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Stock market sectors and financial ratios are extensively studied by banks and financial institutions worldwide. However, when these types of data are expressed as percentages, they present mathematical and statistical challenges, such as skewed distributions. To address this issue, the current thesis proposes an alternative approach based on Compositional Data Analysis (CoDa), a statistical tool designed specifically for dealing with data that represents relative magnitudes within a total. CoDa is particularly suitable for analyzing investment portfolios because it performs the adequate calculations without losing relevant information in the process. The practical section of the thesis focuses on applying the RStudio package coda4microbiome to analyze a dataset of investment funds. Multiple experiments employing Compositional Data Analysis are conducted to identify which sectors have the biggest impact on returns. The goal is to understand how different sectors behave under various macroeconomic conditions and determine if any sectors strictly dominate the others. Additionally, the thesis explores the theoretical foundations of CoDa and discusses its advantages over traditional statistical approaches when working with compositional data. The conclusions of the study reveal several key findings. Firstly, it is observed that no single sector consistently dominates others in terms of long-term performance. Instead, each sector exhibits distinct behaviors depending on the prevailing macroeconomic conditions, such as interest rates and inflation. Finally, the study validates the effectiveness of using Compositional Data Analysis in the field of finance, using the coda4microbiome package as a tool. The code was successfully adapted to suit the specific requirements of financial data, showcasing its versatility and applicability beyond its original biological context Los sectores de la bolsa de valores y las ratios financieras han sido ampliamente estudiados por bancos e instituciones financieras a nivel mundial desde hace décadas. Sin embargo, al expresar este tipo de datos en forma de porcentajes, surgen problemas matemáticos y estadísticos que pueden alterar los resultados. Con el fin de abordar este problema, la presente tesis propone un enfoque alternativo basado en el Análisis de Datos Composicionales. Esta metodología resulta particularmente adecuada para analizar carteras de inversión, ya que está especialmente diseñada para tratar con magnitudes relativas dentro de un total. La sección práctica de la tesis se centra en la aplicación del paquete de RStudio coda4microbiome para analizar un conjunto de datos de fondos de inversión. En ella se realizan múltiples experimentos utilizando el Análisis de Datos Composicionales para identificar qué sectores tienen un mayor impacto en los rendimientos generados. El objetivo es comprender cómo se comportan los diferentes sectores bajo diferentes condiciones macroeconómicas y determinar si algún sector es superior a los demás en cuanto a rendimiento. Además, la tesis explora los fundamentos teóricos de CoDa y discute sus ventajas en comparación con los enfoques estadísticos tradicionales al trabajar con datos composicionales. Las conclusiones del estudio revelan varios hallazgos clave. En primer lugar, se observa que ningún sector en particular domina de manera constante a los demás en términos de rendimiento a largo plazo. En su lugar, cada sector presenta comportamientos distintos dependiendo de las condiciones macroeconómicas predominantes, como las tasas de interés y la inflación. Por lo tanto, comprender el estado general de la economía se vuelve crucial para predecir qué sectores superarán al mercado de valores en el futuro Els sectors bursàtils i les ràtios financeres són àmbits àmpliament estudiats per bancs i institucions financeres arreu del món. No obstant això, quan aquestes dades s’analitzen com a percentatges, sorgeixen reptes matemàtics i estadístics que dificulten la seva anàlisi. Per abordar aquesta qüestió, la present tesi proposa un enfocament alternatiu basat en l'Anàlisi de Dades Composicionals (CoDa), una eina estadística dissenyada específicament per a tractar dades que representen magnituds relatives dins d'un total. El CoDa és particularment adequat per analitzar carteres d'inversió, ja que está especialmente dissenyada per a tractar magnituds relatives dins un total. La secció pràctica de la tesi se centra a aplicar el paquet d’RStudio coda4microbiome per analitzar una base de dades de fons d'inversió. Es realitzen diversos experiments que utilitzen l'Anàlisi de Dades Composicionals per identificar quins sectors tenen el major impacte en els rendiments. L'objectiu és comprendre com es comporten diferents sectors sota diferents condicions macroeconòmiques i determinar si algun sector és superior als altres en quant a rendiment. A més, la tesi explora els fonaments teòrics de CoDa i discuteix els seus avantatges respecte els enfocaments estadístics tradicionals a l’hora de treballar amb dades composicionals. Les conclusions de l'estudi revelen diversos resultats clau. En primer lloc, s'observa que cap sector individual domina estrictament als altres en termes de rendiment a llarg termini. En canvi, cada sector mostra un comportament diferent en funció de les condicions macroeconòmiques prevalents, com ara la tassa d'interès o la inflació. Finalment, l'estudi valida l'efectivitat de l'ús de l'Anàlisi de Dades Composicionals en el camp de les finances, utilitzant el paquet coda4microbiome com a eina. El codi s'ha adaptat amb èxit per satisfer els requisits específics de les dades financeres, mostrant la seva versatilitat i aplicabilitat més enllà del seu context biològic original

