[Prognostic index in wound infection and abdominal sepsis]. / Indice pronóstico en infección de heridas y sepsis abdominal.

OBJECTIVE: To establish an abdominal surgical infection prognostic index with all risk factors. SUMMARY BACKGROUND DATA: Individuals, requiring abdominal surgery have an established surgical infection risk of 1% and this risk increases with several factors, such as age over 50 years, (4%), diabetes mellitus (12%), obesity (8%), hospitalization up to 10 days (4%), bad nutrition (2%), surgical time up to 3 h (6%) summer (4%) shock (6%) immunosuppression (6%), contaminated surgery (from 1%-40%), or emergency surgery (4%). METHOD: We reviewed 199 patients and investigated previous disease, total white blood cells, oxygen saturation, albumin, body weight, type of surgery performed in regard to contamination, surgical time, hospitalization time, preoperative hair removal previous to surgery, presence of emergency surgery, and prevalence of remote site infections at time of surgery. All these parameters were reviewed for 48 h before and after the surgical procedure and every risk factor acquired a number with respect to the established risk in the world literature. An index called Prognostic index of surgical infections (PISI) was performed, made up of the addition of risk factors. Every patient was observed 10 days after the surgical procedure searching for abdominal or wound infection and correlating the index with the presence of surgical infection. RESULTS: Patients with a prognostic index of 12 or less did not show infections in any case; those with an index of 13 to 15 points had 30% of risk infection, 16 to 18 obtained 70%, 19 to 21 acquired 90%, and 22 or more obtained 100% of surgical risk infection. Sensitivity was 100% and specificity, nearby 75%. CONCLUSIONS: PISI is a reliable indicator of surgical infection risk because it takes into account all factors that cause troubles in the patients, and has high sensitivity and very good specificity.

Transient increase in rab 3A and synaptobrevin immunoreactivity after mild hypoxia in neonatal rats.

1. In the present work we describe the short term effects of mild neonatal hypoxia on the synapse as assessed by the immunoreactivity (IR) of two synaptic proteins: rab 3A and synaptobrevin (VAMP). 2. Using the sensitive methodology of immunoblotting, we measured rab 3A and VAMP-IR in homogenates from the cerebral cortex, hippocampus, and corpus striatum of control (breathing room air) and hypoxiated (breathing 95.5% N2-6.5% O2 for 70 min) 4-day-old rats at 1, 2, and 6 h after the end of the hypoxia. Immunostaining with examination by light microscopy was performed using the synaptic protein-specific antibodies on fixed brain sections from animals belonging to the same litter and submitted to hypoxia. 3. A transient increase of VAMP-IR was observed in the hippocampus and corpus striatum, and for rab 3A in the striatum, 1 h after initiating reoxygenation. At the following time points the values returned to control levels. This effect was less clearly observed in the immunostained sections. 4. Mild hypoxia has an effect on sensitive brain regions, eliciting an increase in the IR of at least two proteins involved in the synaptic vesicle cycle. The transient nature of this effect possibly indicates the activation of endogenous neuroprotective mechanisms.

[Assisted fertilization: meditations on the new legislation]. / Fertilización asistida: reflexiones frente a una nueva legislación.

We review philosophical and controversial aspects of assisted fertilization. This exercise is necessary considering the discussion of a bill in the Parliament that intends to regulate these technologies in our Country. We review the definition of life beginning and the cost-benefit problem of adoption as an alternative to assisted fertilization.

[Correlation between plasma progesterone and ultrasonographic detection of corpus luteum in ovulatory cycles]. / Correlacion entre progesterona plasmatica y deteccion ultrasonografica de cuerpo luteo en ciclos ovulatorios.

The ultrasound detection of corpus luteum in the midluteal phase of ovulatory cycles was associated with significantly higher levels of plasma progesterone, opposed to those patients where a corpus luteum could not be identified. The hormone level was directly proportional no the number of corpora lutea seen. However, only 33.3% o patients with no corpus luteum visible were found to have suboptimal plasma progesterone levels (< 10 ng/ml).

[The rupture of a hepatic subcapsular hematoma during pregnancy: a report of 2 cases]. / Ruptura de hematoma subcapsular hepático durante el embarazo: reporte de dos casos.

Two clinical cases of spontaneous rupture of subcapsular hepatic hematomas in two hypertensive pregnant patients are described. They were successfully treated with conservative surgery.