Fijación de tórax inestable con placas y tornillos bioabsorbibles. Presentación de serie de casos / Thoracic inestability fixed with bioabsorbable screws and plates

Resumen: Antecedentes: El tórax inestable se trata con ventilación mecánica o inhaloterapia y analgesia. Poco se ha publicado sobre el uso de material bioabsorbible y su evolución en la fijación de tórax inestable. Métodos: Estudio descriptivo de pacientes con tórax inestable sometidos a fijación con placas y tornillos bioabsorbibles en un período comprendido de Febrero de 2009 a Diciembre de 2011. Resultados: Presentamos 18 casos con edades entre 33 y 74 años (media de 53), tres con tórax inestable bilateral; la fijación costal se realizó entre 1 y 21 días del accidente (media de 1.5). Se inició deambulación al día siguiente en 14 casos; la estancia postoperatoria fue de cuatro días (rango de 3 a 14). La frecuencia cardíaca de los pacientes previa a la cirugía era de 90 por minuto (rango 82 a 100) y bajó a 84 después de la fijación (rango 82 a 92); la frecuencia respiratoria preoperatoria era 26 por minuto (rango 22 a 28) y bajó a 22 por minuto (rango 20 a 26) en el postoperatorio. Conclusiones: El uso de material bioabsorbible para osteosíntesis costal no tiene efectos secundarios atribuibles al material en el corto plazo.

Abstract: Background: Flail chest is managed with mechanical ventilation or inhaloteraphy and analgesia. Little has been published on the use of bioabsorbable material and its evolution in flail chest fixation. Methods: This is a descriptive study of patients with unstable chest undergoing fixation with bioabsorbable plates and screws in a period from February 2009 to December 2011. Results: We report 18 cases, aged 33-74 years (mean 53), three with bilateral involvement; rib fixation was performed between 1-21 days of the accident (mean 1.5). They started walking the next day in 14 cases; postoperative stay was four days (range 3-14). The heart rate of patients prior to surgery was 90 per minute (range 82-100) and lowered to 84 after fixation (range 82-92), preoperative respiratory rate was 26 per minute (range 22-28) and below 22 per minute (range 20 to 26) in postoperative period. Conclusions: The use of bioabsorbable material for osteosynthesis of costal fractures did not show side effects in our period of study.

[Thoracic inestability fixed with bioabsorbable screws and plates]. / Fijación de tórax inestable con placas y tornillos bioabsorbibles. Presentación de serie de casos.

BACKGROUND: Flail chest is managed with mechanical ventilation or inhaloteraphy and analgesia. Little has been published on the use of bioabsorbable material and its evolution in flail chest fixation. METHODS: This is a descriptive study of patients with unstable chest undergoing fixation with bioabsorbable plates and screws in a period from February 2009 to December 2011. RESULTS: We report 18 cases, aged 33-74 years (mean 53), three with bilateral involvement; rib fixation was performed between 1-21 days of the accident (mean 1.5). They started walking the next day in 14 cases; postoperative stay was four days (range 3-14). The heart rate of patients prior to surgery was 90 per minute (range 82-100) and lowered to 84 after fixation (range 82-92), preoperative respiratory rate was 26 per minute (range 22-28) and below 22 per minute (range 20 to 26) in postoperative period. CONCLUSIONS: The use of bioabsorbable material for osteosynthesis of costal fractures did not show side effects in our period of study.

ANTECEDENTES: El tórax inestable se trata con ventilación mecánica o inhaloterapia y analgesia. Poco se ha publicado sobre el uso de material bioabsorbible y su evolución en la fijación de tórax inestable. MÉTODOS: Estudio descriptivo de pacientes con tórax inestable sometidos a fijación con placas y tornillos bioabsorbibles en un período comprendido de Febrero de 2009 a Diciembre de 2011. RESULTADOS: Presentamos 18 casos con edades entre 33 y 74 años (media de 53), tres con tórax inestable bilateral; la fijación costal se realizó entre 1 y 21 días del accidente (media de 1.5). Se inició deambulación al día siguiente en 14 casos; la estancia postoperatoria fue de cuatro días (rango de 3 a 14). La frecuencia cardíaca de los pacientes previa a la cirugía era de 90 por minuto (rango 82 a 100) y bajó a 84 después de la fijación (rango 82 a 92); la frecuencia respiratoria preoperatoria era 26 por minuto (rango 22 a 28) y bajó a 22 por minuto (rango 20 a 26) en el postoperatorio. CONCLUSIONES: El uso de material bioabsorbible para osteosíntesis costal no tiene efectos secundarios atribuibles al material en el corto plazo.

