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The 21st century has seen the launch of new space-borne sensors based on LiDAR (light detection and ranging) technology developed in the second half of the 20th century. Nowadays, these sensors offer novel opportunities for mapping terrain and canopy heights and estimating aboveground biomass (AGB) across local to regional scales. This study aims to analyze the scientific impact of these sensors on large-scale forest mapping to retrieve 3D canopy information, monitor forest degradation, estimate AGB, and model key ecosystem variables such as primary productivity and biodiversity. A worldwide bibliometric analysis of this topic was carried out based on up to 412 publications indexed in the Scopus database during the period 2004-2022. The results showed that the number of published documents increased exponentially in the last five years, coinciding with the commissioning of two new LiDAR space missions: Ice, Cloud, and Land Elevation Satellite (ICESat-2) and Global Ecosystem Dynamics Investigation (GEDI). These missions have been providing data since 2018 and 2019, respectively. The journal that demonstrated the highest productivity in this field was "Remote Sensing" and among the leading contributors, the top five countries in terms of publications were the USA, China, the UK, France, and Germany. The upward trajectory in the number of publications categorizes this subject as a highly trending research topic, particularly in the context of improving forest resource management and participating in global climate treaty frameworks that require monitoring and reporting on forest carbon stocks. In this context, the integration of space-borne data, including imagery, SAR, and LiDAR, is anticipated to steer the trajectory of this research in the upcoming years.
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LESSONS LEARNED: The addition of the heat shock protein 27 (Hsp27)-targeting antisense oligonucleotide, apatorsen, to a standard first-line chemotherapy regimen did not result in improved survival in unselected patients with metastatic pancreatic cancer.Findings from this trial hint at the possible prognostic and predictive value of serum Hsp27 that may warrant further investigation. BACKGROUND: This randomized, double-blinded, phase II trial evaluated the efficacy of gemcitabine/nab-paclitaxel plus either apatorsen, an antisense oligonucleotide targeting heat shock protein 27 (Hsp27) mRNA, or placebo in patients with metastatic pancreatic cancer. METHODS: Patients were randomized 1:1 to Arm A (gemcitabine/nab-paclitaxel plus apatorsen) or Arm B (gemcitabine/nab-paclitaxel plus placebo). Treatment was administered in 28-day cycles, with restaging every 2 cycles, until progression or intolerable toxicity. Serum Hsp27 levels were analyzed at baseline and on treatment. The primary endpoint was overall survival (OS). RESULTS: One hundred thirty-two patients were enrolled, 66 per arm. Cytopenias and fatigue were the most frequent grade 3/4 treatment-related adverse events for both arms. Median progression-free survival (PFS) and OS were 2.7 and 5.3 months, respectively, for arm A, and 3.8 and 6.9 months, respectively, for arm B. Objective response rate was 18% for both arms. Patients with high serum level of Hsp27 represented a poor-prognosis subgroup who may have derived modest benefit from addition of apatorsen. CONCLUSION: Addition of apatorsen to chemotherapy does not improve outcomes in unselected patients with metastatic pancreatic cancer in the first-line setting, although a trend toward prolonged PFS and OS in patients with high baseline serum Hsp27 suggests this therapy may warrant further evaluation in this subgroup.
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Albúminas/administración & dosificación , Desoxicitidina/análogos & derivados , Proteínas de Choque Térmico HSP27/antagonistas & inhibidores , Proteínas de Choque Térmico HSP27/sangre , Oligonucleótidos Antisentido/administración & dosificación , Paclitaxel/administración & dosificación , Neoplasias Pancreáticas/tratamiento farmacológico , Adulto , Anciano , Albúminas/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Desoxicitidina/administración & dosificación , Desoxicitidina/efectos adversos , Supervivencia sin Enfermedad , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Paclitaxel/efectos adversos , Neoplasias Pancreáticas/sangre , Neoplasias Pancreáticas/patología , Pronóstico , Resultado del Tratamiento , GemcitabinaRESUMEN
A comparative analysis was performed in a pilot-scale membrane bioreactor (MBR) treating urban wastewater supplied with either pure oxygen (O2) or air, to assess the influence of each aeration source on the diversity and activity of the bacterial communities in the sludge. The MBR was operated in three experimental stages with different concentrations of volatile suspended solids (VSS) and temperature, and under both aeration conditions. α-Glucosidases, proteases, esterases and phosphatases were tested as markers of organic matter removal in the sludge, and the diversity of the bacterial community was analysed by fingerprinting (temperature-gradient gel electrophoresis of partially-amplified 16S-rRNA genes). Redundancy analysis (RDA) revealed that temperature and VSS concentration were the only factors that significantly influenced the levels of enzyme activities and the values of both the Shannon-Wiener diversity index (H') and the functional organisation index (Fo), while the bacterial community structure experienced significant changes depending on the aeration source supplied in each experimental stage.
