Perforating brain injury from a speargun. A case report.

A case of a perforating brain injury caused by a speargun in a suicide attempt is described. Although this kind of injuries has been previously reported, the present case is specially interesting because the patient showed no neurological deficit after surgery. Some advices about the medical and surgical management are proposed based on this case and our literature review. The use of antibiotics and antiepileptic drugs and the anterograde extraction of the harpoon aided by the performance of a craniotomy surrounding the exit point are recommended.

Simultaneous determination of quinolones for veterinary use by high-performance liquid chromatography with electrochemical detection.

A selective method based on high-performance liquid chromatography with electrochemical detection (HPLC-ECD) has been developed to enable simultaneous determination of three fluoroquinolones (FQs), namely danofloxacin (DANO), difloxacin (DIFLO) and sarafloxacin (SARA). The fluoroquinolones are separated on a Novapack C-18 column and detected in a high sensitivity amperometric cell at a potential of +0.8 V. Solid-phase extraction was used for the extraction of the analytes in real samples. The range of concentration examined varied from 10 to 150 ng g(-1) for danofloxacin, from 25 to 100 ng g(-1) for sarafloxacin and from 50 to 315 ng g(-1) for difloxacin, respectively. The method presents detection limits under 10 ng g(-1) and recoveries around 90% for the three analytes have been obtained in the experiments with fortified samples. This HPLC-ECD approach can be useful in the routine analysis of antibacterial residues being less expensive and less complicated than other more powerful tools as hyphenated techniques.

Quantification of danofloxacin and difloxacin in chicken tissues in the presence of sarafloxacin as interference.

A new spectrofluorimetric method has been developed for the quantification of danofloxacin (DANO) and difloxacin (DIFLO), in the presence of the primary metabolite of difloxacin, with sarafloxacin (SARA) as interference, in chicken tissue samples. The method is based on second-order multivariate calibration, applying parallel factor analysis (PARAFAC), to the excitation-emission matrices (EEMs) of these compounds. High overlapping of the signals and influence of matrix effects were observed. To solve the problem, the standard addition method was used. Chemical variables were optimized. The measured EEMs of the analytes, as analytical signals, allowed their quantification in chicken tissue samples. Solid phase extraction was used for the extraction of the analytes in real samples. The range of concentration examined varied from 30 to 100 ng g(-1) for danofloxacin, and from 100 to 200 ng g(-1) for difloxacin. Both analytes can be analyzed individually, and the binary mixture can be resolved, with recoveries comprising between 88.7 and 106.6%.

[Interventionist endoscopic ultrasonography. A retrospective analysis of 60 procedures]. / Ultrasonografía endoscópica intervencionista. Análisis retrospectivo de 60 procedimientos.

INTRODUCTION AND OBJECTIVE: interventionist endoscopic ultrasonography is increasingly used because of its growing indications. We present here our retrospective and initial experience (60 procedures) with endoscopic ultrasonography (EUS) both for diagnosis (EUS-FNA) and therapy (EUS-guided tumorectomy and mucosectomy). PATIENTS AND METHOD: in a group with 27 cases including 10 submucosal tumors (SMTs), 2 adenopathies, and 15 potential pancreatic tumors (8 pancreatic cancers), a sectorial EUS-FNA at 7.5 MHz was performed for diagnosis prior to therapy (mainly surgical). A pancreatic pseudocyst was drained. In 21 cases with 27 SMTs (10 patients with 13 carcinoids) a tumorectomy was carried out using the standard loop or assisted polypectomy technique with submucosal injection, and in a few cases (two) using elastic band ligation following a radial EUS at 7.5, 12, or 20 MHz. In 6 cases of superficial gastroesophageal cancer or gastric dysplasia an endoscopic mucosal resection (classic EMR) was performed after EUS or MPs at 7.5 and 20 MHz. Fifty-five patients with 60 lesions, 29 femaes and 26 males with a mean age of 60 years (30-88 years) were retrospectively analyzed. RESULTS: diagnostic precision (P), sensitivity (S), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) for EUS-FNA was 85, 83, 100, 100, and 43%, respectively, when comparing results with specimen histology. P was higher for adenopathies (100%) and pancreatic tumors (87%) than for SMTs (80%). No complications arose, except for one episode of upper gastrointestinal bleeding (UGIB) (3.7%) that was endoscopically and satisfactorily treated in a gastric SMT. In the group with 21 patients (10 carcinoids with 13 tumors) 27 SMTs were endoscopically treated by tumorectomy with no perforation and only 2 UGIBs (7.4%), one of them self-limited, recorded. Endoscopic resection was complete in 92% of cases. No complications occurred with classic EMR, and all patients are still alive with no evidence of relapse, either local or metastatic. In this group the rate of complete resections was 100%. CONCLUSIONS: EUS-FNA is a safe technique with high diagnostic accuracy. EUS-guided tumorectomy and mucosectomy are also safe and effective techniques in the endoscopic management of these tumors.

