Cemetery Relocations in Hidroituango: An Interdisciplinary Study.

This study realized the exhumation and transfer of human remains buried in the cemeteries at Orobajo, Barbacoas and La Fortuna (Municipality of Sabanalarga, Peque and Buriticá respectively) within the framework of "Social Management" of the Ituango Hydroelectric Project and the program Integral Restitution of Living Conditions for communities. Methods and techniques from bioanthropology, forensic sciences, archeology and Soil Sciences were used. Cemeteries were characterized by unconventional burials; moreover, documentation of tombs and burial practices were not generalized, nor did they show patterns. In the field assessment, 2,883 pit tests and soil probes using a penetrometer were carried out over a total area of 2,288 square meters. A total of 349 skeletonized human remains were exhumed, almost double of what was expected; of these, 180 were from Orabajo, 151 from Barbacoas, and 18 from La Fortuna. Though the remains showed a great deal of deterioration, age at death was determined for 59% of cases, and sex identified in 49%. Personal artifacts and clothing items were recovered along with the bones in many cases. Remains from Barbacoas and La Fortuna were given over to communities, and final dispositions were made in sites previously agreed upon (cemeteries in Peque, Buriticá and Sabanalarga respectively).

Oil bioremediation in soils contaminated with oil spills in tropical environments.

Bioremediation techniques like bioaugmentation and/or biostimulation are an economical and environmentally friendly procedure which emerged as the most advantageous methodology for treatment of contaminated sites by oil spills pollutants. This research uses a tropical soil contaminated with oil based drilling fluids (OBMs) and drill cuttings were evaluating at laboratory scale. Seven treatments were implemented separately: (C) control; (A) natural attenuation; (B) compost (Bs) nutrients; (BsT) nutrients and tween 80; (BsTL) nutrients, tween 80, leonardite, and (BL) nutrients, tween 80, leonardite and d-limonene. For three months, changes in Total Petroleum Hydrocarbons (TPH) soil microbial counts and activity were monitored as indicators of biodegradation. In order to evaluate the efficiency of treatments in the microcosm experiments. After 90 days of incubation hydrocarbon biodegradation is 76.2% (C), 28.6% (A), 76.2% (B), 66.7% (Bs), 83.3% (BsT), 69% (BsTL) and 88.1% (BL), respectively. Scanning electron microscopy (SEM) of OBMs evidenced absence of heavy metals. Biodiversity analysis showed a decrease in bacterial diversity and a rise in tolerant genus of hydrocarbons such as Nocardiodes, Streptomyces, Dietzia and Advenella. The co-substrate and stimulants had synergistic effect on the biological degradation of hydrocarbons. This research suggests that the implementation of bioaugmentation and biostimulation methods will be used a larger scale in contaminated sites.

Multicenter Experience with the Surfacer Inside-Out Access Catheter System in Patients with Thoracic Venous Obstruction: Results from the SAVE Registry.

PURPOSE: To report the device performance and safety for the Surfacer Inside-Out access catheter system in patients with thoracic central venous obstruction (TCVO) requiring central venous access (CVA). MATERIALS AND METHODS: Five sites prospectively enrolled 30 patients requiring a tunneled dialysis catheter between February 2017 and September 2018 in the SAVE (Surfacer System to Facilitate Access in Venous Obstructions) registry. Patient demographics, medical history, and type of TCVO were documented at enrollment. Device performance and adverse events were collected during the procedure and upon hospital discharge. Twenty-nine of the 30 patients enrolled required CVA for hemodialysis. Retrospective classification of TCVOs according to SIR reporting standards showed 9 patients (30%) had Type 4 obstructions, 8 (26.7%) had Type 3, 5 (16.7%) had Type 2, and 8 (26.7%) had Type 1 obstruction. RESULTS: Central venous catheters (CVCs) were successfully placed in 29 of 30 patients (96.7%). The procedure was discontinued in 1 patient due to vascular anatomical tortuosity. All 29 patients with successful CVC placement achieved adequate catheter patency and tip positioning. There were no device-related adverse events, catheter malposition, or intra- or postprocedural complications. Mean time from device insertion to removal for the 29 patients who successfully completed the procedure was 24 ± 14.9 (range, 6-70) minutes. Mean fluoroscopy time was 6.8 ± 4.5 (range, 2.2-25.5) minutes. CONCLUSIONS: The Surfacer Inside-Out procedure provided an alternative option to restore right-sided CVA in patients with TCVO.

