The novel Mechanical Ventilator Milano for the COVID-19 pandemic.

This paper presents the Mechanical Ventilator Milano (MVM), a novel intensive therapy mechanical ventilator designed for rapid, large-scale, low-cost production for the COVID-19 pandemic. Free of moving mechanical parts and requiring only a source of compressed oxygen and medical air to operate, the MVM is designed to support the long-term invasive ventilation often required for COVID-19 patients and operates in pressure-regulated ventilation modes, which minimize the risk of furthering lung trauma. The MVM was extensively tested against ISO standards in the laboratory using a breathing simulator, with good agreement between input and measured breathing parameters and performing correctly in response to fault conditions and stability tests. The MVM has obtained Emergency Use Authorization by U.S. Food and Drug Administration (FDA) for use in healthcare settings during the COVID-19 pandemic and Health Canada Medical Device Authorization for Importation or Sale, under Interim Order for Use in Relation to COVID-19. Following these certifications, mass production is ongoing and distribution is under way in several countries. The MVM was designed, tested, prepared for certification, and mass produced in the space of a few months by a unique collaboration of respiratory healthcare professionals and experimental physicists, working with industrial partners, and is an excellent ventilator candidate for this pandemic anywhere in the world.

Investigación para el diagnóstico situacional local de la epidemia de ETM: Intervenciones preventivas para su contención: Área Programática del Hospital General de Agudos Juan A. Fernández 2015-2016 / Research for the local situational diagnosis of ETM epidemic: Preventive interventions for its containment: Acute General Hospital Juan A. Fernández Programmatic Area 2015-2016

El plan de Prevención y Control de Enfermedades Transmitidas por Mosquito (ETM): Dengue, Fiebre Chikungunya, Amarilla, y Zika de la CABA establece cuatro escenarios teóricos de riesgo que orientan la implementación de las acciones de prevención y control. En el presente informe se presentan los estudios de foco investigados en nuestra Área Programática (AP) y su georreferencia, a fin de obtener un diagnóstico situacional local que permita la ejecución de intervenciones oportunas y eficaces a fin de limitar la aparición de nuevos casos en el contexto epidémico 2015-2016. El objetivo general fue estudiar la epidemia de ETM para su comprensión y abordaje en el Área Programática del Hospital General de Agudos Juan A. Fernández, y el objetivo específico, prevenir y limitar la aparición de nuevos casos de ETM. (AU)

Efficacy of immunomodulatory therapy with interferon-ß or glatiramer acetate on multiple sclerosis-associated uveitis. / Eficacia del tratamiento inmunomodulador con interferón-ß o acetato de glatirámero en las uveítis asociadas a esclerosis múltiple.

AIM: To analyse the role of interferon-ß or glatiramer acetate in reducing the inflammatory episodes of intra-ocular inflammation in multiple sclerosis-associated uveitis. METHOD: A study was conducted on a non-randomised, retrospective case series of 13 patients with proven multiple sclerosis and uveitis (minimum follow-up, 12 months). All patients were given immunomodulatory treatment (interferon-ß or glatiramer acetate) to control the course of the multiple sclerosis. Patients were compared to themselves before initiating the treatment, in order to assess the difference in uveitis episodes. The main outcome measurements were the number of uveitis episodes with/without immunomodulatory treatment. RESULTS: Uveitis was bilateral in 10 (77%) out of 13 patients. Intermediate uveitis was observed in 11 patients, retinal vasculitis in 3 patients, and one patient was classified as a posterior uveitis. The patients had a mean of 4.15±3.1 episodes of uveitis (range 1-10) during the follow-up period (148.6±84.3 months). When compared to their pre-treatment status, patients on treatment with interferon-ß or glatiramer acetate showed a significant decrease of 0.36 episodes of ocular inflammation per year (P=.02). Mild side effects related to immunomodulatory treatment were observed in 6 (46%) patients, 3 (23%) patients with a flu-like syndrome, and 3 (23%) patients with a skin rash. CONCLUSIONS: Interferon ß or glatiramer acetate could be effective in reducing the uveitis episodes in patients with multiple sclerosis-associated uveitis, and was well tolerated in most patients.

Diagnostic Validity Comparison Between Criteria Based on CSF Alzheimer's Disease Biomarkers.

