percent of the patients declared to be satisfied with the method. CONCLUSION: Even though DGHAL has complications similar to those of other surgical methods, its results present less postoperative pain, allowing faster recovery and return to work. Studies with more cases and a longer follow-up are still necessary to assess the late recurrence.

La pesca artesanal en Arguineguín: Evolución del poder de pesca

[ES] La evolución del poder de pesca de la flota artesanal con base en el puerto de Arguineguín, desde mediados del Siglo XX, ha tenido un impacto negativo en el estado de los recursos del sur y suroeste de la isla de Gran Canaria. El incremento escalonado en el poder de pesca, pasando primero por la motorización de las embarcaciones (1950- 1970), los cambios en los materiales de construcción de artes y trampas utilizadas (1960-1970), mejora de las infraestructuras portuarias y de asistencia a los buques (1980-1990), hasta la introducción de equipamiento electrónico y mejoras de las embarcaciones (1990-2010), han ido siempre acompañadas de fases breves de aumentos en las capturas, seguidos por periodos más prolongados de decrecimiento de los rendimientos.

Le aziende vitivinicole: da “machines à produire” a elementi di attrazione nel paesaggio. Proposte e criteri progettuali per l’efficienza funzionale e la qualità architettonica ed ambientale delle strutture ed infrastrutture della trasformazione enologica.

La ricerca ha per oggetto la messa a punto e applicazione di un approccio metaprogettuale finalizzato alla definizione di criteri di qualità architettonica e paesaggistica nella progettazione di aziende vitivinicole medio-piccole, che effettuano la trasformazione della materia prima, prevalentemente di propria produzione. L’analisi della filiera vitivinicola, della letteratura scientifica, della normativa di settore, di esempi di “architetture del vino eccellenti” hanno esplicitato come prevalentemente vengano indagate cantine industriali ed aspetti connessi con l'innovazione tecnologica delle attrezzature. Soluzioni costruttive e tecnologiche finalizzate alla qualità architettonica ed ambientale, attuali dinamiche riguardanti il turismo enogastronomico, nuove funzionalità aziendali, problematiche legate alla sostenibilità dell’intervento risultano ancora poco esplorate, specialmente con riferimento a piccole e medie aziende vitivinicole. Assunto a riferimento il territorio ed il sistema costruito del Nuovo Circondario Imolese (areale rappresentativo per vocazione ed espressione produttiva del comparto vitivinicolo emiliano-romagnolo) è stato identificato un campione di aziende con produzioni annue non superiori ai 5000 hl. Le analisi svolte sul campione hanno permesso di determinare: modalità di aggregazione funzionale degli spazi costruiti, relazioni esistenti con il paesaggio, aspetti distributivi e materico-costruttivi, dimensioni di massima dei locali funzionali alla produzione. Il caso studio relativo alla riqualificazione di un’azienda rappresentativa del comparto è stato utilizzato per la messa a punto e sperimentazione di criteri di progettazione guidati da valutazioni relative alle prestazioni energetiche, alla qualità architettonica e alla sostenibilità ambientale, economica e paesaggistica. L'analisi costi-benefici (pur non considerando le ricadute positive in termini di benessere degli occupanti ed il guadagno della collettività in termini di danni collegati all’inquinamento che vengono evitati in architetture progettate per garantire qualità ambientale interna ed efficienza energetica) ha esplicitato il ritorno in pochi anni dell’investimento proposto, nonostante gli ancora elevati costi di materiali di qualità e dei componenti per il corretto controllo climatico delle costruzioni.

Le società pubbliche a partecipazione regionale e locale operanti nei settori dei servizi pubblici locali e dei servizi “strumentali” e quelle con scopo lucrativo: la recente evoluzione legislativa, gli ambiti di attività ed i relativi limiti, le prospettive future.

