Arrays of suspended silicon nanowires defined by ion beam implantation: mechanical coupling and combination with CMOS technology.

We present the fabrication, operation, and CMOS integration of arrays of suspended silicon nanowires (SiNWs). The functional structures are obtained by a top-down fabrication approach consisting in a resistless process based on focused ion beam irradiation, causing local gallium implantation and silicon amorphization, plus selective silicon etching by tetramethylammonium hydroxide, and a thermal annealing process in a boron rich atmosphere. The last step enables the electrical functionality of the irradiated material. Doubly clamped silicon beams are fabricated by this method. The electrical readout of their mechanical response can be addressed by a frequency down-mixing detection technique thanks to an enhanced piezoresistive transduction mechanism. Three specific aspects are discussed: (i) the engineering of mechanically coupled SiNWs, by making use of the nanometer scale overhang that it is inherently-generated with this fabrication process, (ii) the statistical distribution of patterned lateral dimensions when fabricating large arrays of identical devices, and (iii) the compatibility of the patterning methodology with CMOS circuits. Our results suggest that the application of this method to the integration of large arrays of suspended SiNWs with CMOS circuitry is interesting in view of applications such as advanced radio frequency band pass filters and ultra-high-sensitivity mass sensors.

[Use of psychoactive drugs in a health and welfare centre]. / Utilización de psicofármacos en un centro sociosanitario.

OBJECTIVE: To analyse the use of psychoactive drugs in a health and welfare centre and compare this use with current guidelines. METHOD: A cross-sectional study of the drug treatment regime of hospitalised patients in a health and welfare centre was carried out. Information was obtained from prescriptions and the clinical histories of patients in the centre. The following variables were assessed: demographic data, treatment with psychoactive drugs, date of commencing treatment, dosage, drug combinations, indication and total number of drugs analysed. The results were compared with the literature and current prescription guidelines. RESULTS: 45 of the 70 patients analysed were taking psychoactive drugs: 51.1% were being treated with neuroleptic drugs, 42.2% with antidepressants, and 6.7% with anxiolytic agents. 62% were women. The overall mean age was 80.3 years old. The average number of psychoactive drugs administered to each patient was 1.6 and the average number of total drugs prescribed was 10.5. The most frequently administered psychoactive drugs were risperidone, lorazepam and citalopram. The most frequent association was neuroleptic drugs with benzodiazepine. The indication and dosage prescribed were appropriate according to the data sheet, although some inappropriate prescription practices were observed. CONCLUSIONS: The results of the study would recommend controlling the duration of treatment with benzodiazepine, confirming the diagnosis of states of depression and correctly monitoring the associations between psychoactive drugs.

[Aponeurotic suspension of the bladder neck as elective treatment of minimal stress urinary incontinence in women]. / Suspensión aponeurótica del cuello vesical como tratamiento electivo de la incontinencia urinaria a mínimos esfuerzos en la mujer.

To correct urine incontinence at minimal exertion in woman, most especially in those who have undergone unsuccessful vaginal techniques, we advice the aponeurotic suspension of the vesical cervix, with anchorage, in fixed tissue (Cooper's ligament or ischiopubic branch) in order to avoid displacement of the supporting band and new drops of the vesical cervix, with incontinence relapse in the long run. Since 1983 this procedure has been performed in 400 women, with various degrees of urinary incontinence on exertion, 140 of whom had previously undergone other procedures. Our results have been completely successful in 383 patient who at year from surgery no longer presented urinary incontinence of any degree. These good results lead us to recommend this procedure as the most suitable to solve urinary incontinence at minimal exertion, relapses and that associated to feeling of urgency in many occasions.

The usefulness of ethylephrine (Efortil-R) in the treatment of priapism and intraoperative penile erections.

We present our experience in the treatment of 8 patients with priapism after intravenous injection of vasoactive drugs, and of 15 patients with persistent erections in the course of transurethral cystoscopy surgery. All of them were treated with intracavernous injection of 10 mg ethylephrine (1 ml Efortil-R). The results were satisfactory in all cases. In one patient we had to draw 75 ml blood and give another 10 mg dose of ethylephrine. We have not observed secondary effects of drug administration except two local haematomas with spontaneous resolution. We consider that this treatment is very useful in the management of patients with persistent erections or priapism because of the excellent results obtained without adverse effects.

Comparative study between the use of a treatment with hyperthermia through the rectal approach versus the urethral approach for benign prostatic hyperplasia.

200 patients suffering from benign prostatic hyperplasia were treated with hyperthermia: 100 cases through the rectal approach and 100 through the urethral approach. Subjective symptoms were assessed as well as nycturia and objective data, urinary flow and postmicturition residue before treatment and 6 months after treatment. In the group of 100 patients treated rectally, the subjective symptoms and nycturia improved in 76; urine flow improved in 63, postmicturition residue decreased in 32 and the vesical catheter could be removed in 5 out of 8 patients. With the urethral approach, 77 patients out of 100 presented an improvement in their symptoms, nycturia improved in 53; urine flow improved in 28; the urine residue was decreased in 40 and the vesical catheter could be removed in 10 out of 16 patients who required it previously. Although slightly better results seem to be achieved with the use of rectal hyperthermia, as concerns nycturia and micturition flow, we prefer the urethral approach for its higher degree of convenience, easier handling, shorter time of treatment and reasonable effectiveness.

Lasertripsy in the treatment of ureteral lithiasis.

UNLABELLED: We submit our experience with laser treatment for ureteral lithiasis. We used the laser Candela MDL 2000 for the treatment of 62 lithiases (40 at the pelvic ureter, 16 at the iliac ureter and 6 at the lumbar ureter) in 58 patients. A semi-rigid Dretler or Gautier multiscope were used. Of the 62 calculi complete fragmentation was not achieved in 4 and they were ascended to the renal pelvis for subsequent ESWL. In 51% of the patients the ureteral catheter was left for 24 hours, and a double-J stent was used in two cases. COMPLICATIONS: 2 simple perforations of the ureter that were solved by means of a double-J stent; occasionally petechiae on the ureteral wall and two cases of rupture of the laser fibre tip that was easily removed with a forceps.

ESWL as the treatment for lithiasis in horseshoe kidney.

Thirteen patients with lithiasis and horseshoe kidney were evaluated (4 cases with bilateral stones). Fifteen kidney units were treated with extracorporeal shock wave lithotripsy (ESWL), and in 2 cases, percutaneous nephrolithotomy (PCN) was used. The excellent results achieved with ESWL (80%) and the low incidence of complications (2 cases of nephritic colics and 1 case of acute pyelonephritis), lead us to propose ESWL as the therapy of choice for lithiasis in patients with horseshoe kidneys. PCN alone or in association with ESWL would be used in cases with large lithiasic masses. Conventional surgery would only be indicated in those cases which due to their high degree of complexity or difficult endourological access prevent the use of the above-mentioned techniques.

Renal artery stenosis in transplanted kidney: management and results in six patients.

Severe hypertension and a decrease of renal function, with or without oliguria, suggest renal artery stenosis in the transplanted kidney. 6 renal artery stenoses were observed in 100 transplanted kidneys followed up for more than 3 months. In 4 patients, percutaneous transluminal angioplasty was performed. 1 patient required a new percutaneous transluminal angioplasty 3 months later and a 2nd patient was submitted to surgery after 14 months. Surgery was performed in 2 more cases, with failure in 1. It seems that the endoarteric lesion during cold perfusion could be the main etiopathological factor, when associated with rejection episodes. Percutaneous transluminal angioplasty is the treatment of choice in the management of renal artery stenosis in transplanted kidneys. Surgery must be reserved when it fails.