Upgrading of solid recovered fuel (SRF) by dechlorination and catalytic pyrolysis over nanocrystalline ZSM-5 zeolite

Globally increasing concern related to municipal solid waste generation is encouraging research efforts on developing alternative routes to valorize mixed refused wastes. In this way, catalytic pyrolysis is emerging as an interesting and efficient technology due to its great flexibility in terms of feedstock. In the current work, upgrading of a Solid Recovered Fuel (SRF) has been investigated by catalytic pyrolysis over nanocrystalline ZSM-5 zeolite (n-ZSM-5), paying special attention to dechlorination effects due to the high Cl content of the raw waste. Thus, pretreatment of the SRF by water washing and mild thermal processing allows for a significant reduction of the Cl concentration. Regarding the catalytic pyrolysis step, the best conditions correspond with a temperature of 400 °C in the catalyst bed and 0.50 catalyst/SRF mass ratio, which lead to ca. 30 wt% oil yield (rich in aromatic hydrocarbons) together with about 40 wt% gas yield (rich in C3-C4 olefins). Accordingly, these products could find use as raw chemicals or for the production of advanced fuels. In addition, zeolite reutilization has been tested for several cycles, denoting a progressive modification of the products distribution because of coke deposition. However, an almost total recovery of the n-ZSM-5 zeolite catalytic performance is achieved after regeneration by air calcination, affording the production of an oil fraction with a Cl content as low as 40 ppm.

Paroxysmal atrial fibrillation ablation with a novel flexible tip radiofrequency catheter incorporating contact force sensing: acute results of the TactiFlex AF IDE trial

Background

Catheter ablation is an established therapy for paroxysmal atrial fibrillation (PAF). The TactiFlex™ Ablation Catheter, Sensor-Enabled™ (TactiFlex SE) is a next-generation radiofrequency ablation catheter incorporating highly accurate fiber optics-based contact force sensing technology with a flexible, laser-cut tip.

Purpose

To demonstrate that ablation with TactiFlex SE is safe and effective for the treatment of drug refractory, symptomatic PAF.

Methods

The TactiFlex AF IDE is a prospective, non-randomized, multi-center clinical study which enrolled 355 subjects worldwide. Enrollment in the main study began on June 26, 2020 and completed on June 18, 2021. Subjects underwent de novo Pulmonary Vein Isolation (PVI) and, if indicated, a Cavotricuspid Isthmus ablation (CTI line) for CTI-dependent atrial flutter.

Results

Subjects were divided into two as treated subgroups: High Standard Power (HSP, n=189), defined as subjects with 100% of left atrial lesions ablated at ≥40 W, and Low Standard Power (LSP, n=119), defined as subjects with at least one left atrial lesion ablated at <40W. First pass success, defined as isolation of all pulmonary veins (PVs) confirmed after a minimum 20 min waiting period was achieved in 93.5% (175/186) and 84.5% (98/116) of HSP and LSP subjects, respectively (p=0.0104). Significant decreases in the HSP versus LSP procedures were also seen in total procedure time (112.0 min [89.0, 139.5] and 149.0 [115.0, 182.0], respectively [p<0.001]), total RF time for PV ablation (14.0 min [11.0, 19.0] and 29.0 [19.0, 41.0], respectively [p<0.0001]), total fluoroscopy time (4.0 min [0.0, 11.0] and 8.0 [3.0, 17.0], respectively [p<0.0001]) and irrigation fluid volume (378.0 mL [310.0, 466.0] and 636.0 [476.0, 829.0], respectively [p<0.0001]) (values given as Median [Q1, Q3]), see Figure 1. Both HSP and LSP subjects had a low rate of repeat procedures (1.6% [3/182] and 4.3% [5/115], respectively [p=0.2684]) and primary safety endpoint events (4.8% [9/189] and 4.2% [5/119], respectively [p=0.8182]) through 90 days post-index procedure.

