IR characterization of plant leaves, endemic to semi-tropical regions, in two senescent states.

We are developing a robust and economic electro-optical remote sensing methodology to monitor the state of health and hydration of trees, endemic to subtropical regions. We measured reflectance spectra with Fourier transform infrared (FTIR) of three samples of two different oak trees. We find that spectral bands suitable for monitoring the state of the health and senescence of the oak include intervals around 0.9 µm and 1.8 µm. The easiest and the most cost-effective strategy would be to implement an electro-optical remote sensing radiometric system featuring a commercial camera incorporating a traditional charge-coupled device (CCD) or complementary metal-oxide-semiconductor (CMOS) detectors and a wideband transmission filter, from about 0.8 to 1 µm.

Procedural pain and anxiety in pediatric patients in a Mexican dental clinic.

BACKGROUND: In dental examining rooms, children experience diagnostic and therapeutic pain related to dental procedures that may be associated with anxiety. Therefore, the main objective of the present study was to evaluate anxiety and pain levels related to dental procedures in children. METHODS: Children in a Mexican pediatric dental clinic rated their dental anxiety using the Modified Dental Anxiety Scale (MDAS), the Children's Fear Survey Schedule Dental Subscale (CFSS-DS) and a 100-mm Visual Analogue Scale (VAS). Pain was evaluated with the VAS. RESULTS: A total of 437 children with a mean age of 9.8 (±2.2) years were evaluated. Four hundred eighty-one dental procedures were completed. The averages in the MDAS and the CFSS-DS were 8.5 (±3.4) and 22.7 (±7.6), respectively. Of all dental procedures, 275 (57.2 %) were rated as stressful prior to their realization, 222 (46.2 %) were stressful during their realization and 175 (36.4 %) were rated as painful. Overall, 12.6 % of the painful events were rated as severe, 25.1 % were rated as moderate, and 62.3 % were rated as slight. CONCLUSION: This study provides data on common procedures performed in dental clinics that cause pain and anxiety in children and young adolescents. Dentistry must consider the best non-pharmacological and pharmacological interventions to reduce dental anxiety and pain.

Heart surgery with cardiopulmonary bypass in pregnant women.

OBJECTIVE: Definite data in heart surgery with extracorporeal circulation during pregnancy is limited. This report analyzes our experience in this area. METHODS: Fifteen women underwent open heart surgery under cardiopulmonary bypass during pregnancy at our institution between 1972 and 1998. Surgical procedures included valve replacement in 13 patients (12 mitral, 1 aortic), declotting of a tilting disk mitral prosthesis in one and closure, of an atrial septal defect in the remaining patient. RESULTS: Thirteen patients were in New York Heart Association functional class III to IV and were operated on urgently. Eight of these women had severe acute dysfunction of either a mechanical or a biological mitral prosthesis. There were 2 maternal operative deaths for a rate of 13.3%. Fetal losses resulted at the time of these maternal deaths. Fetal deaths occurred in 5 of the 13 pregnancies (38.5%) in women who survived the surgical procedure. CONCLUSIONS: Because of the fetal risks, open heart surgery during pregnancy should be advised only in extreme emergencies. Although pregnancy per se does not increase the maternal risk, a high maternal mortality results from the emergency nature of the surgical intervention. Fetal mortality remains high.

Anatomic correlation of left atrial appendage by 3-dimensional echocardiography.

The adequate study of the left atrial appendage is an echocardiographic challenge. The purpose of this study was to assess the ability of 3-dimensional echocardiography in reconstructing this potentially complex structure.

[Helical computerized tomography of the thorax in the diagnosis of unresolved chronic pulmonary thromboembolism]. / La tomografía computarizada helicoidal del tórax en el diagnóstico de la tromboembolia pulmonar crónica no resuelta.

We assessed the diagnostic usefulness of helical CT scan of the thorax in the setting of chronic thromboembolic pulmonary hypertension by prospectively comparing the results of helical CT scan to those of the pulmonary angiogram (gold standard). We studied 40 patients with diagnosis of pulmonary hypertension of diverse etiology (mean age: 40.7 +/- 12 y.o.; mean systolic pulmonary artery pressure: 91 +/- 33 mmHg)). Thirty of these patients fulfilled the diagnostic criteria of chronic thromboembolic pulmonary hypertension and the other ten were used as controls. Diagnosis in control patients included: primary pulmonary hypertension (4); patent ductus arteriosus (2); atrial septal defect (1); rheumatic valve disease (1); ischemic heart disease (1); and acute pulmonary embolism (1). Both helical CT scan and pulmonary angiogram were part of the routine diagnostic work up of these patients, and were, performed and interpreted almost simultaneously (within one week) by a different group of investigators in a blind manner. Only the diagnostic accuracy of the method regarding central (major arteries) vascular lesions was evaluated. Helical CT scan had an overall sensitivity of 100% (29/29), and a specificity of 91% (10/11). Positive predictive and negative predictive values were 96.6% (29/30) and 100% (10/10), respectively. Overall diagnostic accuracy was 97.5% (39/40). We conclude that helical CT scan of the thorax is an excellent alternative approach for the diagnosis of major arteries lesions in the setting of chronic thromboembolic pulmonary hypertension.

