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The present work aims to characterize the ephemeral mineral assemblage related to the fumarolic fields of the Tajogaite volcano, formed in 2021 in La Palma Island (Canary Islands, Spain). A set of 73 samples was obtained after two sampling campaigns in different fumarole sectors of the studied area. Mineralization related to these fumaroles formed efflorescent patches located at variable distance from the main volcanic craters. Distal patches are predominantly whitish, while in the vicinities they typically show yellowish to orange colours. Field observations also revealed that fumaroles usually occur in elevated topographic areas as well as over fractured and porous volcanic pyroclastic materials. The mineralogical and textural characterisation of the Tajogaite fumaroles unfolds a complex mineral assemblage, comprising cryptocrystalline phases related to low (

Chronic obstructive pulmonary disease (COPD) is a prevalent condition mainly related to smoking, which is associated with a substantial economic burden. The purpose was to compare healthcare resource utilization and costs according to smoking status in patients with COPD in routine clinical practice. A retrospective cohort nested case–control study was designed. The cohort was composed of male and female COPD outpatients, 40 years or older, covered by the Badalona Serveis Assistencials (a health provider) health plan. Cases were current smokers with COPD and controls (two per case) were former smokers with COPD (at least 12 months without smoking), matched for age, sex, duration of COPD, and burden of comorbidity. The index date was the last visit recorded in the database, and the analysis was performed retrospectively on healthcare resource utilization data for the 12 months before the index date. A total of 930 COPD records were analyzed: 310 current and 620 former smokers [mean age 69.4 years (84.6 % male)]. Cases had more exacerbations, physician visits of any type, and drug therapies related to COPD were more common. As a consequence, current smokers had higher average annual healthcare costs: €3,784 (1,888) versus €2,302 (2,451), p

Treatment persistence is low in patients with overactive bladder (OAB), but persistence may vary among antimuscarinic agents. This study compared treatment persistence in patients with OAB receiving fesoterodine, solifenacin, or tolterodine as their initial OAB prescription in a routine clinical practice setting. This retrospective study used medical records from primary healthcare centers in three locations in Spain; records from patients aged ≥18 years with a diagnosis of OAB who initiated antimuscarinic treatment for OAB (fesoterodine, tolterodine, or solifenacin) were included. The first prescription of one of the OAB study medications was considered the index date; patients were followed for ≥52 weeks. Persistence was estimated using Kaplan–Meier curves and Cox proportional hazard regression models, adjusting for covariates. A total of 1,971 records of patients (58.3 % women; mean age 70.1 years) initiating treatment with fesoterodine (n = 302), solifenacin (n = 952), or tolterodine (n = 717) were included. Unadjusted mean (±SD) treatment duration was 31.5 ± 17.6 weeks for fesoterodine, 29.9 ± 21.4 for solifenacin and 29.0 ± 21.6 for tolterodine (p = 0.217). At week 52, 35.8 % of fesoterodine-treated patients remained on their initial therapy, versus 31.9 % of solifenacin-treated (hazard ratio [HR], 1.24; 95 % CI, 1.05–1.47; p = 0.011) and 30.9 % of tolterodine-treated (HR = 1.28; 95 % CI, 1.07–1.52; p = 0.006) patients. Findings were consistent when the definition for discontinuation was varied. Overall persistence at week 52 was low, but the cumulative probability of persisting with initial therapy was significantly higher for fesoterodine than for solifenacin or tolterodine in clinical practice in Spain.

Hypoxic hepatitis may be induced by hemodynamic instability or arterial hypoxemia in critically ill patients. We investigated the incidence, etiology, association with systemic ischemic injury and risk factors for mortality in this population. Retrospective analysis of patients with hypoxic hepatitis admitted to a multidisciplinary intensive care unit (ICU) of a university hospital. Hypoxic hepatitis was defined as the existence of a compatible clinical setting (cardiocirculatory failure or arterial hypoxemia) and aminotransferase levels higher than 1000 IU/L. During the 8-year study period, 182 out of the 7674 patients admitted presented hypoxic hepatitis (2.4%). The most common cause was septic shock. The rate of in-hospital mortality in hypoxic hepatitis was 61.5% (112 patients), and was higher in patients with septic shock (83.3%) and cardiac arrest (77.7%). Ischemic pancreatitis (25.6%), rhabdomyolysis (41.2%) and renal failure (67.2%) were common in these patients. Risk factors of mortality were prolonged INR (p = 0.005), need for renal replacement therapy (p = 0.001) and septic shock (p = 0.005). Hypoxic hepatitis was not a rare condition, and was frequently accompanied by multiorgan injury, with high mortality. Risk factors for increased mortality were prolonged INR, need for renal replacement therapy, and septic shock.

Endocrine disturbances are common after traumatic brain injury (TBI). Hypothalamic-pituitary-adrenal (HPA) axis response in TBI patients may be related with hemodynamic status. However, its relationship with outcome is unclear. Our objective was to evaluate HPA axis response in the acute phase after TBI in patients with or without extracerebral trauma (ECT), and to investigate the impact of systemic injury and the mechanisms underlying HPA response.We prospectively studied 165 patients with moderate to severe TBI. Between 24 and 48 h after TBI, blood samples were taken for plasma adrenocorticotrophin hormone (ACTH) and baseline cortisol measurements. Afterwards, a short corticotrophin hormone test (250 mug Synacthen) was performed and samples were obtained at 30 and 60 min. We compared HPA response in TBI patients presenting with and without ECT and investigate potential mechanisms underlying this response.One hundred and eight patients presented with isolated TBI, whereas 57 patients presented associated ECT. Both groups were comparable. Overall, 23.6% of patients fulfilled adrenal insufficiency (AI) criteria. Patients with plasma ACTH9 pg/ml and patients presenting with hemorrhagic shock were more likely to present adrenal impairment. Variables associated with mortality were Injury Severity Score, Glasgow Coma Scale, Traumatic Coma Data Bank classification different than type II, need of second level measures to control intracranial pressure and plasma ACTH9 pg/ml.Patients with TBI presenting with or without associated ECT present similar acute HPA response. AI is present in 23.6% of patients. Risk is increased in patients with low plasma ACTH levels and in patients with hemorrhagic shock. Both primary and secondary mechanisms of HPA failure were found. However, AI did not affect outcome.