Resumen Antecedentes y objetivo El melanoma uveal es el tumor primario maligno intraocular mas frecuente en la poblacion adulta, con una tasa de supervivencia del 50% a pesar de los avances en el tratamiento y conocimiento de esta enfermedad. La presencia de extension extraocular (EE) empeora el pronostico de estos pacientes, por lo que su correcta identificacion puede asegurar su manejo e intervencion temprana. La ecografia oftalmologica es la tecnica de eleccion para el diagnostico y seguimiento de estos pacientes, tanto de la EE anterior mediante biomicroscopia ultrasonica (UBM), como de la EE posterior mediante ecografia A y B. El objetivo de este estudio es describir las caracteristicas ecograficas de la UBM y de la ecografia A y B. Material y metodos Se realiza un estudio descriptivo y retrospectivo de los pacientes diagnosticados de melanoma uveal (UM) y EE desde 2003 hasta 2019. Las caracteristicas ecograficas de la enfermedad local y el seguimiento luego del tratamiento se registraron de manera completa y en cada visita. En caso de EE anteriores se realizaron fotografias de segmento anterior y BMU, por el contrario las que involucran el segmento posterior se exploraron bajo ecografia modo A y B. Todos los ojos enucleados se enviaron para su estudio anatomopatologico. Resultados Se incluyeron 10 pacientes con una edad media de 72,3 anos. La mayor proporcion de ellos eran tumores de tamano medio, seguidos de los grandes y pequenos. La morfologia mas frecuente del tumor primario fue la cupuliforme. Todos los EE presentaban una reflectividad interna inferior a la del tumor primario. No se encontraron puentes de conexion transescleral entre el tumor primario y el EE en los estudios ecograficos. El 50% de los pacientes fueron sometidos a enucleacion primaria en el momento del diagnostico del MU intraocular debido a la presencia de la EE, y el 50% restante presento la EE tras el tratamiento inicial del tumor primario con braquiterapia I125. El 60% de los pacientes presentaron EE posterior, por lo que fueron diagnosticados con ecografia A y B. El patron histopatologico mas frecuente con el 87,5% de los pacientes fue el patron epitelioide. Discusion La ecografia en pacientes con MU es obligatoria para el diagnostico y seguimiento de la EE. La BMU y la ecografia A y B son las pruebas de eleccion para las EE anteriores y posteriores, respectivamente. Las EE tienen caracteristicas ecograficas particulares como la baja reflectividad interna, la regularidad de su contorno y su localizacion generalmente adyacente a la base del tumor intraocular primario.

Uveal melanoma is the most common primary malignant intraocular tumour in the adult population, with a survival rate of 50% despite advances in treatment and knowledge of this disease. The presence of extraocular extension (EE) worsens the prognosis of these patients, so its proper identification can ensure its management and early intervention. Ophthalmological ultrasound is the technique of choice for the diagnosis and follow-up of these patients, both of the anterior EE using ultrasonic biomicroscopy (UBM), and the posterior EE using A and B ultrasound. The aim of this study is to describe the ultrasound characteristics of the BMU and the A and B ultrasound.A descriptive and retrospective study is carried out on patients diagnosed with uveal melanoma (UM) and EE from 2003 to 2019. The ultrasound characteristics of the local disease and the follow-up after treatment were recorded completely and at each visit. In the case of anterior EE, photographs of the anterior segment and UBM were taken, while those involving the posterior segment were explored under A and B mode ultrasound. All enucleated eyes were sent for anatomopathological study.Ten patients with an average age of 72.3 years were included. The largest proportion of them were medium-sized tumours, followed by large and small ones. The most frequent morphology of the primary tumour was cupuliform. All the EE presented lower internal reflectivity compared to the primary tumour. No trans-scleral connection bridges were found between the primary tumour and the EE in the ultrasound studies. 50% of patients underwent primary enucleation at the time of diagnosis of intraocular MU due to the presence of the EE, and the remaining 50% presented the EE after initial treatment of the primary tumour with I125 brachytherapy. Sixty percent of the patients presented with posterior EE, and were therefore diagnosed with ultrasound A and B. The most frequent histopathological pattern with 87.5% of patients was the epithelioid pattern.Ultrasound scanning in patients with MU is mandatory for diagnosis and follow-up of EE. BMU and A and B ultrasound are the test of choice for anterior and posterior EE, respectively. EE have particular ultrasound characteristics such as low internal reflectivity, regularity of their contour and their location usually adjacent to the base of the primary intraocular tumor.

