[Assessment of the sound level in the operating room during urological surgery]. / Évaluation du niveau sonore dans un bloc opératoire d'urologie.

OBJECTIVES: In the operating room, a high sound level is associated with a higher risk of complications and affects the communication between the various workers. The objective of this study was to assess the sound level at the operating room during urological procedures. MATERIAL AND METHODS: A monocentric cross-sectional study was carried out in 100 procedures in urology. They were divided into four groups: open surgical procedures, endoscopic procedures, pure laparoscopic procedures, and robotic-assisted laparoscopic procedures. The sound level was measured with the Sound Metter by Examobile application (Bielsko-Biala, Poland) for i-phone®. RESULTS: For all procedures, mean sound level, mean minimum sound level and mean maximum sound level were 60.31±3.3 db, 52.42±2.6 db and 81.73±2.8 db, respectively. For endourological procedures, they were 61.6±4.1 db, 53.4±4.1 db and 81.3±3.1 db, respectively. For open surgery, they were 59.0±1.0 db, 51.6±1.8 db and 81.4±1.5 db, respectively. For laparoscopic surgery, they were 58.33±0.6 db, 50.66±1.2 db and 83.33±1.5 db, respectively. Robotic-assisted laparoscopic surgery, they were 60.0±2.4 db, 52.5±2.3 db and 83.56±1.8 db, respectively. No difference was found according to the type of surgical approach. However, the sound level in the operating room was increased for endourological procedures using the laser technology as compared to endourological procedures without laser used (58.7±1.1 vs. 66.3±0.1 db, P=0.01, respectively). CONCLUSION: The sound level in the operating room during urological procedures was high. For the endourological procedures, the sound level was the highest when the laser technology was used. LEVEL OF EVIDENCE: 3.

Implantable cardioverter defibrillator discharge rates in patients with unexplained syncope, structural heart disease, and inducible ventricular tachycardia at electrophysiologic study.

BACKGROUND AND HYPOTHESIS: The implantable cardioverter defibrillator (ICD) is the best available strategy to protect patients from life-threatening ventricular arrhythmia. Although unproven, it is commonly utilized to treat subjects with syncope, a negative clinical workup, structural heart disease, and inducible sustained monomorphic ventricular tachycardia (VT) on programmed electrophysiologic stimulation (EPS). The purpose of this paper was to validate this approach. METHODS: We retrospectively identified 36 subjects who received primary ICD therapy for syncope in the setting of structural heart disease with inducible sustained monomorphic VT on EPS. The cohort was predominantly male (32/36) with underlying coronary artery disease (29/36). The mean left ventricular ejection fraction was 31 +/- 12%, and a third of the patients (12/36) had undergone bypass surgery. RESULTS: The study group was followed for a mean of 23 +/- 15 months (range 3-81 months) and experienced an ICD event rate of 22% at 3 months, which increased to 55% at 36 months. This event rate was comparable with the 66% event rate seen in a group of patients with primary ICD therapy for spontaneous life-threatening VT treated during the same time period. No future predictors of ICD events in the study group could be identified. CONCLUSION: Syncope patients with negative workup, structural heart disease, and sustained monomorphic VT at EPS are at high risk for future tachyarrhythmic events. Based on present evidence, primary ICD therapy in this group appears warranted and justified.

Antibodies against linear and conformational epitopes of the human papillomavirus (HPV) type 16 E6 and E7 oncoproteins in sera of cervical cancer patients.

Sera obtained from 137 cervical cancer patients were analysed for the presence of antibodies to the human papillomavirus (HPV) type 16 proteins E6 and E7 by the aid of different assays, i.e. ELISA using as antigen either synthetic peptides or the complete E7 protein and radio-immunoprecipitation (RIPA) which uses the viral protein made by in vitro transcription/translation. In agreement with previous reports, reactivity to the E7 protein was found more frequently than to the E6 protein (31.4% vs. 16.8%) when the sera were assayed by peptide-based ELISA. In contrast, when RIPA was employed, reactivity to either protein was obtained at similar frequency (38.7% vs 46.7%). When the protein was denatured prior to immuno-precipitation the reactivity was lost in all sera tested for E6-specific antibodies but only in a few samples in the E7-RIPA. Therefore it was concluded that the increased sensitivity of the E6-RIPA as compared to the E6 peptide-ELISA is due to the detection of antibodies to conformational epitopes which are presented by the in vitro product but not by the synthetic peptides. Eighty-two sera from healthy donors were tested by HPV 16E6- and E7-RIPA and also by ELISA using the HPV 16E7 protein which was produced in the fission yeast Schizosaccharomyces pombe. One sample reacted each in the E6- and E7-RIPA indicating a high specificity of these assays. The E7 protein-ELISA proved to be less sensitive for the detection of antibodies in cervical cancer patients' sera (22.6% positive) as compared to peptide-based ELISA or RIPA.

[Atypical presentations of strongyloidiasis: a report of 8 cases]. / Presentaciones atípicas de strongyloidiasis: reporte de ocho casos.

Eight clinical cases of patients with an atypical strongyloidiasis are reported. The clinical notes are reviewed, the nematode is demonstrated by serial coproparasitologic modified Baermann's method and in some cases, the parasite is found by direct test of sputum or enterotest. In all cases, the main factor has been the immunological deficiency being this nutritional, neoplasia, autoimmune disease, immunosuppression therapy, although the most frequent is the moderate to severe, nutritional failure, differing with the foreign literature. All of them had a good clinical evolution using Albendazole in high doses or Ivermectin. It is concluded that systemic strongyloidiasis has a clear physiopathological base in relation to cellular immunodeficiency and this must be carefully search in our patients, where the chronic autoinfection is a frequent clinical status, and there are immersed in some type of immunodeficiency, in our environment this is usually nutritional.

Effect of exposure to organophosphate pesticides on serum cholinesterase levels.

In this paper are reported the effects of organophosphate pesticide exposure. Agricultural workers were compared with an age- and sex-matched control group selected from the general population. A significant difference was detected (Student's t = 1.99, p = .05) between the median activity levels of serum cholinesterase in agricultural workers at the end of the work day (mean 4.44, 95% CI = 4.12-4.77), compared with those in the control group (mean = 4.85, 95% CI = 4.57-5.13). The decrease in cholinesterase activity, measured at the beginning (mean = 4.70, 95% CI = 4.38-5.02) and end of the work day, was very significant (paired t = 2.70, p = .01). An interaction was identified between the type of work and the worker's age. Younger workers tended to perform more dangerous activities, and they experienced a greater decrease in cholinesterase activity. This study indicates that subclinical intoxication of agricultural workers, by pesticides, is occurring in Mexico and indicates the need for primary prevention programs that address occupational contact with such substances.

Los actinomicetos termofilos de JuJuy: I. Monosporados / The Actinomycetes thermophiles of Jujuy, Argentina: I. Monosporium

Se aislaron cepas de Thermoactinomyces thalpophilus, T. dichotomica y Saccharomonospora viridis, a partir de restos vegetales y residuos de la industria azucarera obtenidos en la zona subtropical jujeña. Estas especies están consideradas como agentes causales de neumonitis alérgica