AIM: To compare the diagnostic validity of NIA-AA criteria, for AD CSF biomarkers, with our own new criteria. MATERIALS AND METHODS: Between 2008 and 2011, 170 patients with Mild Cognitive Impairment (MCI) were included. CSF levels of Aß1-42, T-tau, P-tau181, and ratios of T-tau/Aß1-42 and P-tau181/Aß1-42 were analyzed. In our criteria, we considered 3 or more abnormal variables indicative of a high likelihood of MCI due to AD. RESULTS: After a clinical follow-up of 4.5 ± 1.2 years, 44 patients remained stable, 95 developed AD, 15 other forms of dementia, 7 died and 9 received other diagnoses. Using the NIA-AA criteria and our own criteria, the diagnostic validity of the CSF biomarkers was 58% versus 85%, specificity 84% versus 72%, PPV 82% versus 79% and NPV 61% versus 79%. CONCLUSION: The inclusion of the ratios in diagnostic criteria increases sensitivity and NPV for the diagnosis of MCI due to AD.

[Intravitreal bevacizumab for choroidal neovascularization associated with Best's disease]. / Bevacizumab intravítreo en neovascularización coroidea asociada a enfermedad de Best.

CASE REPORT: A 27-year old woman presented with loss of vision in the right eye (20/200). Ophthalmoscopic examination showed intrarretinal hemorrhage in the macular region with neurosensory detachment in the right eye, and viteliform deposit on the left eye. Fluorescein angiography and the electrooculogram confirmed the diagnosis of choroidal neovascularization associated with Best's disease. Four weeks after a single bevacizumab intravitreal injection, visual acuity was restored (20/25) and remained stable after a 12 month follow-up. DISCUSSION: Intravitreal bevacizumab appears to be an effective treatment for choroidal neovascularization associated to Best's disease.

Timing of hysterectomy surgery during the menstrual cycle--impact of menstrual cycle phase on rate of complications: preliminary study.

To determine the relationship between the timing of a hysterectomy performed during the menstrual cycle phase and the postoperative complication rate in women who had undergone surgery for dysfunctional uterine bleeding, the authors examined the charts of 24 patients for the 3-month period immediately after the hysterectomy. Twelve of the women were in the follicular phase, and 12 were in the luteal phase at the time they had undergone the hysterectomy. Patients were classified by operative pathology report. No significant differences (P < or = 0.05) were found between the two groups with respect to age, weight, para status, pathology, preoperative and postoperative hemoglobin levels, operation time, blood loss, days before return to full functioning, days in hospital, and uterine morphology. Further prospective studies with longer follow-up time are needed to obtain more conclusive indications regarding the optimal timing of hysterectomy during the menstrual cycle.

Laparoscopic removal of a dermoid cyst in pregnancy. A case report.

BACKGROUND: Laparoscopy in pregnancy can endanger the fetus. It is now being reexamined because of our experience with complex operative procedures and new laparoscopic equipment. CASE: A decision was made to perform laparoscopy instead of laparotomy for a pelvic mass in a pregnant woman. The patient was admitted to the emergency room with a temperature of 38.9 degrees C and was 15 4/7 weeks pregnant. Over several hours she developed septic shock, with the blood pressure and white blood cell count dropping. Bedside ultrasound revealed a complex mass suspicious for an abscess. A dermoid cyst was found and removed by pelviscopic techniques. Blood cultures revealed typhoid fever, and the patient responded to antibiotics. She was discharged on the 10th postoperative day. CONCLUSION: This case demonstrates the value of laparoscopy in pregnancy not only for diagnosis but also for treatment. Laparoscopy in pregnancy should be added to the armamentarium of the gynecologist.

New suturing device for laparoscopic hysterectomy.

Suturing is the most difficult element in laparoscopic surgery. Therefore, surgeons often resort to the use of a linear stapler, which increases the overall cost of the surgery. The Della Badia laparoscopic suturing device facilitates suturing by incorporating the suture before it is inserted into the abdomen. Intra-abdominal needle loading is thereby eliminated. The instrument also allows the surgeon to place the suture at the desired location. In the initial 25 cases in which the device was used, it was found to be effective, and at a fraction of the cost of the linear stapler.