Proximal balloon-guided catheter with flow inversion vs. distal filter protection during the carotid stent placement, a seven years experience in a Colombian reference center.

BACKGROUND AND PURPOSE: The carotid stent placement as a therapeutic option for carotid stenosis has been increasing among years; therefore, studies are required to evaluate the security and efficacy of its materials. The purpose of this study was to evaluate the distal filter and the proximal balloon-guided catheter with flow inversion as protection devices during carotid angioplasty and stenting. METHODS: This is a retrospective, observational study of patients diagnosed with carotid stenosis treated with angioplasty between January 1, 2014, and June 30, 2020; we analyzed a radiology service database to compare the distal filter and the proximal balloon-guided catheter as protection devices during angioplasty. RESULTS: One hundred seventy-five angioplasties were performed, the distal filter was the most prevalent embolic protection device used (66%), patients baseline characteristics did not differ between groups with different embolic protection devices, except for history of dyslipidemia (p < 0.000). As well, we did not find any significant differences between the groups in the device related complications, intervention time (p = 0.140), unrelated complications (p = 0.693) and functional independence at 90 days (p = 0.096). CONCLUSIONS: In our study the proximal balloon-guided catheter and the distal filter protection device as protection devices during the carotid stenting didn't show significant differences regarding complications related to the system.

A Study of Zn-Ca Nanocomposites and Their Antibacterial Properties.

This study aimed to develop Ca2+ doped ZnO nanoparticles (NPs) and investigate their antibacterial properties against microorganisms of dental interest. Zn-Ca NPs were synthesized by the sol-gel method with different concentrations of Ca2+ (1, 3, and 5 wt. %) and subsequently characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), UV-vis spectroscopy and Fourier transform infrared spectroscopy (FT-IR). The Kirby-Bauer method was used to measure antibacterial effects. NPs showed the wurzite phase of ZnO and bandgap energies (Eg) from 2.99 to 3.04 eV. SEM analysis showed an average particle size of 80 to 160 nm. The treatments that presented the best antibacterial activity were Zn-Ca 3% and Zn-Ca 5%. ZnO NPs represent an alternative to generate and improve materials with antibacterial capacity for dental applications.

Effect of TiO2-ZnO-MgO Mixed Oxide on Microbial Growth and Toxicity against Artemia salina.

Mixed oxide nanoparticles (MONs, TiO2-ZnO-MgO) obtained by the sol-gel method were characterized by transmission electron microscopy, (TEM, HRTEM, and SAED) and thermogravimetric analysis (TGA/DTGA-DTA). Furthermore, the effect of MONs on microbial growth (growth profiling curve, lethal and sublethal effect) of Escherichia coli, Salmonella paratyphi, Staphylococcus aureus and Listeria monocytogenes, as well as the toxicity against Artemia salina by the lethal concentration test (LC50) were evaluated. MONs exhibited a near-spherical in shape, polycrystalline structure and mean sizes from 17 to 23 nm. The thermal analysis revealed that the anatase phase of MONs is completed around 480-500 °C. The normal growth of all bacteria tested is affected by the MONs presence compared with the control group. MONs also exhibited a reduction on the plate count from 0.58 to 2.10 log CFU/mL with a sublethal cell injury from 17 to 98%. No significant toxicity within 24 h was observed on A. salina. A bacteriostatic effect of MONs on bacteria was evidenced, which was strongly influenced by the type of bacteria, as well as no toxic effects (LC50 >1000 mg/L; TiO2-ZnO (5%)-MgO (5%)) on A. salina were detected. This study demonstrates the potential of MONs for industrial applications.

The use of metered-dose inhalers in hospital environments.

BACKGROUND: Metered-dose inhalers (MDIs) have become a firsthand therapeutic strategy for the management of respiratory diseases, mainly for chronic obstructive pulmonary disease (COPD) and asthma. It has been determined, however, that patients do not always use these devices correctly. Our primary goal was to establish the level of technical knowledge of patients with COPD and/or asthma on the use of MDIs, as well as other associated factors related to the effective use of this delivery method. METHODOLOGY: This study was performed with 191 patients (49.2% male, 50.8% female) diagnosed with COPD and/or asthma at Hospital Universitario Mayor (Bogotá, Colombia). The agreement between different observers on nine aspects of the use of the inhaler was assessed by testing the unweighted kappa correlation coefficient and its significance. The correlations between demographic variables, risk factors, and proper knowledge of the adequate use of inhalers were established by means of the Pearson chi-square test (also called Fisher exact test) (expected values less than 5). Statistical tests were evaluated at a significance level equivalent to 5% (p<0.05). RESULTS AND CONCLUSIONS: The study detected deficiencies in educational factors, specifically regarding the initial contact with the patient and regular follow-up by the team of health professionals. It also showed insufficient strategies for the training of patients in the use of the inhalers. There were no significant differences by gender (p>0.05) in the implementation of the various aspects of the proper use sequence for MDIs. However, there were significant differences related to education levels, socioeconomic status, age, and current occupation. A worse inhaler technique was associated with lower education level (0.034), higher age (p=0.003), and absence of job (p=0.005). Changes in the education of patients on the issue, together with the use of the spacer/valved holding chamber proved to be valid strategies that, with the support of the patients' health-care team, were able to improve the MDI technique of the studied group.