Oil Bioremediation in a Tropical Contaminated Soil Using a Reactor.

This research was implemented in the Colombian Amazon forest area; to assess the effect of Tween-80® surfactant in the degradation of the Total Petroleum Hydrocarbons (TPH) in bioremediation treatments under aerobic conditions in the laboratory and pilot-scale. One control treatment, Natural Attenuation (AT) and four biostimulation treatments with leonardite with four different dosages of Tween-80® were proposed. The efficacy of organic stimulators and nonionic surfactant in soil microbiota was studied at laboratory and pilot scales, the latter in a passive aeration reactor. The test that presented a better performance was carried out with a Convective Flow Reactor (CFR) at pilot-scale. The results showed that bioremediation strategies improved the natural degradation process; the best outcomes were obtained in a treatment that includes Leonardite and Tween-80® (1.5 g/L) with 52% TPH degradation in 80 days (d).Tween-80® produced an effect in TPH solubility, and increased the production of CO2 in distinctive bioremediation treatments in both periods. The kinetics of CO2 production showed that the system required a periodic addition of a co-substrate as well as an increase of soil microbiota through the addition of compost (pilot scale). In this stage more than 76% of contaminant was degraded in 60d.

Ozonation using a stainless-steel membrane contactor: Gas-liquid mass transfer and pharmaceuticals removal from secondary-treated municipal wastewater.

A tubular porous stainless steel membrane contactor was characterized in terms of ozone-water mass transport, as well as its application in removing 23 pharmaceuticals (PhACs) detected in the secondary-treated municipal wastewater, under continuous mode operation. The volumetric mass transfer coefficient (KLa) was evaluated based on liquid flow rate, gas flow rate, and ozone gas concentration. The KLa values were substantially improved with an increment in liquid flow rate (1.6 times from 30 to 70 dm3 h-1) and gas flow rate (3.6 times from 0.30 to 0.85 Ndm3 min-1) due to the improved mixing in the gas-liquid interface. For the lowest liquid flow rate (30 dm3 h-1), the water phase boundary layer (82%) exhibited the major ozone transfer resistance, but it became almost comparable with membrane resistance for the highest liquid flow rate (70 dm3 h-1). Additionally, the influence of the specific ozone dose (0.39, 0.53, and 0.69 g O3 g DOC-1) and ozone inlet gas concentration ( [Formula: see text]  = 27, 80, and 134 g Nm-3) were investigated in the elimination of 23 PhACs found in secondary-treated municipal wastewater. An ozone dose of 0.69 g O3 g DOC-1 and residence time of 60 s resulted in the removal of 12 out of the 23 compounds over 80%, while 17 compounds were abated above 60%. The elimination of PhACs was strongly correlated with kinetic reaction constants values with ozone and hydroxyl radicals (kO3 and kHO•), leading to a characteristic elimination pattern for each group of contaminants. This study demonstrates the high potential of membrane contactors as an appealing alternative for ozone-driven wastewater treatment.

Application of catalytic ozonation using Y zeolite in the elimination of pharmaceuticals in effluents from municipal wastewater treatment plants.

