Influence of Fiber Orientation on Mechanical Response of Jute Fiber-Reinforced Polymer Composites.

The influence of fiber orientation on the mechanical behavior of a polymer matrix composite reinforced with natural jute fibers is investigated in this study. Two fiber orientation configurations are examined: the first involves woven fibers aligned in the direction of testing, while the second considers a 45° orientation. The research involves manufacturing composite plates using jute fabric with the mentioned orientations, followed by cutting rectangular specimens for tensile testing to determine which orientation yields superior properties. Displacement fields are measured using a digital image correlation technique, synchronized with load data obtained from a universal testing machine equipped with a load cell to obtain stress-strain curves for each configuration. Results indicate that 0° specimens achieve higher stress but lower strain compared to 45° specimens. This research contributes to understanding the optimal fiber alignment for enhancing the mechanical performance of fiber-reinforced polymer composites.

Outcomes and factors associated with relapse of vaccine-induced liver injury after SARS CoV-2 immunization: A nationwide study.

INTRODUCTION AND OBJECTIVES: Different patterns of liver injury have been reported in association with the SARS-CoV-2 vaccines. The aim of this study was to describe a nationwide cohort of patients with SARS CoV-2 vaccine-induced liver injury, focusing on treatment and the evolution after further booster administration. PATIENTS AND METHODS: multicentre, retrospective-prospective study, including subjects who developed abnormal liver tests within 90 days after administration of SARS-CoV-2 vaccination. RESULTS: 47 cases were collected: 17 after prime dose and 30 after booster. Age was 57 years, 30 (63.8 %) were female, and 7 (14.9 %) had a history of prior autoimmune hepatitis (AIH). Most cases were non-severe, though 9 (19.1 %) developed acute liver injury or failure (ALF). Liver injury tended to be more severe in those presenting after a booster (p=0.084). Pattern of liver injury was hepatocellular (80.9 %), mixed (12.8 %) and 3 (6.4 %) cholestatic. Liver biopsy was performed on 33 patients; 29 showed findings of AIH. Forty-one (87.2 %) patients received immunosuppressants, mostly corticosteroids (35/41). One required liver transplantation and another died due to ALF. Immunosuppression was discontinued in 6/41 patients without later rebound. Twenty-five subjects received at least one booster and 7 (28.0 %) relapsed from the liver injury, but all were non-severe. Recurrence was less frequent among patients on immunosuppressants at booster administration (28.6 % vs. 88.9 %, p=0.007). CONCLUSIONS: SARS CoV-2 vaccine-induced liver injury is heterogeneous but mostly immune-mediated. Relapse of liver injury after re-exposure to vaccine is frequent (28.0 %) but mild. Immunosuppression at booster administration is associated with a lower risk of liver injury.

Garlic prevents the oxidizing and inflammatory effects of sepsis induced by bacterial lipopolysaccharide at the systemic and aortic level in the rat. Role of trpv1.

Garlic (Allium sativum) possesses healing properties for diseases like systemic arterial hypertension, cancer and diabetes, among others. Its main component, allicin, binds to the Transient Receptor Potential Vanilloid Type 1 (TRPV1). In this study, we investigated TRPV1's involvement in the regulation of various molecules at the systemic and aortic levels in Wistar rats treated with bacterial lipopolysaccharide (LPS) and garlic to activate the receptor. The experimental groups were as follows: 1) Control, 2) LPS, 3) Garlic, and 4) LPS + Garlic. Using Uv-visible spectrophotometry and capillary zone electrophoresis, we measured the levels of nitric oxide (NO), biopterins BH2 and BH4, total antioxidant capacity (TAC) and oxidizing capacity (OXCA). We also analyzed molecules related to vascular homeostasis such as angiotensin Ang 1-7 and Ang II, as well as endothelin ET-1. In addition, we assessed the inflammatory response by determining the levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNFα), and galectin-3 (GTN-3). For cell damage assessment, we measured levels of malondialdehyde (MDA), malonate (MTO) and 8-hydroxy-2-deoxyguanosine (8HO2dG). The results showed that LPS influenced the NO pathway at both systemic and aortic levels by increasing OXCA and reducing TAC. It also disrupted vascular homeostasis by increasing Ang-II and ET-1, while decreasing Ang1-7 levels. IL-6, TNFα, GTN-3, as well as MDA, MTO, and 8HO2dG were significantly elevated compared to the control group. The expression of iNOS was increased, but TRPV1 remained unaffected by LPS. However, garlic treatment effectively mitigated the effects of LPS and significantly increased TRPV1 expression. Furthermore, LPS caused a significant decrease in calcitonin gene-related peptide (CGRP) in the aorta, which was counteracted by garlic treatment. Overall, TRPV1 appears to play a crucial role in regulating oxidative stress and the molecules involved in damage and inflammation induced by LPS. Thus, studying TRPV1, CGRP, and allicin may offer a potential strategy for mitigating inflammatory and oxidative stress in sepsis.

