ABSTRACT
Coronavirus outbreaks are likely to occur in crowded and congregate indoor spaces, and their effects are most severe in vulnerable long term care facilities (LTCFs) residents. Public health officers benefit from tools that allow them to control COVID-19 outbreaks in vulnerable settings such as LTCFs, but which could be translated in the future to control other known and future virus outbreaks. This study aims to develop and test a methodology based on detection of SARS-CoV-2 in aerosol samples collected with personal pumps that could be easily implemented by public health officers. The proposed methodology was used to investigate the levels of SARS-CoV-2 in aerosol in indoor settings, mainly focusing on LTCFs, suffering COVID-19 outbreaks, or in the presence of known COVID-19 cases, and targeting the initial days after diagnosis. Aerosol samples (N = 18) were collected between November 2020 and March 2022 in Castelló (Spain) from LTCFs, merchant ships and a private home with recently infected COVID-19 cases. Sampling was performed for 24-h, onto 47 mm polytetrafluoroethylene (PTFE) and quartz filters, connected to personal pumps at 2 and 4 L/min respectively. RNA from filters was extracted and SARS-CoV-2 was determined by detection of regions N1 and N2 of the nucleocapsid gene alongside the E gene using RT-PCR technique. SARS-CoV-2 genetic material was detected in 87.5% samples. Concentrations ranged ND-19,525 gc/m3 (gene E). No genetic traces were detected in rooms from contacts that were isolated as a preventative measure. Very high levels were also measured at locations with poor ventilation. Aerosol measurement conducted with the proposed methodology provided useful information to public health officers and contributed to manage and control 12 different COVID-19 outbreaks. SARS-CoV-2 was detected in aerosol samples collected during outbreaks in congregate spaces. Indoor aerosol sampling is a useful tool in the early detection and management of COVID-19 outbreaks and supports epidemiological investigations.
Subject(s)
COVID-19 , SARS-CoV-2 , Humans , COVID-19/epidemiology , Long-Term Care , Respiratory Aerosols and Droplets , Disease OutbreaksABSTRACT
Consumption of high-fat diets (HFD) has been associated with neuronal plasticity deficits and cognitive disorders linked to the alteration of glutamatergic disorders in the hippocampus. As young individuals are especially vulnerable to the effects of nutrients and xenobiotics on cognition, we studied the effect of chronic consumption of saturated (SOLF) and unsaturated oil-enriched foods (UOLF) on: i) spatial memory; ii) hippocampal synaptic transmission and plasticity; and iii) gene expression of glutamatergic receptors and hormone receptors in the hippocampus of adolescent and adult mice. Our results show that both SOLF and UOLF impair spatial short-term memory. Accordingly, hippocampal synaptic plasticity mechanisms underlying memory, and gene expression of NMDA receptor subunits are modulated by both diets. On the other hand, PPARγ gene expression is specifically down-regulated in adolescent SOLF individuals and up-regulated in adult UOLF mice.
Subject(s)
Diet, High-Fat , Hippocampus , Receptors, N-Methyl-D-Aspartate , Animals , Diet, High-Fat/adverse effects , Fats, Unsaturated/adverse effects , Fatty Acids/adverse effects , Hippocampus/metabolism , Hippocampus/physiopathology , Mice , Neuronal Plasticity/physiology , Receptors, N-Methyl-D-Aspartate/metabolismABSTRACT
Puede ser necesaria una reflexión sobre cuál es el mejor abordaje para las enfermedades agudas concomitantes que pueden desarrollar los pacientes críticos con COVID-19. Estos requieren una sospecha diagnóstica y un tratamiento precoz, basados en el trabajo de equipos multidisciplinares. Presentamos dos casos de enfermedades concomitantes en pacientes con COVID-19. Un paciente diagnosticado de COVID-19 con buena evolución respiratoria que tras extubación presentó una colecistitis acalculosa y un paciente con neumonía por COVID-19 que presentó una sobreinfección con neumonía necrotizante, cuyo primer síntoma fue hemoptisis y fue finalmente tratado con embolización arterial por radiología intervencionista
It may be necessary a consideration about the best approach to the acute concomitant problems that critical COVID-19 patients can develop. They require a rapid diagnosis and an early treatment by a multidisciplinary team. As a result, we would like to describe two clinical cases a patient with diagnosis of COVID-19 pneumonia with good respiratory evolution that, after extubation suffered an acalculous cholecystitis and a patient with COVID-19 pneumonia that suffered an overinfection with necrotising pneumonia that presented with haemoptysis and was finally treated with arterial embolisation by the interventional radiologist's team
Subject(s)
Humans , Male , Middle Aged , Aged , Coronavirus Infections/complications , Pneumonia, Viral/complications , Pandemics , Acalculous Cholecystitis/complications , Pneumonia, Necrotizing/complications , Tomography, X-Ray Computed , Acalculous Cholecystitis/diagnostic imaging , Pneumonia, Necrotizing/diagnostic imagingABSTRACT
It may be necessary a consideration about the best approach to the acute concomitant problems that critical COVID-19 patients can develop. They require a rapid diagnosis and an early treatment by a multidisciplinary team. As a result, we would like to describe two clinical cases a patient with diagnosis of COVID-19 pneumonia with good respiratory evolution that, after extubation suffered an acalculous cholecystitis and a patient with COVID-19 pneumonia that suffered an overinfection with necrotising pneumonia that presented with haemoptysis and was finally treated with arterial embolisation by the interventional radiologist's team.