Catalytic ozonation using faujasite-type Y zeolite with two different SiO2/Al2O3 molar ratios (60 and 12) was evaluated for the first time in the removal of 25 pharmaceutical compounds (PhCs) present in real effluents from two municipal wastewater treatment plants both located in the Mediterranean coast of Spain. Additionally, control experiments including adsorption and direct ozonation, were conducted to better understand the fundamental aspects of the different individual systems in wastewater samples. Commercial zeolites were used in sodium form (NaY). The results showed that the simultaneous use of ozone and NaY zeolites significantly improved the micropollutants degradation rate, able to degrade 95 % of the total mixture of PhCs within the early 9 min using the zeolite NaY-12 (24.4 mg O3 L-1 consumed), while 12 min of reaction with the zeolite NaY-60 (31 mg O3 L-1 consumed). In the case of individual experiments, ozonation removed 95 % of the total mixture of PhCs after 25 min (46.2 mg O3 L-1 consumed), while the direct adsorption, after 60 min of contact time, eliminated 30 % and 44 % using the NaY-12 and NaY-60 zeolites, respectively. Results showed that the Brønsted acid sites seemed to play an important role in the effectiveness of the treatment with ozone. Finally, the environmental assessment showed that the total risk quotients of pharmaceuticals were reduced between 87 %-99 % after ozonation in the presence of NaY-60 and NaY-12 zeolites. The results of this study demonstrate that catalytic ozonation using NaY zeolites as catalysts is a promising alternative for micropollutant elimination in real-world wastewater matrices.

Arteriovenous fistula creation using the Optiflow vascular anastomosis device: a first in man pilot study.

Although arteriovenous fistulae are the preferred form of dialysis vascular access they continue to have significant problems with maturation failure. The Optiflow device is a sutureless anastomotic conduit which could potentially reduce surgical time and also standardize the surgical procedure. We report herein on the "First in Man" experience with the Optiflow device.

First-in-human evaluation of a biological regenerative vascular conduit for hemodialysis access.

INTRODUCTION: The long-term survival and low complication rate of autogenous fistulas for hemodialysis access is often offset by early thrombosis and slow or failed maturation leading to the use of central venous catheters. A regenerative material may have the potential to overcome these limitations. A completely biological acellular vascular conduit was investigated in this first-in-human clinical study. METHODS: With approval of the ethics board and patients' informed consent, five subjects were enrolled based on predetermined inclusion criteria. Five patients underwent implant of a novel acellular, biological tissue conduit (TRUE AVC™) in the upper arm in a curved configuration between brachial artery and axillary vein. After maturation, standard dialysis was commenced through the new access. Patients were followed up to 26 weeks with ultrasound and physical exam. Serum samples were evaluated for an immune response to the novel allogeneic human tissue implant. RESULTS: This new tissue conduit handled well surgically, with properties similar to that of native human vein. Post procedure conduit flow was excellent in all cases, averaging 1098 ± 388 ml/min at week 4 and remaining stable through 1248 ± 355 ml/min at 26 weeks. Surgical site healing was normal with no edema or erythema by week 4. Six-month primary assisted patency was 80% and secondary patency was 100%. Prescribed dialysis was successfully delivered without infection, and there was no significant change in conduit diameter. Serum testing showed no increase in PRA or IgG specific to the TRUE AVC. One implant required intervention at 5 months with thrombectomy and covered stent procedure. CONCLUSION: This first-in-human 6-month study with favorable patency and low complication rate establishes the initial safety and feasibility of this novel biological tissue conduit for dialysis access in patients with end-stage kidney disease. Its mechanical durability and lack of immune response establishes TRUE AVC as a potential regenerative material for clinical use.

Novel Biodegradable Zn Alloy with Exceptional Mechanical and In Vitro Corrosion Properties for Biomedical Applications.