Hepatoprotective Mechanisms Induced by Spinach Methanolic Extract in Rats with Hyperglycemia-An Immunohistochemical Analysis.

Spinach methanolic extract (SME) has a hepatoprotective effect due to its polyphenolic antioxidants; however, its action in parenchymal (PQ) and non-parenchymal (nPQ) cells remains unknown. This study investigates the hepatoprotective effect of SME on streptozotocin-induced hyperglycemic rats (STZ), focusing on immunohistochemical analyses. Methods: The extract was prepared, and the total polyphenols and antioxidant activity were quantified. Adult male Wistar rats were divided into four groups (n = 8): normoglycemic rats (NG), STZ-induced hyperglycemic (STZ), STZ treated with 400 mg/kg SME (STZ-SME), and NG treated with SME (SME) for 12 weeks. Serum liver transaminases and lipid peroxidation levels in tissue were determined. The distribution pattern and relative levels of markers related to oxidative stress [reactive oxygen species (ROS), superoxide dismutase-1, catalase, and glutathione peroxidase-1], of cytoprotective molecules [nuclear NRF2 and heme oxygenase-1 (HO-1)], of inflammatory mediators [nuclear NF-κB, TNF-α], proliferation (PCNA), and of fibrogenesis markers [TGF-ß, Smad2/3, MMP-9, and TIMP1] were evaluated. Results: SME had antioxidant capacity, and it lowered serum transaminase levels in STZ-SME compared to STZ. It reduced NOX4 staining, and lipid peroxidation levels were related to low formation of ROS. In STZ-SME, the immunostaining for antioxidant enzymes increased in nPQ cells compared to STZ. However, enzymes were also localized in extra and intracellular vesicles in STZ. Nuclear NRF2 staining and HO-1 expression in PQ and nPQ were higher in STZ-SME than in STZ. Inflammatory factors were decreased in STZ-SME and were related to the percentage decrease in NF-κB nuclear staining in nPQ cells. Similarly, TGF-ß (in the sinusoids) and MMP-9 (in nPQ) were increased in the STZ-SME group compared to the other groups; however, staining for CTGF, TIMP1, and Smad2/3 was lower. Conclusions: SME treatment in hyperglycemic rats induced by STZ may have hepatoprotective properties due to its scavenger capacity and the regulation of differential expression of antioxidant enzymes between the PQ and nPQ cells, reducing inflammatory and fibrogenic biomarkers in liver tissue.

Cross-species transmission and PB2 mammalian adaptations of highly pathogenic avian influenza A/H5N1 viruses in Chile.

H5N1 highly pathogenic avian influenza viruses (HPAIV) emerged in wild birds in Chile in December 2022 and spilled over into poultry, marine mammals, and one human. Between December 9, 2022 - March 14, 2023, a coordinated government/academic response detected HPAIV by real-time RT-PCR in 8.5% (412/4735) of samples from 23 avian and 3 mammal orders. Whole-genome sequences obtained from 77 birds and 8 marine mammals revealed that all Chilean H5N1 viruses belong to lineage 2.3.4.4b and cluster monophyletically with viruses from Peru, indicating a single introduction from North America into Peru/Chile. Mammalian adaptations were identified in the PB2 segment: D701N in two sea lions, one human, and one shorebird, and Q591K in the human and one sea lion. Minor variant analysis revealed that D701N was present in 52.9 - 70.9% of sequence reads, indicating the presence of both genotypes within hosts. Further surveillance of spillover events is warranted to assess the emergence and potential onward transmission of mammalian adapted H5N1 HPAIV in South America.

Psychiatric disorders in post-traumatic brain injury patients: A scoping review.