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Bacterias , Reactores Biológicos/microbiología , Enzimas/metabolismo , Eliminación de Residuos Líquidos/instrumentación , Bacterias/genética , Bacterias/metabolismo , Biodiversidad , Electroforesis en Gel de Gradiente Desnaturalizante , Evolución Molecular , Datos de Secuencia Molecular , Oxígeno/metabolismo , Filogenia , Reacción en Cadena de la Polimerasa , ARN Ribosómico 16S/genética , Aguas del Alcantarillado/microbiología , Temperatura , Eliminación de Residuos Líquidos/métodos , Aguas ResidualesRESUMEN
Microfiltration applied in the dairy industry for bacteria removal is an important technology for extending the shelf life of milk while maintaining or even improving its organoleptic and nutritional properties. This article reviews the evolution of this technique over recent years and the advances currently being made in the field. The cited literature indicates the strategies used to overcome the main drawbacks of this type of operation, the most common operating conditions employed and the reduction degree of bacteria obtained.
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Industria Lechera/métodos , Filtración/métodos , Conservación de Alimentos/métodos , Leche/microbiología , Animales , Bovinos , Filtración/instrumentación , Filtración/tendencias , Contaminación de Alimentos/prevención & control , Conservación de Alimentos/instrumentación , Bacterias Gramnegativas/crecimiento & desarrollo , Bacterias Grampositivas/crecimiento & desarrollo , Viabilidad Microbiana , PasteurizaciónRESUMEN
BACKGROUND Multi-resistant microorganisms are a public health problem. Their incidence has risen due to COVID-19, indiscriminate antibiotics use, corticosteroid treatments, and higher admissions to intensive care units (ICUs) of patients requiring invasive mechanical ventilation. These are risk factors for bacterial over-infection. The present case study that is relevant because of the multiple isolated strains with a resistance pattern: Klebsiella pneumoniae carbapenemases (KPC), extended-spectrum beta lactamases (ESBL) and New Delhi metallo-ß-lactamase (NDM) in a patient without comorbidities. CASE REPORT A 53-year-old Ecuadorian man with no past medical history arrived at the Emergency Department (ED) with dyspnea, nasopharyngeal swab with a positive reverse transcription polymerase chain reaction (RT-PCR) test for SARS-CoV2, and a chest computed tomography (CT) scan showing bilateral ground-glass pulmonary infiltrates with 40% involvement. On day 10 in the ICU, the presence of Klebsiella pneumoniae KPC strain was reported in an axillary swab culture. Consequently, the antibiotic was rotated to vancomycin 1 g intravenously (i.v.) every 12 h and meropenem 1 g i.v. every 8 h. On day 15 in the ICU, a tracheal secretion culture was reported with the presence of Klebsiella pneumoniae ESBL and a blood culture with Klebsiella pneumoniae NDM. CONCLUSIONS The COVID-19 pandemic is a perfect scenario for superinfection with multi-resistant pathogens such as carbapenem-resistant Klebsiella pneumoniae (CRKP), due to the increase in patients admitted to ICUs requiring invasive mechanical ventilation, the use of corticosteroids, and empirical broad-spectrum antibiotic management based on guidelines. The emergence of combined multidrug-resistant strains is a challenge for laboratory detection and the selection of antimicrobial treatment.