Aspectos relevantes de las publicaciones de la Revista ADM a lo largo de la historia / Relevant aspects of Revista ADM publications throughout its history

La Revista ADM se ha publicado desde 1943, y en sus páginas se pueden encontrar una gran cantidad de los aspectos relevantes de la odontología nacional a lo largo de más de 60 años. Objetivo realizar un análisis de los artículos presentados en la Revista, desde su fundación hasta el año de 2004, mediante la revisión de todos los volúmenes disponibles en la Biblioteca de la ADM, recopilando información del año donde aparecieron: número de autores y género del primer autor, tipo de artículo, área temática, adscripción y nacionalidad del primer autor, número de páginas y de referencias bibliográficas. En el análisis de los resultados se puede apreciar la evolución de las publicaciones, en relación con los temas abordados, el perfil de los diversos autores, conformación de grupos académicos adscritos a las instituciones educativas y de salud, incremento en la presencia de mujeres que publican, entre otros datos de interés, que confirman la importancia y solidez que la Revista ADM ha tenido en el gremio odontológico.

Sistema de monitoreo electrocardiográfico ambulatorio

El sistema de monitoreo electrocardiográfico ambulatorio está destinado a la realización de pruebas de Holter. Es un equipo diseñado para la adquisición y estudio de la señal electrocardiográfica (ECG) de un paciente realizando su vida normal durante un período prolongado de tiempo (24h). Esto permite la detección de arritmias que se presentan eventualmente y que son muy difíciles dedetectar mediante la realización de un electrocardiograma en reposo. Ha sido concebido para la adquisición de dos canales de señal ECG en forma ambulatoria y su posterior visualización y análisis en una estación de trabajo(AU)

Brucellosis in Venezuela.

Brucellosis is a public health problem in Venezuela and affects large numbers of animals. The most important biovar in the country is Brucella abortus. In cattle and buffalo it causes high rates of abortions in females and infertility in males; it is transmissible to occupationally exposed humans. In 1968, an official program was set up for the control and eradication of the disease and it is still in place. Amongst the control provisions, this program provides for the vaccination of female calves with strain 19 and the slaughtering of positive reactors following the official diagnosis (rapid agglutination in plate test). According to the official reports, the positive reactors ranged from 0.8 to 1.2% in the past few years. These values do not corroborate reports showing an average positive rate of 10.5% and even higher values in some areas of the country. The government is working to approve a new resolution that will replace the rapid agglutination in plate test with the Card Test, the use of 2-Mercaptoetanol, fixation of complement and competitive ELISA as confirmatory tests. In addition, there will be an obligatory vaccination with B. abortus strain 19 or B. abortus RB51 of all female calves between 3- and 8-month-old and a recommended revaccination at 10-15-month-old and adult cows in high prevalence areas. These measures should allow help to reduce the prevalence of the disease in cattle herds and thus minimize the risk for human populations.

FX distales de tibia, tratamiento con enclavado centromedular bloqueado / Treatment of distal tibial fractures with blocked centromedullary nail

Reportamos nuestra experiencia en la utilidad del clavo universal bloqueado en las fracturas del tercio distal de la tibia, cerradas, como una gran alternativa en su tratamiento. Realizamos un estudio retrospectivo, longuitudinal y observacional en el Hospital Juárez de México de enero de 1995 a enero de 1998, en donde tratamos 24 fracturas de tercio distal de la tibia, cerradas únicamente y desplazadas en diversos sentidos con inestabilidad. Obtuvimos 15 pacientes masculinos y 9 femeninos con un promedio de edad de 28,6 años, con los siguientes trazos de fractura: 10 transversos, 9 oblicuos largos, 3 oblicuos cortos y 3 elicoidales. Se les trata mediante enclavado centromedular bloqueandolo en el 100 por ciento de los casos proximalmente y distalmente, aunque aquí con diversidad de uno o dos tornillos, consiguiendo la consolidación ósea en promedio de 16,9 semanas y en el 53 por ciento de los casos se dinamizó el clavo. El tiempo de consolidación se vio favorecido por la dinamización a pesar de ser trazos transversos, ya que esta se presentó en forma más temprana que la habitual en donde no hubo dinamización (AU)