Subject(s)
COVID-19/complications , Cholecystitis/etiology , Pneumonia, Necrotizing/etiology , Aged , Critical Illness , Humans , Male , Middle AgedABSTRACT
OBJECTIVE: Staphylococcus aureus is a particularly difficult pathogen to eradicate from the respiratory tract. Previous studies have highlighted the intracellular capacity of S.aureus in several phagocytic and non-phagocytic cells. The aim of this study was to define S.aureus interaction within a murine alveolar macrophage cell line. METHODS: Cell line MH-S was infected with Newman strain. Molecular mechanisms involved in phagocytosis were explored. To assess whether S.aureus survives intracellularly quantitative (gentamicin protection assays and bacterial plating) and qualitative analysis (immunofluorescence microscopy) were performed. Bacterial colocalization with different markers of the endocytic pathway was examined to characterize its intracellular trafficking. RESULTS: We found that S.aureus uptake requires host actin polymerization, microtubule assembly and activation of phosphatidylinositol 3-kinase signaling. Time course experiments showed that Newman strain was able to persist within macrophages at least until 28.5 h post infection. We observed that intracellular bacteria are located inside an acidic subcellular compartment, which co-localizes with the late endosome/lysosome markers Lamp-1, Rab7 and RILP. Colocalization counts with TMR-dextran might reflect a balance between bacterial killing and intracellular survival. CONCLUSIONS: This study indicates that S.aureus persists and replicates inside murine alveolar macrophages, representing a privileged niche that can potentially offer protection from antimicrobial activity and immunological host defense mechanisms.
Subject(s)
Macrophages, Alveolar/microbiology , Staphylococcal Infections/microbiology , Staphylococcus aureus/physiology , Animals , Cell Line , Macrophages, Alveolar/immunology , Mice , Microbial Viability , Phagocytosis , Staphylococcal Infections/immunology , Staphylococcus aureus/genetics , Staphylococcus aureus/growth & developmentABSTRACT
Arsenic is a toxic element that affects human health and is widely distributed in the environment. In the area of study, the main Spanish and second largest European industrial ceramic cluster, the main source of arsenic aerosol is related to the impurities in some boracic minerals used in the ceramic process. Epidemiological studies on cancer occurrence in Spain points out the study region as one with the greater risk of cancer. Concentrations of particulate matter and arsenic content in PM10 and PM2.5 were measured and characterized by ICP-MS in the area of study during the years 2005-2010. Concentrations of PM10 and its arsenic content range from 27 to 46 µg/m(3) and from 0.7 to 6 ng/m(3) in the industrial area, respectively, and from 25 to 40 µg/m(3) and from 0.7 to 2.8 ng/m(3) in the urban area, respectively. Concentrations of PM2.5 and its arsenic content range from 12 to 14 µg/m(3) and from 0.5 to 1.4 ng/m(3) in the urban background area, respectively. Most of the arsenic content is present in the fine fraction, with ratios of PM2.5/PM10 in the range of 0.65-0.87. PM10, PM2.5, and its arsenic content show a sharp decrease in recent years associated with the economic downturn, which severely hit the production of ceramic materials in the area under study. The sharp production decrease due to the economic crisis combined with several technological improvements in recent years such as substitution of boron, which contains As impurities as raw material, have reduced the concentrations of PM10, PM2.5, and As in air to an extent that currently meets the existing European regulations.