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COVID-19 , Infecciones por Klebsiella , Neumonía , Antibacterianos/uso terapéutico , Ecuador , Humanos , Unidades de Cuidados Intensivos , Infecciones por Klebsiella/diagnóstico , Infecciones por Klebsiella/tratamiento farmacológico , Klebsiella pneumoniae , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Pandemias , ARN Viral , SARS-CoV-2RESUMEN
The efficient-coding hypothesis asserts that neural and perceptual sensitivity evolved to faithfully represent biologically relevant sensory signals. Here we characterized the spectrotemporal modulation statistics of several natural sound ensembles and examined how neurons encode these statistics in the central nucleus of the inferior colliculus (CNIC) of cats. We report that modulation-tuning in the CNIC is matched to equalize the modulation power of natural sounds. Specifically, natural sounds exhibited a tradeoff between spectral and temporal modulations, which manifests as 1/f modulation power spectrum (MPS). Neural tuning was highly overlapped with the natural sound MPS and neurons approximated proportional resolution filters where modulation bandwidths scaled with characteristic modulation frequencies, a behavior previously described in human psychoacoustics. We demonstrate that this neural scaling opposes the 1/f scaling of natural sounds and enhances the natural sound representation by equalizing their MPS. Modulation tuning in the CNIC may thus have evolved to represent natural sound modulations in a manner consistent with efficiency principles and the resulting characteristics likely underlie perceptual resolution.
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Estimulación Acústica/métodos , Percepción Auditiva/fisiología , Colículos Inferiores/fisiología , Sonido , Vocalización Animal/fisiología , Animales , Gatos , Humanos , Distribución AleatoriaRESUMEN
The cochlea encodes sounds through frequency-selective channels that exhibit low-pass modulation sensitivity. Unlike the cochlea, neurons in the auditory midbrain are tuned for spectral and temporal modulations found in natural sounds, yet the role of this transformation is not known. We report a distinct tradeoff in modulation sensitivity and tuning that is topographically ordered within the central nucleus of the inferior colliculus (CNIC). Spectrotemporal receptive fields (STRFs) were obtained with 16-channel electrodes inserted orthogonal to the isofrequency lamina. Surprisingly, temporal and spectral characteristics exhibited an opposing relationship along the tonotopic axis. For low best frequencies (BFs), units were selective for fast temporal and broad spectral modulations. A systematic progression was observed toward slower temporal and finer spectral modulation sensitivity at high BF. This tradeoff was strongly reflected in the arrangement of excitation and inhibition and, consequently, in the modulation tuning characteristics. Comparisons with auditory nerve fibers show that these trends oppose the pattern imposed by the peripheral filters. These results suggest that spectrotemporal preferences are reordered within the tonotopic axis of the CNIC. This topographic organization has profound implications for the coding of spectrotemporal features in natural sounds and could underlie a number of perceptual phenomena.
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Estimulación Acústica/métodos , Percepción Auditiva/fisiología , Red Nerviosa/fisiología , Células Receptoras Sensoriales/fisiología , Animales , Gatos , Colículos InferioresRESUMEN
PURPOSE: Endothelins and their cell membrane receptors (ET(A)R and ET(B)R) are implicated in neoplastic pathogenesis. atrasentan, a potent, selective ET(A)R antagonist, has a direct effect on tumor proliferation, apoptosis, and angiogenesis. This study was designed to assess the influence of atrasentan on paclitaxel pharmacokinetics and to determine the safety and efficacy of atrasentan in combination with paclitaxel-carboplatin. EXPERIMENTAL DESIGN: Chemonaive patients with stage IIIB (malignant pleural effusion) and IV non-small cell lung cancer were enrolled. Toxicity and response were determined using the National Cancer Institute Common Toxicity Criteria version 2.0 and Response Evaluation Criteria in Solid Tumors criteria, respectively. Treatment consisted of paclitaxel (225 mg/m(2)) and carboplatin (area under the curve, 6) administered on day 1 every 3 weeks. A fixed 10 mg daily oral dose ofAtrasentan was administered continuously, starting on day 4 of cycle 1. Paclitaxel clearance was calculated during the first two cycles (pre- and post-atrasentan) in the first 10 patients. RESULTS: All 44 patients were evaluable for survival, toxicity, and response. No significant change in mean paclitaxel clearance was detected (mean +/- SD, 21.2 +/- 4.5 L/h versus 21.3 +/- 4.9 L/h) for pre- and post-atrasentan values, respectively (P = 0.434). Grade 3/4 toxicities > or = 10% were lymphopenia (22.7%), neutropenia (20.5%), dyspnea (11.4%), and hyperglycemia (11.4%). Response rate was 18.2%, with progression-free survival of 4.2 months, median survival of 10.6 months, and 1-year survival of 43%. CONCLUSION: Atrasentan plus paclitaxel-carboplatin was safe and well tolerated, with no apparent paclitaxel-atrasentan pharmacokinetic interaction. Efficacy and survival in advanced non-small cell lung cancer were comparable with studies of chemotherapy alone.