Gastrostomias para nutricion: Experiencia del Hospital El Tunal / Gastrostomy for Nutrition

Presentamos la experiencia del grupo de terapia nutricional del Hospital El Tunal (ESE) de Bogotá (III nivel), con la realización y manejo de gastrostomías para nutrición. Se revisaron las historias clínicas de los pacientes llevados a gastrostomía abierta (GA) o gastrostomía endoscópica percutánea (GEP), en un periodo de 7 años, comprendido entre marzo de 1994 y marzo de 2000. Se encontraron un total de 86 pacientes, (39 mujeres, 47 hombres), con una edad promedio de 54.6 ± 23 años. Se realizó GA tipo Stamm en 11.6 por ciento y GEP en 88.4 por ciento. La indicación del procedimiento fue en un 88 por ciento incapacidad para la deglución debido a patología neurológica como: secuelas de ACV, POP resección tumor del SNC, etc. y el 11 por ciento restante tuvo otras indicaciones como: cáncer de esófago, dilatación aguda gástrica, etc. La tasa global de complicaciones fue de 23.2 por ciento. Encontrando infección periostomal en 11.6 por ciento, retiro precoz en 4.6 por ciento e infección severa en 2.3 por ciento. Doce pacientes murieron por su enfermedad de base. En 4 pacientes el procedimiento no se pudo realizar por encontrar otra patología gástrica o imposibilidad técnica en la endoscopia. El número de gastrostomías realizadas en nuestro hospital ha aumentado en los tres últimos años, asociado a la implementación de la UCI de adultos y el servicio de Neurocirugía. Los familiares del paciente son involucrados desde el principio para el adecuado manejo de las sondas en la casa y las recomendaciones dietéticas, siendo enseñados y entrenados por los diferentes miembros del grupo

[Growth and sex maturation of a population of Saccostrea palmula (Mollusca: Bivalvia), Costa Rica]. / Crecimiento y madurez sexual de una población de Saccostrea palmula (Mollusca: Bivalvia), Costa Rica.

Growth and sexual maturity in Saccostrea palmula were studied between May 1998 and May 1999, in Morales estuary, Punta Morales, Puntarenas, Costa Rica (n = 540 individuals according to sample size equation). The weight-length relationship for the population was Pt = 2.13 x 10(-2) Lt1.6602 and von Bertalanffy growth function was Lt = 68.2 (l- e -0.1577 t). The mean sex ratio was 1.00 male: 0.92 females with sexually mature individuals found throughout the year. Spawning activity was highest between November and January. The mean condition index (IC = PCF/PV x 100) for the population was 121.53 +/- 2.24 and the mean meat yield was 10.32 +/- 1.64%.

[Body size and fecundity of Juxtafabia muliniarum (Brachyura: Pinnotheridae) associated with Saccostrea palmula (Bivalvia: Ostreidae), Costa Rica]. / Tallas y fecundidad de Juxtafabia muliniarum (Brachyura: Pinnotheridae) asociado con Saccostrea palmula (Bivalvia: Ostreidae), Costa Rica.

Size and fecundity observations of pea crab (Juxtafabia muliniarum) from the paleal cavity of the oyster Saccostrea palmula were made from May 1998 to May 1999. Infestation frequency was 18.52% in a sample of 540 oysters. Of 136 pea crabs, 36% were couples, 60% were single females and 4% were single males. The mean caparace length of J. muliniarum was 5.6 +/- 0.74 mm (range 4.0 to 7.6 mm) for females and 2.71 +/- 0.60 mm (range 1.6 to 4.0 mm) for males. The mean weight was 0.180 +/- 0.084 g (range 0.06 to 0.4 g) for females and 0.011 +/- 0.003 g (range 0.01 to 0.02 g) for males. Ovigerous females (43.75% of all females) were found in all months. The caparace length-fecundity relationship was F = 3904.6 Ln (Lc)--4651.1. The caparace length-weight relationship was P = 6 x 10(-4) Lc3.2122. The mean sex-ratio was 1.0 male: 2.4 females. Saccostrea palmula infected only by females was the dominant group (60.78%). This mollusk is a new host record for the crab.