Subject(s)
Air Pollutants/analysis , Arsenic/analysis , Environmental Monitoring , Particulate Matter/analysis , Aerosols/analysis , Air Pollution/statistics & numerical data , Humans , Industry , Particle Size , SpainABSTRACT
BACKGROUND: Portal vein ligation (PVL) or embolization (PVE) are standard approaches to induce liver hypertrophy of the future liver remnant (FLR) prior to hepatectomy in primarily non-resectable liver tumors. However, this approach fails in about one third of patients. Recently, the new "ALPPS" approach has been described that combines PVL with parenchymal transection to induce rapid liver hypertrophy. This series explores whether isolated parenchymal transection boosts liver hypertrophy in scenarios of failed PVL/PVE. METHODS: A multicenter database with 170 patients undergoing portal vein manipulation to increase the size of the FLR was screened for patients undergoing isolated parenchymal transection as a salvage procedure. Three patients who underwent PVL/PVE with subsequent insufficient volume gain and subsequently underwent parenchymal liver transection as a salvage procedure were identified. Patient characteristics, volume increase, postoperative complications and outcomes were analyzed. RESULTS: The first patient underwent liver transection 16 weeks after failed PVL with a standardized FLR (sFLR) of 30%, which increased to 47% in 7 days. The second patient showed a sFLR of 25% 28 weeks after PVL and subsequent PVE of segment IV, which increased to 41% in 7 days after transection. The third patient underwent liver partition 8 weeks after PVE with a sFLR of 19%, which increased to 37% in six days. All patients underwent a R0 resection. CONCLUSION: Failed PVE or PVL appears to represent a good indication for the isolated parenchymal liver transection according to the newly developed ALPPS approach.
Subject(s)
Hepatectomy/methods , Liver Neoplasms/pathology , Liver Neoplasms/surgery , Liver Regeneration , Liver/surgery , Organ Size , Portal Vein , Salvage Therapy/methods , Adult , Aged , Female , Hepatectomy/adverse effects , Humans , Ligation , Liver/pathology , Male , Middle Aged , Portal Vein/surgery , Treatment OutcomeABSTRACT
A pesar de los avances en la cirugía del trasplante renal, las complicaciones quirúrgicas continúan siendo una importante causa de morbilidad durante el periodo postrasplante inmediato. El objetivo de este estudio es analizar la incidencia, diagnóstico y tratamiento de dichas complicaciones en población pediátrica sometida a un trasplante renal y comparar los resultados con los de otras series descritas en la literatura. Revisamos de forma retrospectiva los trasplantes renales realizados en nuestro centro en pacientes menores de 18 años en los últimos 10 años. Analizamos el diagnóstico, cronología, tratamiento y evolución de las complicaciones quirúrgicas durante el primer mes postrasplante. En 120 trasplantes revisados se produjeron 35 complicaciones quirúrgicas en 27 pacientes (22,5%). Como consecuencia de estas perdieron el injerto 9 pacientes (7,5%) con una mortalidad asociada nula. La incidencia de complicaciones vasculares y urológicas fue de 8,3$ y 6,6% respectivamente. Entre estas destacan por su morbilidad asociada la trombosis del injerto (4,1%), la estenosis de la arterial renal (1,6%), el pseudoaneurisma arterial (0,8%) y la fístula urinaria (5,0%). Los resultados obtenidos en nuestra serie muestran una incidenica de complicaciones quirúrgicas, pronóstico y supervivencia del injerto asociada a las mismas similares a los publicados en otras series de pacientes pediátricos. El trasplante renal pediátrico presenta una tasa de complicaciones quirúrgicas equiparables al realizado en población adulta, siendo una opción terapéutica segura y eficaz (AU)
Despite advances in renal transplantation surgery, surgical complications still remain an important cause of morbidity in the early postransplant period. The objective of this study is to describe incidence, diagnosis and treatment of these complications in pediatric transplanted population and compare our results to published data. A retrospective review of pediatric transplantations (younger than 18 years old) performed in our institution during the last ten years was designed. We analysed diagnosis, chronology, treatment and prognosis of surgical complications during the first postransplant month. Among 120 transplantations reviewed, 35 surgical complications were described in 27 patients (22,5%). Nine patients (7,5%) lost their graft due these complications, although there was no patient associated mortality. Incidence of vascular and urological complications was 8,3% and 6,6% respectively. The higher morbidity was associated with thrombosis of the allograft (4,1%), renal artery stenosis (1,6%), arterial pseudoaneurysm (0,8%) and urinary leakage (5.0%). Our results show an incidence of surgical complications, prognosis and graft survival related to the complications similar to published data in other series of pediatric patients. Pediatric renal transplantation is a safe and effective therapeutic modality, with an associated surgical complications rate similar to that described in adult transplanted population (AU)