Introduction The benefit of cardiac rehabilitation programs (CRP) in ischemic patients is well known and is included as an IA indication in European Cardiology guidelines. At the end of CRP phase II, it is not uncommon to get an isolated electric positive result (silent ischemia) which has an unknown significance as clinical marker. This finding could be more challenging in patients without complete revascularization. Purpose To study whether silent ischemia (SI) and incomplete revascularization acted as markers of future events in patients who participated in a CRP after coronary revascularization. Methods A retrospective descriptive analysis of consecutive patients who were part of a CRP between January 2019 and March 2020 was performed. We analyzed the relationship between the presence of SI (defined as ST-segment depression > or = 1 mm in two or more contiguous leads in the absence of clinical symptoms) in the routine exercise test at the end of CRP phase II and the occurrence of events within first year (defined as: emergency room visits, cardiac complication without admission, admission for non-cardiac cause, admission for cardiac cause or death). Cardiovascular risks factors and type of revascularization (incomplete vs complete) were analyzed as modifiers of outcomes. Results Of the 380 patients analyzed 79 presented some event in the first year. The mean age was 63±10 and 78% were male. The demographic characteristics are shown in Table 1. The presence of SI at the final exercise routine test of phase II CRP was observed more frequently in the group of patients who suffered an event within first year (p 0.030). Although there was a statistically significant correlation between the presence of incomplete revascularization (IR) and the presence of SI (p 0.002), there was no significant relationship between the presence of IR and events (p 0.082). The detailed results are shown in Table 2. Conclusions Among our population, exercise tests is useful for detecting patients at an increased risk of events during the first year after coronary revascularization. However, the incomplete revascularization did not appear to be a prognostic factor. The exercise test seems to be useful for detecting patients in whom intensify preventive efforts. Funding Acknowledgement Type of funding sources: None.

Funding Acknowledgements Type of funding sources: None. Background In ST-segment elevation myocardial infarction (STEMI), emergency medical system delays importantly affect outcomes. The place of first medical contact may affect the time to reperfusion and consequently affect outcomes, as the most direct transfer to the catheterization laboratory is warranted. Purpose The authors aimed to retrospectively describe the association between place of first medical contact and STEMI patient’s care standards and outcomes. Methods Characteristics and outcomes of 1205 consecutive STEMI patients treated in a PCI-centre were collected. Outpatient emergency medical system (EMS) was provided by different vehicles of the Portuguese National Institute of Medical Emergency. Other patients were first observed in primary care centres or in hospitals (PCC/H). Time delays, in-hospital and one-year all-cause mortality were assessed. Results A total of 281 patients (23%) were first observed by the EMS and 924 patients (77%) were first observed in PCC/H. Of those first observed in PCC/H, 258 patients (28%) were admitted in the PCI reference centre. Baseline characteristics were well-balanced between groups, including the percentage of patients that presented in cardiogenic shock (EMS: 6% vs PCC/H: 5%; p=0.43). Median total ischaemic time was significantly lower in patients first observed by EMS when compared to patients admitted in PCC/H (182 min vs. 246 min, respectively. p In patients admitted directly in the PCI-centre, median time from first-medical contact to reperfusion was significantly lower than in those first contacted by the EMS (76 min vs. 105 min; respectively. p First medical contact in a hospital without catheterization laboratory was a strong predictor of time of first-medical contact to artery opening of >120 min (odds ratio 6.09 CI95% [4.74-7.82]; p The authors observed no association between place of first medical contact and in-hospital mortality (EMS: 5% vs. PCC/H 5%, p = 0.94) or 1-year mortality (EMS: 9% vs. PCC/H 10%, p=0.50). Nonetheless, the observed time intervals for nonsurvivors were significantly longer than in survivors (table 1) and time of first-medical contact to artery opening of >120 min was a strong predictor of in-hospital (odds ratio 2.51 CI95%[1.42-4.46]; p < 0.01) and 1 year mortality (odds ratio 2.31 CI95%[1.55-3.44]; p < 0.01). Conclusion In a contemporary well-organized emergency network, STEMI patients should be first observed by the EMS as it leads to shorter delays treatment. However, less than one-third of the patients with STEMI is first contacted by the EMS.