Conclusion

The acute data on the TactiFlex SE catheter demonstrates safe and effective treatment of PAF using either a HSP or LSP ablation strategy. Ablation procedures performed using a HSP strategy were shorter and required less irrigation fluid and fluoroscopy. It is anticipated these results will be reflected in the 12-month safety and effectiveness primary endpoints.

Funding Acknowledgement

Type of funding sources: Private company. Main funding source(s): Abbott

Acute results of a novel flexible tip radiofrequency catheter incorporating contact force sensing

Funding Acknowledgements

Type of funding sources: Private company. Main funding source(s): Abbott

Background

Catheter ablation is an established therapy for paroxysmal atrial fibrillation (PAF). The TactiFlex Ablation Catheter, Sensor-Enabled (TactiFlex SE) is a next-generation radiofrequency ablation catheter incorporating highly accurate fiber optics-based contact force sensing technology with a flexible, laser-cut tip. This is the first report of results from the TactiFlex IDE clinical study.

Purpose

To demonstrate that ablation with TactiFlex SE is safe and effective for the treatment of drug refractory, symptomatic PAF.

Methods

The TactiFlex IDE (NCT04356040) is a prospective, non-randomized, multi-center clinical study which enrolled 305 subjects worldwide in the main study. Enrollment in the main study began on June 26, 2020 and completed on June 8, 2021. Subjects underwent de novo Pulmonary Vein Isolation (PVI) and, if indicated, a Cavotricuspid Isthmus ablation (CTI line) for CTI-dependent atrial flutter.

Results

Acute procedural success was achieved in 98.6% (274/278) of the main study cohort who underwent an ablation procedure using the TactiFlex SE. First pass success, defined as isolation of all pulmonary veins (PVs) confirmed after a minimum 20 min waiting period was achieved in 89.6% (249/278) of subjects. This was a significant improvement versus the TactiSense IDE trial (TactiCath Ablation Catheter, Sensor-Enabled). Significant decreases were also seen in total procedure time (123 min [101.0, 163.5]), total PV ablation time (55.5 min [35.0, 81.0]), total fluoroscopy time (6.0 min [0.0, 13.0]) and irrigation fluid volume (450.0 mL [346.0, 636.0]) (values given as Median [Q1, Q3]), see FIGURE. All subjects have completed at least 90 days of follow-up. Only 2.6% (7/271) of subjects required a repeat procedure during the 90-day blanking period. The primary safety and effectiveness endpoints will be evaluated at 12-months. At 90 days, 4.3% (12/281) subjects had experienced a primary safety endpoint event.

Conclusions

The acute data from the TactiFlex IDE clinical study demonstrate safety and effectiveness of the TactiFlex SE catheter in the treatment of PAF. Ablation procedures performed using the next-generation TactiFlex SE catheter were shorter and had improved acute clinical effectiveness outcomes versus the TactiSense IDE. It is anticipated these results will also be reflected in the 12-month safety and effectiveness endpoints.

[Prevalence and incidence of ictus in Europe: systematic review and meta-analysis]

BACKGROUND

Stroke is the second cause of death and the first cause of disability in Europe. The number of stroke patients shows a rapidly increasing due to the increase in the elderly population. The aim of this meta-analysis is to evaluate the prevalence and incidence of stroke in Europe.

METHOD

We conducted a literature search in MEDLINE, SCOPUS, CINAHL Complete and EMBASE, using the keywords "stroke", "cerebrovascular accident", "epidemiology", "prevalence", "incidence" and "Europe". In order to evaluate the quality and risk of bias, we used the Hoy's modified scale for prevalence studies and the Newcastle Ottawa Scale for incidence studies. A random effects model with 95% confidence intervals (95%CI) was used for the meta-analysis. The I2 statistic was applied to assess heterogeneity.

RESULTS

The prevalence of stroke in Europe adjusted for sex was estimated at 9.2% (95%CI: 4.4-14.0). The prevalence was 9.1% (95%CI: 4.7-13.6) in men and 9.2% (95%CI: 4.1-14.4) in women, and increased with age. The incidence of stroke in Europe adjusted for sex was 191.9 per 100,000 person-years (95%CI: 156.4-227.3); it was 195.7 per 100,000 person-years (95%CI: 142.4-249.0) in men and 188.1 per 100,000 person-years (95%CI: 138.6-237.7) in women. Again, these rates increased with age.

