[Role of malnutrition in intestinal anastomosis collagenization: an analysis of procollagen (PINP) and carboxyterminal telopeptide (ICTP) by radioimmunoassay]. / Efectos de la desnutrición sobre la colagenización de anastomosisintestinales: análisis de procolágeno y telopéptido carboxiterminalmediante radioinmunoanálisis.

INTRODUCTION: some clinical, anatomo-pathological, and technical factors influence the correct healing of intestinal suture following an intestinal resection. One of the most influential factors is patient nutritional status. OBJECTIVES: to evaluate the influence of malnutrition on the viability of primary intestinal anastomosis by the analysis of collagen I deposition. METHODS: 40 Wistar rats, radioimmunoassay material. We used 2 groups of rats, 20 animals in each group: a control group (A) and a "malnutrition" group (B). RESULTS: there was a decrease in PINP (procollagen) deposition in the colon of group B rats as compared to the colon of group A (0.3620 and 0.4340 mg/g respectively) (p = 0.032). There is an increase in ICTP (carboxyterminal telopeptide) in the colon of group B (0.9545 as against 0.8460 mg/g in group A) (p = 0.875). In anastomoses of group B there was a decrease in PINP synthesis as compared to group A (0.376 and 0.468 mg/g respectively, p = 0.002). As regards ICTP, there was an increase in group B (p = 0.330). In relation to the control group no differences were observed in ICTP increases in group B (p = 1). CONCLUSIONS: colonic anastomosis increases the levels of PINP and ICTP in healed tissue (p = 0.000); malnutrition reduces collagenization in anastomoses (p = 0.000).

Acoustic speech analysis for hypernasality detection in children.

Here, an analysis of different acoustic features and their influence in automatic identification of hypernasality is shown. Effective feature selection method includes preprocessing of the initial feature space based on statistical independence analysis. Simultaneously, the synthesis of a specialized diagnostic feature is proposed based on analyzing the acoustic emission of the hyper nasal speech. As a result, It is obtained the acoustic features can differentiate with enough precision the pathology. However, the proposed feature does not require training samples and less computational power, as well.

Feature selection in pathology detection using hybrid multidimensional analysis.

Heuristical algorithms can reduce the computational complexity. Such methods require of some stopping criteria (cost function). Some of these cost functions are based on statistics like univariate and multivariate methods of analysis. Dimensional reduction techniques such as principal component analysis (PCA) allow to find a lower dimension transformed space based on data variance, but this procedure does not take into account information about classes separability, the direction of maximum variance does not necessarily correspond to the direction of maximum separability. In this work, we propose a feature selection algorithm with heuristic search that uses multivariate analysis of variance (MANOVA) as the cost function. This technique is put to test by classifying hypernasal from normal voices of CLP (Cleft Lip and/or Palate) patients. The classification performance, computational time and reduction ratio are also considered by the comparison with an alternate feature selection method founded on unfolding the multivariate analysis into univariate and bivariate analysis.

Utilidad de los bloqueos anestésicos en patología de columna vertebral en el Hospital Universitario Clínica San Rafael / Use fullness of anesthetic blocks in pathology of the spine in the Hospital Universitario Clínica San Rafael / Utilidade dos bloqueios anestésicos em patologia de coluna vertebral no Hospital Universitario Clínica San Rafael

