The Synthesis of Sponge-like V2O5/CNT Hybrid Nanostructures Using Vertically Aligned CNTs as Templates.

The fabrication of sponge-like vanadium pentoxide (V2O5) nanostructures using vertically aligned carbon nanotubes (VACNTs) as a template is presented. The VACNTs were grown on silicon substrates by chemical vapor deposition using the Fe/Al bilayer catalyst approach. The V2O5 nanostructures were obtained from the thermal oxidation of metallic vanadium deposited on the VACNTs. Different oxidation temperatures and vanadium thicknesses were used to study the influence of these parameters on the stability of the carbon template and the formation of the V2O5 nanostructures. The morphology of the samples was analyzed by scanning electron microscopy, and the structural characterization was performed by Raman, energy-dispersive X-ray, and X-ray photoelectron spectroscopies. Due to the catalytic properties of V2O5 in the decomposition of carbonaceous materials, it was possible to obtain supported sponge-like structures based on V2O5/CNT composites, in which the CNTs exhibit an increase in their graphitization. The VACNTs can be removed or preserved by modulating the thermal oxidation process and the vanadium thickness.

Can mask mandates boost nature-based tourism? The role of escapism and travel anxiety.

Tourism in a post-pandemic era will likely be oriented toward nature because contact with nature has restorative health benefits. The purpose of this study was to analyze the antecedents of tourists' intentions to visit nature-based resorts during a pandemic. A nationally representative sample of the Spanish population (n = 500) was recruited by an online commercial panel to test and empirically validate the proposed conceptual framework. The findings confirmed a direct relationship between negative perceptions of wearing face masks during the COVID-19 pandemic and tourists' intentions to visit nature-based resorts. The relationship between the perceived negative effects of wearing face masks and the intention to visit nature-based resorts was positively mediated by the need for escapism. This impact was less pronounced for anxious travelers, as shown by results corroborating the moderating effect of travel anxiety. The findings of this study contribute to research on tourism crises and provide future insights into the recovery of the industry during COVID-19.

Structured light using carbon nanostructures driven by Kerr nonlinearities and a magnetic field.

A substantial influence of a magnetic field on the third-order nonlinear optical properties exhibited by aggregated networks of aligned carbon nanotubes (CNT) is reported by systematic measurements. A two-wave mixing was employed to explore and modulate the refractive index in the nanostructures in the nanosecond and picosecond regime. The presence of a magnetic field was able to modify the optical transmittance in the sample and the potentiality to generate structured light was proposed. Numerical simulations were conducted to analyze the magnetic field phenomena and the oscillations of the electric field in the studied sample. We discussed theoretical concepts, experimental methods, and computational tools employed to evaluate the third-order nonlinear optical properties of CNT in film form. Immediate applications of the system to modulate structured light can be contemplated.

Tunable Low Crystallinity Carbon Nanotubes/Silicon Schottky Junction Arrays and Their Potential Application for Gas Sensing.

Highly ordered nanostructure arrays have attracted wide attention due to their wide range of applicability, particularly in fabricating devices containing scalable and controllable junctions. In this work, highly ordered carbon nanotube (CNT) arrays grown directly on Si substrates were fabricated, and their electronic transport properties as a function of wall thickness were explored. The CNTs were synthesized by chemical vapor deposition inside porous alumina membranes, previously fabricated on n-type Si substrates. The morphology of the CNTs, controlled by the synthesis parameters, was characterized by electron microscopies and Raman spectroscopy, revealing that CNTs exhibit low crystallinity (LC). A study of conductance as a function of temperature indicated that the dominant electric transport mechanism is the 3D variable range hopping. The electrical transport explored by I-V curves was approached by an equivalent circuit based on a Schottky diode and resistances related to the morphology of the nanotubes. These junction arrays can be applied in several fields, particularly in this work we explored their performance in gas sensing mode and found a fast and reliable resistive response at room temperature in devices containing LC-CNTs with wall thickness between 0.4 nm and 1.1 nm.

The Administration of the Synbiotic Lactobacillus bulgaricus 6c3 Strain, Inulin and Fructooligosaccharide Decreases the Concentrations of Indoxyl Sulfate and Kidney Damage in a Rat Model.