Con la prima parte, si intende fornire un quadro pressoché esaustivo delle principali disposizioni in materia di società a partecipazione pubblica regionale e locale operanti nel campo dei servizi pubblici locali e della loro interpretazione giurisprudenziale e dottrinale, prendendo le mosse dagli ultimi interventi legislativo. Nella seconda parte, si affronta, invece, il tema dei limiti legislativi alla capacità di azione delle società a partecipazione pubblica e dei connessi dubbi interpretativi, anche alla luce degli orientamenti giurisprudenziali e dottrinali. In particolare, l’analisi riguarda l’art. 13 del decreto”Bersani” e il comma 9 dell’art. 23 bis (ora pedissequamente trasfuso nel comma 33 dell’art. 4 del d.l. n. 138/2011), ossia le principali disposizioni che definiscono, rispettivamente, la capacità di azione delle società (a partecipazione pubblica) strumentali e di quelle operanti nel campo dei servizi pubblici locali titolari di affidamenti diretti (assentiti con modalità diverse dall’evidenza pubblica). Vengono forniti cenni di inquadramento in relazione al cd. procedimento di riordino delle partecipazioni societarie pubbliche previsto dalla legge finanziaria del 2008 (art. 3, commi 27 – 32). Dal combinato disposto delle suddette norme, così come interpretate dalla giurisprudenza costituzionale ed amministrativa, si ricavano, poi, utili indicazioni in ordine alla possibilità, per gli enti pubblici territoriali, di costituire società con scopo meramente lucrativo (ossia, soggetti societari privi del rapporto di strumentalità con gli enti costituenti o partecipanti, chiamati ad operare, in regime di concorrenza, in settori completamente liberalizzati) e società cd. multiutilities (aventi oggetto sociale complesso, la cui attività si estrinseca tanto nel campo dei servizi strumentali, quanto in quello dei servizi pubblici locali), nonché in relazione alla disciplina applicabile all’attività di detti soggetti societari. La finalità ultima del contributo consiste nell'individuazione delle linee guida finalizzate alla classificazione delle società pubbliche in funzione della loro attività.

Perdite aeree prolungate dopo resezione polmonare

Il tumore del polmone e una delle neoplasie più diagnosticate dal 1985 e rimane ancora oggi la causa più frequente di morte cancro-correlata nel mondo. Una resezione polmonare anatomica completa continua ad essere il cardine della terapia per il tumore non a piccole cellule. Perdite aeree prolungate (PAL) sono la più comune complicanza dopo una chirurgia polmonare e sono state riportate con un’incidenza compresa tra il 3-26%, simile sia nelle resezioni polmonari per via toracotomica sia in quelle per via toracoscopica. Fattori di rischio descritti sono scissure interlobari incomplete, patologie polmonari sottostanti (come enfisema, fibrosi, tubercolosi o neoplasie), aderenze pleuriche, pazienti anziani (>75 anni) e bassa capacita di diffusione. Lo sviluppo di strumentazione all’avanguardia e di nuove tecniche chirurgiche ha contribuito a ridurre l’incidenza di queste complicanze. Considerando l’alto impatto clinico e socio-economico di queste problematiche, e stata inoltre sviluppata una varietà di complementari naturali e materiali sintetici molti utili nella gestione delle perdite aeree.

Prognostic factors in apical surgery with root-end filling: a meta-analysis

INTRODUCTION: Apical surgery has seen continuous development with regard to equipment and surgical technique. However, there is still a shortage of evidence-based information regarding healing determinants. The objective of this meta-analysis was to review clinical articles on apical surgery with root-end filling in order to assess potential prognostic factors. METHODS: An electronic search of PubMed and Cochrane databases was performed in 2008. Only studies with clearly defined healing criteria were included, and data for at least two categories per prognostic factor had to be reported. Prognostic factors were divided into patient-related, tooth-related, or treatment-related factors. The reported percentages of healed teeth ("the healed rate") were pooled per category. The statistical method of Mantel-Haenszel was applied to estimate the odds ratios and their 95% confidence intervals. RESULTS: With regard to tooth-related factors, the following categories were significantly associated with higher healed rates: cases without preoperative pain or signs, cases with good density of root canal filling, and cases with absence or size < or = 5 mm of periapical lesion. With regard to treatment-related factors, cases treated with the use of an endoscope tended to have higher healed rates than cases without the use of an endoscope. CONCLUSIONS: Although the clinician may be able to control treatment-related factors (by choosing a certain technique), patient- and tooth-related factors are usually beyond the surgeon's power. Nevertheless, patient- and tooth-related factors should be considered as important prognostic determinants when planning or weighing apical surgery against treatment alternatives.

INTEGRATION D’UN OBSERVATOIRE URBAIN SUR GOOGLE MAPS : Cas des infrastructures de la santé de la ville de Douala Cameroun

The spectacular advances computer science applied to geographic information systems (GIS) in recent times has favored the emergence of several technological solutions. These developments have given rise to enormous opportunities for digital management of the territory. Among the technological solutions, the most famous Google Maps offers free online mapping dynamic exhaustive of the Maps. In addition to meet the enormous needs of urban indicators geotagged information, we did work on this project “Integration of an urban observatory on Google Maps.” The problem of geolocation in the urban observatory is particularly relevant in the sense that there is currently no data (descriptive and geographical) reliable on the urban sector; we must stick to extrapolate from data old and obsolete. This helps to curb the effectiveness of urban management to make difficult investment programming and to prevent the acquisition of knowledge to make cities engines of growth. The use of a geolocation tool coupled to the data would allow better monitoring of indicators Our project's objective is to develop an interactive map server (WebMapping) which map layer is formed from the resources of the Google Maps servers and match information from the field to produce maps of urban equipment and infrastructure of a city data to the client's request To achieve this goal, we will participate in a study of a GPS location of strategic sites in our core sector (health facilities), on the other hand, using information from the field, we will build a postgresql database that will link the information from the field to map from Google Maps via KML scripts and PHP appropriate. We will limit ourselves in our work to the city of Douala Cameroon with the sectors of health facilities with the possibility of extension to other areas and other cities. Keywords: Geographic Information System (GIS), Thematic Mapping, Web Mapping, data mining, Google API.

