Ruptura de hematoma hepático secundario a terapia neural / Rupture of hepatic hematoma secondary to neural therapy

Objetivo: determinar si la terapia neural es una opción de tratamiento que pueda ser utilizada sin la aparición de efectos adversos. Presentación del caso: se presenta y analiza el caso de una paciente que ingresó a urgencias por dolor abdominal generalizado diagnosticándose hematoma hepático y realizándosele una revisión de la literatura científica. Resultados: se procedió a efectuar laparotomía con cirugía de control de daños, obteniendo resultados satisfactorios con egreso hospitalario sin complicaciones agregadas. Conclusiones: la terapia neural es un tratamiento del cual no se tiene suficiente evidencia científica que avale su seguridad en los pacientes

Objective: to determine whether neural therapy is a treatment option which can be used without the occurrence of adverse effects. Case report: we present and analyze the case of a female patient who was admitted to the emergency room for generalized abdominal pain. A hepatic hematoma was diagnosed, and a review of the scientific literature was conducted. Results: a laparotomy with damage control surgery was performed, obtaining satisfactory outcomes, with hospital discharge without any added complications. Conclusions: neural therapy is a treatment for which there is not enough scientific evidence to support its safety in patients

Asynchronous axonal firing patterns evoked via continuous subthreshold kilohertz stimulation.

Objective.Transcutaneous electrical stimulation of peripheral nerves is a common technique to assist or rehabilitate impaired muscle activation. However, conventional stimulation paradigms activate nerve fibers synchronously with action potentials time-locked with stimulation pulses. Such synchronous activation limits fine control of muscle force due to synchronized force twitches. Accordingly, we developed a subthreshold high-frequency stimulation waveform with the goal of activating axons asynchronously.Approach.We evaluated our waveform experimentally and through model simulations. During the experiment, we delivered continuous subthreshold pulses at frequencies of 16.67, 12.5, or 10 kHz transcutaneously to the median and ulnar nerves. We obtained high-density electromyographic (EMG) signals and fingertip forces to quantify the axonal activation patterns. We used a conventional 30 Hz stimulation waveform and the associated voluntary muscle activation for comparison. We modeled stimulation of biophysically realistic myelinated mammalian axons using a simplified volume conductor model to solve for extracellular electric potentials. We compared the firing properties under kHz and conventional 30 Hz stimulation.Main results.EMG activity evoked by kHz stimulation showed high entropy values similar to voluntary EMG activity, indicating asynchronous axon firing activity. In contrast, we observed low entropy values in EMG evoked by conventional 30 Hz stimulation. The muscle forces evoked by kHz stimulation also showed more stable force profiles across repeated trials compared with 30 Hz stimulation. Our simulation results provide direct evidence of asynchronous firing patterns across a population of axons in response to kHz frequency stimulation, while 30 Hz stimulation elicited synchronized time-locked responses across the population.Significance.We demonstrate that the continuous subthreshold high-frequency stimulation waveform can elicit asynchronous axon firing patterns, which can lead to finer control of muscle forces.

Punica granatum as Anticandidal and Anti-HIV Agent: An HIV Oral Cavity Potential Drug.

The oral cavity is crucial from diagnosis to adherence to HAART therapy in the HIV/AIDS population; consequently, drugs that can maintain healthy conditions in the oral cavity are necessary for patients with HIV/AIDS. Punica granatum (pomegranate) is a tree that has been employed extensively for centuries in the traditional medicine of ancient cultures for the treatment of a wide range of diseases, including oral and dental diseases. In recent decades, its potent anticandidal properties have been shown, especially on Candida albicans, the cause of the most common clinical manifestation in HIV patients. The present work contributes to the review of the anti-HIV and anticandidal properties of the plant species P. granatum as involved with the oral cavity. The literature reviewed revealed that crude extracts of pomegranate and its main isolated compounds possess inhibitory activity on different HIV targets, including binding viral proteins and the three replicative HIV enzymes. In addition, in the literature reviewed, pomegranate exhibited anticandidal effects on 10 different species. Thus, pomegranate appears to be an excellent candidate to explore and incorporate into the treatment of the oral cavity of HIV/AIDS patients, in that, in addition to its pharmacological effects such as antiviral and anticandidal, pomegranate represents an easily available, inexpensive, and safe natural source.