Indoxyl sulfate (IS) is involved in the progression of chronic kidney disease (CKD) and in its cardiovascular complications. One of the approaches proposed to decrease IS is the administration of synbiotics. This work aimed to search for a probiotic strain capable to decrease serum IS levels and mix it with two prebiotics (inulin and fructooligosaccharide (FOS)) to produce a putative synbiotic and test it in a rat CKD model. Two groups of Sprague-Dawley rats were nephrectomized. One group (Lac) received the mixture for 16 weeks in drinking water and the other no (Nef). A control group (C) included sham-nephrectomized rats. Serum creatinine and IS concentrations were measured using high-performance liquid chromatography with diode array detector (HPLC-DAD). Optical microscopy and two-photon excitation microscopy was used to study kidney and heart samples. The Lac group, which received the synbiotic, reduced IS by 0.8% while the Nef group increased it by 38.8%. Histological analysis of kidneys showed that the Lac group increased fibrotic areas by 12% and the Nef group did it by 25%. The synbiotic did not reduce cardiac fibrosis. Therefore, the putative synbiotic showed that function reducing IS and the progression of CKD in a rat model, but no heart protection was observed.

Manejo de un paciente con trasplante renal en terapia de mantenimiento con COVID-19 en un hospital no trasplantador. Reporte de caso / Management of a maintenance renal transplant patient with COVID-19, in a non-transplant hospital

Resumen La enfermedad por SARS-CoV-2 (COVID-19) ha aumentado drásticamente desde marzo 2020 y en la actualidad no existen datos suficientes para establecer el riesgo de contagio de este virus en receptores de trasplante renal en comparación con la población general. El objetivo de este reporte de caso fue presentar las características del curso clínico y terapéutico de una paciente trasplantada renal en terapia de mantenimiento que presentó neumonía por COVID-19 y fue atendida en un hospital no trasplantador. La paciente era una mujer de 47 años con antecedente de insuficiencia renal no filiada que recibió trasplante renal de donante por muerte encefálica en el año 2006. Las características clínicas (síntomas, exámenes de laboratorio e imágenes radiológicas) de la mujer fueron similares a las de otros pacientes con COVID-19 de la población general, por lo que fue tratada con hidroxicloroquina, lopinavir/ritonavir, antibioticoterapia profiláctica y dosis única de tocilizumab. La triple terapia inmunosupresora de mantenimiento que recibía se discontinuó al no poder monitorizar los niveles sanguíneos de algunos fármacos inmunosupresores; asimismo se indicaron dosis bajas de metilprednisolona y 5 dosis de flebogama. La neumonía por COVID-19 en esta paciente inmunodeprimida evolucionó favorablemente sin necesidad de respiración mecánica asistida, y la función renal mejoró a sus valores basales, mantenien- do moderada proteinuria. Al alta se reinició la dosis previa de su medicación inmunosupresora habitual. La experiencia descrita en el presente caso puede ser útil para en tratamiento de pacientes trasplantados y con COVID-19 en hospitales no trasplantadores y que no disponen de la capacidad de verificar los niveles de medicación inmunosupresora.

Abstract SARS-CoV-2 disease (COVID-19) has dramatically increased since March 2020. There is insufficient data to establish the risk of acquiring the infection in kidney transplant recipients in comparison with the general population. The objective of this case is to report here the clinical features and therapeutic course of the renal transplant recipient with confirmed COVID-19 pneumonia in a non-transplant hospital. This is a 47-year-old woman with end stage renal disease (ESRD) of unknown cause who received kidney transplantation 14 years ago. Her clinical characteristics (symptoms, laboratory test results, and chest x-ray images) were similar to those of non-transplanted COVID-19 patients. She was treated with hydroxychloroquine, lopinavir/ritonavir, prophylactic antibiotic therapy, and a single dose of tocilizumab for COVID-19. The triple maintenance immunosuppressive therapy she was receiving was temporarily suspended due to the inability to monitor immunosuppressive drugs levels in our hospital, and low dose methylprednisolone plus five doses of flebogamma were administered instead. The COVID-19 pneumonia in this long-term immunosuppressed patient was successfully recovered without the need to assisted mechanical respiration. The renal function improved to its baseline values, maintaining moderate proteinuria. At discharge, the previous dose of his usual immunosuppressive medication was restarted. We conclude that the experience described with our case may be useful for non-transplant hospitals, which do not have the capacity to perform immunosuppressive medication titration.