CONCLUSION

The prevalence of stroke in Europe is 9.2%. The incidence of stroke in Europe is 191.9 per 100,000 person-years. The prevalence of stroke has increased, whereas the incidence of stroke is stable in comparison with studies conducted at the beginning of the 21st century.

Durable pulmonary vein (PV) isolation at repeat atrial fibrillation (AF) ablation procedure: a comparison between 4 ablation technologies

Background

Durable PV isolation is the sought-after endpoint to obtain long term success after AF catheter ablation. Evolution in technology improves efficiency, safety and effectiveness in AF catheter ablation.

Purpose

To investigate the effectiveness of different catheter technologies in obtaining durable PV isolation in a real-world practice.

Methods

Retrospective analysis of prospectively collected data of patients undergoing repeat procedures for recurrence of AF or atrial flutter at our institution was performed. Incidence of all PVs being isolated at repeat procedure was recorded and patients 4 groups created based on catheter technology used during index AF ablation procedure (SF: multipored, irrigated catheter; ST: contact force sensor catheter; Cryo: 2nd generation cryobaloon; and STSF: multipored, irrigated, contact force sensing catheter).

Results

We identified 269 subjects undergoing repeat ablation from May 2014 to September 2019. Mean age was 67±9.7 years, 54.6% were males, 74.4% non-paroxysmal AF at the index procedure. The mean CHA2DS2Vasc score was 2.5±0.26, LA size 4.2±0.6 cm, EF 55.3±10%. The mean time from index to redo procedure was 374±331 days. At repeat procedure all veins were isolated in 24% (6/25) who were initially ablated using SF; 36% (8/22) with Cryo; 44% (47/108) with ST; and 74% (84/114) with STSF catheter. (Figure)

Conclusion

Patients undergoing index ablation with STSF catheter technology were significantly more likely to have all 4 PVs isolated at repeat procedure compared to previous generation technology.

Funding Acknowledgement

Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Biosense Webster

First pass isolation predicts clinical success after contact force guided paroxysmal atrial fibrillation ablation

Background

Contact force (CF) ablation of AF with a focus on catheter-tissue contact stability optimizes clinical success and may help the operator to achieve pulmonary vein (PV) isolation in a single encirclement. While it seems evident that first pass isolation reduces procedure time, the effect on long term clinical success has not been reported.

Purpose

To evaluate the relationship between first pass isolation and freedom from atrial tachyarrhythmia recurrence at 1 year after PAF ablation.

Methods

Consecutive de novo PAF ablations were performed with a porous tip contact force catheter in 2017. All ablations used wide-area circumferential ablation and first pass isolation was captured separately for the left and right PVs. CF was held between 10–20 g and the catheter was moved every 10–20 s. RF energy was set at 40W throughout the atrium. Clinical success was defined as freedom from recurrent atrial tachyarrhythmia through 1 year following a 90-day blanking period and freedom from reablation at any time through 1 year.

Results

The population included 157 patients, age 62.7±11.5, 54.8% male, with mean CHA2DS2-VASc score of 2.3±1.5. Mean procedure times were 76.2±29.8 minutes and 89.2% of the ablations were performed with no fluoroscopy. The overall clinical success rate at 1 year was 86.1%. The number of ipsilateral PV pairs that could be isolated in a single pass was significantly associated with 1-year success (p=0.0043). Achieving first pass isolation on even one ipsilateral PV pair vs. neither pair was significantly associated with clinical success (Table).

Conclusion

In a real-world setting, first pass isolation on at least one PV side was predictive of 1 year clinical success in a PAF population ablated with CF.

Funding Acknowledgement

Type of funding source: Public Institution(s). Main funding source(s): Biosense Webster, Inc.

