Renopancreatic transplant. Urologic complications

OBJECTIVE: Retrospective study of urological complications in our series of reno-pancreatic transplants. MATERIAL AND METHODS: Between February 1983 and May 1994 our group has conducted 93 RPT, 80 of which, mean age 36 +/- 6 years (24-54 years), are studied in this paper: 57 male and 23 female with an average time in dialysis of 20 +/- 15 months (0-84 months) and diabetes evolution of 21 +/- 5 years (11-37 years). RESULTS: Actuarial annual survival of patient, renal graft and pancreatic graft has been 85%, 79% and 74% respectively. Haematuria: 25% incidence, with graft pancreatitis etiology in 16 cases, rejection in 8 and urinary fistula in 6. Urinary infection: 85% incidence, symptomatic in 23 patients (29%) and asymptomatic in the remaining cases. Dysuria, urethritis and urethral stenosis: 14 patients, all male, most with both conditions associated. Reconversion of pancreatic exocrine secretion by intestinal route was performed in 7 patients. Urinary fistula: secondary to surgery in 9 cases and rejection in 4. Etiology of one case remained unknown. In 4 cases it was resolved with conservative treatment, and with surgical correction in 8. One patient required pancreatic transplantectomy and one patient died of AMI. CONCLUSIONS: Urological complication in RPT account for a significant morbidity, urinary fistula being the one with greater repercussion on the patient and pancreatic graft survival.     

Analysis of the /spl Sigma/-/spl Delta/ pulsed digital oscillator for MEMS

The aim of this paper is the analysis, simulation, and experimental verification of the /spl Sigma/-/spl Delta/ pulsed digital oscillator (PDO) topology. As it has been shown in previous works, the oscillation frequency and output spectrum in the PDO depend on the sampling frequency, the natural frequency of the microelectromechanical systems (MEMS) resonator and its damping factor. Here, extensive discrete-time simulations have been carried out which show that the normalized oscillation frequency as a function of the normalized natural frequency of the resonator is very similar to a distorted Devil's Staircase fractal. This nonlinear behavior is a direct consequence of the damping losses of the MEMS resonator. Analytical conditions for a perfect oscillation at the natural frequency of the resonator are also calculated. For this set of what we call "perfect" frequencies, it is also shown that the energy transfer from the electrical to the mechanical domain is maximum. Then a more generalized structure of the oscillator is considered and the drawn conclusions are tested against experimental results obtained from an oscillator prototype which uses a MEMS resonator with thermoelectric actuation and piezoresistive position sensing.     

The interpretation of X-ray photoelectron spectra of pyrolized S-containing carbonaceous materials

Theoretical models and ab initio Hartree-Fock wavefunctions have been used to investigate the S(2p) core level binding energies (BE), of pyrolized S-containing, carbonaceous materials. Comparison between experimental and calculated data for thiophene permits the accuracy of the present approach to be established. A systematic study of different situations demonstrates that, in these materials, non-oxidized S atoms can show peaks at very high BE relative to the C(1s) peak at 285.0 eV. This study confirms that the peak at 164.1 eV corresponds to ‘thiophenic’ S atoms. On the other hand, it shows that the peaks at higher BE could correspond to S atoms replacing C atoms in three-coordinated structures of graphene layers, in agreement with the arguments suggested in the experimental works. The energetic similarity between the two peaks at very high BE makes it difficult to differentiate between them, although the results of the present study seem to suggest that the peak at experimental BE ≈ 166 eV could correspond to S atoms coordinated to two C and one H atoms at the edge of graphene layers, while the peak at ≈ 169 eV would correspond to S atoms replacing C atoms in inner positions of the graphene layers, and it is bonded to three C atoms.     

Sustainable Development and the Sustainability of Competitive Advantage: A Dynamic and Sustainable View of the Firm

Does the need for sustainable development hinder businesses’ ability to create value? Is a firm’s competitiveness negatively affected by considering that need? After quickly reviewing the main literature contributions on the relationship between business and society, and drawing from resource‐based view of the firm and sustainable development literature, this paper presents a proposal for a dynamic and sustainable view of the firm. It shows how considering the changes introduced into the competitive landscape by sustainable development influences the way in which companies develop their resources, capabilities and activities, fostering the persistence of competitive advantages based on knowledge and innovation.     