Subject(s)
Humans , Male , Female , Child , Kidney Transplantation , Renal Insufficiency, Chronic/surgery , Transplantation Tolerance/physiology , Graft Rejection/epidemiology , Tissue Survival/physiology , Risk Factors , Postoperative Complications/epidemiologyABSTRACT
Objetivos: Determinar la densidad de incidencia, etiología y factores de riesgo de la infección de orina nosocomial (ITUn) en una UCIP de segundo nivel. Diseño: Estudio prospectivo descriptivo durante un periodo de 1 año que incluyó a 104 pacientes ingresados durante más de 48 h en nuestra UCIP. Se recogieron urocultivos diarios a los pacientes con sonda vesical hasta su retirada y cada 48 h a los no sondados hasta el alta. Ámbito: Unidad de cuidados intensivos pediátricos de segundo nivel. Pacientes: Se incluyó a todos los pacientes que ingresaron por más de 48 h en el año 2009. Se excluyó a los menores de 15 días y a los que presentaban una infección de orina o pielonefritisal ingreso o antes de las 48 h tras su ingreso. Resultados: Seis pacientes presentaron una ITUn (el 5,8% de los ingresos), con una densidad de incidencia de 5/1.000 pacientes/día y de 12,19/1.000 días de sonda. Se identificaron 4casos por Escherichia coli (uno, multirresistente) y 2 por Candida albicans. Los niños con ITUn tuvieron significativamente más antecedentes personales y mayor estancia que los niños sin infección y, aunque sin significación estadística, menor edad y mayor número de días con sonda. Conclusiones: Nuestra densidad de incidencia de infección de orina asociada a dispositivo es superior a la publicada; esto puede deberse, entre otras causas, a las características de los pacientes atendidos y al método exhaustivo empleado para su detección (AU)
Objective: To determine the incidence, etiology and risk factors of nosocomial urinary tractinfections (nUTI) in a second level Pediatric Intensive Care Unit (PICU).Patients and methods: A prospective study of 104 patients admitted to the PICU with a length of stay of more than 48 hours was carried out over a one year period (January to December2009) to study the incidence and risk factors of nUTI. Urine samples were collected and cultured in all patients admitted for more than 48 hours to our PICU. Those needing indwelling urinary catheters had urine samples collected upon admission and every 24 hours until catheterretrieval, while those who did not need catheters had samples collected upon admission and every 48 hours until discharge from the PICU. Results: Six patients (5.8% of those admitted) were diagnosed of nUTI, with an incidence density of 5/1000 patients/day and 12.2/1000 catheterization days. Four of these were caused byE. coli (including a multiresistant strain), and two by C. albicans. Patients suffering nUTIs had significantly more relevant medical antecedents and a longer period of admittance than patients without nUTI. A statistically non significant tendency towards increased infection risk was also found in younger patients and in those who needed an indwelling catheter for longer periods. Conclusions: We found a higher incidence density of catheter associated nUTI than in other reports. This at least partially could be due to the characteristics of our patients, and to the exhaustive methodology used for detection (AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Cross Infection , Urinary Tract Infections , Intensive Care Units, Pediatric , Urinary Tract Infections/epidemiology , Urinary Tract Infections/etiology , Cross Infection/epidemiology , Cross Infection/etiology , Prospective Studies , Critical Illness , Risk FactorsABSTRACT
OBJECTIVE: To determine the incidence, etiology and risk factors of nosocomial urinary tract infections (nUTI) in a second level Pediatric Intensive Care Unit (PICU). PATIENTS AND METHODS: A prospective study of 104 patients admitted to the PICU with a length of stay of more than 48 hours was carried out over a one year period (January to December 2009) to study the incidence and risk factors of nUTI. Urine samples were collected and cultured in all patients admitted for more than 48 hours to our PICU. Those needing indwelling urinary catheters had urine samples collected upon admission and every 24 hours until catheter retrieval, while those who did not need catheters had samples collected upon admission and every 48 hours until discharge from the PICU. RESULTS: Six patients (5.8% of those admitted) were diagnosed of nUTI, with an incidence density of 5/1000 patients/day and 12.2/1000 catheterization days. Four of these were caused by E. coli (including a multiresistant strain), and two by C. albicans. Patients suffering nUTIs had significantly more relevant medical antecedents and a longer period of admittance than patients without nUTI. A statistically nonsignificant tendency towards increased infection risk was also found in younger patients and in those who needed an indwelling catheter for longer periods. CONCLUSIONS: We found a higher incidence density of catheter associated nUTI than in other reports. This at least partially could be due to the characteristics of our patients, and to the exhaustive methodology used for detection.