Square wave adsorptive stripping voltametric determination of the mixture of nalidixic acid and its main metabolite (7-hydroxymethylnalidixic acid) by multivariate methods and artificial neural network.

Nalidixic acid (NA) and its main metabolite, 7-hydroximethylnalidixic acid (OHNA), are quinolones antibacterial used as agents used for the treatment of urinary tract infection. For both compounds an adsorption process on a hanging mercury electrode (HMDE). On this basis, a square wave adsorptive stripping voltammetry (SWadSV) method has been developed for the individual and simultaneous determination of NA and OHNA. The variables that affect to accumulation process, such as concentration of perchloric acid, accumulation potential and accumulation time have been optimised by using an experimental design (concretely a Box-Behnken design with three levels) together with the response surface methodology (RSM). Calibration curves were linear in the range (0-1.38)x10(-7)molL(-1) for NA and (0-3.23)x10(-8)molL(-1) for OHNA, in the optimized conditions, with detection limits of 9.48x10(-9)molL(-1) and 8.06x10(-10)molL(-1) for NA and OHNA, respectively. The method was applied to urine samples containing only one of the analytes with satisfactory recoveries. As the voltammetric signals of these compounds show a high overlapping, different chemometric methods, such as classical least squares (CLS), partial least squares (PLS), principal component regression (PCR) and artificial neural network (ANN) have been used for the resolution of the mixture. The analysis of these compounds in urine samples were carried out using the different chemometric tools and the best recoveries were obtained by using ANN. No pre-treatment of the sample was necessary.

Estudio de utilización de psicofármacos en el Centro Penitenciario de León. Análisis comparativo / Study of the use of psychotropic drugs in the prison of león. A comparative analysis

Objetivo: El estudio del consumo de drogas psicotrópicas en el Centro Penitenciario de León (CPL) y su comparación con el consumo de la población general cubierta por el Sistema Nacional de Salud (INSALUD) en la provincia, así como evaluar la naturaleza de la mediación utilizada. Material y Método: La información sobre el consumo de medicación se obtuvo a partir de las fuentes habituales. Se usó el Anatomical, Therapeutic and Chemical Classifying System (ATC) y el Daily Defined Dose (DDD) como unidad de medida. El promedio de consumo se expresa en Dosis Definida Diaria (DDD) por 1.000 habitantes y día.El estadístico aplicado es el Chi Cuadrado. Resultados: El consumo de psicofármacos psicolépticos y psicoanalépticos es 5,1 y 1,15 veces respectivamente superior en las prisiones que en el Sistema Nacional de Salud. El uso de antipsicóticos fue 30,4 DDD/1000H/D en el CPL y 5,7 en el INSALUD (p<0,001). El uso de tranquilizantes es 191,4 DDD/1000H/D en el CPL y 31,6 en el INSALUD (p<0,001). El consumo de tranquilizantes hipnóticos es 29,2 DDD/1000H/D en CPL y 12,9 en el INSALUD. En la prisión 38,34 DDD/1000H/D antidepresivos son consumidos mientras que en el INSALUD lo son 21,5.Conclusiones: En la prisión en la que se desarrolló este trabajo el consumo de medicación psiquiátrica es superior a la que se observa en la población general. El consumo de antipsicóticos, tranquilizantes e hipnóticos es superior en la prisión en comparación con el INSALUD. No se encontraron diferencias significativas en el uso de antidepresivos (AU)

Medullary carcinoma of the breast: an ultrastructural morphometric study of nine cases.

Ultrastructural and morphometric features of 10 medullary carcinomas of the breast (MC) were investigated. Cases with a long follow-up were selected by applying stringent histologic criteria. All tumors had a homogeneous appearance by light microscopy. Under transmission electron microscopy, they showed occasional intracellular lumen formation or keratinization. In one tumor squamous differentiation was prominent and diffuse. Tumors with lymph node metastases possessed over 40% more desmosomes than nonmetastatic tumors. The number of cells with three or more nucleoli per nuclear section was significantly higher in metastatic than in nonmetastatic tumors (p = .02). Classic cases of MC of the breast display a relatively uniform appearance. However, subtle differences can be identified between metastatic and nonmetastatic tumors by ultrastructural morphometry. Although these differences are not associated with changes in the outcome of patients in this study, they seem to bear some relationship to the peculiar behavior of MC.

Renal malakoplakia: report of a case with multifocal involvement.

The authors report the light microscopic and ultrastructural features in one case of malakoplakia involving the kidney, the urinary bladder, and the skin. The kidney was excised. Lesions of the urinary bladder and the skin regressed after topical treatment with cholinergic agonists and antimicrobial drugs. This case illustrates the pathogenesis of malakoplakia and the possibility that early lesions can be cured with medical therapy before extensive tissue destruction has taken place.