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Neoplasias Pulmonares/tratamiento farmacológico , Adenocarcinoma/tratamiento farmacológico , Adenocarcinoma/secundario , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/farmacocinética , Atrasentán , Neoplasias Encefálicas/tratamiento farmacológico , Neoplasias Encefálicas/secundario , Carboplatino/administración & dosificación , Carcinoma de Pulmón de Células no Pequeñas/secundario , Carcinoma de Células Escamosas/tratamiento farmacológico , Carcinoma de Células Escamosas/secundario , Antagonistas de los Receptores de la Endotelina A , Femenino , Humanos , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/tratamiento farmacológico , Estadificación de Neoplasias , Paclitaxel/administración & dosificación , Pronóstico , Pirrolidinas/administración & dosificación , Tasa de SupervivenciaRESUMEN
In patients with bilateral hearing loss, the use of two hearing aids (HAs) offers the potential to restore the benefits of binaural hearing, including sound source localization and segregation. However, existing evidence suggests that bilateral HA users' access to binaural information, namely interaural time and level differences (ITDs and ILDs), can be compromised by device processing. Our objective was to characterize the nature and magnitude of binaural distortions caused by modern digital behind-the-ear HAs using a variety of stimuli and HA program settings. Of particular interest was a common frequency-lowering algorithm known as nonlinear frequency compression, which has not previously been assessed for its effects on binaural information. A binaural beamforming algorithm was also assessed. Wide dynamic range compression was enabled in all programs. HAs were placed on a binaural manikin, and stimuli were presented from an arc of loudspeakers inside an anechoic chamber. Stimuli were broadband noise bursts, 10-Hz sinusoidally amplitude-modulated noise bursts, or consonant-vowel-consonant speech tokens. Binaural information was analyzed in terms of ITDs, ILDs, and interaural coherence, both for whole stimuli and in a time-varying sense (i.e., within a running temporal window) across four different frequency bands (1, 2, 4, and 6 kHz). Key findings were: (a) Nonlinear frequency compression caused distortions of high-frequency envelope ITDs and significantly reduced interaural coherence. (b) For modulated stimuli, all programs caused time-varying distortion of ILDs. (c) HAs altered the relationship between ITDs and ILDs, introducing large ITD-ILD conflicts in some cases. Potential perceptual consequences of measured distortions are discussed.
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Audífonos , Localización de Sonidos , Estimulación Acústica , Implantes Cocleares , Humanos , RuidoRESUMEN
Currently, many sensitive molecules have been studied for effective oral administration. These substances are biologically active compounds that mainly suffer early degradation in the gastrointestinal tract (GIT) and physicochemical instability, inactivation and poor solubility and permeability. The sensibility of the biomolecules has limited their oral administration in the body and today is an important research topic to achieve desired effects in medicine field. Under this perspective, various enhancement approaches have been studied as alternatives to increase their oral bioavailability. Some of these strategies include functionalized polymers to provide specific useful benefits as protection to the intestinal tract by preventing its degradation by stomach enzymes, to increase their absorption, permeability, stability, and to make a proper release in the GIT. Due to specific chemical groups, shapes and sizes, morphologies, mechanical properties, and degradation, recent advances in functionalized polymers have opened the door to great possibilities to improve the physicochemical characteristics of these biopharmaceuticals. Today, many biomolecules are found in basic studies, preclinical steps, and others are late stage clinical development. This review summarizes the contribution of functionalized polymers to enhance oral bioavailability of sensitive molecules and their application status in medicine for different diseases. Future trends of these polymers and their possible uses to achieve different formulation goals for oral delivery are also covered in this manuscript.
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Lemierre syndrome (LS) typically consists of a septic thrombophlebitis of the internal jugular vein caused by Fusobacterium necrophorum. We present an unusual variant of LS with cavernous sinus thrombosis and occlusion of the ipsilateral internal carotid artery secondary to sphenoid sinusitis caused by Streptococcus viridans.