Subject(s)
Cross Infection , Urinary Tract Infections , Adolescent , Child , Child, Preschool , Critical Illness , Cross Infection/epidemiology , Cross Infection/etiology , Female , Humans , Infant , Infant, Newborn , Intensive Care Units, Pediatric , Male , Prospective Studies , Risk Factors , Urinary Tract Infections/epidemiology , Urinary Tract Infections/etiologyABSTRACT
It has been suggested that hyperglycemia and insulin resistance triggered by energy-dense diets can account for hippocampal damage and deficits of cognitive behaviour. We wonder if the impairment of learning and memory processes detected in diet-induced obese (DIO) mice is linked to diet composition itself. With this purpose we have evaluated learning performance in mice undergoing a short-term high-fat (HF) treatment, which leads to a pre-obese state characterized by increased adiposity without significant changes of glucose and insulin plasma levels. C57BL/6J mice were fed either a HF (45 kcal% from fat) or control diet (10 kcal% from fat) during 8 weeks. Learning performance was evaluated by using the four-arm baited version of the eight-arm radial maze test (RAM). Mice were trained to learn the RAM protocol and then memory was tested at different time-points. Time spent to consume food placed in baited arms and errors committed to find them were measured in all sessions. DIO mice significantly spent more time in learning the task and made a greater number of errors than controls. Moreover, retention tests revealed that both working and total memory errors were also more numerous in DIO mice. The current results show that short-term DIO impairs spatial learning and suggest that impairment of hippocampal learning elicited by HF diets might be perceptible before metabolic alterations linked to obesity develop.
Subject(s)
Adiposity/physiology , Diet , Dietary Fats , Maze Learning/physiology , Obesity/physiopathology , Spatial Behavior/physiology , Analysis of Variance , Animals , Body Weight/physiology , Eating/physiology , Insulin/blood , Leptin/blood , Male , Mice , Radioimmunoassay , Space Perception/physiologyABSTRACT
BACKGROUND AND PURPOSE: Leptin regulates energy expenditure and body weight by acting both on the hypothalamus and on peripheral targets. Central actions of leptin are enhanced by cholecystokinin (CCK). The interaction between leptin and CCK makes physiological sense, as rats lacking CCK1 receptors are resistant to peripheral leptin but not to leptin directly infused into the brain. We have recently reported that CCK enhances leptin effects by increasing the entry of leptin into the CNS. The aim of this work was to further characterize the effect of CCK (10 microg kg(-1)) on leptin kinetics as well as the CCK receptor subtype involved in the interaction between CCK and leptin. EXPERIMENTAL APPROACH: Experiments were carried out both in free-feeding and in fasted rats receiving a single dose of leptin (100 microg kg(-1); i.p.). Parameters analysed over the next 6 h were plasma and cerebrospinal fluid concentrations of leptin. KEY RESULTS: We observed that CCK-8 depressed the increase in plasma leptin that followed the i.p. injection and simultaneously increased leptin concentration in the cerebrospinal fluid from 92+/-25 to 230+/-24 pg mL(-1) (P<0.05). The effect of CCK-8 was totally prevented by the CCK1 receptor antagonist, SR-27,897 (0.3 mg kg(-1), s.c.), but not by the CCK2 receptor antagonist, L-365,260 (1 mg kg(-1)). CONCLUSIONS AND IMPLICATIONS: These results show that CCK plays a role in regulating the access of leptin to the brain and suggest that CCK analogues, acting on CCK1 receptors, might be useful drugs in improving leptin actions within the brain.