Semen and urine culture in the diagnosis of chronic bacterial prostatitis.

OBJECTIVE: To assess the diagnostic accuracy of semen and urine culture in the diagnosis of chronic bacterial prostatitis (CBP). MATERIALS AND METHODS: In 70 consecutive men suspected of having chronic bacterial prostatitis along with 17 asymptomatic controls, we obtained urine and semen cultures followed 1 week later by the Meares and Stamey test, our reference standard. The interpretation of each of the cultures was blind to the results of other tests. RESULTS: 139 men were referred for evaluation of chronic bacterial prostatitis and 70 received all tests. Additionally, 17 control men volunteered to participate. The Meares and Stamey Test was positive in 69 (79%) patients. The semen culture had a sensitivity of 45% and a specificity of 94%. The likelihood ratio associated with a positive semen culture was 8.1 (95% confidence interval (CI) 1.2 to 55.3); the likelihood ratio associated with a negative semen culture was 0.6 (95% CI 0.5 to 0.7). The urine culture had a sensitivity of 4% and a specificity of 100%. The likelihood ratio of a positive urine culture was infinity and of a negative urine culture was 0.96 (95% CI 0.9 to 1). CONCLUSIONS: While a positive semen culture in a symptomatic patient may suffice to select and start antibiotic treatment against chronic bacterial prostatitis, a negative culture does not rule out the condition. Urine cultures alone are not useful for diagnosing CBP. The Meares and Stamey test remains important for the diagnosis of CBP in practice.

Comparación de costo-efectividad entre dos técnicas anestésicas: anestesia con sevofluorane-remifentanil frente a isofluorane-remifentanil / Cost-Effective Comparison Between Two Anesthesia Techniques: Sevofluorane-Remifentanyl vs Isofluorane-Remifentanyl

Nos encontramos en la era de la optimización de costos, por lo que es necesario realizar estudios farmacoeconómicos para identificar la costo- efectividad de los anestésicos actuales. Metodología: este estudio prospectivo, cegado al paciente, comparó los costos directos, los tiempos de recuperación y satisfacción de 45 pacientes que se asignaron aleatoriamente a dos grupos de anestesia balanceada (grupo sevofluoraneremifentanil n = 24 o grupo isofluoraneremifentanil n = 21) que iban a ser sometidos a cirugías de otorrinolaringología. Resultados: los tiempos de recuperación temprana (apertura ocular, respuesta a comandos, extubación, orientación y salida de sala) fueron menores en el grupo ISO y tuvieron diferencia estadísticamente significativa. Se encontraron datos variables en los costos de adquisición de los halogenados gastados, que fueron menores para el isofluorane, lo cual hacía también menos costosos los insumos anestésicos durante las cirugías; sin embargo, los costos en la sala de cirugía, en recuperación y sala de ambulatorios y los costos totales no mostraron diferencias significativas. La satisfacción fue similar entre los dos grupos. Conclusiones: una técnica basada en sevofluorane-remifentanil no es más costo-efectiva que utilizar isofluorane-remifentanil para pacientes ambulatorios sometidos a cirugías de otorrinolaringología.

We are in the of costs optimization era, reason why it is necessary to make pharmaceutical economics studies to identify the costeffectiveness of today's anesthetics. Methods: this prospective study, blinded to the patient, compared the direct costs, recovery times and satisfaction of 45 patients randomly assigned to two balanced anesthesia groups (sevofluoraneremifentanil group n = 24 or isofluoraneremifentanil group n = 21) submitted to otorhinolaringology surgical procedures. Results: the times of early recovery (ocular opening, answer to commandos, extubación, orientation and room leave) were smaller in ISO group and had statistically significant difference. Variable data was found in acquisition costs of halogenados gastados, lesser for isofluorane, which also made the anesthetic supplies less expensive during surgical procedures; nevertheless, costs in the delivery room, in recovery and ambulatory room, and the total costs did not show significant differences. Satisfaction was similar between both groups. Conclusions: a sevofluorane-remifentanil based technique is not more cost-effective than to use isofluoraneremifentanil for ambulartory patients submitted to otorhinolaringology surgical procedures.