Trends in mortality from stroke in the European Union, 1996-2015

BACKGROUND AND PURPOSE

Stroke is the second largest single cause of death in Europe, responsible for 9% and 13% of all deaths in men and women, respectively. There have been large overall declines in stroke mortality rates in the majority of European countries in recent decades. The aim of this study was to analyse trends in mortality caused by stroke in the 28 member countries of the European Union (EU) over the last two decades.

METHODS

We extracted data for age-standardized stroke mortality rates per 100 000 in the EU for the period 1996-2015 from the World Health Organization database. Joinpoint regression analysis was used to analyse the trends and compute the annual percent change (APC) in the EU as a whole and by country. Analyses were conducted by gender and by European region.

RESULTS

Mortality from stroke has decreased in the EU over the study period by an average APC of 4.2%. All countries showed downward trends, with the sharpest decreases in Estonia, Portugal and Austria. We recorded statistically significant decreases of 4.2% and 4.3% in mortality rates in men and women, respectively, in the whole EU. Southern and western countries showed the steepest decreases, whereas mortality has increased in northern countries in recent years.

CONCLUSIONS

Stroke mortality has decreased in the EU, in both sexes, especially in southern and western European countries. Our results could be a reference for the development of primary prevention and acute management of stroke policies focused on countries with higher mortality.

P2835Feasibility and safety of same day discharge after radiofrequency catheter ablation for paroxysmal atrial fibrillation

Background

Atrial fibrillation catheter ablation (CA) is the most frequent arrhythmia ablation and accounts for a significant proportion of treatment cost. Same day discharge (SDD) after paroxysmal atrial fibrillation (PAF) ablation is an attractive strategy for both patients and hospitals.

Objective

To understand the eligibility criteria and outcomes for PAF patients who can safely undergo same day discharge after radiofrequency catheter ablation.

Methods

Patients undergoing CA for PAF were evaluated for SDD at a pre-procedure visit to assess the risk of groin, respiratory, cardiac or bleeding complications. Eligibility criteria for SDD were stable anticoagulation and absence of bleeding history, systolic/diastolic heart failure, or interventional procedures within 60 days, with recommended BMI <35. Patient proximity to the hospital was also considered. Anesthesia included propofol with endotracheal intubation and all patients were ablated with a porous tip contact force catheter (STSF). Patients were on bed rest for 6 hours post-procedure, then ambulated intermittently for 1–2 hours. Discharge followed if they were stable with no evidence of vascular access complications or bleeding. A dedicated RN telephoned patients the following morning to ask a series of standard questions designed to elicit evidence of any complications.

Results

52 procedures were identified for SDD, with 7 patients declining. 45 planned SDD procedures for 43 patients occurred 4/17–6/18. Average age was 57±11 years and CHA2DS2-VASc was 1.5±1.1 at procedure. Procedure time was 69±26 min (IQR: 49 - 84 min) with maximum fluoroscopy usage of 0.2 min and 508±149 mL of fluid infused through the catheter. Two patients stayed overnight due a groin bleed and atelectasis with fever, and one chose to stay for comfort. The remaining 42 discharges occurred after 7.2±1.0 hours in recovery, with no SDD-related complications and no required return visits after the follow-up call. There were 3 AF recurrences (6.7%) as of the 10 week visit.

Conclusion

Appropriate low risk patients identified by simple clinical criteria can be safely discharged the same day after CA of PAF. Further evaluation is required for higher risk patients.

Acknowledgement/Funding

The study was funded by Biosense Webster Inc.

ZrO2-SBA-15 catalysts for the one-pot cascade synthesis of GVL from furfural

Controlling the zirconia coating thickness in ZrO₂-SBA-15 materials allows tuning their catalytic performance in the one-pot transformation of furfural into GVL.