Distribution of M-Wave and H-Reflex in Hand Muscles Evoked via Transcutaneous Nerve Stimulation: A Preliminary Report.

Neuromuscular electrical stimulation (NMES) targeting the muscle belly is commonly used to restore muscle strength in individuals with neurological disorders. However, early onset of muscle fatigue is a major limiting factor. Transcutaneous nerve stimulation (TNS) can delay muscle fatigue compared with traditional NMES techniques. However, the recruitment of Ia afferent fibers has not be specifically targeted to maximize muscle activation through the reflex pathway, which can lead to more orderly recruitment of motor units, further delaying fatigue. This preliminary study assessed the distribution of M-wave and H-reflex of intrinsic and extrinsic finger muscles. TNS was delivered using an electrode array placed along the medial side of the upper arm. Selective electrode pairs targeted the median and ulnar nerves innervating the finger flexors. High-density electromyography (HD EMG) was utilized to quantify the spatial distribution of the elicited activation of finger intrinsic and extrinsic muscles along the hand and forearm. The spatial patterns were characterized through isolation of the M-wave and H-reflex across various stimulation levels and EMG channels. Our preliminary results showed that, by altering the stimulation amplitude, distinct M-wave and H-reflex responses were evoked across EMG channels. In addition, distinct stimulation locations appeared to result in varied levels of reflex recruitment. Our findings indicate that it is possible to adjust stimulation parameters to maximize reflex activation, which can potentially facilitate physiological recruitment order of motoneurons.

Anti-HIV and Anti-Candidal Effects of Methanolic Extract from Heteropterys brachiata.

Nowadays, the HIV pandemic is far from controlled. HIV+/AIDS patients show a serious risk of developing resistance to HIV antiretroviral drugs and to be orally colonized by albicans and non-albicans Candida strains resistant to antifungals. As a consequence, new drugs that possess anti-candidal and anti-HIV effects would represent an alternative in the comprehensive treatment of HIV+/AIDS patients. The present study evaluates the possible anti-HIV and anti-Candida effects of a methanolic extract from Heteropterys brachiata (Hb MeOH), an American tropical plant. The anti-HIV effect of Hb MeOH was tested using a non-radioactive colorimetric method (Lenti RT® Activity Assay; Cavidi Tech) that uses reverse transcriptase of HIV-1 enzyme as enzymatic target. The anti-candidal effect of HbMeOH extract was evaluated by following a standardized test protocol of microdilution for yeast using the Candida albicans strain ATCC® 90028. The Hb MeOH at 1 mg/mL concentration shows 38.5% RT-HIV inhibition, while Hb MeOH at 10 mg/mL concentration produced 98% C. albicans growth inhibition. Our findings show that the Hb MeOH possesses a strong anti-candidal activity and moderate anti-HIV effect and suggests that the plant extract could be considered as a potential candidate for HIV/AIDS treatment.

Stiffness Perception using Transcutaneous Electrical Stimulation during Active and Passive Prosthetic Control.

Haptic feedback allows an individual to identify various object properties. In this preliminary study, we determined the performance of stiffness recognition using transcutaneous nerve stimulation when a prosthetic hand was moved passively or was controlled actively by the subjects. Using a 2x8 electrode grid placed along the subject's upper arm, electrical stimulation was delivered to evoke somatotopic sensation along their index finger. Stimulation intensity, i.e. sensation strength, was modulated using the fingertip forces from a sensorized prosthetic hand. Object stiffness was encoded based on the rate of change of the evoked sensation as the prosthesis grasped one of three objects of different stiffness levels. During active control, sensation was modulated in real time as recorded forces were converted to stimulation amplitudes. During passive control, prerecorded force traces were randomly selected from a pool. Our results showed that the accuracy of object stiffness recognition was similar in both active and passive conditions. A slightly lower accuracy was observed during active control in one subject, which indicated that the sensorimotor integration processes could affect haptic perception for some users.

Evoking haptic sensations in the foot through high-density transcutaneous electrical nerve stimulations.

