Microplastics and anthropogenic debris in rainwater from Bahia Blanca, Argentina.

Concern about atmospheric microplastic (MP) contamination has increased in recent years. This study assessed the abundance of airborne anthropogenic particles, including MPs, deposited in rainfall in Bahia Blanca, southwest Buenos Aires, Argentina. Rainwater samples were collected monthly from March to December 2021 using an active wet-only collector consisting of a glass funnel and a PVC pipe that is only open during rain events. Results obtained show that all rain samples contained anthropogenic debris. The term "anthropogenic debris" is used to refer to the total number of particles as not all the particles found could be determined as plastic. Among all the samples, an average deposition of 77 ± 29 items (anthropogenic debris) m-2d-1 was found. The highest deposition was observed in November (148 items m-2d-1) while the lowest was found in March (46 items m-2d-1). Anthropogenic debris ranged in size from 0.1 mm to 3.87 mm with the most abundant particles being smaller than 1 mm (77.8%). The dominant form of particles found were fibers (95%), followed by fragments (3.1%). Blue color predominated (37.2%) in the total number of samples, followed by light blue (23.3%) and black (21.7%). Further, small particles (<2 mm), apparently composed of mineral material and plastic fibers, were recognized. The chemical composition of suspected MPs was examined by Raman microscopy. The analysis of µ-Raman spectra confirmed the presence of polystyrene, polyethylene terephthalate, and polyethylene vinyl acetate fibers and provided evidence of fibers containing industrial additives such as indigo dye. This is the first assessment of MP pollution in rain in Argentina.

Amnesia global transitoria: una entidad infrecuente pero presente en Pediatría / Transient global amnesia: an infrequent entity but present in Pediatrics

Introducción: La amnesia global transitoria es una entidad caracterizada por la aparición súbita de amnesia anterógrada con amnesia retrógrada variable, conservando intacta la memoria inmediata. No asocia otros déficits neurológicos. La recuperación es progresiva en pocas horas, habitualmente menos de 12, aunque suele persistir amnesia del episodio y presentar posteriormente cefalea leve. Caso clínico. Niño de 10 años, sin antecedentes de interés, que consulta en Urgencias por aparición brusca de amnesia retrógrada de las últimas 48 horas, así como incapacidad para la fijación de nueva información. Se mostraba ansioso y desorientado, y repetía la misma pregunta varias veces. La exploración neurológica por lo demás era estrictamente normal y negaba cefalea u otra sintomatología asociada. No antecedente de traumatismo craneoencefálico. Se realiza analítica sanguínea y gasometría venosa, sin alteraciones significativas; tóxicos en orina, negativos; TAC cerebral que descarta patología intracraneal aguda y punción lumbar, que es normal. Ingresa en planta de hospitalización con evolución favorable, con cese espontáneo de la clínica a las 8 horas, permaneciendo amnesia del episodio, con resto de la memoria conservada. Comentarios. La fisiopatología de la amnesia global transitoria no está del todo aclarada, aunque hay trabajos que sugieren un origen vascular de la misma, produciéndose durante estos episodios una hipoperfusión del lóbulo temporal medial. Es una entidad típica de adultos de mediana edad y ancianos siendo excepcional en pediatría. Sin embargo, debemos considerar este diagnóstico ante niños con clínica típica, normalidad de la neuroimagen y resolución espontánea de los síntomas.(AU)

Introduction: Transient global amnesia is an entity characterized by the sudden onset of anterograde amnesia with variable retrograde amnesia, preserving immediate memory intact. It is not associated with other neurological deficits. Recovery is progressive in a few hours, usually less than 12 hours, although amnesia of the episode usually persists and later presents mild headache. Case report. A 10-year-old boy, with no previous history of interest, consulted the emergency department for sudden onset of retrograde amnesia of the last 48 hours, as well as inability to fix new information. He was anxious and disoriented and repeated the same question several times. The neurological examination was otherwise strictly normal, and he denied headache or other associated symptoms. There was no history of cranioencephalic trauma. Blood analysis and venous blood gas analysis were performed, with no significant alterations; urine toxins were negative; brain CAT scan ruled out acute intracranial pathology and lumbar puncture was normal. She was admitted to the hospital ward with favorable evolution, with spontaneous cessation of the clinical symptoms after 8 hours, remaining amnesia of the episode, with the rest of the memory preserved. Comments. The pathophysiology of transient global amnesia has not been fully clarified, although some studies suggest a vascular origin, with hypoperfusion of the medial temporal lobe occurring during these episodes. It is a typical entity of middle-aged and elderly adults, being exceptional in pediatrics. However, we should consider this diagnosis in children with typical clinical symptoms, normal neuroimaging and spontaneous resolution of symptoms.(AU)

Estimating the Internal Oxidation of Ni-Al Alloys.