Biological removal of pharmaceutical compounds using white-rot fungi with concomitant FAME production of the residual biomass

The efficiency of two white-rot fungi (WRF), Trametes versicolor and Ganoderma lucidum, to eliminate thirteen pharmaceutical pollutants with concomitant biodiesel production from the accumulating lipid content after treatment, was examined. The removal efficiency was studied using both individual and combined strains. The results of individual and combined strains showed a total removal (100%) of diclofenac (DCF), gemfibrozil (GFZ), ibuprofen (IBP), progesterone (PGT) and ranitidine (RNT). Lower removals were achieved for 4-acetamidoantipyrin (AAA), clofibric acid (ACF), atenolol (ATN), caffeine (CFN), carbamazepine (CZP), hydrochlorothiazide (HCT), sulfamethoxazole (SMX) and sulpiride (SPD), although the combination of both strains enhanced the system's efficiency, with removals ranging from 15 to 41%. This increase of the removal efficiency when combining both strains was attributed to the interactions developed between them (i.e., competition). Results from enzymatic and cytochrome P450 examination suggested that both extracellular (laccase, MnP, LiP) and intracellular oxidation mechanisms participate in the biological removal of pharmaceuticals. On the other hand, the "green" potential of the fungal sludge generated during the biological removal process was assessed for biodiesel production by means of one-step direct (in-situ) transformation. This process consists of the simultaneous extraction and conversion of lipids contained in the sludge by catalytic esterification/transesterification using a robust acid heterogeneous Zr-SBA-15 catalyst. This catalytic system provided conversions close to 80% of the saponifiable fraction (including free fatty acids and glycerides) in the presence of high amount of impurities. The overall weight FAME yield, based on the initial dried mass, was close to 30% for both strains.

[Characteristics of drug interactions in a pediatric intensive care unit]

INTRODUCTION

The aim of this study is to calculate the theoretical frequency of potential drug interactions (PDI) and their characteristics in the therapeutic plan of hospitalized patients in a Pediatric Intensive Care Unit (PICU).

PATIENTS AND METHODS

An observational study was conducted which analyzed PICU prescriptions between September and November 2011. The inclusion criteria included to be hospitalized in a PICU, requirements of at least 3 drugs, except those topically applied, either gender, no age limit, no hospital stay required. The Micromedex® 2.0 program was used to detect and classify PDI.

RESULTS

Of 223 patients, 100 met inclusion criteria, 610 prescriptions were analyzed and 815 drugs were prescribed. 1,240 PDI were detected in 44 patients; 12 patients received more than 10 drugs each, presenting 1,162 PDI (93.7% of total PDI). 8 patients were hospitalized for more than 10 days, presenting 1,035 PDI (83.5% of total PDI). According to PDI theoretical severity, 37.5% were high, 51.7% moderate, 6.7% low and 4.1% contraindicated. The therapeutic group most involved was antimicrobials (17.6%) and the most frequently involved individual drugs were chloral hydrate (15.9%), midazolam (14.1%) and vecuronium (13.4%).

CONCLUSION

PDI were more frequent in patients associated with major polypharmacy and longer hospital stay.

The upgraded Large Plasma Device, a machine for studying frontier basic plasma physics

In 1991 a manuscript describing an instrument for studying magnetized plasmas was published in this journal. The Large Plasma Device (LAPD) was upgraded in 2001 and has become a national user facility for the study of basic plasma physics. The upgrade as well as diagnostics introduced since then has significantly changed the capabilities of the device. All references to the machine still quote the original RSI paper, which at this time is not appropriate. In this work, the properties of the updated LAPD are presented. The strategy of the machine construction, the available diagnostics, the parameters available for experiments, as well as illustrations of several experiments are presented here.

Bulk Polymerization of Styrene using Multifunctional Initiators in a Batch Reactor: A Comprehensive Mathematical Model

A detailed, comprehensive mathematical model for bulk polymerization of styrene using multifunctional initiators – both linear and cyclic – in a batch reactor was developed. The model is based on a kinetic mechanism that considers thermal initiation and chemical initiation by sequential decomposition of labile groups, propagation, transfer to monomer, termination by combination and re-initiation reactions due to undecomposed labile groups. The model predicts the evolution of global reaction variables (e.g, concentration of reagents, products, radical species and labile groups) as well as the evolution of the detailed complete polymer molecular weight distributions, with polymer species characterized by chain length and number of undecomposed labile groups. The mathematical model was adjusted and validated using experimental data for various peroxide-type multifunctional initiators: diethyl ketone triperoxide (DEKTP, cyclic trifunctional), pinacolone diperoxide (PDP, cyclic bifunctional) and 1,1-bis(tert-butylperoxy)cyclohexane (L331, linear bifunctional). The model very adequately predicts polymerization rates and complete molecular weight distributions. The model is used to theoretically evaluate the influence of initiator structure and functionality as well as reaction conditions.