Aortic rupture in high-speed skiing crashes

BACKGROUND: New equipment and techniques in winter sports, such as carving skis and snowboards, have brought up new trauma patterns into the spectrum of leisure trauma. The injuries resemble high-energy trauma known from road crashes. The aim of the present study was to assess the incidence of acute traumatic descending aortic rupture in recreational skiing-crashes. MATERIAL: Between January 1995 and December 2004, 22 patients were admitted to our hospital for aortic rupture. Four patients had skiing crashes (18.2%). Mean age was 31 years, all patients were male. In two cases, aortic rupture was associated with fractures of the upper and lower extremities. One patient additionally had a cerebral contusion with an initial Glasgow Coma Scale score of 13. In two patients, isolated aortic rupture was diagnosed. RESULTS: Two patients were treated by graft interposition, and one by endograft. One patient arrived under mechanical resuscitation without blood pressure. He died at admission. He had been observed for 5 hours in another hospital, complaining of severe intrascapular back pain, before transport to our trauma unit for unknown bleeding. In the other three cases, treatment was successful. CONCLUSION: Rescue services and paramedics should be aware of this new type of injury. Acute aortic rupture has to be considered as possible injury in high velocity skiing crashes.

Interactional behaviour as a marker for screening patients with environment-related complaints

BACKGROUND: Adequate assessment of symptoms of patients suffering from environmental illnesses requires appropriate procedures such as psychological and psychiatric diagnostics, medical screening and a thorough analysis of noxious environmental factors. The Basel pilot research project established a multi-methodological assessment procedure that meets these criteria. However, an exhaustive three-fold analysis is very costly in terms of both equipment and personnel, and hence the need for a heuristic approach and pre-screening persists. METHOD: The three-fold diagnostic approach was preceded by a structured psychodynamic interview; the findings were used to construct a new profile of the patient's interactional behaviour (IB) in conjunction with the interviewer's countertransference. The extent to which this new profile could predict the results of the multi-method assessment was then assessed. RESULTS: A low level of IB on the part of the patient significantly predicted the degree of stress and the extent of the psychiatric diagnosis, including personality disorders. A negative IB was associated with negative personality traits. Furthermore, a high level of IB implied more medical, but not more environmental, findings which could plausibly be related to the patient's complaints. CONCLUSIONS: Assessment of patients' IB in conjunction with one's own countertransference is very helpful as a preliminary heuristic approach and may lead to consequences for treatment and therapy. Therefore, the training provided for experts who deal with patients suffering from environment-related complaints should place more specific emphasis on assessing patients' behaviour and on incorporating information gathered from countertransference. Nevertheless, an interdisciplinary assessment including medical, psychological/psychiatric, and environmental expertise remains mandatory for adequate and satisfactory diagnosis of patients with environment-related complaints.

[Herd problem: udder health. Retrospective study of farms assessed by the Swiss Bovine Health Service (BHS) from 1999 to 2004]

Data from 59 farms with complaints of udder health problems and insufficient quality of delivered milk that had been assessed by the Swiss Bovine Health Service (BHS) between 1999 and 2004 were retrospectively analysed. Data evaluated included farm characteristics such as farm size, herd size, average milk yield, milking system and housing system, deficits of the milking equipment and the milking practices, and bacteriological results of milk samples from all cows in lactation. The average size of the farms assessed by the BHS was larger than the size of the were evaluated, 42 showed obvious failures which the farm managers could have noticed. Only 5 of the 57 milkers carried out their work according to the generally valid guidelines of the National Mastitis Council. More than 2 basic mistakes were observed in the milking practices of 36 milkers. In 51 farms, mixed infections with several problem bacteria (those present in at least 20 % of the tested cows on a farm) were found. Staphylococcus aureus proved to be the most common problem germ. As the bacteria responsible for the herd problem (the sole problem bacteria detectable on a particular farm) Staphylococcus aureus was detected in 4 farms. The current study revealed that education in the area of milking techniques and milking practices of farmers should be improved in order to reduce the incidence of udder health problems on herd level. Staphylococcus aureus is the most important problem bacteria involved in herds with udder health problems in Switzerland. Staphylococcus aureus might be used in practice as the indicator germ for early recognition of management problems in dairy farms.