Ni-Al alloys create a cone- shaped figure when there is internal oxide. This behavior was studied by TEM, SEM, X-Ray (XRD), Optical Microscopy and Image Processing. The internal oxide precipitates and its results indicate that this precipitation forms continuous rods in a cone-shaped configuration extending from the surface to the internal oxide front for Ni-Al alloys, whereas for Ni-X (X = Cr, Mo, V, W and Mn) alloys the precipitation is discrete and more irregularly-shaped. Furthermore, in a high atomic percentage (5.18% to 8.67%), the precipitation was rod-like and continuous from the surface to the internal oxide front for all temperature\time conditions. For the Ni-2.47% Al alloy at 800 °C, observations showed a mixture of rod-like and fork like precipitates, whereas after oxidation at 1000 and 1100 °C the precipitation was rod-like and continuous. For the Ni-1.18% Al alloy the aluminum concentration was insufficient for fully continuous precipitation to develop, and the internal oxides were generally acicular-shaped and discontinuous. Images obtained by TEM and, after that, analyzed by image processing allowed us to understand their behavior and the internal oxide patterns.

La otorragia. Una complicación de la hemicolectomía laparoscópica / Otorrhagia. A complication of laparoscopic hemicolectomy

El creciente y rápido avance de la tecnología quirúrgica en las últimas décadas ha permitido el desarrollo de la cirugía laparoscópica. La cirugía «mínimamente invasiva» se ha popularizado en los últimos años, y sus fronteras no solo se limitan a los procedimientos ginecológicos, sino que se ha extendido al campo de la cirugía general, la ortopedia, el tórax y la urología. La insuflación de gas en la cavidad peritoneal y la posición del paciente se acompañan de cambios fisiológicos y complicaciones que no se presentan en la cirugía abierta. Presentamos el caso de una paciente que tras hemicolectomía izquierda laparoscópica presentó otorragia bilateral postoperatoria. El neumoperitoneo y la posición de Trendelenburg a más de 35° provocan alteraciones hemodinámicas que condicionan un aumento de la presión arterial y de la presión venosa central. La vascularización del conducto auditivo externo sufre directamente estas modificaciones, pudiendo aparecer otorragia postoperatoria después de una cirugía laparoscópica prolongada (AU)

The fast and increasing advance in surgical technology during the last decades has led to a remarkable development in laparoscopic surgery. «Minimally invasive» surgery has become very popular in the last few years, not only in gynecological procedures but also in general surgery, orthopedics, thoracic and urological procedures. Gas inflation into the abdominal cavity and patient position provokes physiological changes, as well as complications that are not seen in open surgery. Pneumoperitoneum and the Trendelenburg position beyond 35° cause hemodynamic changes, resulting in an increase in arterial and central venous pressure. The external auditory canal vessels are directly affected by these changes, and postoperative otorrhagia after a prolonged laparoscopic surgery may be present. A case is presented of postoperative bilateral otorrhagia after laparoscopic left hemicolectomy (AU)

[Otorrhagia. A complication of laparoscopic hemicolectomy]. / La otorragia. Una complicación de la hemicolectomía laparoscópica.

The fast and increasing advance in surgical technology during the last decades has led to a remarkable development in laparoscopic surgery. "Minimally invasive" surgery has become very popular in the last few years, not only in gynecological procedures but also in general surgery, orthopedics, thoracic and urological procedures. Gas inflation into the abdominal cavity and patient position provokes physiological changes, as well as complications that are not seen in open surgery. Pneumoperitoneum and the Trendelenburg position beyond 35° cause hemodynamic changes, resulting in an increase in arterial and central venous pressure. The external auditory canal vessels are directly affected by these changes, and postoperative otorrhagia after a prolonged laparoscopic surgery may be present. A case is presented of postoperative bilateral otorrhagia after laparoscopic left hemicolectomy.

[Supreme laryngeal mask airway vs the I-gel supraglottic airway in patients under general anesthesia and mechanical ventilation with no neuromuscular block: a randomized clinical trial]. / Estudio comparativo entre las mascarillas laríngeas Supreme e I-gel en pacientes con anestesia general sin bloqueo neuromuscular, con ventilación mecánica.