How To Achieve Durable Pulmonary Vein Antral Isolation?

The inability to achieve durable pulmonary vein isolation(PVI) remains a major limitation to a catheter ablation for thew treatment of atrial fibrillation(AF), potentially resulting in AF recurrence.In this review,we discuss the research performed investigating methods to improve lesion permanence for the goal of durable PVI.Investigations evaluted procedural techniques,various catheres utilized, adjunctive pharamacologic therapy and novel energy sources designed to improve ablation lesion permanence are discussed.

Are urology residents ready to treat premature ejaculation after their training?

INTRODUCTION

The management of premature ejaculation (PE) among urology residents (URs) in the era of standard definition and new treatments is unknown.

AIM

To determine how future urologists currently address PE and to review their adherence to guidelines.

METHODS

A specifically designed survey on the preferred approaches to the treatment of PE was given to residents during the Eighth European Urology Education Programme. The results were tabled, and descriptive statistics were used to analyze differences in practice patterns.

MAIN OUTCOMES MEASURES

The responses are compared with clinical guidelines and recommendations.

RESULTS

A total of 360 URs attended the recommendation course, and 140 answered the survey (response rate: 38.8%). Seventeen (12.1%) of the respondents considered PE to be a very common sexual dysfunction, 62 (44.3%) considered PE to be frequent, 33 (23.6%) considered this condition uncommon, and 28 (20%) did not consider PE to be a dysfunction. Regarding incidents, 67 residents (47.9%) treated one patient per week. To assess PE, 132 (94.3%) used sexual history, 37 (26.4%) used physical examination, 38 (27.1%) used questionnaires, and 4 (2.9%) used laboratory testing. The preferred initial management strategy for PE was psychological/behavioral therapy for 65 (46.4%) residents. Topical anesthetic, andrological referral, and prescription of selective serotonin reuptake inhibitors (SSRIs) on demand were favored by 34 (24.3%), 19 (13.6%), and 8 (12.9%) of the respondents, respectively. Other options were psychiatric referral, which was preferred by two (1.4%) respondents, and prescription of daily SSRIs, which was preferred by two (1.4%) respondents. The preferred secondary treatment for patients who did not improve initially was prescription of SSRIs for on demand, which was 46 (32.9%) respondents. In cases where patients had concomitant erectile dysfunction (ED), 16 (11.4%) URs treated only the ED and 60 (42.9%) treated both conditions.

CONCLUSIONS

The majority of URs follow the established guidelines for diagnosis of PE, but not for treatment. The URs have an insufficient medical education in sexual medicine.

Usefulness of bladder-prostate ultrasound in the diagnosis of obstruction/hyperactivity in males with BPH

OBJECTIVE

To determine the utility of prostate ultrasound in the diagnosis of infravesical obstruction (IVO) and detrusor hyperactivity(DH).

METHODS

Prospective study with 39 patients consulting for LUTS. Clinical history was compiled, IPSS was determined, a digital rectal exam was performed, abdominal ultrasound was used to calculate detrusor thickness/weight, prostate volume, and middle lobe length (MLL). Urodynamic study (UD) was performed with determination of the Abrams-Griffiths number and ICS nomogram. Mean values were compared with Mann-Whitney U-test, and ROC curves were plotted determining the cutoff points for optimum sensitivity/specificity.

