Canulación axilar mediante prótesis de Dacron en cirugía del arco y la aorta ascendente / Axillary artery cannulation with a Dacron graft for surgery of the aortic arch and ascending aorta

La canulación de las arterias axilares para instaurar la circulación extracorpórea es una alternativa en la cirugía del arco y la aorta ascendente. Su canulación mediante una prótesis de Dacron presenta ciertas ventajas. En el presente trabajo comunicamos nuestra experiencia con esta técnica en 7 pacientes consecutivos. En todos se realizó un recambio de la aorta ascendente. Se asociaron los siguientes procedimientos: reconstrucción de la raíz aórtica según técnica de David en 2 pacientes, intervención de Bentall en uno, hemiarco en dos, arco completo y trompa de elefante en uno, resuspensión de velos aórticos en uno y reconstrucción de senos de Valsalva en uno. Se realizó parada circulatoria con perfusión anterógrada en 3 casos. La mortalidad hospitalaria fue nula. No hubo complicaciones vasculares ni infecciosas del abordaje axilar. Un paciente presentó una parestesia transitoria por afección del plexo braquial. El flujo de la circulación extracorpórea fue adecuado en todos los casos

Cannulation of the axillary artery is one possible means of establishing cardiopulmonary bypass during surgery of the ascending aorta and aortic arch. Use of a Dacron graft for cannulation has a number of advantages. In this article, we report our experience with this technique in seven consecutive patients in whom we performed an ascending aorta replacement. The associated procedures involved were aortic root reconstruction using David's procedure in two patients, the Bentall procedure in one, the hemi-arch technique in two, the complete arch and elephant trunk technique in one, aortic valve repair in one, and Valsalva sinus reconstruction in one. Circulatory arrest with antegrade cerebral perfusion was carried out in three cases. There was no in-hospital mortality, and there were no vascular or infectious complications related to axillary access. One patient presented with transient paresthesia of the brachial plexus. In all cases, cardiopulmonary bypass flow was adequate

Fungi in bottled water: a case study of a production plant

A one-year fungal survey of a water bottling plant was conducted in order to evaluate the incidence and fluctuations of the mycobiota. The dominant fungal genera in order of highest numbers isolated were Penicillium, Cladosporium and Trichoderma followed by Aspergillus, Paecilomyces, and others. As expected, the highest number of isolates were collected during the warmer months, particularly May and June. Indeed during these two months there were more fungi present in the water, indicating that during those times of the year when fungal contamination is high, 0.4 mm filters should be changed on a more regular basis. In order to assess whether contamination was single or multi-loci, molecular methods based on the PCR were used for Penicillium brevicompactum. Overall, fungal contamination arose from multiple sources. Some P. brevicompactum strains were very "alike" and were detected during different sampling times, indicating that they were endemic to the plant. There was no evidence to suggest that fungi detected in the source water passed through to other parts of the plant. However, there was evidence that fungal strains isolated from the water filter were detected elsewhere in the factory, confirming the need to change filters more regularly during periods of high fungal contamination. In order to improve quality control a HACCP programme was implemented and Best Practice Guidelines introduced(AU)