Nickel Nanopillar Arrays Electrodeposited on Silicon Substrates Using Porous Alumina Templates.

Nickel nanopillar arrays were electrodeposited onto silicon substrates using porous alumina membranes as a template. The characterization of the samples was done by scanning electron microscopy, X-ray diffraction, and alternating force gradient magnetometry. Ni nanostructures were directly grown on Si by galvanostatic and potentiostatic electrodeposition techniques in three remarkable charge transfer configurations. Differences in the growth mechanisms of the nanopillars were observed, depending on the deposition method. A high correlation between the height of the nanopillars and the charge synthesis was observed irrespective of the electrochemical technique. The magnetization measurements demonstrated a main dependence with the height of the nanopillars. The synthesis of Ni nanosystems with a controllable aspect ratio provides an effective way to produce well-ordered networks for wide scientific applications.

ANTIBIOTIC RESISTANCE SURVEILLANCE OF HELICOBACTER PYLORI AT THE BIOBÍO REGION (CHILE) IN A DECADE.

BACKGROUND: Helicobacter pylori infection in Chile remains as a public and private health-care system's challenge, with a prevalence of the infection over 70%. Nowadays, antibiotic treatment of the infection is mandatory to prevent the arising of severe associated diseases but failures in the eradication therapy mainly due to clarithromycin resistance has been observed worldwide and first line eradication therapy seems to be not effective anymore in several geographical areas. Thus, health-care systems are committed to maintain an epidemiological surveillance upon the evolution of the antibiotic resistance of this priority 2 pathogen. OBJECTIVE: This work reports a 10 years surveillance of the primary antibiotic resistance of H. pylori clinical isolates at the Biobío region-Chile, and the evolution of resistance toward amoxicillin, clarithromycin, levofloxacin, metronidazole, and tetracycline among the species. METHODS: H. pylori strains were investigated during the periods 2005-2007 (1435 patients analysed) and 2015-2017 (220 patients analysed) by inoculating a saline homogenate biopsy onto the surface of Columbia agar (Oxoid, Basingstoke, UK) - supplemented with 7% horse red blood cells plus DENT inhibitor (Oxoid, Basingstoke, UK) - following by incubation at 37ºC under 10% CO2 atmosphere for five days. Antibiotic resistance pattern of the isolates was assessed using the disk diffusion test in Müeller-Hinton agar supplemented with 7% horse red blood cells followed by incubation for further three days under 10% CO2 atmosphere. Statistical analysis was done using the SPSS v22 software and P values <0.05 were considered statistically significant. RESULTS: A total of 41% of 1435 patients were detected to be infected with H. pylori by bacteriological culture in 2005-2007 period, meanwhile 32.7% from 220 patients were also infected in 2015-2017 period. The clinical isolates of H. pylori are mostly susceptible to amoxicillin and tetracycline (both over 98% of strains), but less susceptible to levofloxacin in both periods analysed (over 79% of the strains). On the other hand, metronidazole continuous showing the highest score of resistant isolates (over 40% of resistant strains), although an 18% fewer resistant strains were observed in 2015-2017 period. Clarithromycin, the key antibiotic in eradication therapies, has an increased frequency of resistant strain isolated in the decade (22.5% in 2005-2007 and 29.2% in 2015-2017). Multidrug resistant strains (two, three and four antibiotics) were also detected in both periods with the highest scores for simultaneous resistance to clarithromycin-metronidazole (18%) and clarithromycin-metronidazole-levofloxacin (12.5%) resistant strains. According to gender, the isolates resistant to amoxicillin, clarithromycin and metronidazole were more frequent in female, with a specific increment in amoxicillin and clarithromycin resistance. CONCLUSION: The frequency of clarithromycin resistance (29.2%) detected in 2015-2017 suggests that conventional triple therapy is no longer effective in this region.