RESULTS

Mean age was 63.1 years (SD: 7.8), with a mean IPSS score of 14 (SD: 6). 53.8% of the patients presented IVO at UD evaluation, and 43.6% DH. The differences between free flowmetry Qmax(p=0.015) and MLL (p=0.003) between patients with and without IVO proved significant. The ROC curves yielded an AUC for middle lobe length of 0.772, with a maximum sensitivity and specificity cutoff point at 10.5 mm (sensitivity 90%, specificity 73%, PPV 76%, NPV 85%). There were no significant differences in any parameter between patients with and without DH.

CONCLUSION

Ultrasound MLL measurement in patients with LUTS offers high sensitivity/specificity in diagnosing IVO, with a cutoff point of 10.5 mm. In our study it wasn't effective in the noninvasive diagnosis of DH.

In vitro activity of retapamulin against linezolid and methicillin-resistant Staphylococcus aureus isolates

OBJECTIVES

To determine the in vitro activity of retapamulin and other topical antibiotics (mupirocin, bacitracin, and fusidic acid) usually employed for nasal decolonization, against methicillin-susceptible Staphylococcus aureus (MSSA), methicillin-resistant S. aureus (MRSA), and linezolid and methicillin-resistant S. aureus.

METHODS

The minimum inhibitory concentrations (MICs) were determined on Mueller-Hinton agar according to the guidelines of the Clinical and Laboratory Standards Institute and of the European Committee for Antimicrobial Susceptibility Testing. Presence of the cfr gene in linezolid and methicillin-resistant S. aureus isolates was detected using polymerase chain reaction.

RESULTS

Retapamulin inhibited all the isolates of MSSA and MRSA at 0.125 mg/L, but the 18 linezolid-resistant-MRSA strains proved resistant, with MICs over 32 mg/L. Most MSSA isolates (9/10) were susceptible to mupirocin with MICs under 0.19 mg/L, although this value decreased to half against MRSA, and almost all linezolid-resistant MRSA (17/18) strains were resistant to mupirocin with an MIC range of between 8 mg/L and 28 mg/L. The MIC of fusidic acid increased substantially against linezolid-resistant MRSA, whereas that of bacitracin showed no differences.

CONCLUSIONS

Retapamulin demonstrated excellent in vitro activity against MSSA and MRSA strains, but not against MRSA isolates harbouring the cfr gene. The results of this in vitro study support cut-off values for retapamulin of ≤ 0.5, 1, and ≥ 2 mg/L for susceptible, intermediate, and resistant strains, respectively.

[Causes, characteristics and mid-term course of acute urinary retention in women referred to a urodynamics unit]

OBJECTIVES

Acute urinary retention (AUR) is uncommon in women and can be related to different conditions. Only some patients are referred to the urodynamics units for a more extensive study. We intend to describe the charcteristics and causes of AUR in women referred to our unit and to analyze their middle term evolution.

MATERIAL AND METHODS

We performed a descriptive retrospective study (January 1982-December 2006), including the women referred to our Uro-Neurology and Urodynamics Unit after suffering an AUR. Medical charts were reviewed with special emphasis on medical history, physical examination, and also complete urodynamics study during the AUR event and after its resolution.

RESULTS

A total of 202 women were included, median age of 57 years (12-87 years). Prior to the AUR, 59 women (28.7%) reported voiding symptoms. The urodynamics findings were: 65 (32.2%) detrusor hypocontractility; 64 (31.7%) normal study; 37 (18.3%) detrusor acontractility; 21 (10.4%) bladder outlet obstruction; 15 (7.4%) poor pelvic floor relaxation. The causes of the AUR were: 53 neurological (26.2%); 46 unknown (22.8%); 19 gynecological (9.4%); 22 diabetes mellitus (10.9%); 16 urological (7.9%). Renal insufficiency was observed in 14 patients (6.9%). After the AUR 106 women (52.4%) needed some kind of prolonged treatment.

CONCLUSIONS

In our experience, AUR in the female is mainly related to underlying neurologic/urogynecologic disease, even though the etiology could not be known in a significant percentage of patients. Half of the patients recovered completely and did not require any treatment.