Subject(s)
Blood-Brain Barrier/metabolism , Cell Membrane Permeability , Leptin/metabolism , Receptors, Cholecystokinin/metabolism , Sincalide/metabolism , Animals , Benzodiazepinones/pharmacology , Blood Glucose/metabolism , Blood-Brain Barrier/drug effects , Cell Membrane Permeability/drug effects , Eating , Indoleacetic Acids/pharmacology , Injections, Intraperitoneal , Insulin/blood , Kinetics , Leptin/administration & dosage , Leptin/blood , Leptin/cerebrospinal fluid , Male , Phenylurea Compounds/pharmacology , Rats , Rats, Sprague-Dawley , Receptors, Cholecystokinin/agonists , Recombinant Proteins/metabolism , Sincalide/administration & dosage , Thiazoles/pharmacologyABSTRACT
The aim of the present work is to compare the performance of the Radiello passive sampler versus UV-photometric ozone analyser to measure surface ozone in a Mediterranean Spanish coastal area. The comparison presented considers precision, bias, accuracy, selectivity, detection limit, cost and applicability. For assessing precision, co-located samplers were exposed in duplicate in two reference-sampling sites, beside UV-photometric ozone analyser. Bias was calculated comparing results of passive samplers exposed in three reference-sampling sites and two contrast-sampling sites with the measurements given by the reference analysers. Accuracy was calculated following the EN 482:1994 standard. The limit of detection was calculated as 3 times the standard deviation of the blanks in a batch of passive samplers. The compared Radiello passive samplers give a precision of 5.2%, a bias of 13.8%, an accuracy of 20.5% and a limit of detection of 12.6 microg m(-3). The selectivity and applicability of this methodology is in both aspects successful. Surface ozone levels measured with passive samplers were comparable with the averaged values measured with the reference analyser both in the reference-sampling sites and in the contrast-sampling sites.
Subject(s)
Environmental Monitoring/instrumentation , Environmental Monitoring/methods , Ozone/analysis , Spectrophotometry, Ultraviolet/instrumentation , Mediterranean Region , Sensitivity and Specificity , Spain , Spectrophotometry, Ultraviolet/methodsABSTRACT
O provável fator de início de tradução 5A (eIF5A) é uma proteína abundante e altamente conservada em todos os organismos eucarióticos observados e também está presente em arquebactérias. eIF5A é essencial para aviabilidade celular e esse fator é a única proteína descrita que contém o resíduo de aminoácido hipusina. Em Saccharomyces cerevisiae, eIF5A é expressa em condições aeróbicas pelo gene TIF51A. Apesar de eIF5A ser conhecida há quase 30 anos, a sua função biológica ainda é obscura. Este artigo revisa os estudos de caracterização funcional de eIF5A, evidenciando como esse fator foi envolvido com diferentes etapas do metabolismo de RNA mensageiro (mRNA), como o início de tradução, o transporte nucleocitoplasmático e o decaimento de RNA mensageiro. Ainda, estudos que evidenciaram o envolvimento de eIF5A com a proliferação celular e progressão no ciclo celular também foram abordados. Finalmente, esse artigo apresenta os resultados recentes dos experimentos que colocam eIF5A novamente no cenário da tradução. Novos experimentos serão necessários para definir o papel desempenhado por eIF5A na maquinaria de tradução.
Subject(s)
Protein Biosynthesis , Cell Proliferation , Cell SurvivalABSTRACT
Aneurysmal bone cysts are very rare in the calvaria. We are reporting a 23 year old white male with a very large right frontal aneurysmal bone cyst and a large follow-up period. The MRI findings--a multiloculated expansive tumor with fluid levels inside--are almost pathognomonic for this lesion. Radical surgery was curative for this patient.