Vigilância da resistência a antibióticos contra o Helicobacter pylori na região do Biobío (Chile) em uma década / Antibiotic resistance surveillance of helicobacter pylori at the biobío region (chile) in a decade

ABSTRACT BACKGROUND: Helicobacter pylori infection in Chile remains as a public and private health-care system's challenge, with a prevalence of the infection over 70%. Nowadays, antibiotic treatment of the infection is mandatory to prevent the arising of severe associated diseases but failures in the eradication therapy mainly due to clarithromycin resistance has been observed worldwide and first line eradication therapy seems to be not effective anymore in several geographical areas. Thus, health-care systems are committed to maintain an epidemiological surveillance upon the evolution of the antibiotic resistance of this priority 2 pathogen. OBJECTIVE: This work reports a 10 years surveillance of the primary antibiotic resistance of H. pylori clinical isolates at the Biobío region-Chile, and the evolution of resistance toward amoxicillin, clarithromycin, levofloxacin, metronidazole, and tetracycline among the species. METHODS: H. pylori strains were investigated during the periods 2005-2007 (1435 patients analysed) and 2015-2017 (220 patients analysed) by inoculating a saline homogenate biopsy onto the surface of Columbia agar (Oxoid, Basingstoke, UK) - supplemented with 7% horse red blood cells plus DENT inhibitor (Oxoid, Basingstoke, UK) - following by incubation at 37ºC under 10% CO2 atmosphere for five days. Antibiotic resistance pattern of the isolates was assessed using the disk diffusion test in Müeller-Hinton agar supplemented with 7% horse red blood cells followed by incubation for further three days under 10% CO2 atmosphere. Statistical analysis was done using the SPSS v22 software and P values <0.05 were considered statistically significant. RESULTS: A total of 41% of 1435 patients were detected to be infected with H. pylori by bacteriological culture in 2005-2007 period, meanwhile 32.7% from 220 patients were also infected in 2015-2017 period. The clinical isolates of H. pylori are mostly susceptible to amoxicillin and tetracycline (both over 98% of strains), but less susceptible to levofloxacin in both periods analysed (over 79% of the strains). On the other hand, metronidazole continuous showing the highest score of resistant isolates (over 40% of resistant strains), although an 18% fewer resistant strains were observed in 2015-2017 period. Clarithromycin, the key antibiotic in eradication therapies, has an increased frequency of resistant strain isolated in the decade (22.5% in 2005-2007 and 29.2% in 2015-2017). Multidrug resistant strains (two, three and four antibiotics) were also detected in both periods with the highest scores for simultaneous resistance to clarithromycin-metronidazole (18%) and clarithromycin-metronidazole-levofloxacin (12.5%) resistant strains. According to gender, the isolates resistant to amoxicillin, clarithromycin and metronidazole were more frequent in female, with a specific increment in amoxicillin and clarithromycin resistance. CONCLUSION: The frequency of clarithromycin resistance (29.2%) detected in 2015-2017 suggests that conventional triple therapy is no longer effective in this region.