Background: Traumatic Brain Injury (TBI) is an important antecedent in the evaluation of patients with psychiatric disorders. The association between TBI and the subsequent appearance of psychiatric disorders has been documented, however, the findings found in the literature are diverse and controversial. Objective: To identify the most prevalent psychiatric disorders after head trauma. Design: An exploratory review (SCOPING) was carried out using the PRISMA extension protocol. Articles published between the years 2010-2022 were used to identify and describe the most prevalent psychiatric disorders after a TBI. Psychiatric disorders were classified according to clinical characteristics in neurotic syndromes, psychotic syndromes, cognitive disorders, among others. Results: A total of 32 articles were included. In the framework of neurotic syndromes, depression is the most prevalent psychiatric alteration after a TBI, becoming a sequel that shows a higher incidence in the first year after the traumatic event. The findings found in relation to post-traumatic stress disorder are controversial, showing great variability regarding the degree of severity of the injury. The prevalence of psychotic syndromes is relatively low because it is difficult to determine if the psychosis is a direct consequence of a TBI. In the cognitive sphere, it was found that people with TBI presented alterations in cognitive functions. Conclusions: The findings found in the review respond to the hypothesis initially raised, which assumes that head trauma is an important etiological factor in the appearance of psychiatric disorders.

División de Pediatría UC: más de 50 años de historia de crecimiento y desarrollo / UC Division of Pediatrics: more than 50 years of history of growth and development

Con mucha alegría y satisfacción celebramos 52 años de la creación del Departamento (hoy División) de Pediatría en la Facultad de Medicina de la Pontificia Universidad Católica de Chile en 1970, y 50 años desde el egreso de los primeros pediatras de nuestro programa de especialidad médica. Si bien oficialmente el Departamento de Pediatría nació en 1970 por un decreto del entonces Decano Dr. Juan Ignacio Monge, las raíces de la enseñanza de la pediatría se remontan a enero de 1954, cuando Monseñor Alejandro Silva Santiago, Rector de la Universidad, creó la Cátedra de Pediatría y nombró como su primer Profesor Titular al Dr. Julio Meneghello Rivera.

Deodorized Garlic Decreases Oxidative Stress Caused by Lipopolysaccharide in Rat Heart through Hydrogen Sulfide: Preliminary Findings.

Deodorized garlic (DG) may favor the activity of the antioxidant enzymes and promote the synthesis of hydrogen sulfide (H2S). The objective was to test if DG favors an increase in H2S and if it decreases the oxidative stress caused by lipopolysaccharide (LPS) in rat hearts. A total of 24 rats were divided into 4 groups: Group 1 control (C), Group 2 LPS, Group 3 DG, and Group 4 LPS plus DG. The cardiac mechanical performance (CMP), coronary vascular resistance (CVR), and oxidative stress markers, such as total antioxidant capacity (TAC), glutathione (GSH), selenium (Se), lipid peroxidation (LPO), thiols, hydrogen sulfide (H2S), and the activities and expressions of thioredoxin reductase (TrxR), glutathione peroxidase (GPx), and glutathione-S-transferase (GST), cystathionine synthetase (CBS), cystathionine γ-lyase (CTH), iNOS, and eNOS-p, were analyzed in the heart. Infarct zones in the cardiac tissue were present (p = 0.01). The CMP and CVR decreased and increased (p ≤ 0.05), TAC, GSH, H2S, NO, thiols, and GST activity (p ≤ 0.01) decreased, and LPO and iNOS increased (p ≤ 0.05). The activities and expressions of TrxR, GPx, eNOS-p, CTH, and CBS (p ≤ 0.05) decreased with the LPS treatment; however, DG normalized this effect. DG treatment decreases heart damage caused by LPS through the cross-talk between the H2S and NO systems.

A novel model to predict severe COVID-19 and mortality using an artificial intelligence algorithm to interpret chest radiographs and clinical variables.