OBJECTIVE: Evoking haptic sensation on upper limb amputees via peripheral nerve stimulation has been investigated intensively in the past decade, but related studies involving lower limb amputees are limited. This study aimed to evaluate the feasibility of using non-invasive transcutaneous electrical nerve stimulation to evoke haptic sensation along the phantom limb of the amputated foot of transtibial amputees. APPROACH: A high-density electrode grid (4 × 4) was placed over the skin surface above the distal branching of the sciatic, tibial, and common peroneal nerves. We hypothesized that electrical stimulation delivered to distinct electrode pairs created unique electric fields, which can activate selective sets of sensory axons innervating different skin regions of the foot. Five transtibial amputee subjects (three unilateral and two bilateral) and one able-bodied subject were tested by scanning all possible electrode pair combinations. MAIN RESULTS: All subjects reported various haptic percepts at distinct regions along the foot with each corresponding to specific electrode pairs. These results demonstrated the capability of our non-invasive nerve stimulation method to evoke haptic sensations in the foot of transtibial amputees and the able-bodied subject. SIGNIFICANCE: The outcomes contribute important knowledge and evidence regarding missing tactile sensation in the foot of lower limb amputees and might also facilitate future development of strategies to manage phantom pain and enhance embodiment of prosthetic legs in the future.

Object Shape and Surface Topology Recognition Using Tactile Feedback Evoked through Transcutaneous Nerve Stimulation.

Tactile feedback is critical for distinguishing different object properties. In this article, we determined if tactile feedback evoked by transcutaneous nerve stimulation can be used to detect objects of different shape and surface topology. To evoke tactile sensation at different fingers, a 2x8 electrode grid was placed along the subject's upper arm, and two concurrent electrical stimulation trains targeted the median and ulnar nerve bundles, which evoked individually modulated sensations at different fingers. Fingertip forces of the prosthetic hand were transformed to stimulation current amplitude. Object shape was encoded based on finger-object contact timing. Surface topology represented by ridge height and spacing was encoded through current amplitude and stimulation time interval, respectively. The elicited sensation allowed subjects to determine object shape with success rates >84%. Surface topology recognition resulted in success rates >81%. Our findings suggest that tactile feedback evoked from transcutaneous nerve stimulation allows the recognition of object shape and surface topology. The ability to recognize these properties may help improve object manipulation and promote fine control of a prosthetic hand.

Object stiffness recognition using haptic feedback delivered through transcutaneous proximal nerve stimulation.

OBJECTIVE: Haptic feedback is crucial when we manipulate objects. Information pertaining to an object's stiffness in particular can help facilitate fine motor control. In this study, we seek to determine whether objects of different stiffness levels can be recognized using haptic feedback provided by transcutaneous electrical stimulation of peripheral nerves. APPROACH: Using a stimulation electrode grid placed along the medial side of the upper arm, the median and ulnar nerve bundles were targeted to evoke haptic sensation on the palmar side of the hand. Stimulation current amplitude was modulated in real-time with the fingertip force recorded from a sensorized prosthetic hand. In order to evaluate which stimulation pattern was more critical, object stiffness was encoded either by the rate of change of the stimulus amplitude or the level of peak stimulus amplitude, as the prosthesis grasped the objects. MAIN RESULTS: Both encoding methods allowed the subjects to differentiate objects of different stiffness levels with >90% accuracy. No significant difference was observed between the two encoding methods, which indicated that both the rate of change of the stimulation amplitude and the peak stimulation amplitude could effectively provide stiffness information of the objects. SIGNIFICANCE: The outcomes suggest that it is possible to elicit haptic sensations describing various object stiffness levels using transcutaneous nerve stimulation. The haptic feedback associated with object stiffness can facilitate object manipulation/interactions. It may also improve user experience during human-machine interactions, when object stiffness information is incorporated.

Evoked Haptic Sensation in the Hand With Concurrent Non-Invasive Nerve Stimulation.

