Spanish primary care in pediatric trauma (AITP) consensus: An AITP checklist. / Consenso AITP español: Una lista de verificación AITP.

INTRODUCTION: The course in Primary Care in Pediatric Trauma (ATIP in Spanish) has been taught in Spain since 1997, and there are currently 9 accredited training centers. Care of polytraumatized pediatric patients often takes place in an environment conducive to errors resulting from forgetfulness, which is why checklists - mnemonic tools widely used in industry and medicine - are particularly useful to avoid such errors. Although several checklists exist for pediatric trauma care, none have been developed within the setting of our course. MATERIALS AND METHODS: The criteria for being selected as an expert in Primary Care in Pediatric Trauma were agreed upon with the scientific polytrauma committee of the Spanish Pediatric Surgery Society. The items that make up the checklist were obtained from a review of the literature and consultation with selected experts, using the Delphi Technique. RESULTS: 10 experts representing the 9 groups or training centers in Primary Care in Pediatric Trauma were selected, and a 28-item checklist was drawn up in accordance with their design recommendations. CONCLUSIONS: With the consensus of all the groups, a checklist for the treatment of polytraumatized pediatric patients was drawn up using the Delphi Technique, an essential requirement for the dissemination of this checklist, which should be adapted and validated for use in each healthcare center.

INTRODUCCION: El curso de Asistencia Inicial al Trauma Pediátrico se imparte en España desde 1997, existiendo en la actualidad 9 centros formadores acreditados. La asistencia al paciente pediátrico politraumatizado se produce muchas veces en un ambiente proclive al error por olvido, por lo que las listas de verificación, como herramientas mnemotécnicas de amplia difusión en la industria y en medicina, serían especialmente útiles para evitarlos. Aunque existen varias listas de verificación para la asistencia al traumatismo pediátrico, ninguna se ha desarrollado en el entorno de nuestro curso. MATERIAL Y METODOS: Se acordaron los criterios para ser seleccionado como experto en Asistencia Inicial al Trauma Pediátrico con la comisión científica de politrauma de la Sociedad Española de Cirugía Pediátrica. Los ítems para formar la lista de verificación se obtuvieron a partir de una revisión bibliográfica y de la consulta a los expertos seleccionados, empleando un método Delphi. RESULTADOS: Se seleccionaron 10 expertos que representan los 9 grupos o centros formadores en Asistencia Inicial al Trauma Pediátrico y se elaboró una lista de verificación con 28 ítems, siguiendo sus recomendaciones de diseño. CONCLUSIONES: Se diseñó una lista de verificación para el manejo del paciente pediátrico politraumatizado, con el consenso de todos los grupos empleando un método Delphi, requisito fundamental para facilitar la difusión de esta lista. Sería preciso adaptar y validar dicha lista para su uso en cada centro asistencial.

Diagnosis and management of isthmocele (Cesarean scar defect): a SWOT analysis.

The purpose of this State-of-the-Art Review was to provide a strategic analysis, in terms of strengths, weaknesses, opportunities and threats (SWOT analysis), of the current evidence regarding the management of uterine isthmocele (Cesarean scar defect). Strengths include the fact that isthmocele can be diagnosed on two-dimensional transvaginal ultrasound, and that surgical repair may restore natural fertility potential and prevent secondary infertility, as well as reduce the risk of miscarriage and other obstetric complications. However, there is a lack of high-quality evidence regarding the best diagnostic method and criteria, as well as the potential benefits of surgical repair with respect to fertility. There is a need for experienced surgeons skilled in the various isthmocele repair techniques. Isthmocele repair does not prevent the need for Cesarean delivery in subsequent pregnancies. There is increasing awareness regarding the accuracy of transvaginal ultrasound in diagnosing isthmocele. This may lead to surgical correction and prevention of obstetric and perinatal complications in subsequent pregnancies, including Cesarean scar pregnancy. Regarding threats, the existence of different surgical techniques means that there is a risk of selecting an inadequate approach if the type of isthmocele and the patient's characteristics are not considered. There is a risk of overtreatment when asymptomatic defects are repaired surgically. Finally, there is an absence of cost-effectiveness analyses to justify routine repair. Thus, while there are many data suggesting that isthmocele has an adverse effect on both natural fertility and the outcome of assisted reproduction techniques, high-quality evidence to support surgical isthmocele repair in all asymptomatic patients desiring future fertility are lacking. There is increasing agreement to recommend hysteroscopic repair of isthmocele as a first-line approach as long as the residual myometrial thickness is at least 2.5-3.0 mm. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Effects of solvent density on retention in gas-liquid chromatography. I. Alkanes solutes in polyethylene glycol stationary phases.

