Abordaje endoscópico extendido del seno frontal: Experiencia en Hospital Clínico Universidad de Chile / Extended endoscopic approach of the frontal sinus: Experience at Hospital Clínico Universidad de Chile

Introducción: El seno frontal es una estructura compleja y desafiante en términos quirúrgicos, siendo descritas numerosas técnicas para su abordaje. Dentro de ellas se destaca el abordaje endoscópico extendido de seno frontal: Draf IIB y Draf III, como una importante alternativa para resolución de patología refractaria de seno frontal. Objetivo: Describir las características de pacientes sometidos a abordaje endoscópico extendido de seno frontal en Hospital Clínico Universidad de Chile (HCUCH). Material y Método: Estudio retrospectivo, descriptivo. Se incluyeron a pacientes sometidos a abordaje endoscópico extendido de seno frontal entre los años 2013 y 2021. Se analizaron variables clínicas, intraoperatorias y de seguimiento. Resultados: Se registraron 118 pacientes, de los cuales 64 cumplieron criterios de inclusión al estudio, con una edad promedio de 48 años. La patología más frecuente fue la rinosinusitis crónica poliposa (42%) seguido del mucocele (20%). Del total de pacientes, el 68% fue sometido a cirugía Draf IIB y el resto a Draf III. Todos los pacientes fueron estudiados con endoscopía e imágenes, y seguidos con parámetros clínicos y endoscópicos. El porcentaje de estenosis postoperatoria se estimó en 10%. Conclusión: El abordaje endoscópico nasal extendido figura como una alternativa útil para manejo de patología de seno frontal refractario a tratamiento. En nuestra experiencia las indicaciones, tipos de cirugía y tasa de complicaciones son concordantes con la literatura internacional.

Introduction: The frontal sinus is a complex and challenging structure in surgical terms, numerous techniques have been described for its approach, among them the extended endoscopic approach: Draf IIB and Draf III, figures as an important alternative for the resolution of refractory pathology of frontal sinus. Aim: To describe the characteristics of patients who underwent an extended endoscopic approach to the frontal sinus at the Hospital Clínico Universidad de Chile (HCUCH). Material and Method: A retrospective, descriptive study included patients who underwent an extended endoscopic approach to the frontal sinus between 2013 and 2021. Clinical, intraoperative, and follow-up variables were analyzed. Results: 118 patients were registered, of which 64 met the inclusion criteria for the study, with an average age of 48 years. The most frequent pathology was chronic polypous rhinosinusitis (42%), followed by mucocele (20%). Of the patients, 68% underwent Draf IIB surgery, while the rest received a Draf III type procedure. All patients were studied with endoscopy and images and followed up with clinical and endoscopic parameters. The percentage of post operatory stenosis was 10%. Conclusion: The extended nasal endoscopic approach appears as a valuable alternative for managing frontal sinus pathology refractory to treatment. In our experience, the indications, types of surgery, and rate of complications are consistent with the international literature.

Differential impact of Limnoperna fortunei-herbicide interaction between Roundup Max® and glyphosate on freshwater microscopic communities.

Multiple anthropogenic stressors act simultaneously on the environment, with consequences different from those caused by single-stressor exposure. We investigated how the combination of the invasive mussel Limnoperna fortunei and a widely applied herbicide, Roundup Max®, affected freshwater microscopic communities and water quality. Further, we compared these results with those induced by the combination of the mussel and technical-grade glyphosate. We carried out a 34-day experiment in outdoor mesocosms, applying the following six treatments: 6 mg L(-1) of technical-grade glyphosate (G), the equivalent concentration of glyphosate in Roundup Max® (R), 100 mussels (M), the combination of mussels and herbicide either in the technical-grade or formulated form (MG and MR, respectively), and control (C). Herbicides significantly increased total phosphorus in water; R and MR showed greater initial total nitrogen and ammonium. R increased picoplankton abundance and caused an eightfold increase in phytoplankton, with high turbidity values; G had a lower effect on these variables. Herbicide-mussel combination induced an accelerated dissipation of glyphosate in water (MG 6.36 ± 0.83 mg G g DW(-1) day(-1) and MR 5.16 ± 1.26 mg G g DW(-1) day(-1)). A synergistic effect on ammonium was observed in MR but not in MG. MR and MG had an antagonistic effect on phytoplankton, which showed a drastic reduction due to grazing, as revealed by M. We provide evidence of differential effects of Roundup Max® and technical-grade glyphosate over water quality and microscopic communities, and in combination with mussels. However, in the combination of mussels and herbicides, mussels seem to play a leading role. In the presence of L. fortunei, the effects of higher nutrient availability provided by herbicides addition were counteracted by the filtration activity of mussels, which released nutrients, grazed on picoplankton and phytoplankton, and boosted the development of other primary producers, periphyton and metaphyton.