OBJECTIVE: Haptic perception is critical for prosthetic users to control their prosthetic hand intuitively. In this study, we seek to evaluate the haptic perception evoked from concurrent stimulation trains through multiple channels using transcutaneous nerve stimulation. METHODS: A 2 × 8 electrode grid was used to deliver current to the median and ulnar nerves in the upper arm. Different electrodes were first selected to activate the sensory axons, which can elicit sensations at different locations of the hand. Charge-balanced bipolar stimulation was then delivered to two sets of electrodes concurrently with a phase delay (dual stimulation) to determine whether the evoked sensation can be constructed from sensations of single stimulation delivered separately at different locations (single stimulation) along the electrode grid. The temporal delay between the two stimulation trains was altered to evaluate potential interference. The short-term stability of the haptic sensation within a testing session was also evaluated. RESULTS: The evoked sensation during dual stimulation was largely a direct summation of the sensation from single stimulations. The delay between the two stimulation locations had minimal effect on the evoked sensations, which was also stable over repeated testing within a session. CONCLUSION: Our results indicated that the haptic sensations at different regions of the hand can be constructed by combining the response from multiple stimulation trains directly. The interference between stimulations were minimal. SIGNIFICANCE: The outcomes will allow us to construct specific haptic sensation patterns when the prosthesis interacts with different objects, which may help improve user embodiment of the prosthesis.

Merged Haptic Sensation in the Hand during Concurrent Non-Invasive Proximal Nerve Stimulation.

When individuals interact with the environment, sensory feedback is a critical aspect of the experience. Individuals using prosthesis often have difficulty controlling their device, partly due to a lack of sensory information. Transcutaneous nerve stimulation has the potential to elicit focal haptic sensation when controlled electrical current was delivered to a pair of electrodes in proximity to the nerve. The objective of this preliminary study was to evaluate how different elicited focal haptic sensation were altered, when multiple concurrent electrical stimuli were delivered to different portions of the median and ulnar nerve bundles. The delay between the individual stimulation during concurrent stimuli was also varied to identify if this parameter could alter the resulting sensation region. Lastly, the stability/repeatability of the perceived sensation during concurrent stimuli was determined. Our preliminary results showed that the spatial distribution of the haptic sensation was largely a direct summation/merge of the sensation regions from the individual nerve stimulation when comparing the regions to that of the concurrent double stimulation. Our results also showed that merged sensation region was not sensitive to different time delays the two concurrent stimuli. Lastly, the sensation regions remained stable and showed repeatable sensation in the hand even with 20-60 minutes between repeated stimulations.

Dual function of EDTA with silver nanoparticles for root canal treatment-A novel modification.

The chelating and antimicrobial capacity of a novel modification of 17% EDTA with silver nanoparticles (AgNPs) (EDTA-AgNPs) was evaluated in-vitro for root canal treatment (RCT). The EDTA-AgNPs solution was characterized by UV-Vis spectroscopy, ζ-potential and high-resolution transmission electron microscopy (HRTEM). Antimicrobial capacity was evaluated against Candida albicans and Staphylococcus aureus in planktonic and biofilm cells by broth macrodilution (24 h) and XTT assays, (1, 10 and 30 min) respectively. The chelating capacity of EDTA-AgNPs was assessed indirectly (smear layer removal) and directly (demineralizing effect) in bovine dentin at two silver concentrations, 16 and 512 µg/ml at 1 and 10 minutes of exposure time. Smear layer removal was evaluated by atomic force microscopy (AFM) and scanning electron microscopy (SEM). The demineralizing effect was determined by atomic absorption spectroscopy (AAS), microhardness test (MH) and X-ray diffractometer (XRD). Synthesized AgNPs were quasi-spherical in shape with an average size of 13.09 ± 8.05 nm. 17% EDTA-AgNPs was effective to inhibit C. albicans and S. aureus in planktonic and biofilm cultures. The smear layer removal and demineralizing effect were similar between 17% EDTA-AgNPs and 17% EDTA treatments. The 17% EDTA-AgNPs solution proved to be an effective antimicrobial agent, and has a similar chelating capacity to 17% EDTA alone. These in-vitro studies strongly suggest that EDTA-AgNPs could be used for effective smear layer removal, having an antimicrobial effect at the same time during RCT.