OBJECTIVE: The Supreme Laryngeal Mask Airway (SLMA) and the I-gel Supraglottic Airway (IGSA) are recently introduced devices incorporating a gastric channel. This study assessed the ease of insertion of the devices and their efficacy in mechanical ventilation. MATERIAL AND METHODS: Eighty-five patients undergoing major outpatient surgery under general anesthesia were randomized to 2 groups for intubation using the SLMA or the IGSA. After induction of general anesthesia, the assigned mask was inserted and positioning was checked with a fiberoptic scope. Ease of insertion was evaluated. Seal pressure was measured and the following ventilatory parameters were recorded 10, 30, and 60 minutes after the start of surgery: peak pressure, mean pressure, compliance, and the ratio of tidal volume to respiratory frequency. Conditions at the moment of inserting the nasogastric tube were also noted. RESULTS: First-attempt placement of the airway was possible in 95.2% of patients using the SLMA and in 86% using the IGSA (P = .147). The mean times required for placement were 27.1 seconds for the SLMA and 32.5 seconds for the IGSA (P = .195). The nasogastric tube was inserted on the first attempt in 97.6% of patients with an SLMA and in 85.7% of patients with an IGSA. The mean times required for tube insertion were 9.5 seconds through the SLMA and 22.1 seconds through the IGSA (P < .001). Seal pressure and compliance were similar in the 2 groups at the start of surgery and at 10, 30, and 60 minutes. The incidences of complications during surgery and at 90 minutes were likewise similar (P = .945 and P = .698, respectively). CONCLUSIONS: The SLMA and the IGSA are easy to put into position on the first attempt. It is easier to insert the nasogastric tube through the gastric channel of the SLMA. Both devices provide an effective seal and the incidences of complications were similar for both in the patients we studied.

Estudio comparativo entre las mascarillas laríngeas Supreme® e I-gel® en pacientes con anestesia general sin bloqueo neuromuscular, con ventilación mecánica / Supreme Laryngeal Mask Airway vs the I-gel Supraglottic Airway in patients under general anesthesia and mechanical ventilation with no neuromuscular block: a randomized clinical trial

OBJETIVO: La mascarilla laríngea Supreme(R) y la mascarillaI-gel(R) son dos dispositivos supraglóticos de recienteaparición que incorporan un canal de acceso gástrico.En este estudio valoramos la facilidad de inserción deldispositivo, así como la eficacia de ambos en ventilaciónmecánica controlada. MATERIAL Y MÉTODOS: Estudio prospectivo de 85pacientes intervenidos en cirugía mayor ambulatoriacon anestesia general. Se asignaron aleatoriamente a dosgrupos, grupo LMA-S pacientes a los que se coloca mascarillalaríngea Supreme(R) y grupo I-gel(R) pacientes a losque se colocó la mascarilla laríngea I-gel(R). Tras la inducciónde anestesia general se colocó la mascarilla asignaday se comprobó la posición con un fibrobroncoscopio.Se valoró la facilidad de inserción. Se midió la presión desellado y los siguientes parámetros ventilatorios: presiónpico (Pp), presión media (Pm), complianza, volumencorriente y frecuencia respiratoria (VT/FR) al inicio, y alos 10, 30 y 60 minutos de iniciada la intervención. Secomprobó asimismo las condiciones del paso de una sondanasogástrica.RESULTADOS: La LMA-S se colocó al primer intento en el95,2% de los pacientes, frente a 86% de los casos con I-gel(R) (p = 0,147). El tiempo medio de colocación fue de 27,1segundos con la mascarilla laríngea Supreme(R) frente a 32,5 segundos en el caso de la I-gel(R) (p = 0,195). La colocaciónal primer intento de la sonda nasogástrica en el grupoLMA-S fue del 97,6% frente al 85,7% de I-gel(R). El tiempomedio de colocación de la sonda nasogástrica para el grupoLMA-S fue de 9,5 segundos y de 22,1 segundos para elgrupo I-gel(R) (p < 0,001). No se evidenciaron diferenciasentre ambas mascarillas para las variables presión de selladoy complianza al inicio, y a los 10, 30 y 60 minutos, nitampoco entre los efectos secundarios intraoperatorios(p = 0,945) y dichos efectos a los 90 minutos (p = 0,698) (AU)