Funding Acknowledgements Type of funding sources: None. Introduction The most common clinical presentation of non-ST-segment elevation myocardial infarction (NSTEMI) is angina pectoris. However, some groups of patients such as elderly, women and patients with diabetes or chronic renal disease,may have atypical symptoms, like isolated dyspnea or syncope. Aim The aim of this study was to identify the outcomes of NSTEMI patients with different types of presenting symptoms and to verify if these presentations were independent predictors of the studied outcomes. Methods We studied patients >18 year-old admitted with NSTEMI between October 2010 and September 2019. Data was collected from a national multicentric registry. From an initial pool of 13739 patients, a total of 4726 were included (the main exclusion criterion was lack of follow-up registry). The patients were divided into 3 groups according to the main presentation symptom: group 1 – chest pain; group 2 – dyspnea/fatigue; group 3 – syncope. The primary endpoint was 1-year death from any cause. Results The most common presentation sympton was chest pain (91.3%; n=4313), followed by dyspnea/fatigue (7%; n=332) and syncope (1.7%; n=81). Seventy-one percent (n=3352) of patients were male and 29.1% (n=1374) female. Mean age was 68±13 years. Patients presenting with dyspnea/fatigue were older (75±11 vs 68±13 [group 1] vs 74±13 [group 3], p 1 80% vs 9.9% [group 1] vs 23.5% [group 3], p Conclusion This study reveals that patients with dyspnea/fatigue at presentation have an overall worse prognosis than those who present with chest pain or syncope. The former patients were more commonly women, older and had more comorbidities; also, they presented with worse Killip class. However, symptoms themselves were not independent predictors of 1-year mortality.

Old patients with hepatotoxicity have been scarcely studied in idiosyncratic drug-induced liver injury (DILI) cohorts. We sought for the distinctive characteristics of DILI in older patients across age groups. A total of 882 DILI patients included in the Spanish DILI Registry (33% ≥65 years) were categorized according to age: “young” (

Introduction The global pandemic due to Covid-19 has constituded a challenge in the follow up and monitoring of cardiac rehabilitation's programs. The State of alarm declared last year in Spain, led to strict home confinement that could have had an impact in the progress of patients Aim To analyze the effect of home confinement on the managment of cardiovascular risk factors (CVRF) in patients included in phase III of a cardiac rehabilitation program (CRP) and also to evaluate the self-care education received during CRP. Methods and materials Descriptive, comparative and retrospective analysis of patients in phase III of a CRP. The sample was divided into two groups: Post-Covid group (consecutive CRP patients with follow up one year after the cardiac event from 6/21/2020 [date of end of home confinement in Spain] to 12/31/2020) and Group Pre-Covid (consecutive CRP patients with follow up one year after the cardiac event from 6/21/2019 to 12/31/2019). Demographic and CVRF data from end of phase II consultation were compared with those from the phase III consultation (one year after the event) for both groups. The SPSS statistics v23 program was used for statistical analysis. Results 283 patients, 137 patients from the pre-Covid group and 146 patients from the post-Covid group. No statistically significant differences were found between the two populations (Table 1). No statistically significant differences were found in the achievement of the CVRF target values: systolic blood pressure Regarding the variation of the CVRF figures between the final consultation of phase III and that of phase II, no statistically significant differences were found between the two groups: difference in LDL-c figure for phase III consultation with respect to phase II (−0.5±20.3 mg/dl in pre-Covid group vs −5.3±24.4 mg/dl in post-Covid group; p=0.102), difference in HDL-c (4.6±26.1 mg/dl pre-Covid group vs −0.6±24.9 mg/dl post-Covid group; p=0.113), difference in total cholesterol level (4.6±26.1 mg/dl vs −0.6±24.9 mg/dl; p=0.113), difference in HbA1c (0.1±0.3% in pre-Covid group vs 0.1±0.6% in group post-Covid), Table 2. Conclusions Home confinement has not contribute to a worsening in CVRF control in patients in a phase III of a CRP, in our study. The education given in a CRP concerning to the management of CVRF is the essential factor that grant an adequate patient control in extraordinary circumstances. Funding Acknowledgement Type of funding sources: None.