Background: Patients with coronavirus disease 2019 (COVID-19) could develop severe disease requiring admission to the intensive care unit (ICU). This article presents a novel method that predicts whether a patient will need admission to the ICU and assesses the risk of in-hospital mortality by training a deep-learning model that combines a set of clinical variables and features in chest radiographs. Methods: This was a prospective diagnostic test study. Patients with confirmed severe acute respiratory syndrome coronavirus 2 infection between March 2020 and January 2021 were included. This study was designed to build predictive models obtained by training convolutional neural networks for chest radiograph images using an artificial intelligence (AI) tool and a random forest analysis to identify critical clinical variables. Then, both architectures were connected and fine-tuned to provide combined models. Results: 2552 patients were included in the clinical cohort. The variables independently associated with ICU admission were age, fraction of inspired oxygen (F iO2 ) on admission, dyspnoea on admission and obesity. Moreover, the variables associated with hospital mortality were age, F iO2 on admission and dyspnoea. When implementing the AI model to interpret the chest radiographs and the clinical variables identified by random forest, we developed a model that accurately predicts ICU admission (area under the curve (AUC) 0.92±0.04) and hospital mortality (AUC 0.81±0.06) in patients with confirmed COVID-19. Conclusions: This automated chest radiograph interpretation algorithm, along with clinical variables, is a reliable alternative to identify patients at risk of developing severe COVID-19 who might require admission to the ICU.

Determination of Cabernet Sauvignon wine quality parameters in Chile by Absorbance-Transmission and fluorescence Excitation Emission Matrix (A-TEEM) spectroscopy.

A-TEEM spectroscopy is presented as a novel rapid quantitative analysis method for 44 individual phenolic and basic wine chemistry compounds. To date no practical and combined analysis method for these recognized quality parameters important to the wine industry exists. The method was implemented in a Lambert-Beer linear concentration range to facilitate traceable absorbance and fluorescence spectral signatures. Both components were comparatively analyzed as single- and combined multi-block variable sets, and regressed against HPLC-DAD, UV-vis spectroscopy and other analytical reference data, using the Extreme Gradient Boost Regression (XGBR) and Partial Least Squares Regression (PLSR) algorithms. The approach was applied on 126 wines, and subsequently validated by a random split of 13% of the set and an additional independent set of 16 wines. XGBR with multi-block data organization systematically yielded the highest prediction accuracy and precision with respective overall valid fits indicated by mean R2 and relative bias of 0.94 ± 0.04 and 4.1 ± 1.8%.

TRPV1 Contributes to Modulate the Nitric Oxide Pathway and Oxidative Stress in the Isolated and Perfused Rat Heart during Ischemia and Reperfusion.

The transient vanilloid receptor potential type 1 (TRPV1) regulates neuronal and vascular functions mediated by nitric oxide (NO) and by the calcitonin gene-related peptide (CGRP). Here, we study the participation of TRPV1 in the regulation of myocardial injury caused by ischemia-reperfusion and in the control of NO, tetrahydrobiopterin (BH4), the cGMP pathway, CGRP, total antioxidant capacity (TAC), malondialdehyde (MDA) and phosphodiesterase-3 (PDE-3). Isolated hearts of Wistar rats perfused according to the Langendorff technique were used to study the effects of an agonist of TRPV1, capsaicin (CS), an antagonist, capsazepine (CZ), and their combination CZ+CS. The hearts were subjected to three conditions: (1) control, (2) ischemia and (3) ischemia-reperfusion. We determined cardiac mechanical activity and the levels of NO, cGMP, BH4, CGRP, TAC, MDA and PDE-3 in ventricular tissue after administration of CS, CZ and CZ+CS. Western blots were used to study the expressions of eNOS, iNOS and phosphorylated NOS (pNOS). Structural changes were determined by histological evaluation. CS prevented damage caused by ischemia-reperfusion by improving cardiac mechanical activity and elevating the levels of NO, cGMP, BH4, TAC and CGRP. TRPV1 and iNOS expression were increased under ischemic conditions, while eNOS and pNOS were not modified. We conclude that the activation of TRPV1 constitutes a therapeutic possibility to counteract the damage caused by ischemia and reperfusion by regulating the NO pathway through CGRP.

Depressive symptomatology in adults during the COVID-19 pandemic.

Depression entails changes in the mental health of individuals worldwide. Episodes of depression lead to mood swings and changes in the motivational dimension. Our research focused on the prevalence of depression in the adult population and on how it affected the social and affective dimensions. Owing to the current pandemic, we deemed it necessary to explore how protective measures against COVID-19 infection, such as quarantines, could be related to mental health. Moreover, we found it important to determine the prevalence of depressive and anxious symptomatology in adults from the Valle del Cauca region in Colombia during the social isolation connected to COVID-19. Our study was descriptive, analytical and cross-sectional, and involved 1248 subjects. As tools, we used the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale. The data demonstrated that women were more likely to display symptoms of depression and that individuals aged between 24 and 29 were less likely to reveal symptoms of anxiety than those aged between 18 and 23. Moreover, childless or economically dependent individuals proved to be more likely to display symptoms of depression during the pandemic.