To demonstrate that blind insertion of the protected telescoping catheter (PTC-NB) through the orotracheal tube can provide reliable pulmonary samples for the diagnosis of nosocomial pneumonia (NP) in ventilated patients.We performed a random comparison between the protected telescoping catheter introduced through a bronchofiberscope (PTC-B) and the PTC-NB to diagnose NP.A general intensive care unit of a University Hospital.40 consecutive patients on mechanical ventilation and with suspicion of NP. The diagnosis of NP was suspected by clinical and chest X-ray findings.NP was confirmed microbiologically in 26 (65%) patients and maintained in 8 patients by clinical and radiological criteria. PTC-NB confirmed the microbiological diagnosis of PN in 21 (80%) patients. The use of antibiotics prior taking respiratory samples reduced the sensitivity of PTC-NB and PTC-B from 100-74% and from 94-70% (p = 0.001). Both techniques agreed in 24 of 33 (73%) patients but such agreement was better when PN was on the right lung. Two patients developed a self-limiting hemoptysis after the PTC-B procedure.PTC-NB is as sensitive as specific as PTC-B for diagnosing PN in mechanically ventilated patients, being a much easier technique to use.

We have analyzed the degree of crystalline lattice recovery in samples implanted with Ti concentrations well above the Mott limit and subsequently Pulsed-Laser Melting (PLM) annealed by means of Raman spectroscopy and Rutherford Backscattering Spectroscopy (RBS). Since very recently, theoretical studies predicted Ti interstitial sites for the Intermediate Band (IB) formation, the knowledge of the Ti impurity lattice location after PLM annealing is an essential point that can be elucidated by means of RBS measurements. After PLM annealings, Raman and RBS measurements have shown a decrease in the lattice crystalline quality as implanted dose is increased, yielding a significantly improvement of the lattice quality at the highest energy density studied. The RBS channeling spectra show that after PLM annealings Ti impurities are mostly occupying interstitial lattice sites.

Raman scattering measurements were carried out on a bulk, single crystal of wurtzite ZnO over a temperature range from 80 to 760 K and the temperature-dependent shift and broadening of the E2high and A1(LO) modes was analyzed. The E2high mode exhibits a visibly asymmetric line shape that can be related to the interaction with the continuum of acoustic two-phonon density of states. A Fermi resonance model was used to describe the E2high temperature dependence. On the other hand, the anharmonic shift and broadening of the A1(LO) mode are adequately accounted for by a decay model with a dominating Ridley channel involving TO and LA modes. Phonon lifetimes of ∼0.9 and 0.5 ps are found for the E2high and A1(LO) modes, respectively, which corroborates that anharmonic decay involves in both cases a three-phonon process. The A1(LO)lifetime is one order of magnitude lower than that of GaN, which suggests that hot phonon effects should be expected to play a less relevant role in carrier relaxation in ZnO as compared with GaN.

Introduction: The use of glutamine as a dietary supplement is associated with a reduced risk of infection. We hypothesized that the underlying mechanism could be an increase in the expression and/or functionality of Toll-like receptors (TLR), key receptors sensing infections. The objective of this study was to evaluate whether glutamine supplementation alters the expression and functionality of TLR2 and TLR4 in circulating monocytes of trauma patients admitted to the intensive care unit (ICU). Methods: We designed a prospective, randomized and single-blind study. Twenty-three patients received parenteral nutrition (TPN) with a daily glutamine supplement of 0.35 g/kg. The control group (20 patients) received an isocaloric-isonitrogenated TPN. Blood samples were extracted before treatment, at 6 and 14 days. Expression of TLR2 and TLR4 was determined by flow cytometry. Monocytes were stimulated with TLR specific agonists and cytokines were measured in cell culture supernatants. Phagocytic ability of monocytes was also determined. Results: Basal characteristics were similar in both groups. Monocytes from patients treated with glutamine expressed the same TLR2 levels as controls before treatment (4.9 +/- 3.5 rmfi vs. 4.3 +/- 1.9 rmfi, respectively; P = 0.9), at Day 6 (3.8 +/- 2.3 rmfi vs. 4.0 +/- 1.7 rmfi, respectively; P = 0.7) and at Day 14 (4.1 +/- 2.1 rfim vs. 4.6 +/- 1.9 rmfi, respectively; P = 0.08). TLR4 levels were not significantly different between the groups before treatment: (1.1 +/- 1 rmfi vs 0.9 +/- 0.1 rmfi respectively; P = 0.9), at Day 6 (1.1 +/- 1 rmfi vs. 0.7 +/- 0.4 rmfi respectively; P = 0.1) and at Day 14 (1.4 +/- 1.9 rmfi vs. 1.0 +/- 0.6 rmfi respectively; P = 0.8). No differences in cell responses to TLR agonists were found between groups. TLR functionality studied by phagocytosis did not vary between groups. Conclusions: In trauma patients in the intensive care unit, TPN supplemented with glutamine does not improve the expression or the functionality of TLRs in peripheral blood monocytes., The ESPEN Peter Furst Research Prize was funded by Nestle Nutrition Institute and by Fresenius Kabi.; This work was funded by a grant from the ESPEN Peter Furst Research Prize awarded to JPB. All other authors declare that they have no competing interests.