Efeitos do exercicio cronico com orientacao nutricional sobre parametros lipidicos de mulheres obesas / Effect of chronic exercise with nutritional orientation on lipidics variables at plasm from obese women

A obesidade e uma doenca com incidencia epidemiologica atinge 41,5 (por cento)da populacao brasileira e esta fortemente relacionada as dislipidemias. O objetivo do presente estudo foi observar os efeitos do exercicio cronico de intensidade moderada, realizado 2 vezes por semana durante um periodo de 12 semanas, acompanhado de orientacao nutricional, sobre a composicao lipidica no plasma de mulheres obesas. Para este estudo foram considerados os seguintes parametros: avaliacao antropometrica (peso, estatura e circunferencias da cintura e do quadril), concentracao de glicose e lipidios no soro (lipidios totais triglicerides e colesterol total, pelo metodo colorimetrico enzimatico) e avaliacao clinica nutricional. Decorrente do exercicio e da orientacao nutricional observou-se diminuicao significativa de 29,8(por cento) na concentracao de lipidios totais e de 9,50(por cento) no colesterol total (*p< 0,05), reducao media de 9,9(por cento) na concentracao de glicose sanguinea e de 18,9(por cento) na concentracao de triglicerides. Desse modo, acreditamos que este modelo de intervencao (exercicio moderado associado a orientacao nutricional) contribui de forma substancial para o controle da obesidade e alteracoes no metabolismo lipidico

[Evidence for glutamatergic neurotransmission in the geniculo-cortical pathway in the rat]. / Evidencias de la participación del ácido glutámico en la neurotransmisión de la vía genículo-cortical en la rata.

PURPOSE: To investigate the possible participation of glutamate in the neurotransmission of the rat geniculo-cortical pathway. METHODS: In a first set of experiments, we studied the effects of microiontophoresis of kynurenate, a broad spectrum antagonist of glutamate receptors, on the excitation evoked in visual cortex cells by electrical stimulation of the dorsal lateral geniculate nucleus and the optic tract. Cell activity was determined by extracellular unit recordings. In a second set of experiments, we studied the effects of electrical stimulation of the dorsal lateral geniculate nucleus and the optic tract on the release of glutamate and aspartate in the visual cortex in vivo. Push pull perfusions were made in the visual cortex and the amino acids contents of the perfusates were analysed by high performance liquid chromatography. RESULTS: Microiontophoresis of kynureate in area 17 cells selectively supressed the excitatory response to dorsal geniculate nucleus and optic tract stimulation. On the other hand, stimulation of these structures significantly increased glutamate, but not aspartate, release in area 17. CONCLUSIONS: These results demonstrate that glutamate is the neurotransmitter of the geniculo-cortical pathway in the rat.

Spectrophotometric detection of arsenic using flow-injection hydride generation following sorbent extraction preconcentration.

An automated system with a C(18) bonded silica gel packed minicolumn is proposed for spectrophotometric detection of arsenic using flow-injection hydride generation following sorbent extraction preconcentration. Complexes formed between arsenic(III) and ammonium diethyl dithiophosphate (ADDP) are retained on a C(18) sorbent. The eluted As-DDP complexes are merged with a 1.5% (w/v) NaBH(4) and the resulting solution is thereafter injected into the hydride generator/gas-liquid separator. The arsine generated is carried out by a stream of N(2) and trapped in an alkaline iodine solution in which the analyte is determined by the arsenomolybdenum blue method. With preconcentration time of 120 s, calibration in the 5.00-50.0 mug As l(-1) range and sampling rate of about 20 samples h(-1) are achieved, corresponding to 36 mg ADDP plus 36 mg ammonium heptamolybdate plus 7 mg hydrazine sulfate plus 0.7 mg stannous chloride and about 7 ml sample consumed per determination. The detection limit is 0.06 mug l(-1) and the relative standard deviation (n=12) for a typical 17.0 mug As l(-1) sample is ca. 6%. The accuracy was checked for arsenic determination in plant materials from the NIST (1572 citrus leaves; 1573 tomato leaves) and the results were in agreement with the certified values at 95% confidence level. Good recoveries (94-104%) of spiked tap waters, sugars and synthetic mixtures of trivalent and pentavalent arsenic were also found.

[Shaping of the migratory process in northern Mexico, 1930-1990]. / Conformacion del proceso migratorio al norte de Mexico, 1930-1990.

"During the third decade of this century Mexican geographical structure began to change notoriously. Due to the strong influence of [the] North American economy, the north of Mexico became progressively one of the most important regions in the country, with the emergence of favorable perspectives of economic growth. Soon it became attractive to migration from the demographically pressed regions of Central Mexico. Thus, the north of Mexico was favored by the presence of qualified workers and a growing population. However, the region was not evenly populated, due to geographic, historic, and socio-economic factors that...[affect] the processes of migration and settlement. Some regions present important changes in their migratory flow, evidenced by the presence of new entities of origin and the disappearance of others." (SUMMARY IN ENG)