RESUMO CONTEXTO: A infecção por Helicobacter pylori no Chile permanece como um desafio do sistema de saúde público e privado, com prevalência da infecção acima de 70%. Hoje em dia, o tratamento antibiótico da infecção é obrigatório para prevenir o surgimento de graves doenças associadas, mas falhas na terapia de erradicação, principalmente devido à resistência à claritromicina, têm sido observadas em todo o mundo, e a terapia de erradicação de primeira linha parece não ser mais eficaz em várias áreas geográficas. Assim, os sistemas de saúde estão comprometidos em manter uma vigilância epidemiológica sobre a evolução da resistência aos antibióticos deste patógeno prioritário tipo 2. OBJETIVO: Este trabalho relata uma vigilância de 10 anos da resistência antibiótica primária de isolados clínicos de H. pylori na região do Biobío-Chile, e a evolução da resistência em relação à amoxicilina, claritromicina, levofloxacina, metronidazol e tetraciclina entre as espécies. MÉTODOS: As cepas de H. pylori foram investigadas durante os períodos 2005-2007 (1435 pacientes analisados) e 2015-2017 (220 pacientes analisados) inoculando uma biópsia de homogeneizado fisiológico na superfície do agar Columbia (Oxoid, Basingstoke, Reino Unido) - suplementado com 7% de glóbulos vermelhos do cavalo mais o inibidor de DENTE (Oxoid, Basingstoke, Reino Unido) - seguindo pela incubação em 37ºC a atmosfera de 10% de CO2 por cinco dias. O padrão de resistência aos antibióticos dos isolados foi avaliado utilizando-se o teste de difusão em disco em agar Müeller-Hinton suplementado com 7% de glóbulos vermelhos de cavalo seguidos de incubação por mais três dias a atmosfera de 10% de CO2. A análise estatística foi realizada utilizando-se o software SPSS V22 e os valores de P<0,5 foram considerados estatisticamente significantes. RESULTADOS: Um total de 41% dos 1435 pacientes foram detectados como contaminados por H. pylori pela cultura bacteriológica no período 2005-2007, ao mesmo tempo 32,7% de 220 pacientes foram contaminados igualmente no período 2015-2017. Os isolados clínicos de H. pylori são principalmente suscetíveis à amoxicilina e tetraciclina (tanto mais de 98% das cepas), mas menos suscetíveis à levofloxacina em ambos os períodos analisados (mais de 79% das cepas). Por outro lado, o metronidazol permaneceu mostrando a maior pontuação de resistentes isolados (mais de 40% de cepas resistentes), embora tenham sido observados 18% menos cepas resistentes no período de 2015-2017. A claritromicina, o antibiótico-chave em terapias de erradicação, tem uma frequência aumentada de cepa resistente isolada na década (22,5% em 2005-2007 e 29,2% em 2015-2017). Cepas multirresistentes (dois, três e quatro antibióticos) também foram detectadas em ambos os períodos com os maiores escores de resistência simultânea à claritromicina-metronidazol (18%) e claritromicina-metronidazol-levofloxacina (12,5%) cepas resistentes. De acordo com o sexo, os isolados resistentes à amoxicilina, claritromicina e metronidazol foram mais frequentes no sexo feminino, com incremento específico em amoxicilina e resistência à claritromicina. CONCLUSÃO: A frequência de resistência à claritromicina (29,2%) detectada em 2015-2017 sugere que a terapia tripla convencional não é mais efetiva nesta região.

Dynamics of Helicobacter pylori infection in infants during the first six months of life. / Dinámica de la infección por Helicobacter pylori en lactantes durante los primeros 6 meses de vida.

INTRODUCTION: Mainly due to the high percentage of infection and the ineffectiveness of treatments, Helicobacter pylori is a global health problem. Knowing the age at acquisition is key to preventing the infection. PATIENTS: Sixty-seven mothers and their respective children participated. To evaluate the presence of H. pylori, the faeces of the mother and her child were analysed using the HpSA antigen test. RESULTS: 71.6% (48/67) of pregnant mothers were positive for H. pylori at the term of their pregnancy. In newborns, 8.96% (6/67) of them showed H. pylori colonisation/persistent infection. During the first month of life, a prevalence and incidence of infection of 23.9% and 13%, respectively, was observed. CONCLUSION: Overall, the results suggest that there is a high risk of H. pylori infection during the first month of life, even of the persistent type.

Estado actual de la ablación de la fibrilación auricular / Current status on atrial fibrillation ablation

La fibrilación auricular es la arritmia más común en la práctica clínica. La ablación se considera el tratamiento de elección (indicación clase I) en los pacientes sintomáticos con recurrencias a pesar del tratamiento con fármacos antiarrítmicos. El presente artículo revisa tanto los mecanismos propuestos de esta arritmia como las diferentes metodologías de ablación con catéter y sus indicaciones.

Summary Atrial fibrillation is the most common arrhythmia in clinical practice. Catheter ablation is the treatment of choice (Class I indication) for symptomatic patients with recurrences despite antiarrhythmic drugs. The present article reviews the proposed mechanisms of this arrhythmia and the different ablation methods and indications.