A series of quaternary Zn-Al-Cu-Li alloys with different weight fractions of Cu, Al, and Li were developed and investigated for potential application in high load bearing bioresorbable implants. The developed alloys provided various fractions of binary and ternary intermetallic structures, which resulted in formation of multiphase microstructures containing a zinc-rich η-phase and LiZn4 and CuZn4 phases. The intermetallic phases promoted grain refinement and a good combination of mechanical properties. The developed Zn-2Al-4Cu-0.6Li alloy showed strength and ductility close to commercially pure Ti alloys with a UTS value of ∼535 MPa and elongation of 37%. The examination of in vitro corrosion behavior of the developed alloys in the modified Hanks' solution revealed suitable corrosion rates (∼38.5 µm/year). The moderate corrosion rate was controlled by the formation of a homogeneous layer of stable corrosion products that protected the alloys from the corrosive environment, particularly in the late stages of immersion. The developed alloys with the most promising mechanical and corrosion properties appeared to be biocompatible to mouse fibroblast cells and human umbilical mesenchymal stem cells, making them suitable candidates for implant applications.

Development of high strength and ductile Zn-Al-Li alloys for potential use in bioresorbable medical devices.

A series of Zn-Al-Li alloys with potential application in bioresorbable implants were cast, thermomechanically processed and tested. The formation of secondary phases, such as LiZn4, LiZn3Al and Al3Li, contributed to both dynamic recrystallization and grain refinement of the matrix (η-phase) during the hot-extrusion process, leading to grain sizes as small as 1.75 µm for Zn-4Al-0.6Li alloy (wt%). This alloy exhibited an ultimate tensile strength (UTS) of 451 MPa, a total elongation of 46% and a corrosion rate of 60 µm/year in simulated body fluid. The grain refinement played a major role in increasing the strength, but it also weakened the basal texture and promoted non-basal slip and grain boundary sliding, thus contributing to the increased plastic deformation of the alloy. The corrosion rate was affected by a layer of zinc oxide and phosphate formed in the early stages of the immersion tests. The corrosion products protected the substrate and tended to reduce the corrosion rate over time. The developed Zn-4Al-0.6Li and Zn-6Al-0.4Li alloys which showed promising mechanical and corrosion properties appeared to be cytocompatible in the mouse fibroblast cell line and human umbilical mesenchymal stem cells making them promising candidates for bioresorbable stent and implant applications.

α-Helical peptides on plasma-treated polymers promote ciliation of airway epithelial cells.

Airway respiratory epithelium forms a physical barrier through intercellular tight junctions, which prevents debris from passing through to the internal environment while ciliated epithelial cells expel particulate-trapping mucus up the airway. Polymeric solutions to loss of airway structure and integrity have been unable to fully restore functional epithelium. We hypothesised that plasma treatment of polymers would permit adsorption of α-helical peptides and that this would promote functional differentiation of airway epithelial cells. Five candidate plasma compositions are compared; Air, N2, H2, H2:N2 and Air:N2. X-ray photoelectron spectroscopy shows changes in at% N and C 1s peaks after plasma treatment while electron microscopy indicates successful adsorption of hydrogelating self-assembling fibres (hSAF) on all samples. Subsequently, adsorbed hSAFs support human nasal epithelial cell attachment and proliferation and induce differentiation at an air-liquid interface. Transepithelial measurements show that the cells form tight junctions and produce cilia beating at the normal expected frequency of 10-11 Hz after 28 days in culture. The synthetic peptide system described in this study offers potential superiority as an epithelial regeneration substrate over present "gold-standard" materials, such as collagen, as they are controllable and can be chemically functionalised to support a variety of in vivo environments. Using the hSAF peptides described here in combination with plasma-treated polymeric surfaces could offer a way of improving the functionality and integration of implantable polymers for aerodigestive tract reconstruction and regeneration.

Carbon Nanofibers Functionalized with Active Screen Plasma-Deposited Metal Nanoparticles for Electrical Energy Storage Devices.