Texture Analysis of Al and Cu Metallization Materials Using Orientation Imaging Microscopy

X-ray diffraction (XRD) is generally used to measure crystallographic texture, but complete analysis is rarely performed. Orientation imaging microscopy (OIM) gives similar data by electron diffraction and has potential for widespread use since it may be added to any scanning electron microscope. Analysis software has been developed to reduce QIM results into a form which may be compared directly to XRD results. OIM texture parameters measured from Al films showed good quantitative agreement with XRD parameters, however the texture in Cu films is more complex and difficult to compare. Although subject to certain limitations, OIM has several advantages over XRD including more efficient data collection, better sensitivity to minor texture components, and more flexible data analysis.

[Basic techniques of electroencephalography: principles and clinical applications]

The electroencephalogram is a technique for the functional exploration of the central nervous system (CNS). It is a relatively old technique but even today it continues to be a tool of great assistance to the clinician in diagnosing and treating certain pathologies, such as epilepsy, encephalopathies, alterations to the state of consciousness, CNS infections, etc. On the other hand, it is a diagnostic tool whose applications are expanding in combination with other neurophysiological techniques, such as in the field of the study and diagnosis of sleep pathology (polysomnography, multiple sleep latency test...) and in intraoperative monitoring together with somasensory evoked potentials. This article describes the basic techniques of electroencephalography, with special emphasis on its main clinical applications and on future perspectives.

[Narcolepsy: update on etiology, clinical features and treatment]

Narcolepsy is a disease that involves an alteration in the generation and organisation of sleep. The main symptoms are excessive daytime sleepiness and cataplexy, followed by hypnagogic hallucinations, sleep paralysis and disrupted nocturnal sleep. The prevalence of typical narcolepsy oscillates between 25-50: 100.000 in general. Recently there has been a peak incidence in patients born in the month of March. According to the new classification, the Multiple Sleep Latency Test (MSLT) is mandatory for diagnosing narcolepsy without cataplexy, and advisable for diagnosing narcolepsy with cataplexy. Until now, the attempt has been made to control each symptom by its own specific treatment. At present, new American and European treatment guidelines propose new drugs that act on all the symptoms. The application of new criteria of diagnosis and treatment has improved the diagnosis, giving better options of treatment.

[Clinical Neurophysiology: past, present, future]

Clinical Neurophysiology is a medical speciality whose aim is the study of the nervous and muscular system for diagnostic, prognostic and therapeutic purposes. This article analyses the basic objective pursued by this discipline, the techniques it employs and its recognition as a medical speciality. The article briefly reviews its definition and scope, how it is structured at present and the future possibilities it offers.

[Transcranial magnetic stimulation]

Transcranial magnetic stimulation is a non-invasive tool for the electrical stimulation of the cerebral cortex, and for evaluation of the excitability of the motor cortex and pathways. Transcranial magnetic stimulation can be applied as single pulses of stimulation, pairs of stimuli separated by variable intervals to the same or different brain areas, or as trains of repetitive stimuli at various frequencies. Single stimuli can depolarize neurons and evoke measurable effects. Series of stimuli (repetitive transcranial magnetic stimulation) can modify the excitability of the cerebral cortex at the stimulated site and also at remote areas along functional anatomical connections. TMS might provide novel insights into the pathophysiology of the neural circuitry underlying neurological and psychiatric disorders, but more work is needed to establish the role of transcranial magnetic stimulation in clinical neurology.

Descriptive spatial and spatio-temporal analysis of the 2000-2005 canine rabies endemic in Santa Cruz de la Sierra, Bolivia

The authors analysed laboratory samples testing positive for rabies virus collected between 2000 and 2005 from Santa Cruz de la Sierra, Bolivia, to assess the spatial and spatio-temporal distribution of the endemic of canine rabies. According to the results of the spatial analysis, canine rabies was not evenly distributed in the city. Significant spatio-temporal clustering of canine rabies cases showed a trend towards clusters with high incidence rates in two particular areas compared with surrounding areas in the city. Benefits obtained from each of the analytical techniques utilised are described and practical difficulties in conducting and interpreting the results are discussed.