The essential oil of Allium sativum as an alternative agent against Candida isolated from dental prostheses / Aceite esencial de Allium sativum como tratamiento alternativo contra aislamientos de Candida procedentes de prótesis dentales

Background. The colonization of the surfaces of dental prostheses by Candida albicans is associated with the development of denture stomatitis. In this context, the use of fluconazole has been proposed, but its disadvantage is microbial resistance. Meanwhile, the oil of Allium sativum has shown an effect in controlling biofilm formation by C. albicans. Aims. The objective of this study was to determine the antifungal activities of the essential oil of A. sativum and fluconazole against clinical isolates of Candida species obtained from rigid, acrylic-based partial or total dentures and to compare these agents’ effects on both biofilm and planktonic cells. Methods. A total of 48 clinical isolates obtained from the acrylic surface of partial or complete dentures were examined, and the following species were identified: C. albicans, Candida glabrata, Candida tropicalis, and Candida krusei. For each isolate, the antifungal activities of the essential oil of A. sativum and fluconazole against both biofilm and planktonic cells were evaluated using the Clinical & Laboratory Standards Institute (CLSI) M27-A3 method. The isolates were also evaluated by semiquantitative XTT reduction. Results. All planktonic Candida isolates were susceptible to the essential oil of A. sativum, whereas 4.2% were resistant to fluconazole. Regarding susceptibilities in biofilms, 43.8% of biofilms were resistant to A. sativum oil, and 91.7% were resistant to fluconazole. Conclusions. All planktonic cells of the different Candida species tested are susceptible to <1mg/ml A. sativum oil, and the majority are susceptible to fluconazole. Susceptibility decreases in biofilm cells, with increased resistance to fluconazole compared with A. sativum oil. The essential oil of A. sativum is thus active against clinical isolates of Candida species obtained from dentures, with effects on both biofilm and planktonic cells in vitro (AU)

Antecedentes. La colonización por parte de Candida albicans de las superficies de las prótesis dentales se asocia con el desarrollo de estomatitis. Se ha propuesto el uso de fluconazol, pero su desventaja es la resistencia microbiana. El aceite de Allium sativum ha mostrado su efectividad al controlar la formación de biopelícula de objetivos. Objetivos. Determinar la sensibilidad de cepas clínicas de especies de Candida, obtenidas de prótesis dentales parciales o totales rígidas de base acrílica, al aceite esencial de A. sativum y comparar su efecto en células planctónicas y en biopelícula. Métodos. Se incluyeron 48 cepas clínicas de la superficie acrílica de prótesis dentales totales o parciales, identificadas entre las siguientes especies: C. albicans, Candida glabrata, Candida tropicalis y Candida krusei. Se evaluó la sensibilidad de cada una al aceite esencial de A. sativum y al fluconazol mediante la metodología M27-A3 del CLSI, tanto sobre células planctónicas como en biopelícula, y mediante el método semicuantitativo de la reducción de XTT en el último caso. Resultados. Todas las cepas planctónicas de Candida fueron sensibles al aceite esencial de A.sativum, mientras que el 4,2% fue resistente al fluconazol. En cuanto a su sensibilidad en biopelícula, el 43,8% fue resistente a A. sativum y el 91,7% lo fue al fluconazol. Conclusiones. Todas las cepas en forma planctónica de las diferentes especies de Candida fueron sensibles a concentraciones inferiores a 1mg/ml del aceite esencial de A. sativum y en menor proporción a fluconazol. La sensibilidad disminuyó en las células en biopelícula, con mayor resistencia al fluconazol en comparación con el aceite esencial de A. sativum. Por tanto, el aceite esencial de A. sativum es activo frente a cepas clínicas de diferentes especies de Candida, obtenidas de dentaduras, con efectos en biopelícula y células planctónicas in vitro (AU)

Aplicación de la hipoterapia en los niños con parálisis cerebral / Hippotherapy application in children with cerebral palsy