Additional effects of homeopathy on chronic periodontitis: a 1-year follow-up randomized clinical trial.

BACKGROUND AND OBJECTIVE: The aim of this study was test the hypothesis that homeopathy (H) enhances the effects of scaling and root planing (SRP) in patients with chronic periodontitis (CP). MATERIALS AND METHODS: 50 patients with CP were randomly allocated to one of two treatment groups: SRP (C-G) or SRP + H (H-G). Assessments were made at baseline and after 3 and 12 months of treatments. The local and systemic responses to the treatments were evaluated by clinical and serologic parameters, respectively. RESULTS: Both groups displayed significant improvements, however, using clinical attachment gain and reductions in HDL, LDL and Total Cholesterol, Triglycerides, Glucose and Uric acid, from baseline to 1 year, as criteria for treatment success, H-G performed significantly better than C-G. CONCLUSION: The findings of this 1-year follow-up randomized clinical trial suggest that homeopathic medicines, as an adjunctive to SRP, can provide significant local and systemic improvements for CP patients.

La mantención de peso en humanos podría ser equivalente a la restricción calórica de los modelos animales? / Weight maintenance in humans. Could it mimic calorie restriction of animal models?

BACKGROUND: Energy restriction (ER) extends life span in animals, by decreasing oxidative stress. AIM: To compare adiposity, metabolic variables and DNA oxidative damage, among adults, reporting a constant body weight (weight maintainers), versus those reporting a progressive increase (weight gainers). SUBJECTS AND METHODS: Clinical history, dietary recall, anthropometric measures, abdominal CT scan and fasting blood samples (to measure lipoproteins, glucose and insulin), were obtained in 44 males. These subjects were classified as weight maintainers if they had a change in weight of 3 kg or less in the last 10 years, or weight gainers, if they had a weight increment of more than 6 kg, in the same lapse. Oxidative damage was assessed by 8-hydroxydeoxyguanosine (8-OHdG), in DNA extracted from circulating lymphocytes, in 5 weight maintainers, 8 weight gainers and 5 healthy elders. RESULTS: Energy Intake was 18% higher in weight gainers (p <0.01). Adiposity and central fat were higher among weight gainers (p <0.01). Abdominal fat correlated with serum lipoproteins, glucose and insulin sensitivity, assessed by the Homeostasis Model Assessment (HOMA). 8-OHdG levels did not differ between groups. CONCLUSIONS: The analysis of weight change based on the clinical history correlates with actual body composition, thus it may be a reliable indicator of long term energy Intake. This method could be comparable to weight clamp models employed in animals to study aging.

Environmental toxicity assessment in the Paraná river delta (Argentina): simultaneous evaluation of selected pollutants and mortality rates of Corbicula fluminea (Bivalvia) early juveniles.

Water and sediment samples were collected in the lower Paraná delta at four sites with different levels of exposure to pollution to evaluate the anthropogenic impact through chemical analyses and mortality bioassays. Individual polychlorinated biphenyls, chlorinated pesticides, aliphatic hydrocarbons, polycyclic aromatic hydrocarbons, and heavy metals were measured in waters, porewaters and sediments. The same three phases were also subjected to toxicity assays with straight-hinged juveniles of Corbicula fluminea. Concentrations of several pollutants were above levels recommended for the protection of aquatic life: in waters, Zn, Cu and Cr were 1.6-4.9 times higher, whereas in the sediments Cr was 1.8-3.6, and benzo(a)pyrene was 2.8-5.6 times higher. Pollutant concentrations followed a clear geographic pattern with highest values in the densely populated area of the Reconquista and Luján rivers, lower levels in the San Antonio, and lowest loadings in the remote Paraná de las Palmas. This gradient was adequately matched by the pattern of mortality rates of C. fluminea early juveniles, which were highest in the Reconquista-Luján (40-93%) and lowest (and not significantly different from the control) in the Paraná (3.3-23%). Mortality rates also increased from surface waters (3.3-53%), to porewaters (12-73%), to sediments (23-93%). Although toxicity was probably mainly due to dissolved contaminants, agreement between chemical and biological evidence of pollution was best for the sediment compartment, whereas porewater and surface water showed a higher degree of variability.