Complications and outcomes of posterior fossa decompression with duraplasty versus without duraplasty for pediatric patients with Chiari malformation type I and syringomyelia: a study from the Park-Reeves Syringomyelia Research Consortium.

OBJECTIVE: The aim of this study was to determine differences in complications and outcomes between posterior fossa decompression with duraplasty (PFDD) and without duraplasty (PFD) for the treatment of pediatric Chiari malformation type I (CM1) and syringomyelia (SM). METHODS: The authors used retrospective and prospective components of the Park-Reeves Syringomyelia Research Consortium database to identify pediatric patients with CM1-SM who received PFD or PFDD and had at least 1 year of follow-up data. Preoperative, treatment, and postoperative characteristics were recorded and compared between groups. RESULTS: A total of 692 patients met the inclusion criteria for this database study. PFD was performed in 117 (16.9%) and PFDD in 575 (83.1%) patients. The mean age at surgery was 9.86 years, and the mean follow-up time was 2.73 years. There were no significant differences in presenting signs or symptoms between groups, although the preoperative syrinx size was smaller in the PFD group. The PFD group had a shorter mean operating room time (p < 0.0001), fewer patients with > 50 mL of blood loss (p = 0.04), and shorter hospital stays (p = 0.0001). There were 4 intraoperative complications, all within the PFDD group (0.7%, p > 0.99). Patients undergoing PFDD had a 6-month complication rate of 24.3%, compared with 13.7% in the PFD group (p = 0.01). There were no differences between groups for postoperative complications beyond 6 months (p = 0.33). PFD patients were more likely to require revision surgery (17.9% vs 8.3%, p = 0.002). PFDD was associated with greater improvements in headaches (89.6% vs 80.8%, p = 0.04) and back pain (86.5% vs 59.1%, p = 0.01). There were no differences between groups for improvement in neurological examination findings. PFDD was associated with greater reduction in anteroposterior syrinx size (43.7% vs 26.9%, p = 0.0001) and syrinx length (18.9% vs 5.6%, p = 0.04) compared with PFD. CONCLUSIONS: PFD was associated with reduced operative time and blood loss, shorter hospital stays, and fewer postoperative complications within 6 months. However, PFDD was associated with better symptom improvement and reduction in syrinx size and lower rates of revision decompression. The two surgeries have low intraoperative complication rates and comparable complication rates beyond 6 months.

DESARROLLO E IMPLEMENTACIÓN DE UNA NORIA MODIFICADA COMO PROPUESTA SOSTENIBLE DE RECIRCULACIÓN DE AGUA PARA UNA ESTACIÓN PISCÍCOLA / DEVELOPMENT AND IMPLEMENTATION OF A MODIFIED WATERWHEEL AS A PROPOSAL FOR SUSTANTAINABLE WATER CIRCULATION FOR A FISHING STATION

Existen problemas de abastecimiento de agua en verano e invierno, en la Estación Piscícola de la Universidad de Caldas (Colombia). El trabajo muestra la manera como, por medio de un sistema de recirculación de agua, se provee a la Estación del líquido, de manera persistente, conservando parámetros fisicoquímicos aptos para el cultivo de peces. Cambios en el uso del suelo, como desarrollos urbanísticos, han generado impacto sobre la microcuenca que abastece la Estación. Surge la propuesta de reutilizar el agua mediante un modelo sostenible, adaptando un mecanismo ancestral: la Noria. Éste trabajo se desarrolló en tres etapas: recopilación de información, seguimiento e implementación de la propuesta. Para el montaje se requirió adaptar parte de la infraestructura existente de la Estación para recolectar el agua. El diseño de la Noria consta de un sistema de captación de agua (Cilindro con compartimentos) que impulsa un sistema de poleas y a su vez a la Noria modificada con canjilones, la cual capta agua (1,5 l/seg) y la elevan 7 m. Los parámetros físicoquímicos (temperatura, oxígeno y pH) y biológicos (macroinvertebrados acuáticos) permanecieron en rangos normales para un cultivo de peces tropicales. El diseño realizado es modular, no requiere energía eléctrica, ni mano de obra especializada para su mantenimiento, puede ser utilizado como una herramienta alterna en el sector agropecuario particularmente en el sector acuícola, donde se presenten dificultades hídricas, es de bajo costo y ambientalmente sostenible.