Embolización de pseudoaneurisma renal como complicación de nefrototomia percutanea / Renal pseud-aneurysm embolization as complication of percutaneus nephrolithotomy

La nefrolitotomía percutánea es el método de elección en el manejo de la litiasis coraliforme. Como método invasivo, pueden ocurrir complicaciones durante su realización/ como por ejemplo el trauma vascular de las arterias interlobares y/o interlobulillares y la consiguiente formación de fístulas arteriovenosas o pseudoaneurismas. La forma de tratamiento de estas complicaciones es utilizando la embolización del vaso nutricio ya sea con materiales reabsorbibles (Gelfoam) o embolización permanente (coils)

The alveolar-arterial difference in oxygen tension increases with temperature-corrected determination during moderate hypothermia.

UNLABELLED: Moderate hypothermia (32-33 degrees C) occurs in anesthetic practice. However, intrapulmonary gas exchange and the effect of temperature correction of blood gases on oxygen and carbon dioxide exchange have not been investigated in these patients. We investigated alveolar-arterial difference in oxygen tension (AaDO2) and arterial to end-tidal difference in carbon dioxide (Pa-ETCO2) during rewarming of eight ASA physical status I patients from hypothermia of 32 degrees C. Anesthesia was maintained with fentanyl/propofol. AaDO2 and Pa-ETCO2 were assessed by analyzing arterial blood gases and saturated water vapor pressure, uncorrected or corrected to actual body temperature. The respiratory quotient (RQ) was measured by calorimetry. After temperature correction of blood gases and water vapor pressure, the AaDO2 was significantly higher at 33 and 32 degrees C compared with 36 degrees C (56 +/- 13 and 64 +/- 14 vs 39 +/- 10 mm Hg; P < 0.05 and P < 0.01). The deterioration of pulmonary oxygen exchange was not detected if arterial blood gases and water vapor pressure were not corrected. The RQ did not change during moderate hypothermia compared with 36 +/-C. The temperature-corrected Pa-ETCO2 was not affected by hypothermia. We conclude that AaDO2 is increased during moderate hypothermia. This is only detected when water vapor pressure and arterial blood gases are corrected to actual body temperature. IMPLICATIONS: We investigated intrapulmonary oxygen and carbon dioxide exchange during moderate hypothermia (32 degrees C) in eight patients. If oxygen, carbon dioxide, and water vapor pressure were corrected to actual body temperature, the alveolar-arterial oxygen tension difference was increased during hypothermia. The carbon dioxide tension difference and the respiratory quotient were unaffected by hypothermia.

Oxyuriasis pélvica / Pelvic oxyuriasis

El enterobius vermicularis, es un parásito que comúnmente infesta el lumen intestinal, en raras ocasiones es posible encontrarlo en otras localizaciones. Se presenta caso clínico, en el que se encontraron granulomas por enterobius vermicularis en serosa de trompa uterina, que se habrían instalado allí por fístula rectal secundaria a perforación por un dispositivo intrauterino. Se describen las lesiones histopatológicas, sus implicancias clínicas y revisión de la literatura

Proximal duodeno-jejunostomy for the safe management of the difficult duodenal stump

Seven patients with peptic ulcer disease had severe scarring of the duodenum, making its closure at the time of gastrectomy difficult. They were managed intraoperatively with proximal duodeno-jejunostomy as a means to avoid the catastrophic complication of disruption of the duodenal stump closure with its consequent peritonitis. The jejunum used for this anastomosis was an extension of the long limb of a Roux en Y which is brought up to perform the gastrojejunostomy. The end to end duodeno-jejunostomy is performed proximal to a side to side gastrojejunostomy, hence the name, proximal duodeno Jejunostomy. These seven patients had no unexpected immediate postoperative complications during the thirty days following surgery and were all discharged from the hospital well. During the same three and a half year period twenty five other patients were submitted to gastrectomy and had two duodenal stump leaks after conventional closures. One patient died and the other survived after prolonged intensive care stay. These differences were not statistically significant. These duodenojejunostomies are non-functional anastomoses and should consequently stricture, but in one patient it remained open and he developed bile reflux gastritis in spite of the Roux en Y gastrojejunostomy constructed to avoid this complication. These anastomoses should be constructed as stenotic as possible

Proximal duodeno-jejunostomy for the safe management of the difficult duodenal stump.