Supercapacitors are energy storage devices with higher energy densities than conventional capacitors but lower than batteries or fuel cells. There is a strong interest in increasing the volumetric and gravimetric capacitance of these devices to meet the growing demands of the electrical and electronic sectors. The capacitance depends largely on the electrode material, and carbon nanofibers (CNFs) have attracted much attention because of their relatively low cost, large surface area, and good electrical conductivity as well as chemical and thermal stability. The deposition of metal nanoparticles on CNFs is a promising way to increase their surface properties and, ultimately, the capacitance of the devices. In this study, nickel and silver nanoparticles were deposited on CNFs using the active screen plasma technology. The CNFs were characterized, and their electrochemical performance was assessed in a three-electrode cell. The results show significant improvements over the untreated CNFs, particularly after functionalization with silver nanoparticles.

Transcatheter Alcohol-Mediated Perivascular Renal Denervation With the Peregrine System: First-in-Human Experience.

OBJECTIVES: This study evaluated the first clinical use of a new endovascular approach to renal denervation, using chemical neurolysis, via periadventitial infusion of dehydrated alcohol (ethanol) to perform "perivascular" renal artery sympathetic denervation. BACKGROUND: Renal denervation remains a promising technology for the treatment of hypertension and other disorders. METHODS: A novel 3-needle delivery device (Peregrine System Infusion Catheter, Ablative Solutions, Inc., Kalamazoo, Michigan) was introduced into the renal arteries of 18 subjects with refractory hypertension. Microdoses of alcohol were infused bilaterally via the 3 needles into to the adventitial space (0.30 ml/artery, 37 arteries). Renal artery angiography was performed at the time of the procedure and at 6 months (n = 16). The primary safety endpoints were complications associated with the catheter insertion and delivery of the neurolytic agent or any major vascular access complications. The secondary performance endpoint was a reduction in office-based systolic blood pressure at 6 months compared with baseline. RESULTS: Procedural success was achieved in 100% of subjects (N = 18) and arteries (N = 37). There were no study-related adverse clinical events at follow-up. One death of a subject was recorded but determined by the investigator and an independent medical monitor to be non-study related. There were no angiographic observations of renal artery stenosis, aneurysms, or other renal artery abnormalities at 6 months (32 renal arteries). Sixteen of the 18 subjects had a 6-month follow-up. The mean office systolic blood pressure decreased from 175 ± 17 mm Hg to 151 ± 26 mm Hg (-24 mm Hg). There was an average reduction of antihypertensive medications from 3.4 (baseline) to 2.0 per subject at 6 months. CONCLUSIONS: Chemical renal denervation using the infusion of very low doses of alcohol directly into the adventitial space appears to be feasible and safe. This approach may be a promising alternative approach to perform catheter-based renal denervation. These results need to be confirmed in larger scale clinical studies.

TRINITY heart valve prosthesis: a novel repositionable and retrievable transapical transcatheter aortic valve system.

AIMS: Transcatheter aortic valve implantation (TAVI) has become a viable option for selected high-risk patients with severe and symptomatic aortic stenosis. First- and second-generation TAVI devices are either self- or balloon-expandable, and are often not repositionable or not fully retrievable, leading to suboptimal positioning in some cases. This may result in paravalvular regurgitation, AV conduction delay, or compromise of coronary perfusion. A broader application of TAVI requires advances in both valve and delivery systems. Therefore, in order to facilitate accurate positioning, to minimise paravalvular leakage, possibly to reduce the risk of AV conduction delay, and possibly to be able to abort the procedure, a "next-generation" TAVI system has been developed which is repositionable and retrievable, the TRINITY heart valve system. METHODS AND RESULTS: The TRINITY heart valve system was implanted in a first-in-human study using the transapical approach to demonstrate feasibility and procedural success. All endpoints were adjudicated according to VARC definitions at seven and 30 days. The TRINITY heart valve system was implanted in a 74-year-old patient with severe symptomatic aortic valve stenosis. In this case, repositioning of the TRINITY resulted in optimal position without paravalvular leakage and with perfect function. CONCLUSIONS: The TRINITY heart valve is a repositionable and retrievable TAVI system. Both the implantation result and short-term clinical and haemodynamic outcome were excellent.