Introduction In ST-segment elevation myocardial infarction (STEMI) patients, emergency medical system delays importantly affect outcomes. The effect of admission time in STEMI patients is dubious when percutaneous coronary intervention (PCI) is the preferred reperfusion strategy. Aims The authors aimed to retrospectively describe the association between admission time and STEMI patient's care standards and outcomes. Methods Characteristics and outcomes of 1222 consecutive STEMI patients treated in a PCI-centre were collected. On-hours were defined as admission on non-national-holidays from Monday to Friday from 8 AM to 6 PM. Time delays, in-hospital and one-year all-cause mortality were assessed. Results A total of 439 patients (36%) were admitted on-hours and 783 patients (64%) were admitted off-hours. Baseline characteristics were well-balanced between groups, including the percentage of patients admitted in cardiogenic shock (on-hours: 4.6% vs off-hours 4%; p=0.62). Median emergency system dependent time to reperfusion (i.e. first-medical contact to reperfusion) did not differ between the two groups (on-hours: 120 min vs. off-hours 123 min, p=0.54). The authors observed no association between admission time and in-hospital mortality (on-hours: 5% vs. off-hours 4.9%, p=0.90) or 1-year mortality (on-hours: 10% vs. off-hours 10%, p=0.97). In patients admitted directly in the PCI-centre, median time from first-medical contact to reperfusion (on-hours: 87 min vs off-hours: 88 min, p=0.54), in-hospital mortality (on-hours: 4% vs off-hours: 7%, p=0.30) and 1 year mortality (on-hours: 9% vs off-hours: 13%, p=0.27) did not differ between the two groups. Survival analysis showed no survival benefit of on-hours PCI over off-hours PCI (HR 1.01; 95% CI [0.77–1.46], p=0.95). Conclusion In a contemporary well-organized emergency network, STEMI patients admission time in the PCI-centre was not associated with reperfusion delays or increased mortality. Funding Acknowledgement Type of funding sources: None. Kaplan-Meier curve

espanolIntroduccion: Las metastasis cutaneas son diseminaciones de celulas malignas en la piel de tumores distantes que deben sospecharse en lesiones de rapido crecimiento sin respuesta al tratamiento. Representan un reto clinico pues no tienen una morfologia macroscopica especifica, mientras que histologicamente se localizan en dermis e hipodermis (carecen de componente in situ). Presentacion del caso: Se describe el caso de una mujer adulta mayor quien presenta metastasis en nariz de payaso tras desarrollar cancer de pulmon con dos variantes distintas: adenocarcinoma y carcinoma escamocelular mal diferenciado macrocitico. Se confirmo la relacion con estudio de inmunohistoquimica positivo para marcadores de carcinoma escamocelular pobremente diferenciado. Discusion: El signo de la nariz de payaso es una lesion inflamatoria nodular en la piel de la punta nasal como manifestacion de metastasis cutanea de un tumor visceral. Se ha identificado junto con multiples neoplasias entre las que se destacan el cancer de pulmon en hombres y el cancer mamario en mujeres. A pesar de su baja frecuencia se debe tener en cuenta por su efecto en la sobrevida de los pacientes. Conclusiones: La aparicion de lesiones inflamatorias en punta nasal de rapido crecimiento que no respondan al tratamiento obliga realizar estudios de extension para analizar la etiologia. EnglishIntroduction: Cutaneous metastases are sowings of malignant cells in the skin of distant tumors that should be suspected in rapidly growing lesions without response to treatment. They represent a clinical challenge because they do not have a specific macroscopic morphology, while histologically they are located in the dermis and hypodermis (they lack an in situ component). Case presentation: We describe the case of an older adult woman who has metastasis in Clown Nose after developing lung cancer with two different variants: adenocarcinoma and squamous cell carcinoma poorly differentiated from large cells. In whom the association with positive immunohistochemical study for markers of poorly differentiated squamous cell carcinoma was confirmed. Discussion: The Clown Nose Sign is a nodular inflammatory lesion in the skin of the nasal tip as a manifestation of cutaneous metastasis of a visceral tumor. It has been associated with multiple neoplasms specially lung cancer in men and breast cancer in women. Despite its low frequency, it must be taken into account due to its impact on patient survival. Conclusions: The appearance of inflammatory lesions in nasal tip of rapid growth that do not respond to therapy, requires extension studies to analyze its etiology.