There are problems of water supply in the summer and the winter, in the Fishing Station of Universidad de Caldas (Colombia). This article shows how, by means of a water recirculation system, the Station is provided with the liquid persistently, keeping physicochemical parameters fit for fish farming. Changes in land use, such as urban development, have generated impact on the watershed that supplies the Station. Then, a proposal to reuse water through a sustainable model, adapting an ancestral mechanism surges: the Waterwheel. This work was developed in three stages: data collection, monitoring and implementation of the proposal. For the assembly adaption of part of the existing infrastructure of the Station to collect water was required. The design of the waterwheel consists of a water catchment system (cylinder with compartments) that drives a pulley system and in turn to the modified waterwheel with buckets, which capture the water (1.5 l / sec) and then raise it 7 m. The physicochemical parameters (temperature, oxygen and pH) and biological (macroinvertebrate) remained within normal ranges for a crop of tropical fish. The design developed is modular, it does not require electricity or skilled workforce for maintenance, it can be used as an alternative tool in agriculture particularly in the aquaculture sector where water difficulties arise, and it is inexpensive and environmentally sustainable .

Environmental behavior of arsenic(III) and (V) in soils.

This paper presents an evaluation of the environmental behavior of arsenic species in soils (F. F. Dias, Master Thesis, University of Delaware, 1997). The results obtained were used to determine adsorption constants that were incorporated in mathematical models using forward and backward stepwise linear regression to correlate data. The amount of adsorption was significantly different depending on soil properties, such as organic matter, iron oxide content, and surface area. Arsenic speciation on the soil surface was deduced from desorption data, with As(V) being more strongly retained in the soil. As(III) was oxidized on the soil surface and desorbed as As(V); an important factor since As(V) is less toxic. In order to develop an adequate adsorption model, Langmuir and Freundlich isotherms were obtained for each soil without pH alteration. Results indicated that the maximum amount of As(V) adsorbed was greater than the amount of As(III) adsorbed. Adsorption edges for As(III) and As(V), with pH varying from 3 to 10, were obtained at concentrations that ranged from 0.1 to 200 mg L(-1). The soils studied exhibited an L-type Langmuir isotherm. Maximum As(III) adsorption occurred around pH 6 to 9, while maximum As(V) adsorption occurred in the 4 to 5 pH range. Experiments to determine arsenic kinetics were carried out and showed that adsorption and desorption equilibrium was reached within 48 hours for both species.

Characterization of copper in uterine fluids of patients who use the copper T-380A intrauterine device.

BACKGROUND: The copper intrauterine device (IUD) is a highly effective method of contraception that requires the dissolution of the copper into uterine cavity. However, there is little information about the amount and form of copper in the fluid and whether the presence of this element produces any change in the protein concentration. METHODS: Twenty-seven women were divided into three groups that had used IUD for about 6 months, 1 year and > or =3 years. The samples were collected during the proliferative phase (Pp), secretory phase (Sp) and menstruation (M). Square-wave anodic stripping voltammetry (SWASV), cyclic voltammetry (CV), high performance liquid chromatography (HPLC) and atomic absorption spectrometry (AAS) were used in this study. RESULTS: Total copper concentrations were between 3.9 and 19.1 micro g/ml. The mean and standard deviations were as follows: 6 months, 11.4+/-4.7 micro g/ml of copper; 1 year, 11.5+/-7.0 micro g/ml of copper; and 3 years, 6.2+/-1.5 micro g/ml of copper. Total proteins were quantified by measuring the area under the chromatographic peaks. The mean areas obtained with uterine fluid samples from women who used IUDs for 6 months, 1 year and 3 years were 290,013, 538,934 and 201,863 arbitrary units (AU), respectively. The control sample was only 22323. CONCLUSIONS: The amount of copper released from IUD, although high, is in the form of complexes with proteins. IUDs have a constant copper release for at least 6-12 months. Copper(I) was not detected in the fluid. Copper induces a change in the total protein concentration. The amount of copper released and the amount of proteins is slightly larger during the menstrual stage.