Seven patients with peptic ulcer disease had severe scarring of the duodenum, making its closure at the time of gastrectomy difficult. They were managed intraoperatively with proximal duodeno-jejunostomy as a means to avoid the catastrophic complication of disruption of the duodenal stump closure with its consequent peritonitis. The jejunum used for this anastomosis was an extension of the long limb of a Roux en Y which is brought up to perform the gastrojejunostomy. The end to end duodeno-jejunostomy is performed proximal to a side to side gastrojejunostomy, hence the name, proximal duodeno Jejunostomy. These seven patients had no unexpected immediate postoperative complications during the thirty days following surgery and were all discharged from the hospital well. During the same three and a half year period twenty five other patients were submitted to gastrectomy and had two duodenal stump leaks after conventional closures. One patient died and the other survived after prolonged intensive care stay. These differences were not statistically significant. These duodenojejunostomies are non-functional anastomoses and should consequently stricture, but in one patient it remained open and he developed bile reflux gastritis in spite of the Roux en Y gastrojejunostomy constructed to avoid this complication. These anastomoses should be constructed as stenotic as possible.

Effectiveness of calcium and magnesium on testicular sulfatase activity.

Nucleotides and calcium ions have been implicated in the regulation of biosynthesis of steroids, although the exact locus of calcium activity is not yet known. The administration of Ca2+ to Leydig cells increases testosterone production. Steroid sulfatase activity is reported to be enhanced by adenine nucleotides. In the present study the testicular sulfatase was evaluated in subcellular fractions by conversion of sulfate to free steroids in the presence or absence of Ca2+ and Mg2+ ions. The specific activity of the enzyme, which was located predominantly in submitochondrial fraction, showed a positive correlation with calcium, increasing 1.5-fold in the presence of 2.54 mM of calcium (62 nmol/h mg protein-1). In contrast, magnesium inhibited the enzymatic activity 1.79-fold in presence of 1.18 mM (23 nmoles/h mg protein-1). It would appear that testicular sulfatase is predominantly located in the mitochondria, which is recognized as one of the major sites of control of intracellular metabolism, and that its enzymatic activity could be modulated by calcium regulating the levels of potentially active androgens.

No seroconversions among steady sex partners of methadone-maintained HIV-1-seropositive injecting drug users in New York City.

OBJECTIVE: To assess the incidence of heterosexual HIV-1 transmission from seropositive methadone-maintained injecting drug users (IDU) to their seronegative, non-IDU steady sex partners. DESIGN: A prospective, longitudinal study. SETTING: HIV-1-seropositive IDU and their HIV-1-seronegative, non-IDU steady sex partners were recruited from six methadone-maintenance clinics in the New York City boroughs of Brooklyn and Manhattan. PATIENTS, PARTICIPANTS: Between December 1988 and October 1991, 60 research participants were recruited [30 methadone-maintained, HIV-1-seropositive IDU (index subjects) and their non-IDU HIV-1-seronegative steady partners]. Baseline and follow-up (every 3-4 months) data included a structured questionnaire and blood testing for HIV infection and CD4+ cell subsets. RESULTS: Demographic characteristics of the 30 steady sex partners were evaluated as follows: sex (22 women, eight men); age (mean, 32 years; range, 21-55 years) and race (African-American, 13; Hispanic, 13; other, 4). The average duration of relationship between index subject and partner at study entry was 7.5 years (range, 4 months to 19.4 years). At entry, 27 of the 30 partners reported no or intermittent use of condoms with the index subject during a typical 12-month period. Follow-up data (median follow-up, 298 days; range, 85-992 days) were available for 22 partners. Of these, 15 reported no or intermittent condom use. For a total study observation time of 23 person-years, there were no seroconversions. The upper 95% confidence interval for the observed seroconversion rate of 0% is 13%. CONCLUSIONS: These results suggest that the likelihood of heterosexual HIV-1 transmission from seropositive methadone-maintained IDU to their seronegative, non-IDU steady sex partners is low.

In vitro activity of teicoplanin compared with vancomycin against methicillin-resistant Staphylococcus aureus derived from cystic fibrosis sputum.

We evaluated the in vitro activity of teicoplanin compared with vancomycin against methicillin-resistant Staphylococcus aureus (MRSA) derived from cystic fibrosis (CF) sputum. Teicoplanin had a slightly lower median minimum inhibitory concentration (MIC) for these strains (0.25 micrograms/ml) than did vancomycin (0.5 micrograms/ml). Inoculum size increased the MICs similarly for both drugs, and pH variations did not significantly affect their activity. The presence of serum and sputum in the growth media decreased the activity of both drugs, although this was more pronounced for teicoplanin which is highly protein bound. We conclude that teicoplanin has activity against this pathogen and might be evaluated in clinical protocols designed to address this emerging clinical problem.