[Background & Aims] Prospective drug-induced liver injury (DILI) registries are important sources of information on idiosyncratic DILI. We aimed to present a comprehensive analysis of 843 patients with DILI enrolled into the Spanish DILI Registry over a 20-year time period., [Methods] Cases were identified, diagnosed and followed prospectively. Clinical features, drug information and outcome data were collected., [Results] A total of 843 patients, with a mean age of 54 years (48% females), were enrolled up to 2018. Hepatocellular injury was associated with younger age (adjusted odds ratio [aOR] per year 0.983; 95% CI 0.974–0.991) and lower platelet count (aOR per unit 0.996; 95% CI 0.994–0.998). Anti-infectives were the most common causative drug class (40%). Liver-related mortality was more frequent in patients with hepatocellular damage aged ≥65 years (p = 0.0083) and in patients with underlying liver disease (p = 0.0221). Independent predictors of liver-related death/transplantation included nR-based hepatocellular injury, female sex, higher onset aspartate aminotransferase (AST) and bilirubin values. nR-based hepatocellular injury was not associated with 6-month overall mortality, for which comorbidity burden played a more important role. The prognostic capacity of Hy’s law varied between causative agents. Empirical therapy (corticosteroids, ursodeoxycholic acid and MARS) was prescribed to 20% of patients. Drug-induced autoimmune hepatitis patients (26 cases) were mainly females (62%) with hepatocellular damage (92%), who more frequently received immunosuppressive therapy (58%)., [Conclusions] AST elevation at onset is a strong predictor of poor outcome and should be routinely assessed in DILI evaluation. Mortality is higher in older patients with hepatocellular damage and patients with underlying hepatic conditions. The Spanish DILI Registry is a valuable tool in the identification of causative drugs, clinical signatures and prognostic risk factors in DILI and can aid physicians in DILI characterisation and management., [Lay summary] Clinical information on drug-induced liver injury (DILI) collected from enrolled patients in the Spanish DILI Registry can guide physicians in the decision-making process. We have found that older patients with hepatocellular type liver injury and patients with additional liver conditions are at a higher risk of mortality. The type of liver injury, patient sex and analytical values of aspartate aminotransferase and total bilirubin can also help predict clinical outcomes., The present study has been supported by grants of Instituto de Salud Carlos III cofounded by Fondo Europeo de Desarrollo Regional – FEDER (contract numbers: PI19/00883, PI16/01748, PI18/00901, PI18/01804, PI-0285-2016, PI-0274-2016, PI-0310-2018, PT17/0017/0020) and Agencia Española del Medicamento. CIBERehd and Plataforma ISCIII Ensayos Clinicos are funded by Instituto de Salud Carlos III. MRD holds a Joan Rodes (JR16/00015)/Acción B clinicos investigadores (B-0002-2019) and JSC a Rio Hortega (CM17/00243) research contract from ISCIII and Consejería de Salud de Andalucía.

The presence of emerging contaminants (EC), such as antibiotics in water bodies, is considered an environmental issue. In this work, the iron sources FeC2O4•2H2O (FOD), complexes of iron/oxalate (Fe2+/Ox), and FeSO4 as reference were evaluated as catalysts on the degradation of pyrazinamide (10 mg L−1) antibiotic by the photo-Fenton process. Different parameters were studied such as initial pH value (3, 4.5, and 6), Fe2+/H2O2 molar ratio (1:20, 1:30, and 1:40), and Fe2+/Ox with different molar ratios (1:3, 1:6, and 1:9). The best performance was achieved with a 1:20 Fe2+/H2O2 molar ratio using FeSO4 and FOD showing similar results as FeSO4 catalyst at pH 3 and 4.5. The degradation rate at pH 6 was enhanced using Fe2+/Ox (1:3) compared to FeSO4, and this behavior was explained by Fenton reactants consumption and the oxalate use. The iron source FOD exhibited a poor performance at pH 6 compared with FeSO4; however, FOD activity was notably increased at pH 6 using a greater amount of catalyst, reaching 86.8% of pyrazinamide degradation in 60 min, even higher than using Fe2+/Ox 1:3 complex (68.9%), which makes it a suitable catalyst for the degradation of pyrazinamide by the photo-Fenton process.

En este trabajo se expone el uso de la colorimetría para la medición de pH del hidróxido de sodio (NaOH) el cual captura CO2 contenido en el biogás producto de un biodigestor anaerobio. Para tener una noción de como el hidróxido de sodio va perdiendo la capacidad de absorber CO2 el sistema propuesto utiliza fenolftaleína cuyos valores de viraje (de 10 a 8.2 de pH) son estimados con datos obtenidos de un sensor de color y enviados a un microprocesador para posteriormente procesar la señal. Debido a que la señal contiene mucho ruido se lleva a cabo una ventana promediadora utilizando programación en Visual Basic (VBA) para aplicaciones y así poder observar una tendencia de los datos. La parte importante de esta propuesta es poder utilizar biogás en una celda de combustible de membrana de intercambio protónico evitando el deterioro del catalizador del platino por el CO2. &nbsp

© 2014 Elsevier España, S.L.U. and SEMNIM. All rights reserved., Objectives: In 2009-2010 a Portuguese consortium was created to implement the methodologies proposed by the Dose Datamed II (DDM2) project, aiming to collect data from diagnostic X-ray and nuclear medicine (NM) procedures, in order to determine the most frequently prescribed exams and the associated ionizing radiation doses for the Portuguese population. The current study is the continuation of this work, although it focuses only on NM exams for the years 2011 and 2012. Material and methods: The annual frequency of each of the 28 selected NM exams and the average administered activity per procedure was obtained by means of a nationwide survey sent to the 35 NM centres in Portugal. Results: The results show a reduction of the number of cardiac exams performed in the last two years compared with 2010, leading to a reduction of the annual average effective dose of Portuguese population due to NM exams from 0.08 mSv ± 0.017 mSv/caput to 0.059 ± 0.011 mSv/caput in 2011 and 0.054 ± 0.011 mSv/caput in 2012. Portuguese total annual average collective effective dose due to medical procedures was estimated to be 625.6 ± 110.9 manSv in 2011 and 565.1 ± 117.3 manSv in 2012, a reduction in comparison with 2010 (840.3 ± 183.8 manSv). Conclusions: The most frequent exams and the ones that contributed the most for total population dose were the cardiac and bone exams, although a decrease observed in 2011 and in 2012 was verified. The authors intend to perform this study periodically to identify trends in the annual Portuguese average effective dose and to help to raise awareness about the potential dose optimization.