La ablación de fibrilación auricular en España

Introducción: la ablación de la fibrilación auricular es uno de los procedimientos más frecuentemente realizados en las unidades de arritmias. La información de los resultados proviene de estudios prospectivos, registros multicéntricos y registros nacionales. Objetivo: evaluar la situación de la ablación de la fibrilación auricular en España a través de los datos recogidos en el Registro Español de Ablación, auspiciado por la Sección de Electrofisiología y Arritmias de la Sociedad Española de Cardiología. Métodos: los datos analizados provienen de los formularios remitidos, de forma voluntaria y anónima, por los diferentes centros hospitalarios, tanto de financiación pública como privada, durante el período 2008-2013. Cada centro fue analizado, año a año, de forma independiente. Analizamos los recursos humanos y materiales de los centros que realizaron procedimientos de ablación de fibrilación auricular durante ese período de tiempo. Asimismo, analizamos la técnica utilizada, el tipo de energía, complicaciones, etcétera. Comparamos todas las variables de forma evolutiva, año a año. Dividimos a los centros en función del número de procedimientos de ablación realizados cada año: 1-49, grupo A; 50-99, grupo B, y 100 o más, grupo C. Resultados: trescientos noventa y un centros (n=391) y 8.926 procedimientos de ablación fueron analizados. Año a año ha aumentado el número de centros que realizan ablación de fibrilación auricular y el número de procedimientos que realiza cada centro. El porcentaje de complicaciones se ha mantenido estable reduciéndose ligeramente la mortalidad. Los centros con mayor volumen tienen mayor dotación de recursos humanos y materiales. Realizan ablación de fibrilación auricular persistente con mayor frecuencia y realizan crioablación con menor frecuencia. Asimismo, estos centros tienen una menor incidencia de complicaciones. Conclusiones: la ablación de fibrilación auricular en España ha aumentado en los últimos años y presenta resultados similares a los recogidos en otros registros nacionales y multinacionales.

Embolic stroke secondary to spontaneous thrombosis of unruptured intracranial aneurysm: Report of three cases.

Intracranial aneurysms uncommonly present with ischemic stroke. Parent artery occlusion due to local extension of the luminal thrombus, aneurysms ejecting emboli to distal arteries, or increased mass effect have been described as possible pathogenic mechanisms. Guidelines for the management of these patients are absent. We present the clinical outcome and radiological characteristics of three patients with spontaneous thrombosis of intracranial aneurysms as a cause of ischemic stroke. This information is relevant given the possible benign history in terms of stroke recurrence and risk of bleeding.

Time to recanalisation in patients with cerebral venous thrombosis under anticoagulation therapy.

BACKGROUND AND PURPOSE: Few studies have investigated the rates of recanalisation after cerebral venous thrombosis (CVT). Our objective was to investigate the recanalisation rate and to identify predictors of recanalisation in patients with CVT. METHODS: We included 102 patients with confirmed first-ever, non-septic CVT. All patients received anticoagulation for 12 months or until complete recanalisation. To assess recanalisation, patients underwent MR venography every 3 months until partial or complete recanalisation or for 12 months after diagnosis. We conducted two parallel analyses of complete recanalisation versus partial and no recanalisation versus any recanalisation. As a secondary objective we explored the influence of recanalisation on outcome and recurrent events. We calculated the probability of recanalisation using Kaplan-Meier analysis and conducted multivariate analysis using a Cox model. RESULTS: The mean age of patients was 33.5±11 years (80 (78.4%) women). Survival analysis indicated that 50% of the patients had any recanalisation (grades I, II and III) by 64 days and complete recanalisation (grade III) by 169 days. Adjusted Cox proportional model revealed that age <50 years (HR=11.5 95% CI=1.58 to 84.46, p=0.01) and isolated superior sagittal sinus thrombosis (HR=0.39, 95% CI=0.14 to 1.04, p=0.05) predict complete recanalisation, while age <50 years (HR=4.79; 95% CI=1.69 to 13.5, p=0.003) predicts any recanalisation. Patients with complete recanalisation had a greater chance of good functional outcome (HR=5.17; 95% CI=2.8 to 9.53, p<0.001). CONCLUSIONS: We found that recanalisation occurs over time, until month 11. Complete recanalisation may influence functional outcome.