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Estenosis Carotídea/etiología , Trombosis del Seno Cavernoso/etiología , Síndrome de Lemierre/etiología , Sinusitis del Esfenoides/complicaciones , Humanos , Masculino , Adulto JovenRESUMEN
A MBR (membrane bioreactor) was performed to quantify the improvement in nitrogen removal terms when pure oxygen and air were used to supply the aerobic conditions at different HRT (hydraulic retention time) and mixed liquid suspended solids concentrations. The improvement in the efficiency was 8.0% and 13.5% when pure oxygen was used with 12h and 18 h of HRT respectively. The ammonium utilization rates with HRT of 18 h with pure oxygen was 1.23 mg N(t)/(L h) and with air 0.66 mg N(t)/(L h) and with HRT of 12h was 1.14 mg N(t)/(L h) and 1.18 mg N(t)/(L h) respectively. Model simulation (DESSAS software) confirmed the validity for nitrogen removal, hydrolysis constant was increased (106% and 184%), decay constant was decreased and Monod's constant was increased (190.4% to 324.1%), and a multivariate analysis with CANOCO v4.5 demonstrated that temperature and HRT have the higher influence in kinetics.
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Aire , Reactores Biológicos , Membranas Artificiales , Nitrificación/fisiología , Oxígeno/metabolismo , Aguas del Alcantarillado/química , Purificación del Agua/métodos , Hidrólisis , Cinética , Modelos Biológicos , Aguas del Alcantarillado/microbiología , Temperatura , Factores de TiempoRESUMEN
Tympanic paragangliomas usually present as a vascular middle ear mass, with the most common presenting symptoms being pulsatile tinnitus and hearing loss. We report an unusual case of a recurrent tympanic paraganglioma extending along the Eustachian tube and nasopharynx, presenting with recurrent epistaxis.
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Neoplasias del Oído/patología , Oído Medio/patología , Trompa Auditiva/patología , Nasofaringe/patología , Paraganglioma/patología , Neoplasias del Oído/irrigación sanguínea , Neoplasias del Oído/complicaciones , Neoplasias del Oído/diagnóstico por imagen , Neoplasias del Oído/cirugía , Oído Medio/diagnóstico por imagen , Oído Medio/cirugía , Endoscopía , Epistaxis/etiología , Trompa Auditiva/diagnóstico por imagen , Femenino , Humanos , Persona de Mediana Edad , Nasofaringe/diagnóstico por imagen , Invasividad Neoplásica , Recurrencia Local de Neoplasia/cirugía , Paraganglioma/irrigación sanguínea , Paraganglioma/complicaciones , Paraganglioma/diagnóstico por imagen , Paraganglioma/cirugía , Radiocirugia , Tomografía Computarizada por Rayos XRESUMEN
The performance of a wastewater bench-scale ultrafiltration membrane bioreactor (MBR) treatment plant using pure oxygen to supply the aerobic conditions for 95 days was studied. The results showed the capacity of the MBR systems to remove organic material under a hydraulic retention time of 12h and a sludge retention time of 39.91 days. Aeration represents its major power input; this is why the alpha-factor of the aeration and kinetic parameters (design parameters) were determined when the mixed liquid suspended solids (MLSS) was increased from 3420 to 12,600 mg/l in order to understand the system. An alpha-factor in the range 0.462-0.022 and the kinetic parameters measured with the respirometric method (K(M) of 73.954-3.647 mg/l, k(d) of 0.0142-0.104 day(-1), k(H) of 0.1266-0.655 day(-1), and the yield mean coefficient of 0.941) were obtained. Our study suggested significant changes in the behaviour of the biological system when the concentration of MLSS was increased.
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Reactores Biológicos , Oxígeno/metabolismo , Cinética , Membranas Artificiales , UltrafiltraciónRESUMEN
Anatomical and functional studies have shown that the NADPH-diaphorase-positive cholinergic neurons of the pedunculopontine nucleus (PPN) send projections to several areas in the brain. The purpose of this work was to investigate whether bilateral lesions with quinolinic acid, a neurotoxin with greater selectivity for NADPH-diaphorase-positive neurons, aimed at the compact portion of the PPN would affect the performance of adaptive behaviors, such as sleep, locomotion, and spontaneous alternation. Lesioned animals were divided in a low lesion group (LL, <50% neuron loss) and a high lesion group (HL, ≥50% neuron loss). The LL animals did not show any significant changes in sleep patterns, as compared to controls. In contrast, the HL group showed a significant increase in the number of REM sleep periods, and a reduction of REM sleep average duration, but did not differ in the total time spent in REM sleep. HL animals also showed an increase in the number of SWS periods, though wakefulness parameters did not show significant alterations. The duration and number of both REM and SWS sleep episodes were significantly correlated with the number of NADPH-diaphorase-positive neurons in the PPN. The short-term habituation pattern of locomotion, the vertical exploratory activity, as well as the thigmotaxis (an index of emotionality), displayed by LL and HL rats in a novel environment were similar to those of control animals. Likewise, there were no significant differences in spontaneous alternation among the groups. Our results indicate that quinolinic acid lesions of NADPH-diaphorase-positive cholinergic neurons localized in the posterior region of the PPN disrupt normal sleep structure, while motor activity and spontaneous alternation remain unaffected.