The aim of this study is the development and validation of a methodology for modelling corrugated board adhesive joints subjected to shear, considered to be the main load in most of these joints, and the analysis of the influence of several joint parameters. Testing and simulation of double-lap corrugated cardboard adhesive joints has been carried out. The corrugated board was glued with a hot-melt adhesive, the type of adhesive commonly used in the assembly of corrugated boxes. The corrugated board adhesive joint model reproduced quite well the stiffness obtained in the test samples, as well as the failure load with a deviation of less than 14%. A simplified plane strain model has also been evaluated in order to obtain a significant reduction in generation and computational costs. Finally, the influence of some of the most significant parameters in the corrugated board adhesive joint has been analysed independently using the simplified model.

Understanding the determinants of the host innate immune response to systemic administration of adenoviral (Ad) vectors is critical for clinical gene therapy. Acute toxicity occurs within minutes to hours after vector administration and is characterized by activation of innate immune responses. Our data indicate that in mice, indicators of vector toxicity include elevations of cytokine levels, liver transaminase levels and thrombocytopenia. To discern potential targets for blunting this host response, we evaluated genetic factors in the host response to systemically administered first-generation Ad vectors (FGV) and helper-dependent Ad vectors (HDV) containing beta-galactosidase expression cassettes. A preliminary screen for modulation of vector-induced thrombocytopenia revealed no role for interferon-gamma, mast cells or perforin. However, vector-induced thrombocytopenia and interleukin 6 (IL-6) expression are less evident in tumor necrosis factor alpha (TNFalpha)-deficient mice. Moreover, we also demonstrated that TNFalpha blockade via antibody or huTNFR:Fc pretreatment attenuates both thrombocytopenia (40% increase in platelet count) and IL-6 expression (80% reduction) without affecting interleukin 12 , liver enzymes, hematological indices or vector transduction in a murine model. Our data indicate that the use of HDV, in combination with clinically approved TNFalpha immunomodulation, may represent an approach for improving the therapeutic index of Ad gene therapy for human clinical trials.

Epithelioid Hemangioendothelioma (EH) is a vascular neoplasm of soft tissue, recently described by Weiss and Enzinger. The biologic al behavior of the tumor has a intermediate malignant potential, in the sense that it has an indolent course, with the potential for recurrence, but rarely metastasizes. This tumor arises from medium- to large-sized vessels, primarily involves the soft tissues of the extremities, as well as the liver, lung, and bone, and rarely occurs in the head and neck region. Only fifteen well--documented cases of Epithelioid Hemangioendothelioma involving the head and neck region have been reported. Nine cases have been recently reported in the oral cavity. This is a report of one additional case in the tongue. Because of the intermediate malignant potential of Epithelioid Hemangioendothelioma, complete tumor resection is recommended for intraoral lesions.

Gait and stability disorders of the elderly are frequent and a cause of disability, but studies on their clinical features and etiology are scarce, including the relationship between both disorders.To evaluate an extensive series of patients with gait and stability disorders, its clinical variants and posible pathogenic significance.259 patients older than 70 years consulting for chronic gait and stability symptoms in an outpatients neurologic clinic were retrospectively reviewed. Several clinical and evolution data are analyzed.Mean age was 78.8 years and 61.8% were women. 52 % were hypertensive. 161 cases had disequilibrium, 91 a cautious gait and seven other types of gait abnormality. 11 % had associated dementia. 27 % showed subcortical white matter abnormalities on computed tomography scan. In 28 cases a specific cause could be established. In follow-up 33.5 % worsened. Significant differences between cases of disequilibrium and cautious gait were increased age, functional disability and turn abnormality in the latter.Disequilibrium and cautious gait of the elderly share some clinical features, have few specific causes and vary from mild cases to a disablingencephalic gait disease.