Phenolic and anthocyanin content characterization related to genetic diversity analysis of Solanum tuberosum subsp. tuberosum Chilotanum Group in southern Chile.

The potato (Solanum tuberosum L) is one of the four most important crops worldwide in production and consumption. It originated from South America along the Andes, where six hotspots of diversity known as subcenters of origin are described from Venezuela to Chiloe Island in Chile, and where the greatest diversity of potatoes in the world is found. Today, the use of ancestral genetic resources has gained significant relevance, recovering and producing foods with a greater nutrient content and beneficial to human health. Therefore, native potatoes possess a set of characteristics with great potential for use in potato breeding guided primarily to produce better feed, especially potatoes of the Chilotanum Group that are easily crossed with conventional varieties. The primary objective of this study was to evaluate 290 accessions of S. tuberosum subsp tuberosum belonging to the Chilotanum Group using a set of molecular markers and correlate them to its phenotypic traits for future use in breeding programs. For this purpose, 290 accessions were analysed through 22 specific microsatellites described previously, correlating them with flesh and skin colour, total phenolic content, and anthocyanin content. A division into groups considering all the 290 accessions resulted in two clusters using STRUCTURE analysis and seven different genetic clusters using UPGMA. The latter exhibited common phenotypic characteristics as well as anthocyanin content, strongly supporting a correlation between phenotypic traits and the genetic fingerprint. These results will enable breeders to focus on the development of potatoes with high polyphenol and anthocyanin content.

LC-MS-Based Metabolomics Discriminates Premium from Standard Chilean cv. Cabernet Sauvignon Wines from Different Valleys.

Cabernet Sauvignon grapes in Chile, mainly grown between the 30° S and 36° S, account for more than 30% of Chilean wine production, and yield wines with different characteristics which influence their quality. The aim of this study was to apply a liquid chromatography-mass spectrometry (LC-MS)-based metabolomic protocol to investigate the quality differentiation in a sample set of monovarietal wines from eight valleys covering 679 km of the north-south extension. All samples were produced using a standardized red winemaking process and classified according to a company categorization in two major groups: premium and standard, and each group in two subcategories. The results pointed out that N-containing metabolites (mainly small peptides) are promising biomarkers for quality differentiation. Moreover, the premium wines were characterized by higher amounts of anthocyanins and other glycosylated and acetylated flavonoids, as well as phenolic acids; standard quality wines, on the other hand, presented stilbenoids and sulfonated catabolites of tryptophan and flavanols.

Effects of Microwave Heating and Long-Term Aging on the Rheological and Chemical Properties of Recovered Bitumen.

Microwave heating of asphalt pavement is a promising technique to reduce the maintenance and increase the service life of materials through self-healing of cracks. Previous studies have shown that microwave heating technology at high temperatures could damage the bitumen of asphalt mixture, which is an unwanted effect of the crack-healing technique. In this study, the effects of microwave heating and long-term aging on the rheological and chemical properties of recovered bitumen were quantified using a frequency sweep test and Fourier Transform Infrared Spectrometry analysis, respectively. The main results indicate that microwave heating has no significant effect on the aging performance of G* and δ for aged asphalt mixtures. However, for newer bitumens, the rheological properties G* and δ show minor changes after microwave heating was applied. Overall, this study confirms that microwave heating is a potential alternative for maintenance of asphalt pavements, without severely affecting the rheological and chemical properties of bitumen.

Role of the Transient Receptor Potential Vanilloid Type 1 (TRPV1) in the Regulation of Nitric Oxide Release in Wistar Rat Aorta.