Subject(s)
Bone Cysts, Aneurysmal/diagnosis , Frontal Bone/pathology , Skull Neoplasms/diagnosis , Adult , Bone Cysts, Aneurysmal/surgery , Frontal Bone/surgery , Humans , Magnetic Resonance Imaging , Male , Neoplasms, Second Primary/pathology , Neoplasms, Second Primary/surgery , Skull Neoplasms/surgeryABSTRACT
Desde finales de 1992 hemos venido realizando artrodesis intersomática lumbar, inicialmente añadiendo fusión posterolateral instrumentada con tornillos pediculares y, posteriormente artrodesis intersomática sola con cilindros de titanio y hueso autólogo. Queremos presentar nuestros resultados en un grupo de 52 pacientes con seguimiento que oscila desde los 4 años y medio hasta los seis meses. Para valorar los resultados hemos usado la, escala de Prolo (Prolo Functional Economic Outcome Rating Scale) obteniendo un alto porcentaje ( 92 por ciento ) de resultados satisfactorios. El porcentaje de fusión, aun considerando la dificultad de su valoración por el artefacto radiológico provocado por los cilindros, es igualmente muy elevada cercana al 100 por ciento ).Concluimos que la artrodesis intersomática con cilindros-es una-intervención- quirúrgica con la que se obtienen resultados muy favorables si se siguen unos criterios clínicos estrictos en su aplicación y una correcta técnica quirúrgica (AU)
Subject(s)
Adult , Male , Humans , Aged , Female , Middle Aged , Lumbar Vertebrae , Spinal Fusion , Follow-Up StudiesABSTRACT
OBJECTIVE: To determine the extent of Internet connectivity and use by GPs in the Lothian Health Board area and to investigate which Internet medical information resources GPs find most useful for work related purposes. DESIGN: Postal questionnaire. SETTING: General Practice. SUBJECTS: Postal questionnaires were sent to all GPs listed in the Lothian Health Primary Care mailing list. In total 546 questionnaires were sent to 126 practices during April/May 1999. RESULTS: At least one response was received from 86% of practices and overall 56% of questionnaires were returned. Ninety two percent of practices that responded indicated that an Internet connection was available with 86% reporting that access was restricted to one computer. Sixty seven percent of responding GPs indicated that they had used the Internet, with more time being spent using the Web than Email. Of the Internet users 54%, rated the Internet as useful or very useful for work related purposes. Accessibility and immediacy of access to information were among the most useful aspects of Internet use, with locating specific resources and lack of time being highlighted as commonly reported difficulties. Popular medical Internet resources included Medline/Pubmed, the eBMJ/BMA site and a range of other resources produced by authoritative medical bodies. CONCLUSION: This study indicates high Internet connectivity in Lothian general practices, with increased levels of use by GPs compared with previous benchmark studies and high levels of perceived usefulness of the Internet in relation to GPs work. Training and education of GPs is clearly required if they are to take best advantage of improved Internet accessibility.
Subject(s)
Health Knowledge, Attitudes, Practice , Internet/statistics & numerical data , Physicians, Family , Adult , Female , Humans , Male , Scotland , Surveys and QuestionnairesABSTRACT
Since late 1992 we started performing posterior lumbar interbody fusions together with pedicular screws and intertransverse fusion. Later on we decided to use posterior lumbar interbody fusions with titanium cages and autologous bone. We are presenting our results with a group of 52 patients with 6 months to 4 and a half years of follow-up. We have used the Prolo Functional Economic Outcome Rating Scale to evaluate our results, obtaining a high percentage (92%) of satisfactory results. The fusion's percentage was also very high, although we express the difficulty to evaluate the fusion grade considering the X-ray artifact produced by the cages. We conclude that PLIF with cages it is a surgical procedure with a high rate of success if we establish clearly the clinical criteria for its application and perform correctly the surgical technique.
Subject(s)
Lumbar Vertebrae/surgery , Spinal Fusion/methods , Adult , Aged , Female , Follow-Up Studies , Humans , Male , Middle AgedABSTRACT
Los quistes óseos aneurismáticos son muy poco frecuentes en su localización craneal. Presentamos un paciente de 23 años de edad con un quiste aneurismático frontal de grandes proporciones y largo tiempo de evolución. Las características del quiste en la RNM -lesión expansiva ósea multiloculada y con niveles líquidos- son casi patognomónicas y facilitan su diagnóstico preoperatorio. La cirugía radical fue curativa en este paciente (AU)
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