Consorcio microbiano nativo con actividad catalítica para remoción de índigo y surfactantes en agua residual industrial textil a través de una matriz de inmovilización / Microbial consortium native catalytically active for removal of indigo and surfactants in textile industry wastewater through an immobilization matrix

El siguiente estudio tuvo como objetivo aislar seis diferentes cepas bacterianas provenientes de las descargas de agua utilizadas en la tintura de hilo con colorante índigo, que tuviesen capacidad de degradación de compuestos orgánicos del tinte índigo y tres surfactantes de tipo no iónicos. Igualmente, se evaluaron diferentes medios de soporte para inmovilizar las cepas seleccionadas. Las cepas con mejor capacidad de decoloración se combinaron para conformar cuatro consorcios (I, II, III, y IV) con el fin de potenciar el proceso de decoloración, considerando que la sinergia y el complemento de actividades metabólicas de cultivos mixtos dentro de una comunidad microbiana incrementan la eficiencia de remoción de carga orgánica. Los porcentajes de remoción que se alcanzaron fueron 64, 73, 76 y 59 %, respectivamente. Los cultivos individuales no presentaron porcentajes de remoción superiores a los reportados por los consorcios, lo que permite pensar en su utilización para la remoción de tintes índigos en aguas residuales.

The aim of this study was isolate six different bacterial strains from water discharges used in dyeing yarn with indigo, capable of degradation of organic compounds with indigo dye and three type nonionic surfactants. Similarly, various supporting media were evaluated for immobilizing the selected strains. Strains with better capacity were combined to form four consortia (I, II, III, and IV) in order to enhance the bleaching process, whereas synergy and complement metabolic activities of mixed cultures within a community increase microbial removal efficiency of organic load. Removal percentages were achieved which were 64, 73, 76 and 59%, respectively. Individual cultures showed no higher than rates reported by consortia removal, which suggests in its use for the removal of indigo dyes in wastewater.

Fístula gastrocutánea gigante / Giant gastrocutaneus fistula

Las fístulas gastrointestinales siguen siendo una complicación frecuente y de manejo dificil en la cirugía abdominal. La presentación de la fístulas gástrica es del 2% al 20% de las fístulas gastrointestinales y la fístulas gigante raramente se observa. Son más frecuentes después de esplenectomía y cirugías gástricas en donde se puede dañar la circulación del estómago. El tratamiento inicial siempre deberá de ser conservador a base de alimentación enteral y/o parenteral y sólo se llevarán a cirugía los casos que sean rebeldes al tratamiento médico o cuando existan datos de sepsis abdominal. Se reporta un caso de fístulas gastrocutánea gigante y se discute su manejo médico y quirúrgico

Superioridad del pantoprazol sobre la ranitidina en el tratamiento de la úlcera duodenal: experiencia clínica mexicana / Superiority of pantoprazole vs. ranitidine in the treatment of duodenal ulcer: a Mexican clinical experience

Antecedentes: El pantoprazol es un nuevo inhibidor de la bomba de protones de la célula parietal gástrica, que ha demostrado ser superior a la ranitidina en el tratamiento de la enfermedad ácido-péptica. Objetivos: Comparar la eficacia y tolerancia del pantoprazol oral, con la ranitidina, en el tratamiento de pacientes con úlcera duodenal activa confirmada por endoscopia en pacientes mexicanos. Métodos: Estudio prospectivo, comparativo, en grupos paralelos, multicéntrico, equilibrado, alazar, doble ciego. Mediante estudio endoscópico, se incluyeron pacientes con una o dos úlceras duodenales activas con diámetro total entre 5 y 20 mm. Cada paciente recibió pantoprazol (40 mg más placebo) o ranitidina (300 mg más placebo) diariamente durante dos semanas. Cuando no se consiguió la cicatrización se continuó el tratamiento hasta por cuatro semanas y se realizó una tercera endoscopia de control. Resultados: Se analizaron 163 pacientes: 82 para el grupo pantoprazol y 81 para el grupo ranitidina. Los índices de curación al final de la segunda semana de tratamiento fueron: 72 por ciento para pantropazol y 51 por ciento para ranitidina (p< 0.01), y de 95 y 86 por ciento a la cuarta semana, respectivamente. El porcentaje de pacientes con dolor disminuyó más rápidamente en el grupo pantoprazol. Ambos medicamentos fueron bien tolerados e inocuos. Conclusiones: El pantoprazol es bien tolerado y superior a la ranitidina en la curación de la úlcera duodenal activa.