Gas-liquid chromatographic columns were prepared coating silica capillaries with poly(oxyethylene) polymers of different molecular mass distributions, in the range of low number-average molar masses, where the density still varies significantly. A novel, high-temperature, rapid evaporation method was developed and applied to the static coating of the low-molecular-mass stationary phases. The analysis of alkanes retention data from these columns reveals that the dependence of the partition coefficient with the solvent macroscopic density is mainly due to a variation of entropy. Enthalpies of solute transfer contribute poorly to the observed variations of retention. Since the alkanes solubility diminishes with the increasing solvent density, and this variation is weakly dependent with temperature, it is concluded that the decrease of free-volume in the liquid is responsible for this behavior.

[Complications of stereotaxic surgery for cerebral tumors. Minimal access neurosurgery]. / Complicaciones de la cirugía estereotáxica de los tumores cerebrales. Neurocirugía de mínimo acceso.

INTRODUCTION: Complications of neurosurgery include the clinical, neurological and neurosurgical aspects. Their prevention and correction depend on satisfactory preoperative assessment and close postoperative follow-up. Although minimum access neurosurgery reduces some problems, the complexity and depth of many cerebral lesions cause problems. Therefore it is important to adhere to the above principles to obtain good results. OBJECTIVES: To determine the clinical complications, their early detection and course to be followed when they occur. PATIENTS AND METHODS: We studied 29 patients with intracranial tumors operated on using stereotaxic surgery during a period of two years. They were evaluated before and after surgery and the complications recorded. RESULTS: We discuss the most significant clinical aspects of peri-operative management. The main complications found were lower respiratory tract infection and hyperglycemia. CONCLUSIONS: These results show the need for suitable management, even in minimum access surgery, in patients with cerebral tumors operated on using stereotaxis and underline the most significant complications.

Hold-up time in gas chromatography. V. Dependence of the retention of n-alkanes on the chromatographic variables in isothermal gas chromatography.

The chromatographic behaviour of n-alkanes and other homologous series in isothermal gas chromatography has been shown to depart from the "linear" representation of the logarithms of the adjusted retention times vs. carbon number. One of the expressions proposed to describe this behaviour is tR(z)=A+exp(B+CzD). In this paper, a regression analysis shows that three of the parameters of the equation depend on different chromatographic variables such as hold-up time, average linear gas velocity, volume and polarity of the stationary phase and temperature of the column. The fourth parameter (D), responsible for the departure from the "linearity", does not depend on any chromatographic variable, and represents a gradual decrease of the contribution of the methylene groups to the general properties of n-alkanes, with no relation to the chromatographic phenomenon.

[Sepsis and antibiotic prophylaxis in stereotaxic neurosurgery]. / Sepsis y profilaxis antibiótica en neurocirugía estereotáxica.

INTRODUCTION: Stereotaxic surgery is becoming increasingly important because of the possibility of approaching the deep zones of the brain with less risk. It is in daily use in cerebral tumours and in the functional surgery of Parkinson's disease. The use of antibiotic prophylaxis in neurosurgery is controversial, although in many centres, including ours, all patients receive it. OBJECTIVE: To study the pre-operative clinical characteristics analysing the antibiotic prophylaxis used, septic complications seen and their management. PATIENTS AND METHODS: In this study we included 93 patients with neurosurgical disorders operated on using a stereotaxic approach in the Neurosurgical Department of the Centro Internacional de Restauración Neurologica (Cuba) during 1997 and 1998, in which antibiotic prophylaxis was used and septic patients detected. The variables studied included age, sex, neurological disorders, surgical operations done and the antibiotic used for prophylaxis. We analysed the test of clinical criteria for sepsis in all patients. RESULTS: We found that a greater number of patients operated on had had functional surgery, which showed its importance as an alternative surgical method in Parkinson's disease. There was satisfactory use of antibiotic prophylaxis with a reduction in the rate of nosocomial infection; most infections were seen in the lower respiratory tract. CONCLUSION: These results support the hypothesis of use of antibiotic prophylaxis in stereotaxic surgery to achieve a reduction in intra-hospital infections in surgical patients.

Comparison of the Binax Legionella urinary antigen enzyme immunoassay (EIA) with the Biotest Legionella Urin antigen EIA for detection of Legionella antigen in both concentrated and nonconcentrated urine samples.

We evaluated a newly commercial enzyme immunoassay (EIA) (Biotest Legionella Urin Antigen EIA; Biotest AG, Dreieich, Germany) for detection of antigens of all Legionella pneumophila serogroups with a relatively wide spectrum of cross-reactivity as well as antigens of other Legionella spp. by comparing its sensitivity and specificity with those of an EIA for detection of L. pneumophila serogroup 1 antigen (Legionella urinary antigen EIA; Binax, Portland, Maine). Both tests were performed with both concentrated and nonconcentrated urine samples. We also evaluated the capabilities of both EIAs to detect extracted soluble antigens of American Type Culture Collection (ATCC) Legionella strains (L. pneumophila serogroups 1 to 14, L. bozemanii, and L. longbeachae). The sensitivity of the Biotest EIA was 66.66% in nonconcentrated urine and 86.66% in concentrated urine. The sensitivity of the Binax EIA was 63.76% and 88.88% in nonconcentrated and concentrated urine, respectively. The specificity was 100% in nonconcentrated and concentrated urine for both assays. The Binax EIA and Biotest EIA detected extracted soluble antigens of L. pneumophila serogroups 1 to 14 and L. bozemanii ATCC strains. The cross-reactions observed with the Binax EIA were probably due to common epitopes directly related to lipopolysaccharide. Further studies are required to determine the usefulness of the Binax EIA for detection of urinary antigens from Legionella species and serogroups other than L. pneumophila serogroup 1. The Biotest EIA proved to be as rapid, sensitive, and specific as the Binax EIA for the diagnosis of legionellosis. Concentration of antigen present in urine increased the sensitivities of both techniques with no reduction in specificity.