Fundamento: la hipoterapia se ha usado en la rehabilitación de pacientes con afecciones neurológicas con resultados positivos, en cuanto a la obtención de habilidades y mejoramiento del estado postural. Objetivo: difundir los beneficios de la aplicación de la hipoterapia en niños con parálisis cerebral. Métodos: se realizó un estudio retrospectivo, descriptivo de una serie de 13 niños con criterios diagnósticos de parálisis cerebral. Se diseñó un programa de hipoterapia, el cual se aplicó a los pacientes, se aplicaron evaluaciones iniciales y posteriores a la recolección de datos y su procesamiento estadístico. Resultados: promedio de edad de 3,6 años ± 3. El grupo de edades más representado fue el comprendido entre los tres y cinco años de edad. Predominó el sexo masculino (61,5 %) y el color de la piel blanco (69,2 %). La totalidad de los pacientes presentaron antecedentes patológicos personales que justificaron la aparición de la enfermedad, se destacaron los procesos infecciosos (45,4 %). El 53,8 % de los pacientes evidenció mejoría en todas las esferas estudiadas. El área motora fue la de mejores resultados donde se evidenció una mejoría en el 76,9 % de los casos. Conclusiones: la hipoterapia mostró resultados alentadores en el desarrollo de habilidades en niños con parálisis cerebral. La evidencia de mejoría puede estar determinada por el tiempo, frecuencia y duración de la hipoterapia, pero se necesitarían estudios más profundos para verificar esta hipótesis.

Background: hippotherapy has been used in the rehabilitation of patients with neurological affections with positive results, regarding the development of skills and the improvement of postural state. Objective: to diffuse the benefits of the application of hippotherapy in children with cerebral palsy. Methods: a descriptive retrospective study of 13 children with diagnoses of cerebral palsy was conducted. A hippotherapy program was designed, which was applied to the patients. Initial and further assessments were applied to data collection and its statistical processing. Results: the age average is 3.6 years ± 3. The most represented group of age was the three to five age group. Male sex prevailed (61, 5 %) and the skin color was white (69, 2 %). The majority of patients presented personal pathological antecedents that justified the disease. Conclusions: hippotherapy showed hopeful results in the development of skills in children with cerebral palsy. Improvement depends on the time, frequence, and length of hippotherapy. Nevertheless, deeper studies would be needed to verify this hypothesis.

Complicaciones de los tubos de tórax / Complications of tube thoracostomy

El drenaje del espacio pleural es una frecuente práctica clínica de valor diagnóstico y terapéutico. Las indicaciones más frecuentes de este procedimiento tienen que ver con situaciones en las que se producen depósitos de fluidos en esta cavidad, como aire, sangre, linfa, líquido pleural, pus y otros. Es importante conocer la técnica quirúrgica de inserción y las complicaciones más frecuentes derivadas de la colocación de los tubos de tórax.Realizamos una revisión de la literatura existente sobre el tema, enfatizando en estudios que evaluaran las tasas de complicaciones derivadas de las toracostomías cerradas con tubo. Encontramos que la gran mayoría de estudios sobre complicaciones de la colocación de los tubos de tórax son retrospectivos y en el contexto del trauma. Las complicaciones se han clasificado así: por inserción, posicionales e infecciosas. La tasa general de complicaciones se encuentra entre 3,4% y 36%. Las complicaciones por inserción ocurren en 0% a 7,9% de los casos, las posicionales en 2,4% a 33,3% y las infecciosas en 0,8% a 12%, con empiema en 1,1% a 2,7%. También, hay complicaciones anecdóticas reportadas.Las complicaciones producto de la colocación de un tubo de tórax en la cavidad pleural son frecuentes y en muchos casos clínicamente relevantes. El uso de la técnica de disección roma, la habilidad y el conocimiento, la identificación precoz y el manejo de las posibles complicaciones, pueden reducir la morbimortalidad de este procedimiento.

La atención del personal de salud al paciente en situaciones interculturales / The health care staff to the patient in intercultural situations

Las diferentes actitudes, valores y conocimientos que tanto el personal de salud como sus pacientes tienen sobre la naturaleza de las diferencias interculturales deben generar conductas específicas y evaluables, que llevarán a la mejoría de la calidad y calidez de los servicios, evaluadas ya sea mediante los criterios de la administración científica.