Alteraciones de la saturación de oxígeno arterial en pacientes que se someten a endoscopía de tubo digestivo alto / Alterations in oxygen saturation of patients submitted to upper gastrointestinal endoscopy

Este trabajo estudia los cambios en la saturación de oxígeno arterial en los pacientes que son sometidos a endoscopía del tubo digestivo alto; la extensión de la desaturación después de la sedación con diazepam, la relación de desaturación con el grado de función respiratoria del paciente y la comparación de dos tipos de instrumentos endoscópicos Olympus (XQ y K10). Noventa y nueve pacientes consecutivos sometidos a endoscopía de tubo digestivo alto electiva y de urgencia fueron monitorizados con oxímetro de pulso antes de la sedación, durante el procedimiento y al final del mismo. No encontramos desaturación clínicamente significativa en ninguno de los casos estudiados

Superioridad clínical del pantoprazol sobre la ranitidina en la curación de la esofagitis por reflujo grado II y III. Estudio prospectivo, doble ciego, doble pacebo. Experiencia clínica mexicana / Clinical superiority of pantoprazol over ranitidine in the treatment of reflux esophagitis grade II and III. Prospective, double blind and double placebo study. Mexican clinical experience

Objetivo. Comparar y contrastar la eficacia y tolerabilidad de un inhibidor de bomba de protones, pantoprazol, con un antagonista de los receptores H2, ranitidina, en el tratamiento de pacientes con esofagitis por reflujo moderada y severa. Antecedentes. La esofagitis por reflujo es una enfermedad común que afecta del 5 al 10 por ciento de la población mundial. El reflujo ácido juega un papel importante en el desarrollo de la enfermedad, así como las alteraciones en la motilidad del esófago y estómago. Pacientes y métodos. 315 pacientes (intento de tratamiento) con esofagitis por reflujo (Savary-Miller (SM) grados II y III) confirmada endoscópicamente fueron reclutados en este estudio por 46 investigadores mexicanos en nueve centros. Los pacientes recibieron ya sea pantoprazol 40 mg una vez al día o 150 mg de ranitidina dos veces al día en este estudio doble ciego, aleatorizado, con comparación de grupos paralelos. Los pacientes que no alcanzaron una cicatrización endoscópica completa después de cuatro semanas de tratamiento recibieron cuatro semanas adicionales. La tolerabilidad a los medicamentos fue valorada a través del informe de eventos adversos durante el estudio. Resultados. Después de cuatro semanas de tratamiento con pantoprazol el 81 por ciento de los pacientes con SMII y 67 por ciento de los pacientes con SM III habían cicatrizado; en contraste en el grupo tratado con ranitidina cicatrizaron solamente 67 y 30 por ciento respectivamente, todos los resultados están expresados en pacientes protocolo correcto. Después de ocho semanas de tratamiento los índices de cicatrización para el grupo pantoprazol se incrementaron a 94 por ciento y en el grupo de ranitidina 74 por ciento (p=0.001). La incidencia de eventos adversos fue menor del 2 por ciento en ambos grupos de tratamiento, por lo tanto encontramos que ambas terapias fueron bien toleradas. Conclusiones. El pantoprazol es superior a la ranitidina en el tratamiento de esofagitis por reflujo moderada y severa y ambos tratamientos son igualmente bien tolerados