OBJECTIVE: The Supreme Laryngeal Mask Airway(SLMA) and the I-gel Supraglottic Airway (IGSA) arerecently introduced devices incorporating a gastricchannel. This study assessed the ease of insertion of thedevices and their efficacy in mechanical ventilation.MATERIAL AND METHODS: Eighty-five patients undergoingmajor outpatient surgery under general anesthesiawere randomized to 2 groups for intubation usingthe SLMA or the IGSA. After induction of generalanesthesia, the assigned mask was inserted and positioningwas checked with a fiberoptic scope. Ease of insertionwas evaluated. Seal pressure was measured and thefollowing ventilatory parameters were recorded 10, 30,and 60 minutes after the start of surgery: peak pressure,mean pressure, compliance, and the ratio of tidalvolume to respiratory frequency. Conditions at themoment of inserting the nasogastric tube were alsonoted.RESULTS: First-attempt placement of the airway waspossible in 95.2% of patients using the SLMA and in 86%using the IGSA (P=.147). The mean times required forplacement were 27.1 seconds for the SLMA and 32.5seconds for the IGSA (P=.195). The nasogastric tube wasinserted on the first attempt in 97.6% of patients with anSLMA and in 85.7% of patients with an IGSA. The meantimes required for tube insertion were 9.5 secondsthrough the SLMA and 22.1 seconds through the IGSA(P<.001). Seal pressure and compliance were similar inthe 2 groups at the start of surgery and at 10, 30, and 60 minutes. The incidences of complications during surgeryand at 90 minutes were likewise similar (P=.945 and P=.698, respectively).CONCLUSIONS: The SLMA and the IGSA are easy to putinto position on the first attempt. It is easier to insert thenasogastric tube through the gastric channel of theSLMA. Both devices provide an effective seal and theincidences of complications were similar for both in thepatients we studied (AU)

Nervio abducens: estudio microanatómico / Abducens nerve: microanatomical study

El sexto par craneal constituye el nervio motor del músculo recto externo del globo ocular. Sus fibras emergen del neuroeje lateralmente al foramen caecum. Su recorrido intracraneal resulta muy extenso, involucrando la cisterna del ángulo cerebelopontina, el área petroclival, el seno cavernoso. Dentro de las cavidades craneal y orbitaria mantiene estrechas relaciones con múltiples estructuras vásculo-nerviosas. Estos complejos aspectos anatómicos inherentes al nervio abducens lo convierten en un elemento noble altamente vulnerable a una gran multitud de injurias posibles. De esta forma, concluímos que el conocimiento de la anatomía de este nervio tiene gran importancia, tanto para el tratamiento quirúrgico de las lesiones que en torno a él se alojan, como para explicar la fisiopatología de los símdromes clínicos que afectan a las distintas regiones por donde discurre.

Nervio abducens: estudio microanatómico / Abducens nerve: microanatomical study

El sexto par craneal constituye el nervio motor del músculo recto externo del globo ocular. Sus fibras emergen del neuroeje lateralmente al foramen caecum. Su recorrido intracraneal resulta muy extenso, involucrando la cisterna del ángulo cerebelopontina, el área petroclival, el seno cavernoso. Dentro de las cavidades craneal y orbitaria mantiene estrechas relaciones con múltiples estructuras vásculo-nerviosas. Estos complejos aspectos anatómicos inherentes al nervio abducens lo convierten en un elemento noble altamente vulnerable a una gran multitud de injurias posibles. De esta forma, concluímos que el conocimiento de la anatomía de este nervio tiene gran importancia, tanto para el tratamiento quirúrgico de las lesiones que en torno a él se alojan, como para explicar la fisiopatología de los símdromes clínicos que afectan a las distintas regiones por donde discurre. (AU)

[Anesthesia in a patient with along-standing congenital heart malformation of the complete atrioventricular canal type for non-cardiac surgery]. / Anestesia en una paciente con malformación cardíaca congénita tipo canal auriculoventricular completo de larga evolución para cirugía no cardíaca.

Atrioventricular canal defects are a class of malformation attributable to anomalies in embryonic development of the anterior and posterior endocardial cushions. In the absence of surgical correction, death usually ensues in the first few years of life. Defects as severe as those observed in our patient are rare in adults. We describe the anesthetic management (epidural anesthesia with spontaneous ventilation by laryngeal mask) for a 46-year-old woman with this malformation who underwent emergency laparotomy.