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Emociones/fisiología , Conducta Exploratoria/fisiología , Locomoción/fisiología , Memoria a Corto Plazo/fisiología , Núcleo Tegmental Pedunculopontino/fisiología , Ácido Quinolínico/toxicidad , Fases del Sueño/fisiología , Animales , Neuronas Colinérgicas/metabolismo , Neuronas Colinérgicas/fisiología , Emociones/efectos de los fármacos , Conducta Exploratoria/efectos de los fármacos , Locomoción/efectos de los fármacos , Masculino , Memoria a Corto Plazo/efectos de los fármacos , NADPH Deshidrogenasa/metabolismo , Núcleo Tegmental Pedunculopontino/efectos de los fármacos , Ratas , Ratas Wistar , Fases del Sueño/efectos de los fármacosRESUMEN
OBJECTIVE: The purpose of this paper is to demonstrate the feasibility and utility of developing economic cost models for noise-induced hearing loss (NIHL). First, we outline an economic model of NIHL for a population of US Navy sailors with an "industrial"-type noise exposure. Next, we describe the effect on NIHL-related cost of varying the two central model inputs--the noise-exposure level and the duration of exposure. Such an analysis can help prioritize promising areas, to which limited resources to reduce NIHL-related costs should be devoted. METHODS: NIHL-related costs borne by the US government were computed on a yearly basis using a finite element approach that took into account varying levels of susceptibility to NIHL. Predicted hearing thresholds for the population were computed with ANSI S3.44-1996 and then used as the basis for the calculation of NIHL-related costs. Annual and cumulative costs were tracked. Noise-exposure level and duration were systematically varied to determine their effects on the expected lifetime NIHL-related cost of a specific US Navy sailor population. RESULTS: Our nominal noise-exposure case [93 dB(A) for six years] yielded a total expected lifetime cost of US $13,472 per sailor, with plausible lower and upper bounds of US $2,500 and US $26,000. Starting with the nominal case, a decrease of 50% in exposure level or duration would yield cost savings of approximately 23% and 19%, respectively. We concluded that a reduction in noise level would be more somewhat more cost-effective than the same percentage reduction in years of exposure. CONCLUSION: Our economic cost model can be used to estimate the changes in NIHL-related costs that would result from changes in noise-exposure level and/or duration for a single military population. Although the model is limited at present, suggestions are provided for adapting it to civilian populations.
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Pérdida Auditiva Provocada por Ruido/economía , Personal Militar/estadística & datos numéricos , Modelos Económicos , Ruido en el Ambiente de Trabajo/economía , Ayuda a Lisiados de Guerra/economía , Adolescente , Adulto , Anciano , Costos y Análisis de Costo , Financiación Gubernamental , Pérdida Auditiva Provocada por Ruido/epidemiología , Humanos , Persona de Mediana Edad , Ruido en el Ambiente de Trabajo/efectos adversos , Ruido en el Ambiente de Trabajo/estadística & datos numéricos , Reproducibilidad de los Resultados , Estados Unidos/epidemiología , Ayuda a Lisiados de Guerra/estadística & datos numéricos , Adulto JovenRESUMEN
El síndrome de Lemierre (SL) consiste típicamente en una tromboflebitis séptica de la vena yugular interna causada por Fusobacterium necrophorum. Presentamos una variante excepcional del SL con trombosis del seno cavernoso y oclusión de la carótida interna ipsilateral secundaria a una sinusitis esfenoidal causada por Streptococcus viridans (AU)
Lemierre syndrome (LS) typically consists of a septic thrombophlebitis of the internal jugular vein caused by Fusobacterium necrophorum. We present an unusual variant of LS with cavernous sinus thrombosis and occlusion of the ipsilateral internal carotid artery secondary to sphenoid sinusitis caused by Streptococcus viridans (AU)
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Humanos , Masculino , Adulto Joven , Síndrome de Lemierre/etiología , Trombosis del Seno Cavernoso/etiología , Enfermedades de las Arterias Carótidas/complicaciones , Sinusitis del Esfenoides/complicaciones , Estenosis Carotídea/etiologíaRESUMEN