Common sexually transmitted diseases in clients under twenty and sexually abused children attending the Comprehensive Clinic, Kingston. A study of knowledge, attitudes and practices of new clients and repeaters

Today, health officials throughout the globe are concerned about the present trend of the sexually transmitted diseases (STDs). This study was carried out with the aims of eliciting common STDs in clients under twenty and in sexually abused children attending the Comprehensive Clinic, Kingston. Other aims were to assess the knowledge, attitudes and practices of new and old clients relating to STD infection. 140 clients 14 years and over were interviewed by questionnaire, while information on clients under 14 years was obtained from medical records in 13 cases. Results showed that the three prominent STDs affecting this age group are gonorrhoea, syphilis and NSU/NGU. Even though knowledge of the two common diseases gonorrhoea and syphilis was good, clients lacked knowledge about other STDs. The study revealed that there is a brand new attitude towards sexual morality among young people. The use of ganja was found to be a factor influencing recurrence while the use of unauthorised treatment was not a serious problem. The study identified two males under 14 molested by older females. Recommendations included the formation of health clubs, health education for the public and special programmes for constant repeaters (AU)

Creencias y actitudes en la alimentación e higiene del neonato

El estudio creencias y actitudes en la Alimentación e higiene del "Neonato" se realizó con 60 mujeres gestantes del Servicio de Control Prenatal del Hospital General "San Juan de Dios" durante los meses de julio y agosto de 1985. Este estudio nos da a conocer como la población materna del Hospital, a pesar de residir dentro del perímetro de la capital conservan muchas tradiciones y creencias que en una u otra forma influyen en la alimentación e higien del neonato. Encontrádose creencias positivas como lo son: la totalidad de las personas entre vistadas está de acuerdo en ponerlo al pecho inmediatamente cuando nace, un 58.33% da el pecho a libre demanda, 56.66% le continúa el pecho en caso de enfermedad, se recomienda dentro de los atoles como galactogénicos a la incaparina, la cual recomiendan comer y tomar durante el período del puerperio con mayor frecuencia. Dentro de las creencias negativas están: la falta de un real conocimiento sobre beneficios de la lactancia natural como su técnica ya que ponen como causas para suspenderla en caso de embarazo (91.66%) en caso de trabajo por parte de la madre (85%) en caso de enojo o cólera (71.66%). Se denota que un 91.66% desconoce la técnica de extracción manual de leche materna. Que un 88.33% tienen la creencia que es necesario una restricción dietética durante le período del puerperio por clasificar los alimentos como de efecto "frio" o "caliente", además inician los alimentos complementarios, tempranamente, así durante el primer mes 66.66% de las personas entrevistadas. Los factores tradicionales y el síndrome "calor-frío" interviene negativamente al creer que el muñón umbilical no debe de tocar el agua porque "Chupa frío" en un 65%; interesante que un 65% de las madres entrevistadas creen enfermedades populares como el "Mal de Ojo" no físico "Mollera caída" o Varillas Caídas" y chpa frio ("elombligo" a las que se cree están suceptibles los niños dando una serie de datos para reconocer, diagnosticar y especialmente prevenir estas enfermedades; quizá los porcentajes fueron más altos en comparación con otros estudios ya que fue por entrevista dirigida como se obtuvo la información. En fin las madres de los niños están imersas en un ambiente em donde existen tradiciones, claro no mágico-sobre natural, pero si explicable dentro de lo emocional, mecánico, y el equilibrio frío-caliente. Muchas de las personas sin importar su grado académico intermedio, desconoce completamente la técnica de la Lactancia Na