Search

Objective: To analyze the relationship between the inappropriate use of topical corticosteroids and the development of Cushing's syndrome in pediatric age. Methods: Literature review study. A search was carried out in the databases PubMed, EbscoHost, MedLine complete and CINAHL, using a combination of descriptors and Boolean operators. The article selection process was carried out based on the research question, the proposed objectives and the inclusion criteria, applying the SIGN criteria. Results: The sample consisted of 13 articles, of which the scientific evidence was evaluated using SIGN criteria. Currently, Cushing's syndrome, which is diagnosed in most pediatric cases, is due to the overuse and misuse of topical corticosteroids. This disease is due to the excess of free cortisol provided by the drug. The disease is due to the excess of free cortisol provided by the drug that emerges in systemic life thus producing the release of the natural hormone and the secondary effects that it entails. In turn, being a rare syndrome, its late diagnosis or its non-association to drug abuse, could lead to irreversible causes and condition the life of the minor. Conclusions: Cushing's syndrome is associated with the use of topical corticosteroids in pediatric ages due to lack of information and education to the legal guardian/s of the minor, as well as, due to the unconsciousness that exists due to the abuse of drugs that cause immediate effect. That is why, after this review, we propose to establish an action protocol for patients with dermatological alterations that require treatment dermatological alterations that require its use., Objetivo: Analizar la relación entre el uso inadecuado de corticoides tópicos y el desarrollo de síndrome de Cushing en edades pediátricas. Métodos: Se realizó una búsqueda en las bases de datos PubMed, EbscoHost, MedLine complete y CINAHL; mediante la combinación de descriptores y operadores booleanos. El proceso de selección de los artículos se realizó en base a la pregunta de investigación, los objetivos propuestos y los criterios de inclusión, aplicando los criterios SIGN. Resultados: La muestra estuvo compuesta por 13 artículos, de los cuales se evaluó la evidencia científica mediante criterios SIGN. Actualmente, el síndrome de Cushing que se diagnostica en la mayoría de los casos pediátricos, se debe al excesivo y mal uso de corticoides tópicos. Esta enfermedad se debe al exceso de cortisol libre proporcionado por el fármaco que se emerge en vida sistémica produciendo así la liberación de la hormona natural y los efectos secundarios que conlleva. A su vez, al ser un síndrome poco frecuente, su diagnóstico tardío o su no asociación al abuso del fármaco, podría llevar a causas irreversibles y condicionar la vida del menor. Conclusiones: El síndrome de Cushing se asocia al empleo de corticoides tópicos en edades pediátricas por falta de información y educación al tutor/es legales del menor, así como, por la inconsciencia que existe por el abuso de fármacos que causa efecto inmediato. Es por ello que, tras esta revisión, se propone establecer un protocolo de actuación ante los pacientes con alteraciones dermatológicas que precisen de su empleo.

Incontinence is a problem with strong presence in geriatric population. The most common skin lesions are the ones caused by the moisture and by the direct contact with urine and/or feces. Our goal was to design a diaper rash scale for developing a care guide about the proper use of absorbent dressings within incontinent elderly and about the treatment of wounds caused by moisture. Methodology: A retrospective, observational, descriptive study was conducted to design the iconographic visual scale of the diaper rash caused by moisture. A total of 140 patients were screened in this study. A multicenter, prospective study was conducted to apply the moisture scale within the treatment of elderlies with the use of absorbents dressings. A total of 134 institutionalized patients were screened in this study during a week. The absorbent dressings were provided by the investigation team in order to avoid bias in the investigation. Results: 45% of studied patients was over 80 years old, and 87% was women. 88% experienced mixed incontinence, and more than 50% ran the risk of developing pressure ulcers. The absorbent dressing used did not have any problem by its use in the 78% of the studied cases. Regarding the humidity-related factors, erythema and dryness were the most improved lesions. Conclusion: The use of skin lesion scales based on absorbent dressings stimulates the care of the skin integrity in incontinent elderlies., La incontinencia es un problema con elevada presencia en la población geriátrica. La lesiones cutáneas que se desarrollan con más frecuencia son las causadas por la humedad y el contacto directo de la orina y/o las heces sobre la piel. Nuestro objetivo fue diseñar una escala de valoración de la dermatitis del pañal por humedad para desarrollar un plan de cuidados sobre el uso adecuado de los dispositivos absorbentes en personas incontinentes y el tratamiento de lesiones producidas por la humedad. Metodología del estudio: Para el diseño de la escala visual iconográfica de la dermatitis del pañal por humedad (DPH) se realizó un estudio retrospectivo, observacional descriptivo sobre 140 Historias Clínicas. Para la aplicación de la escala de humedad y su tratamiento sobre ancianos con uso de dispositivos absorbentes se realizó un estudio prospectivo multicéntrico, durante una semana, sobre 134 pacientes institucionalizados. Los dispositivos absorbentes utilizados fueron proporcionados por el equipo investigador por las características del producto y para evitar el sesgo en la investigación. Resultados: El 45% de la población a estudio era mayor de 80 años y el 87% eran mujeres. El 88% tenía incontinencia mixta y más del 50% riesgo medio-alto de desarrollar úlceras por presión. Para 78% de los casos el dispositivo absorbente utilizado no presentó incidencias por uso. Con relación a los factores relacionados con la humedad las lesiones que más mejoraron fueron el eritema y la sequedad. Conclusiones: La utilización de escalas de valoración cutánea adecuadas al uso de dispositivos absorbentes favorece el cuidado de la integridad de la piel en pacientes incontinentes.