The potential transient vanilloid receptor type 1 (TRPV1) plays important functional roles in the vascular system. In the present study, we explored the role of the TRPV1 in the production of nitric oxide (NO), biopterines (BH4 and BH2), cyclic guanosine monophosphate (cGMP), malondialdehyde (MDA), phosphodiesterase-3 (PDE-3), total antioxidant capacity (TAC), and calcitonin gene-related peptide (CGRP) in the rat aorta. Wistar rats were divided into four groups: (1) control, (2) capsaicin (CS, 20 mg/kg), (3) capsazepine (CZ, 24 mg/kg), and (4) CZ + CS. Treatments were applied daily for 4 days before removing the thoracic aortas for testing of aortic tissue and endothelial cells. TRPV1 activation produced increases in BH4 14%, cGMP 25%, NO 29%, and TAC 59.2% in comparison to the controls. BH2 and MDA increased with CZ. CGRP shows a tendency to decrease with CZ. The analysis by immunocytochemistry confirmed that the TRPV1 is present in aortic endothelial cells. Aortic endothelial cells were obtained from healthy rats and cultured to directly explore the effects of CS and CZ. The activation of the TRPV1 (CS 30 µM) produced increases in BH4 17%, NO 36.6%, TAC 56.3%, and CGRP 65%, when compared to controls. BH2 decreased with CZ + CS. CS effects were diminished by CZ in cells and in the tissue. We conclude that the TRPV1 is a structure present in the membrane of aortic endothelial cells and that it participates in the production of NO. The importance of the TRPV1 should be considered in vascular reactivity studies.

Evolution of endodontic medicine: a critical narrative review of the interrelationship between endodontics and systemic pathological conditions.

Endodontics has gained emphasis in the scientific community in recent years due to the increase in clinical and in animal models studies focused on endodontic medicine, which aims to evaluate the interrelationship between systemic and periapical tissues pathological conditions. These studies have shown that systemic changes can boost the pathogenesis of endodontic infection, favoring its development and progression. A contrary relationship is reported in numerous studies that affirm the potential of endodontic infection to trigger systemic damage and may lead to the worsening of pre-existing pathologies. Recently, the potential of filling materials to develop systemic changes such as neurological alterations had been evaluated, also showing that systemic diseases can negatively influence tissue responses to filling materials after endodontic treatment. Despite advances in endodontic medicine studies, there are still gaps in knowledge on the mechanisms of interactions between apical periodontitis (AP) and systemic diseases and much research to be done. In this sense, this critical narrative literature review aimed to show the evolution of studies in endodontic medicine to help the endodontist to know the role of systemic diseases in the pathogenesis of AP and the possible interference in the repair of periapical tissues after endodontic treatment, as well as to evidence the systemic complications that can be triggered or aggravated in the presence of endodontic infection.

Factores de riesgo preoperatorios en pacientes con pielonefritis xantogranulomatosa sometidos a nefrectomía.

OBJETIVO: Identificar factores de riesgo asociados a complicaciones mayores en pacientes con pielonefritis xantogranulomatosa sometidos a nefrectomía. MÉTODO: Análisis retrospectivo de expedientes clínicos de pacientes con pielonefritis xantogranulomatosa sometidos a nefrectomía. Se analizaron el sexo, el índice de masa corporal, el índice de comorbilidad de Charlson, la clasificación del estado físico de la American Society of Anesthesiologists, la etapa de Malek, el conteo leucocitario y los valores de creatinina. Las complicaciones se estratificaron en menores y mayores según la clasificación de Clavien-Dindo. Se realizó análisis univariado y bivariado usando las pruebas exacta de Fisher y ji al cuadrado de Pearson, y se establecieron medidas de riesgo utilizando la odds ratio (OR). RESULTADOS: Se analizaron 72 pacientes con una edad media de 50 años, el 83% mujeres, el 58.3% con urocultivo positivo y el 66% con litiasis renal. El 32% tuvieron alguna complicación mayor y el 15% requirieron admisión a la unidad de cuidados intensivos. Los valores elevados de creatinina (OR: 3.8; intervalo de confianza del 95% [IC95%]: 1.1-13; p = 0.02) y la etapa Malek II-III (OR: 4.5; IC95%: 1.2-17.5; p = 0.02) se asociaron con complicaciones mayores. CONCLUSIÓN: El estadio de Malek y los valores elevados de creatinina incrementan el riesgo de desarrollar complicaciones mayores en los pacientes con pielonefritis xantogranulomatosa sometidos a nefrectomía. OBJECTIVE: To identify preoperative risk factors associated with major complications in patients with xanthogranulomatous pyelonephritis undergoing total nephrectomy. METHOD: Retrospective analysis of patient's charts with xanthogranulomatous pyelonephritis who underwent nephrectomy. Risk factors included for analysis were gender, body mass index, Charlson comorbidity index, American Society of Anesthesiologists physical status classification, Malek's stage, leukocyte count and creatinine levels. Postoperative complications were stratified in minor and major according to Clavien-Dindo's classification. Univariate and bivariate analysis using Fisher's exact test, Pearson's chi-squared and odds ratio (OR) was performed. RESULTS: 72 patients were analyzed, 83% women, mean age of 50 years, 58.3% positive urine cultures and 66% kidney stones. Major complications were present in 32% of cases, and 15% were admitted to the intensive care unit. Elevated creatinine (OR: 3.8; 95% confidence interval [95%CI]: 1.1-13; p = 0.02) and Malek's stage II to III (OR: 4.5; 95%CI: 1.2-17.5; p = 0.02) were associated with major complications. CONCLUSION: The Malek Stage and elevated creatinine increases the risk of major complications in patients undergoing nephrectomy due to xanthogranulomatous pyelonephritis.