Los bloqueos peridurales y facetarios han sido controvertidos por su utilidad en el manejo del dolor en pacientes con patología de columna vertebral, utilizándose actualmente como último recurso. Para el presente trabajo de recolectaron, entre enero de 2005 y enero de 2006, en el Hospital Universitario Clínica San Rafael de Bogotá, 50 pacientes, que según su patología se dividieron en tres grupos. Mientras que al primero, que incluyó 34 pacientes con hernia discal y al segundo, con nueve pacientes con canal lumbar estrecho se les realizó bloqueo peridural, al tercer grupo, con siete pacientes con enfermedad facetaria, se le aplicó bloqueo facetario. Para determinar la utilidad de los bloqueos se evaluó la mejoría del dolor, el regreso a la actividad laboral, la utilización de analgésicos adyuvantes y la necesidad de algún tipo de procedimiento quirúrgico de acuerdo a la patología presentada. El porcentaje de mejoría del dolor para los distintos grupos fue del 71,5% para los pacientes con enfermedad facetaria, del 77,7% para los pacientes con canal lumbar estrecho y del 65% para los pacientes con hernia discal lumbar. El porcentaje de regreso a la actividad laboral en los tres grupos fue similar, con un 85,7% para los pacientes con enfermedad facetaria, 67% para los pacientes con canal lumbar estrecho y 73,5% para los pacientes con hernia discal. La terapia analgésica adyuvante fue requerida por 42,9% de los pacientes con enfermedad facetaria, por el 55,5% de los pacientes con canal lumbar estrecho y por el 29,5% de los pacientes con hernia discal. La cirugía debió realizarse al 11% del grupo con canal estrecho, al 14% del grupo con hernia discal y no se necesitó en ninguno paciente con enfermedad facetaria. Teniendo en cuenta la efectividad de los bloqueos facetarios para aliviar el dolor en pacientes con enfermedad facetaria y de los bloqueos peridurales para los pacientes con canal lumbar estrecho y hernia discal lumbar, con una mejoría del dolor superior al 50% en los tres grupos, con una tasa de regreso al trabajo alta y con una disminución en la necesidad de cirugía, se propone la realización de estos bloqueos, antes de recurrir a procedimientos invasivos...

The usefulness of peridural and facet blocks has been controversial in the management of pain in patients with pathology of the spine, being used only as a last resort. For this work we collected 50 patients between January 2005 and January 2006 at the Hospital Universitario Clínica San Rafael de Bogotá. There were separated in 3 groups based on their pathology. The first group included 34 patients with a herniated disc and the second group 9 patients with a narrow lumbar canal who received epidural block, and the third group with facet disease received a facet block. To determine the result of the blocks, we evaluated the improvement in the pain, the return to laboral activity, the use of adjuvant analgesics and the need for surgical intervention. The pain improvement was 71,5% for those patients with facet disease, 77.7% for those patients with a narrow canal and 65% for those with a herniated disc. The percentage of return to laboral activity was similar in the three groups, 85,7% for patients with facet disease, 67% for patients with a narrow canal and 73,5% for patients with a herniated disc. Adjuvant analgesics were required by 42,9% of the patients with facet disease, 55,5% of the patients with a narrow lumbar canal and 29,5% of the patients with a herniated disc. Surgery was necessary in 11% of the patients with a narrow canal and 14% of the patients with a herniated disc. Patients with facet disease did not require surgery. In view of the efficacy of the blocks above 50% for all of the measured parameters, it is proposed that the blocks should always be attempted prior to the use of more invasive methods...

Os bloqueios peridurais e facetarias foram discutidos por sua utilidade no manejo da dor em pacientes com patologia de coluna vertebral, utilizando-se atualmente como último recurso. Para o presente trabalho de coletaram, entre janeiro de 2005 e janeiro de 2006, no Hospital Universitário Clínica San Rafael de Bogotá, 50 pacientes, que segundo sua patologia se dividiram em três grupos. Enquanto ao primeiro, que incluiu 34 pacientes com hérnia discal e ao segundo, com nove pacientes com canal lombar estreito se lhes realizou bloqueio peridural, ao terceiro grupo, com sete pacientes com doença facetaria, se lhe aplicou bloqueio facetaria. Para determinar a utilidade dos bloqueios se avaliou a melhoria da dor, o regresso à atividade trabalhista, a utilização de analgésicos adjuvantes e a necessidade de algum tipo de procedimento cirúrgico de acordo à patologia apresentada. A percentagem de melhoria da dor para os diferentes grupos foi do 71,5% para os pacientes com doença facetaria, do 77,7% para os pacientes com canal lombar estreito e do 65% para os pacientes com hérnia discal lombar. A percentagem de regresso à atividade trabalhista nos três grupos foi similar, com um 85,7% para os pacientes com doença facetaria, 67% para os pacientes com canal lombar estreito e 73,5% para os pacientes com hérnia discal. A terapia analgésica adjuvante foi requerida por 42,9% dos pacientes com doença facetaria, pelo 55,5% dos pacientes com canal lombar estreito e pelo 29,5% dos pacientes com hérnia discal. A cirurgia deveu realizar-se aos 11% do grupo com canal estreito, ao 14% do grupo com hérnia discal e não se precisou em nenhum paciente com doença facetaria. Tendo em conta a efetividade dos bloqueios facetarias para aliviar a dor em pacientes com doença facetaria e dos bloqueios peridurais para os pacientes com canal lombar estreito e hérnia discal lombar, com uma melhoria da dor superior ao 50% nos três grupos, com uma taxa de regresso ao trabalho alta e com uma diminuição na necessidade de cirurgia, propõe-se a realização destes bloqueios, antes de recorrer a procedimentos invasivos...