[Intradural anesthesia: an alternative in surgery on premature infants]. / Anestesia intradural: una alternativa en la cirugía en los lactantes prematuros.

The greater survival of premature infants, the frequency with which these children present a pathology of surgical treatment, and their physiological immaturity, particularly in the respiratory system, entail a great many difficulties in the postoperative process. With the aim of decreasing these postoperative difficulties and because of the publications of several articles with the same goal, it is implemented a study of spinal anesthesia with isobaric bupivacaine in the premature babies put under a treatment or surgery of the inguinal canal, in order to asses the efficiency of this technique and the cardiovascular consequences. The average duration of the anesthesia was 59 +/- 13 minutes. The latency period is practically nonexistent and the average level that was achieved is situated between D4-D6, which is enough so as to carry out the operation without problems and achieving a complete analgesia in the inguinal area. It has not been observed relevant hemodynamic alterations. The outcomes are obvious, for the difficulties disappear, especially those coming from the respiratory system in the general anesthesia with intubation such as apnea, cyanosis and bradycardia, stridor and atelectasis. This kind of anesthesia allows the surgeon a perfect relaxation and analgesia and the children a comfort throughout the surgical event. By way of conclusion, the spinal anesthesia is a good option instead of the general anesthesia for suckling babies because of the risk of respiratory difficulties they present, alone all when they are premature and they are recovering from a syndrome of respiratory difficulty.

[Bouveret's syndrome. Diagnostic and therapeutic considerations apropos of a new case]. / Síndrome de Bouveret. Consideraciones diagnósticas y terapéuticas a propósito de una nueva observación.

A case is presented of Bouveret's syndrome, an unusual form of biliary ileus, that developed a high intestinal obstruction simulating pyloric stenosis. We emphasize the value of fiberendoscopy, which permits an early diagnosis to be made, thus avoiding delays in treatment.

Estudio de depresiones en alcoholistas / Depression in alcoholic patients

Se evaluaron 86 pacientes alcohólicos hospitalizados, cuya edad promedio fue de 44 años (24-60), con escala de Hamilton para depresiones y se pudo observar que el 57% eran alcohólicos no deprimidos y el 43% con depresión, siendo esta diferencia estadísticamente significativa. Además de ello se recogieron datos personales y demográficos que aportan a la cuestión estudiada

Oral papillomatosis in two laboratory rabbits in Mexico.

Oral papillomas were identified in two New Zealand white male rabbits from Mexico City. The growths were observed on the tip and ventral aspect of the tongue in a 3-year-old rabbit weighing 4 kg and on the tip of the tongue in a 15-month-old rabbit weighing 3.6 kg. Microscopic examination of the lesions revealed epithelial papillomas around fibrovascular stalks, and ultrastructural examination disclosed crystalline arrays of viral particles consistent with papova virus. This finding extends the known geographic distribution of the disease. Previous cases have been from the United States, The Netherlands, and Great Britain.

Factores etiologicos de la diarrea aguda del lactante en la Republica Dominicana.

Se estudian los microorganismos enteropatogenos relacionados a diarrea aguda del lactante en muestras de heces tomadas al azar a lo largo de un periodo de 7 meses, durante el ano de 1979, encontrandose E. coli enteroxigenico (14,4%), rotavirus (9,2%) y shigelas (2,6%), en un grupo de 76 ninos.Dentro de este mismo grupo de 25 ninos (8%) y 1 de 25(4%) mostraron ascaris y amebas respectivamente.Los rotavirus se encontraron solo en los meses frios. Los E. coli enterotoxigenicos tanto en los meses frios como calidos. En el 73, 8% de los casos no pudo aislarse un microorganismo sugerente de enteropatogenicidad

Ageing of columns of homogeneous mixed stationary phases in gas chromatography.

Chromatographic columns of homogeneous mixed phase prepared with squalane and polyethylene glycol 1540 have been subjected to an ageing process of about 1700 hours at 100 degrees C followed by a similar period of time at 120 degrees C. Little change is observed at the lower temperature, while at 120 degrees C, a selective loss of the most volatile component of the mixture seems to occur, producing changes in the values of the retention indices obtained.