Tratamiento biológico de efluentes de industrias procesadoras de cangrejo azul usando lodos activados / Biological treatment of effluents from crab processing industries using an activated sludge system

En vista de la falta de información básica, en particular los valores de las constantes biocinéticas, para diseñar los sistemas de tratamiento biológico de las aguas residuales producidas por plantas procesadoras de cangrejos, camarones y conservas de pescado, se realizó un estudio de tratabilidad biológica de los efluentes de una planta procesadora de cangrejos, ubicada en el Municipio San Francisco, Estado Zulia, Venezuela. Se determinó un caudal de agua residual generado en la planta de 7,81L/kg de cangrejo procesado, con un caudal promedio de descarga de 214775L/día. Se caracterizaron muestras de los efluentes de la planta para determinar su calidad y se encontró que los parámetros analizados, en su mayoría, estuvieron fuera de los límites establecidos por la normativa ambiental venezolana para descargas en cuerpos de agua. Los resultados indican que es necesaria la instalación de un sistema de tratamiento que mejore la calidad de los efluentes descargados. Se realizó un estudio experimental a escala de laboratorio del sistema de tratamiento mediante lodos activados empleando reactores biológicos continuos, para cuatro tiempos de residencia (8, 12, 16 y 20h), y se determinaron las constantes biocinéticas. Los resultados indican que el valor de las constantes biocinéticas del sistema son K= 0,0046L/(mgDQO.d) con coeficiente de correlación del 91,4 por ciento; Yt= 0,5442mgSSV/mgDQO y Kd= 0,1175 d-¹ ambas con coeficientes de correlación del 93,9 por ciento.

Repair of a ruptured globe using topical anesthesia.

We present a 76-year-old patient who had ocular trauma with dehiscence of the wound and scleral rupture with a prolapsed iris, ciliary body, intraocular lens, and vitreous after uneventful cataract surgery with a self-sealing sclerocorneal tunnel incision. General anesthesia was not possible because the patient had a history of lung cancer with extensive emphysema and unstable coronary disease. Local retrobulbar or peribulbar anesthesia was not considered because of the risk for further extrusion of intraocular contents. Topical anesthesia was applied with a 10.0 mm x 2.5 mm cellulose sponge soaked in oxybuprocaine 0.4% (Novesine) placed under the upper and lower lid for 20 minutes. Surgical repair of a 14.0 mm scleral wound was achieved without complication or pain during the procedure.

Evaluation of preoperative and postoperative prophylactic regimens for prevention and treatment of diffuse lamellar keratitis.

PURPOSE: To investigate preoperative and postoperative prophylactic treatment with different pharmacological agents before flap cutting and exposure to a diffuse lamellar keratitis (DLK) causative agent. SETTING: Magill Research Center for Vision Correction, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA. METHODS: The study comprised 48 eyes of 24 Dutch-belted rabbits. Three days before a corneal flap was cut and the corneal interface was exposed to Pseudomonas aeruginosa lipopolysaccharide endotoxin, a DLK causative agent, the eyes were randomly assigned to treatment with a mast-cell stabilizer, a nonsteroidal antiinflammatory drug (NSAID), or a corticosteroid or left without treatment as controls. The treatment was maintained throughout the 1-week follow-up. Slitlamp examinations and photographs were performed at 1, 3, 5, and 7 days; DLK was graded by a masked observer from 0 (no DLK) to IV. Corneal interface scrapings were performed in selected eyes on day 7. RESULTS: At the end of the follow-up, 36 eyes were available for evaluation. At 1 week, 100% of the control eyes and the eyes treated with the mast-cell stabilizer developed DLK; in the NSAID-treated and corticosteroid-treated eyes, the DLK rate was 86% and 70%, respectively. At 1 day, the severity of DLK was significantly lower in eyes treated with the mast-cell stabilizer (0.44) and at 7 days, it was significantly lower in corticosteroid-treated eyes (0.3) than in the control group (1.5 and 1.4, respectively) (P<.05, Wilcoxon test). Corneal interface scraping from an eye with grade III DLK showed numerous inflammatory cells. CONCLUSIONS: Preoperative and postoperative treatment with corticosteroids significantly reduced the severity of DLK compared to the untreated control eyes in this animal model. Treatment with a mast-cell stabilizer and an NSAID had less effect on the postoperative course of DLK.