10.1371/journal.pone.0031280, De novo lipogenesis is involved in fatty acid biosynthesis and could be involved in the regulation of the triglyceride storage capacity of adipose tissue. However, the association between lipogenic and lipolytic genes and the evolution of morbidly obese subjects after bariatric surgery remains unknown. In this prospective study we analyze the association between the improvement in the morbidly obese patients as a result of bariatric surgery and the basal expression of lipogenic and lipolytic genes.

This work presents a two-phase flow model for compressible fluids coupled with heat transport simulation. The coupling is realized via equations of state, which are used to determine the relation between temperature, pressure and density of a fluid. The density correlation is necessary to describe the compressibity of a gas or a liquid, furthermore, density together with temperature affects fluid viscosity and thermal conductivity. Using the coupled H(2)T-model, we developed a test scenario based on an enhanced gas recovery application. This test case consists of a 1D cutout from a natural gas reservoir in the vicinity of the CO(2) injection well. The simulation shows the displacement of natural gas by carbon dioxide at the first stage of injection. A simplified simulation with constant fluid properties but similar conditions was compared to an analytical solution to prove the validity of the governing equations.

In this work, a high precision groundwater flow model integrating all important geological features of the hydrogeological system is developed to investigate the hydrological processes in the Wadi Kafrein area. The object-oriented software OpenGeoSys (OGS) is applied and then updated in order to meet the challenges of complex geological features of the study area. The comparisons between the simulation results and the observation data show that the flow model is capable of reproducing historical groundwater level changes to a satisfactory degree. Since the Wadi Kafrein area is one of the arid and semiarid regions in the Lower Jordan Valley, the models developed in this study can be a useful tool for analyzing the hydrological processes and improving groundwater management practices elsewhere affected by similar geological and hydrogeological conditions.

In this paper a ppT-formulation for non-isothermal multi-phase flow is given including diffusion and latent heat effects. Temperature and pressure dependencies of governing parameters are considered, in particular surface tension variation on phase interfaces along with temperature changes. A weak formulation of the governing equations is obtained by applying Galerkin's method of weighted residuals. The numerical model is implemented in the framework of the open source scientific software OpenGeoSys based on object-oriented programming (OOP) principles allowing model applications in various geotechnical areas. The classic benchmark for two-phase flow by McWhorter and Sunada(1) is used as a reference case on which non-isothermal effects and non-linear material behavior are studied.

In this paper, the conceptual modeling and the numerical simulation of two-phase flow during CO2 injection into deep saline aquifers is presented. The work focuses on isothermal short-term transport and deformation processes in the vicinity of the injection well, including hydromechanical failure analyses. Governing differential equations are based on balance laws for mass and momentum, and completed by constitutive relations for the fluid and solid phases as well as their mutual interactions. Constraint conditions for the partial saturations and the pressure fractions of CO2 and brine are defined. To characterize the stress state in the solid matrix the effective stress principle is applied. The coupled problem is solved using the in-house scientific code OpenGeoSys (an open source finite element code) and verified with benchmarks.

Numerical modelling of interacting flow processes between roots and soil is essential for understanding the influence of different root geometries and types on the hydro-system and remains a challenging task especially for multiple interacting root systems. This is mainly due to the geometric complexity, the coupled physical processes, scale differences and the required computational resources. These days, coupled 3D-soil-root models at the plant scale are available simulating the water flow along potential gradients within root as well as in soil. Although the biological, chemical and physical processes along the soil-root interface have not been fully investigated yet, current models suggest strong gradients in water potential at the soil-root interface. We develop high-precision models, which capture the main small scale features of plant-water uptake (aRoot) but run on the bulk soil scale coupled to soil water infiltration (OpenGeoSys). This requires an appropriate combination of the geometric models and time stepping schemes to solve both, the plant-water uptake and the soil water flow. The three-dimensional root architectures are embedded into bulk soil and the water flow is modeled along a network of resistances from the bulk soil along radial soil discs towards the root system up to the root collar. The non-linear dynamics of water flow within the soil surrounding the roots are covered by a 3D-Richards model. The numerical analysis of such coupled multiple-root-soil problems with a high precision involves significant computational resources and parallel computing is a way to enable the use of the necessary computer power of SMP machines or clusters. Moreover, we apply adaptive time stepping with automatic control, which assures model stability and a shorter total run-time as compared to a static and steady time-step scheme.

Sustainable river basin management often requires an integrated understanding of surface-subsurface flow and transport processes. The software framework OpenGeoSys (OGS) and the EPA Storm Water Management Model (SWMM) have been coupled to accomplish this. In this work OGS simulates flow in confined and unconfined aquifers applying the Darcy equation, while surface channel runoff is described with the Saint-Venant approach using EPA-SWMM. Aquifer and river are coupled via exchange fluxes. The sensitivity of the simulation results is examined in reference to a leakance parameter in the calculation of coupling source terms. The application of the coupled model to a real-life case study (Poltva catchment, Western Ukraine) is outlined.