Efectos de la desnutrición sobre la colagenización de anastomosis intestinales: análisis de procolágeno y telopéptido carboxiterminal mediante radioinmunoanálisis / Role of malnutrition in intestinal anastomosis collagenization: an analysis of procollagen (PINP) andcarboxyterminal telopeptide (ICTP) by radioimmunoassay

Introducción: diversos factores influyen en la cicatrización correcta de las suturas intestinales tras la práctica de una resección intestinal. Uno de los factores más implicados es el estado nutricional del paciente. Objetivos: evaluar la influencia de la desnutrición inducida sobre la viabilidad de una anastomosis intestinal primaria mediante el análisis del procolágeno (PINP) como marcador de la síntesis de colágeno I, y del telopéptido carboxiterminal del colágeno I (ICTP) como marcador de la destrucción del mismo. Métodos: 40 ratas Wistar y material de radioinmunoensayo. Métodos: diseñamos 2 grupos de ratas, 20 animales por cada grupo: grupo control (A) y grupo “desnutrición” (B). Se analiza PINP e ICTP mediante RIA sobre tejido colónico homogeneizado, preanastomótico y anastomótico. Resultados: existen unos niveles menores de PINP en el colon de las ratas del grupo B comparado con el colon del grupo A (0,3620 y 0,4340 μg/g respectivamente) (p = 0,032). Hay un mayor nivel de ICTP analizado en el colon del grupo B (0,9545 en contraposición a 0,8460 μg/g en el grupo A) (p = 0,875). En las anastomosis del grupo B existe una menor síntesis de PINP en comparación con el grupo A (0,376 y 0,468 μg/g respectivamente, p = 0,002). Conclusiones: la anastomosis colónica incrementa los niveles de PINP e ICTP en el tejido cicatricial (p = 0,000); la malnutrición reduce la colagenización de las anastomosis (p = 0,000)

Introduction: some clinical, anatomo-pathological, and technical factors influence the correct healing of intestinal suture following an intestinal resection. One of the most influential factors is patient nutritional status. Objectives: to evaluate the influence of malnutrition on the viability of primary intestinal anastomosis by the analysis of collagen I deposition. Methods: 40 Wistar rats, radioimmunoassay material. We used 2 groups of rats, 20 animals in each group: a control group (A) and a “malnutrition” group (B). Results: there was a decrease in PINP (procollagen) deposition in the colon of group B rats as compared to the colon of group A (0.3620 and 0.4340 μg/g respectively) (p = 0.032). There is an increase in ICTP (carboxyterminal telopeptide) in the colon of group B (0.9545 as against 0.8460 μg/g in group A) (p = 0.875). In anastomoses of group B there was a decrease in PINP synthesis as compared to group A (0.376 and 0.468 mg/g respectively, p = 0.002). As regards ICTP, there was an increase in group B (p = 0.330). In relation to the control group no differences were observed in ICTP increases in group B (p = 1). Conclusions: colonic anastomosis increases the levels of PINP and ICTP in healed tissue (p = 0.000); malnutrition reduces collagenization in anastomoses (p = 0.000)