Los paragangliomas timpánicos suelen presentarse como una masa hipervascular en oído medio, siendo los síntomas de presentación más frecuentes acúfeno pulsátil e hipoacusia. Presentamos un caso infrecuente de recidiva de paraganglioma timpánico con extensión a trompa de Eustaquio y nasofaringe, que se manifestó con epistaxis recurrente(AU)
Tympanic paragangliomas usually present as a vascular middle ear mass, with the most common presenting symptoms being pulsatile tinnitus and hearing loss. We report an unusual case of a recurrent tympanic paraganglioma extending along the Eustachian tube and nasopharynx, presenting with recurrent epistaxis(AU)
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Humanos , Femenino , Persona de Mediana Edad , Paraganglioma/complicaciones , Paraganglioma/diagnóstico , Trompa Auditiva/patología , Neoplasias Nasofaríngeas/complicaciones , Epistaxis/complicaciones , /métodos , Cirugía Endoscópica por Orificios Naturales/métodos , Cirugía Endoscópica por Orificios Naturales , Paraganglioma , Oído Medio/patología , Trompa Auditiva , Oído Medio , Neoplasias Nasofaríngeas/patología , Neoplasias Nasofaríngeas , Epistaxis/fisiopatología , Epistaxis , Angiografía/métodos , Diagnóstico DiferencialRESUMEN
Presentamos un estudio prospectivo longitudinal y observacional, realizado en el Hospital de Traumatología "Magdalena de las Salinas" del IMSS, durante el periodo comprendido de diciembre de 1991 a diciembre de 1993, seleccionando a 22 pacientes con el diagnóstico de fracturas diafisarias de el húmero, complejas (figuras 1 y 2) y/o complicadas (figura 3), tratados con el sistema de fijación externa tubular modular no transfictivo (figuras 4, 5 y 6). Durante el seguimiento de los pacientes, obtuvimos buenos resultados en un 72.7 por ciento, regulares en un 18.1 por ciento y malos resultados en un 9 por ciento. Observamos las siguientes complicaciones: Clínicas: cuatro casos con lesión del nervio radial postquirúrgico con recuperación del mismo sin secuelas, cuatro casos con alteraciones funcionales en codo y hombro que no limitaban para la realización de sus actividades y que mejoraron con rehabilitación y un caso con anquilosis severa de codo y muñeca (reportados como resultados regulares). Mecánicas: Dos pacientes que evolucionaron a pseudoartrosis (resultados malos). Multifactoriales: en todos los casos se presentó exudado a través de los tornillos Shanz como dato de aflojamiento de los mismos. Con lo referido previamente podemos establecer que el sistema de fijación externa propuesto, es de utilidad en el tratamiento de las fracturas complejas y complicadas de la diáfisis humeral en adultos, proporcionando resultados funcionales y radiológicos satisfactorios y que las complicaciones van estrechamente relacionadas a la magnitud y severidad de la lesión pero que la mayoría puede resolverse satisfactoriamente sin secuelas
Asunto(s)
Adulto , Humanos , Fijadores Externos , Fracturas del Húmero/clasificación , Fracturas del Húmero/complicaciones , Fracturas del Húmero/fisiopatologíaRESUMEN
En este estudio retrospectivo fueron seleccionados 184 pacientes sometidos a artroplastía total primaria de cadera, 95 fueron abordados por la región ántero lateral y 89 por la posterior, desde junio de 1993 a junio de 1997. Los eventos evaluados fueron parámetros perioperatorios (tiempo quirúrgico, de internación hospitalaria, e intervalo entre cirurgía y el alta, hemorragia y necesidad de transfusión sanguínea), y complicaciones (trombosis venosas profundas, embolia pulmonar, lesión de nervio periférico, inestabilidad de la prótesis y otras). Los dos grupos no diferían en cuanto a las indicaciones preoperatorias. Los pacientes de abordaje posterior tuvieron un tiempo quirúrgico reducido (p<0,001), además de presentar menores hemorragias transoperatorias (p<0,05) y necesidad de transfusión post operatoria (p<0,001). Los grupos no diferían en cuanto a los demás parámetros y complicaciones, que tuvieron baja frecuencia. El abordaje posterior ha sido realizado con éxito por el Grupo de Cirurgía de Cadera del Hospital de Clínicas de Posto Alegre, siendo una excelente opción de acceso quirúrgico para artroplastía total de cadera.