Epithelioid Hemangioendothelioma (EH) is a vascular neoplasm of soft tissue, recently described by Weiss and Enzinger. The biologic al behavior of the tumor has a intermediate malignant potential, in the sense that it has an indolent course, with the potential for recurrence, but rarely metastasizes. This tumor arises from medium- to large-sized vessels, primarily involves the soft tissues of the extremities, as well as the liver, lung, and bone, and rarely occurs in the head and neck region. Only fifteen well--documented cases of Epithelioid Hemangioendothelioma involving the head and neck region have been reported. Nine cases have been recently reported in the oral cavity. This is a report of one additional case in the tongue. Because of the intermediate malignant potential of Epithelioid Hemangioendothelioma, complete tumor resection is recommended for intraoral lesions.

Schwannomas are benign tumors of neural source produced from Schwann cells, which are the constituents and the maintenance of myelin sheath of peripheral nerves. Parapharyngeal schwannoma are sporadic and vagus nerve the one more frequently giving raise to parapharyngeal schwannoma. Those originated in sympathetic neck chain are more rare. We inform about a parapharyngeal schwannoma case of the neck sympathetic chain and perform an analyse of clinic, diagnostical, histological and therapeutical characteristics of this so infrequent pathology.

Neck emphysema is an unusual pathology in childhood depending on several conditions. We report the case of a subcutaneous emphysema of the neck after an oropharyngeal injury in a child and take the advantage of the event in order to review the etiology and pathogeny of neck emphysema, because the otolaryngologist must know the differential diagnosis, face to the presence of air inside the neck, since the definitive treatment depends on is etiology.

The great majority of parotid gland tumours are benign. Metastatic malignant ones are scarce in number. The source of these metastasis are growths localized either in head and neck or distant tumours spreading on intra- or periparotid lymph nodes. Two cases of metastatic parotid growths diagnosed and treated last year are reported. Bibliographic review of the topic.

It is being tumor developed from Schwann cells of peripheral nerves sheath. In its plexiform type it is a rare growth presenting solitary or in the context of von Recklinghausen's disease. The aim of this article is to present one plexiform neurofibroma localized in the parotid gland. At the same time we make a perusal on the literature of this kind of tumor.

Malignant melanomas of the oral mucous membrane seems an infrequent pathology. They are characterized by a late diagnosis, bad prognosis and a disappointing treatment, because of the difficulties encountered for its total removal owing to complicated accessibility. We report one case of mucous membrane of the mouth in a 56 year-old man, diagnosed and operated in the General Hospital of Specialties "Ciudad de Jaen". The article end with a careful revision of the literature.

Chronic instability is a frequent complaint in elderly patients. As literature on the subject is scarce, we investigated reversible causes, evaluating patients over 65 years of age referred to a regional neurological practice for disequilibrium lasting longer than three months. Clinical features were analyzed. Computerized tomography (CT) of the brain, and thyroid hormone and cyanocobalamin (Cc) serum levels were studied for all patients, as was clinical course. No CT abnormalities were found. Low Cc levels were observed in 6 patients, and 2 were diagnosed of previously undetected hypothyroidism. During the mean follow-up period of 12 months, improvement was seen in 3 specifically-treated patients, one with hypothyroidism and two with Cc deficit. We conclude that chronic instability in the older patient cannot usually be traced to a specific cause, but that it is important to protocolize the assessment of such patients, including routine tests for thyroid hormone and Cc levels, in order to rule out treatable causes.

Oncocytoma of the salivary gland is uncommon and its histogenesis and pattern of evolution are debated. The criteria for malignancy are not well established. We report a morphologically benign oncocytoma of the parotid gland that was studied using various cell proliferation and tumor markers. These markers may have prognostic value and correlate with the aggressiveness of the tumor.

10 patients, aged 25-46, with dysfunctional menstrual bleeding, were inserted a progesterone-releasing IUD, delivering 65 mcg. of progesterone daily. Complete examinations were carried out before insertion, and after 3 and 6 months. Amount and duration of bleeding diminished in 9 patients; 2 patients presented short periods of amenorrhea. Proliferative endometria changed in secreting endometria, while vaginal cytology with previous estrogenic activity did not change in 2 cases, or insufficiently in 2 more cases. From these results it is concluded that progesterone has a local action at endometrial level, but no systemic collateral actions, and that it can be usefully employed in controlling dysfunctional bleeding.

30 patients, most of them with dysfunctional uterine bleeding, were inserted with Progestasert, a T-shaped IUD, releasing 65 mcg. of progesterone daily. All patients were carefully examined before and after insertion. In 90% of cases bleeding decreased in amount and in duration; there were 2 cases of amenorrhea. Endometrial action was characterized by secretory changes, decidual reaction, and desquamation of glandular structure. Vaginal cytology was not sensibly modified, while uterine contractility and uterine tonus were increased, particularly during the second phase of the menstrual cycle. It is obvious that progesterone has a definite in situ effect but no collateral systemic action, which makes it indicated in the treatment of dysfunctional uterine bleeding.