Preoperative and Postoperative Sagittal Alignment and Compensatory Mechanisms in Patients With Posttraumatic Thoracolumbar Deformities Who Undergo Corrective Surgeries.

BACKGROUND: Secondary posttraumatic spinal kyphosis is a fixed deformity that has an asymptomatic presentation in most patients, but in some, persistent pain and disability can develop refractory to conservative treatment, which may result in the need for corrective surgery. Our aim was to analyze the modification of sagittal alignment and the variation in compensation mechanisms of spinal-pelvic segments before and after surgical correction in a group of patients with symptomatic posttraumatic kyphosis. METHODS: A retrospective cohort study of 16 consecutive patients from the beginning of 2007 until the beginning of 2017 who underwent surgery due to thoracolumbar sagittal deformities was performed. Regional kyphosis (RK), thoracic kyphosis (TK), lumbar lordosis (LL), lower lumbar lordosis (LLL), lumbar lordosis under the deformity (LLUD), pelvic incidence (PI), pelvic tilt (PT), sagittal vertical axis (SVA), and PI-LL were measured in preoperative and postoperative lateral full spine x rays. Statistical analysis was performed with the nonparametric Wilcoxon test to compare preoperative and postoperative radiologic variables. RESULTS: Sixteen patients were included with a median age of 47.5 years (32-62 years), the median time elapsed from the accident until corrective surgery was 7 months (2-33 months), the median follow-up time was 16.5 months (6-80 months), and the most used corrective strategy was pedicle subtraction osteotomy (11/16 patients). Statistically and radiologically significant improvements were observed in RK (33.5° versus 12°, P < .001) and LLUD (68.5° versus 61°, P = .017), with a noticeable decrease in PI-LL (15° versus 9.5°, P = .233). There were no statistically significant results regarding TK, LL, LLL, PI, PT, or SVA. CONCLUSIONS: Osteotomies are an effective tool to correct angular deformities at a local level after spine trauma. Posttraumatic kyphosis results in the compensation of sagittal imbalance through modification of segmental alignment of the mobile spine under the deformity. LEVEL OF EVIDENCE: 3. CLINICAL RELEVANCE: This work shows the compensation mechanisms after post-traumatic kyphosis in patients with previously healthy spines.

Effect of two different chest compression techniques on ventilation during neonatal resuscitation.

OBJECTIVE: To assess tidal volume (Vt) and minute ventilation (MV) during cardiopulmonary resuscitation (CPR) with two different chest compressions techniques: two-finger (TFT) or two-thumb technique (TTT) in a neonatal model. METHODS: Vt and MV were continuously measured during consecutive periods of resuscitation in an intubated manikin. Thirty participants performed the two compression techniques in a random order for 2-min periods while performing positive pressure ventilation using a T-piece resuscitator (TPR) or a self-inflating bag (SIB). RESULTS: Vt during CPR with TFT was significantly higher than TTT with either TPR: 44.9 ± 4.3 vs 39.2 ± 5.4 ml (p < 0.001) or SIB: 39.2 ± 5.7 vs 35.6 ± 6.5 ml (p < 0.023). Similarly MV was significantly higher in TFT than TTT with either mode: 1346 ± 130 vs 1175 ± 162 ml/min, respectively, with TPR (p < 0.001) and 1177 ± 170 vs 1069 ± 196 ml/min with SIB (p < 0.03). CONCLUSIONS: Chest compressions during CPR using the TFT achieved higher Vt and MV than TTT in this model of neonatal resuscitation.