Acute hepatic failure and Hodgkin's disease]

We present the clinical outcome and imaging micro and macroscopic of a patient who died of e liver acute failure. Hodgkin disease with massive infiltration was found at necropsy. We offer a review of the liver complaint in this particular disease.     

Inhibition of platelet-vessel wall interactions by thromboxane receptor antagonism in a human in vitro system: potentiation of antiplatelet effects of aspirin

BACKGROUND: Pharmacological inhibition of arachidonic acid metabolism has proven therapeutically useful in the prevention of cardiovascular events. METHODS: We have investigated the ability of Bay u 3405, a synthetic thromboxane antagonist, to interfere with platelet aggregation and arachidonic acid metabolism. The antiplatelet action was also analysed in a perfusion system in which vascular subendothelium was exposed to circulating human blood (10 min; shear rate = 800 s-1). Platelet interactions were morphometrically analysed and results compared with those obtained in studies with blood from donors taking aspirin (acetylsalicylic acid, ASA) (500 mg day-1). The additional effect of Bay u 3405 on the antiplatelet action of ASA was also evaluated. RESULTS: Bay u 3405 caused a dose-dependent inhibition of platelet aggregation induced by U46619 with a maximal effect at concentrations > or = 0.01 microgram mL-1. Higher concentrations (> or = 0.05 micrograms mL-1) also inhibited aggregations induced by ADP or collagen. Bay u 3405 did not interfere with platelet arachidonic acid metabolism. In perfusion studies, Bay u 3405 (0.01 microgram mL-1) significantly decreased the total surface of the vessel covered by platelets (%CS = 18.7 +/- 1.09 vs. 24.4 +/- 1.94; P < 0.05) and the formation of large aggregates %T = 7.5 +/- 0.87 vs. 19.3 +/- 1.61; P < 0.01). ASA treatment reduced platelet aggregate formation (%T = 13.7 +/- 2.06; P < 0.05) but did not affect the total surface covered by platelets. The in vitro addition of Bay u 3405 to blood from ASA-treated donors further reduced the formation of large aggregates (%T = 2.7 +/- 0.79; P < 0.01 vs. ASA). CONCLUSIONS: In vitro effect of Bay u 3405 on platelet function were superior to those observed with ASA. The thromboxane antagonism antagonism provided by Bay u 3405 further enhanced the inhibition of platelet aggregate formation found after ASA treatment.     

Injury profiles of road traffic deaths

The objective is to describe injuries of road traffic deaths in Barcelona and identify injury profiles by road user type, through a cross-sectional study including road traffic deaths for the period 1997-2004. The data source was the Institut de Medicina Legal de Catalunya. Diagnoses were coded using the International Classification of Diseases, 9th revision, Clinical Modification, and classified using the Barell Matrix. Of the 719 deaths studied, 45% were pedestrians, 32% two wheel motor vehicle users, and 23% car occupants. The injury profile of the road traffic deaths in Barcelona is internal injuries and fractures to the torso and to the head/neck. This profile is repeated in all the road user groups, although pedestrians present higher frequencies of fractures and contusions to extremities and contusions to the head/neck, and fewer internal torso injuries than car occupants or two wheel motor vehicle users.     

Nonmetastatic accumulations in bone radionuclide scans in a patient with breast neoplasm

Left ventricular dilation and systolic dysfunction develop in 14-16% of patients with hypertrophic cardiomyopathy. Such findings may easily be misdiagnosed as dilated cardiomyopathy. It is unknown whether left ventricular dilatation and systolic dysfunction in patients with hypertrophic cardiomyopathy are reversible. A 35-year-old man had been a heavy drinker for 13 years and was abstinent for 1 year. Five years previously he suffered cardiac arrest and, based on echocardiographic, radionuclide, and cardiac catheterization findings, the diagnosis of alcohol-induced dilated cardiomyopathy was established. At presentation the heart was of normal size, with concentric left ventricular hypertrophy and only slightly reduced systolic function. Hypertrophic cardiomyopathy was diagnosed since no other cause for left ventricular hypertrophy could be detected. In hypertrophic cardiomyopathy, alcohol may induce reversible systolic dysfunction and left ventricular dilatation.