La discapacidad en niños hasta los seis años de edad del municipio Majibacoa / The discapacity in children up to 6 years in Majibacoa municipality

La discapacidad infantil constituye un gran problema de salud a nivel mundial; conocer sus características permite mejorar su asistencia. Se realizó un estudio descriptivo de corte transversal, en una muestra de 84 niños diagnosticados con discapacidad transitoria y/o permanente, con el objetivo de caracterizar la discapacidad en niños hasta seis años de edad en el municipio de Majibacoa. Se aplicó un cuestionario a los padres y se realizó un examen físico detallado a los niños, la discapacidad fue definida mediante la clasificación internacional de las funciones, tomando para el estudio las funciones corporales. El mayor por ciento ocurrió en el momento del nacimiento, encontrándose una superior incidencia en el grupo de los menores de un año, la diferencia de sexo no fue significativa. Los factores de riesgo en la etapa perinatal se encontraron como los de mayor repercusión. Las discapacidades físico-motoras fueron las más frecuentes, presentándose el retardo en el desarrollo psicomotor como la mayor limitación. Gran parte de la muestra procedió de la zona rural, de la cual un número considerable no asistió a los servicios de rehabilitación (AU)

Infant incapacity constitutes a great health problem all over the world, to know their characteristics constitutes a great advance for their medical attention. A descriptive study was carried out, a transversal cut in a sample of 84 diagnosed children with transitory and/or permanent discapacity was performed with the objective of characterizing the discapacity in children up to 6 years in Majibacoa municipality. A questionary and physical examination was carefully explained, the discapacity was defined through the international classification of the functions taking for the study the corporal functions. The greatest percentage occurred at birth moment, finding a great incidence in the group of children under one year of birth, the difference of sex was not significant. The risk factors during the perinatal period were considered of great repercussion. The physicho-motor discapacities wene the most frequent presented in the retarded phisichomotor development as the major limitation, a great part of the sample comes from rural areas from which a considerable number of patients did not come to rehabilitation facilities (AU)

What is behind radiofrequency delivery at the cavo-tricuspid isthmus?

Catheter-based ablation of isthmus-dependent common atrial flutter results in very high success rates and almost no complications. However, bidirectional conduction block through the isthmus may be challenging in a small percentage of patients regarding the use of high power and high temperature settings during radiofrequency delivery. Anatomical and physiological circumstances may be the reason for such difficulties to achieve bidirectional block at the cavo-tricuspid isthmus. However, in the present case we show edema formation after multiple shots of radiofrequency delivery at the cavo-tricuspid isthmus, which complicates the achievement of bidirectional conduction block.

What is behind radiofrequency delivery at the cavo-tricuspid isthmus? / ¿Qué sucede en el istmo cavo-tricuspídeo durante la ablación con radiofrecuencia?

Catheter-based ablation of isthmus-dependent common atrial flutter results in very high success rates and almost no complications. However, bidirectional conduction block through the isthmus may be challenging in a small percentage of patients regarding the use of high power and high temperature settings during radiofrequency delivery. Anatomical and physiological circumstances may be the reason for such difficulties to achieve bidirectional block at the cavo-tricuspid isthmus. However, in the present case we show edema formation after multiple shots of radiofrequency delivery at the cavo-tricuspid isthmus, which complicates the achievement of bidirectional conduction block.

La ablación con catéter del flutter de tipo común dependiente del istmo es un procedimiento con elevada tasa de éxito y rara vez complicaciones. Sin embargo, en un pequeño porcentaje de casos puede resultar complicado conseguir el objetivo de bloquear bidireccionalmente el istmo durante el procedimiento de ablación a pesar de incrementar la potencia y temperatura del catéter de radiofrecuencia. Las características anatómicas y fisiológicas del istmo cavo-tricuspídeo pueden ocasionar dificultades en la consecución del bloqueo bidireccional. Sin embargo, en el presente caso mostramos cómo la propia aplicación de radiofrecuencia puede ocasionar edema importante tras múltiples aplicaciones con las consiguientes dificultades para conseguir el bloqueo bidireccional del istmo.