[Surgical treatment of chronic non-insertional Achilles tendinopathy in runners using bipolar radiofrequency]. / Tratamiento quirúrgico de la tendinopatía aquílea crónica no insercional en corredores mediante el uso de radiofrecuencia bipolar.

OBJECTIVE: To present the surgical technique with release of peritendon and radiofrequency as an effective treatment for athletes with chronic tendinopathy of the Achilles tendon body. MATERIALS AND METHODS: This is a retrospective case series descriptive type study. The series consists of 17 Achilles tendon surgeries in 13 patients, who habitually run. The study included patients with non-insertional Achilles tendinopathy refractory to conservative treatments. After a minimum follow-up of 12 months, clinical improvement of the athletes was assessed using the Nirschl pain scale, as well as athletic performance. RESULTS: An improvement was obtained in 94% of symptoms and a return to the previous performance in of 70% of cases in the 12 months follow-up. DISCUSSION: Peritendon release combined with bipolar radiofrequency is presented as an effective solution in this condition, for which there is currently no consensus on the best treatment. In patients in whom, after an appropriate conservative treatment for a sufficient period (at least 6 months) the non-insertional Achilles tendinopathy persists, open adhesiolysis combined with bipolar radiofrequency is a safe and with a high success rate clinical and functional intervention. In high performance athletes this technique allows a return to previous activity in a high percentage of cases.

[Trabecular metal box for acute acetabular fracture in an elderly patient]. / Caja de metal trabecular para fractura acetabular aguda en paciente anciano.

BACKGROUND: We are currently observing an increase in the incidence of acetabular fractures in elderly patients due to the increase in this population age group. These fractures represent a challenge to the traumatologist because in some cases there is the surgical alternative of combining fixation with total acute hip arthroplasty. In this paper we explore the use of trabecular metal combining the stability provided by a cage with potential bone incorporation, applying the principles of revision surgery to speed-up the healing process without the limitations resulting from the restrictions in the load of the operated limb. MATERIAL AND METHODS: We assessed the clinical and radiological results, with a 2-year follow-up, after total hip arthroplasty for the acute treatment of an acetabular fracture of the anterior column, with involvement of the quadrilateral lamina in an elderly 85 year-old patient. RESULTS: Important pain relief occurred, with functional improvement and an appropriate range of motion using the Merle d'Aubigné system. Radiologically, the graft areas in the particles surrounding the acetabular component were uniformly integrated. No loosening, screw rupture or implant migration occurred. CONCLUSIONS: This indication using a revision technique based on a trabecular metal reconstruction cage should be considered as an alternative to bear in mind in these patients.

Major degradation product identified in several pharmaceutical formulations against the common cold.

Different pharmaceutical preparations against the common cold containing acetaminophen, phenylephrine hydrochloride, and chlorpheniramine have been studied. An unidentified degradation product has been discovered in these preparations after short- and long-term stability studies, with increasing concentration at increasing storage temperatures and times. LC/MS was employed to identify and obtain molecular weights of the degradation products using an electrospray ionization interface. To obtain detailed structural information on the major degradation product, its isolation by SPE followed by HPLC was required. Final isolation was accomplished by using a new pentafluorophenyl stationary phase. Once the major degradation product was isolated, MS/MS, 1H NMR, 13C NMR, COSY, HMBC, and HSQC techniques permitted the complete characterization of this new compound formed under the usual stability conditions at climatic chambers. Its origin was also established as a result of the interaction between two of the components in the formulation. It is important to remark that this compound has not been described in the literature up to now and that, moreover, it has been identified in several commercial preparations containing phenylephrine hydrochloride and chlorpheniramine maleate.

Anthocyanin quantification and radical scavenging capacity of Concord, Norton, and Marechal Foch grapes and wines.

The anthocyanin content and the radical scavenging capacity of three non-Vitis vinifera grapes (Marechal Foch, Norton, and Concord varieties) were determined. Analyses of anthocyanins in the skin (S) and wine (W) of these grape varieties were performed by spectrophotometry, HPLC with electrochemical detection, and matrix-assisted laser desorption ionization (MALDI). The total anthocyanin contents of S samples were 258 +/- 37 mg/100 g of wet weight for Foch, 888 +/- 78 mg/100 g for Norton, and 326 +/- 5.9 mg/100 g for Concord grapes. The malvidin 3,5-diglucoside content quantified by HPLC indicated that Norton S had the highest amount of the compound (327 +/- 110 mg/100 g). The MALDI mass spectrometric analysis indicated an abundance of malvidin glucosides in W of Foch grapes and in S and W of Norton grapes and of cyanidin aglycon in S and W of Concord grapes. S samples were subjected to a radical scavenging capacity test using the 2,2-diphenyl-1-picrylhydrazyl radical and compared to Trolox. The radical scavenging capacity for Foch S was 0.78 mM Trolox equiv, that of Concord S, 0.80 Trolox equiv, and that of Norton S was highest at 0.95 Trolox equiv. The higher concentrations of malvidin 3,5-diglucoside in S of grape varieties were associated with greater radical scavenging capacity.

Reforma del sistema de salud de Bolivia, 1999 / Health system reform from Bolivia, 1999

Los cambios estructurales iniciados en Bolivia a partir del año 1993 concuerdan con la mayoría de las recomendaciones de los organismos internacionales para acelerar la implementación de la Atención Primaria de Salud y así alcanzar la meta social de Salud para Todos con equidad, eficiencia, eficacia y calidad, con solidaridad y universalidad. Se cumplen seis años de un proceso de cambio estructural, que se condiera todavía breve para medir los impactos en las condiciones de vida de la población. Es evidente el cambio importante en el desarrollo y fortalecimiento de los servicios de primer nivel aumentando de esta forma la accesibilidad geográfica de los sectores más marginados. Otro logro importante en este proceso es la implementación del seguro básico de salud que permite romper las barreras económicas para la gran mayoría de la población y de esta forma aumentar la cobertura en salud particularmente de los grupos vulnerables. Por último es innegable, el valor de la incorporación de la comunidad, dentro de este proceso de cambio al asumir con responsabilidad la toma de decisiones y control de las acciones de salud

Narrow-mouthed water storage vessels and in situ chlorination in a Bolivian community: a simple method to improve drinking water quality.

Epidemiologic investigations of the Latin America cholera epidemic have repeatedly implicated untreated drinking water and water touched by hands during storage as important vehicles for disease transmission. To prevent such transmission, we provided a new narrow-mouthed, plastic, water storage vessel and 5% calcium hypochlorite solution for home disinfection of stored water to a Bolivian Aymara Indian community at risk for cholera. We evaluated acceptance of this intervention and its effect on water quality. Each of 42 families in the study obtained water from a household well; fecal coliform bacteria were found in water from 39 (93%) of 42 wells and 33 (79%) of 42 usual water storage vessels. One group of families received the special vessels and chlorine (group A), a second received only the special vessels (group B), and a third served as a control group (group C). Water samples collected every three weeks from group A special vessels had lower geometric mean fecal coliform colony counts (P < 0.0001) and lower geometric mean Escherichia coli colony counts (P < 0.0001) than water from group B or C vessels. Adequate levels of free chlorine persisted in these vessels for at least 5 hr. The special vessels and chlorine solution were well accepted and continued to be used for at least six months. Use of the vessel and chlorine solution produced drinking water from nonpotable sources that met World Health Organization standards for microbiologic quality.