[History of surgical treatment of gastroesophageal reflux]. / La historia de las operaciones para el tratamiento del reflujo gastroesofágico.

There exists, in our times, a great confusion concording the different techniques for the treatment of gastroesophageal reflux. Today, for instance, we use the name "fundoplication" for different operations that, in many occasions, have nothing to do with the original description of the technique. It can be said that there exists a great lack of knowledge of the historical origins and of the evolution of all of these operations. The authors of this article have done a large-scale review of the original publications, as they appeared, for the first time, in medical literature.

An approach to the historical evolution of surgical operations for the treatment of gastroesophageal reflux.

There exists great confusion concerning the different techniques for the treatment of gastroesophageal reflux. For instance, we apply the term fundoplication to different operations that often have nothing to do with the original description, and there is a serious lack of knowledge of the historical origins of many of these operations. This analysis is the result of a large review of the operations, and of the original papers as they were published.

[Coronary revascularization without extracorporeal circulation. An alternative therapy (preliminary report)]. / Revascularización coronaria sin circulación extracorpórea. Una alternativa terapéutica. (Reporte preliminar).

Direct myocardial revascularization techniques has earned great acceptance in the treatment of ischemic coronary syndromes in the past two decades. Almost since its beginnings the procedure was done with the aid of extracorporeal circulation, since the technical accessibility with cardiac standstill further helped to evolve the procedure. As years went by, complications due to the use of the pump became evident, such as microembolism, bleeding disorders, and others. Besides this, there is a special group of patients, those with high surgical risk, with preexisting pulmonary, hepatic or cerebral disease, who benefit a great deal when bypass grafting procedure is done without the pump. In this article we delineate the indications, contraindications, and the procedure itself based in our personal experience, reporting our first five patients with this technique.

Primary antiphospholipid syndrome presenting as chronic thromboembolic pulmonary hypertension. Treatment with thromboendarterectomy.

Pulmonary hypertension may occur in the antiphospholipid syndrome as a result of recurrent pulmonary embolism or microthrombosis of pulmonary vessels. We describe 3 cases of primary antiphospholipid syndrome (APS) and cor pulmonale that fulfilled the criteria for chronic major vessel thromboembolic pulmonary hypertension. Pulmonary thromboendarterectomy was performed in all 3 patients and it was successful in 2. One patient died in the immediate postoperative period from hemorrhagic pulmonary edema. Chronic thromboembolic pulmonary hypertension should be added to the list of pulmonary vascular complications of primary APS. Despite its risk, pulmonary thromboendarterectomy represents a treatment option for this otherwise lethal condition.

Influencia de la administración de información preoperatoria sobre los niveles de ansiedad en pacientes adultos sometidos a cirugía de terceros molares / Influence of pre-operative information in decreasing anxiety of adults submitted to surgical procedures

La influencia de la información preoperatoria, ha sido encontrada útil en la disminución del nivel de ansiedad de estado, ó condición emocional transitoria del organismo humano inducido por el procedimiento quirúrgico. En el presente estudio se comparó el dar o no información prequirúrgica a un grupo de 50 sujetos siendo asignados aleatoriamente, 25 al grupo control (sin información) y 25 al grupo estudio. Primero se les suministró un cuestionario de pregunta abierta semiestructurada para indagar en el sentido común del paciente su concepto sobre la cirugía, antecedentes, experiencias, inquietudes y temores. Luego se administró la información y el día de la cirugía se ofreció un ejemplar de dos cuestionarios de autoevaluación correspondientes a la prueba de STAL para evaluar la Ansiedad Estado y la Rasgo. El grupo control presentó mayor nivel de Ansiedad Estado que el grupo estudio, siendo esta diferencia estadísticamente significativa (p=0.0002). Se necesita más investigación para determinar la importancia clínica de la preparación prequirúrgica de los pacientes. Los pacientes sin experiencias previas mostraron mayores niveles de Ansiedad Estado y Rasgo que los que tenían experiencias; y los pacientes con experiencias previas negativas presentaron igualmente mayores niveles de Ansiedad Estado y Rasgo con respecto a los de experiencias positivas, aunque ninguna de las dos diferencias fue estadísticamente significante.

Octreotide therapy of large-volume refractory AIDS-associated diarrhea: a randomized controlled trial.

OBJECTIVE: To compare the effect of octreotide (a long-acting somatostatin analog) to that of antidiarrheal therapy plus placebo on large-volume refractory AIDS-associated diarrhea. DESIGN: A randomized controlled trial. SETTING: Referral-based clinic and hospital in a tertiary care center. PATIENTS: Twenty male patients with AIDS and refractory diarrhea, with stool volume > 1000 ml/day who failed to improve after initial supportive management. All patients finished the study. INTERVENTIONS: Patients were randomly given either octreotide in doses of 100, 200 and 300 micrograms subcutaneously every 8 h, or high doses of loperamide and diphenoxylate orally plus placebo subcutaneously for 10 days. MAIN OUTCOME MEASURES: Bowel movements and stool volume were registered before and every day after treatment by the patients themselves and the nursing personnel. RESULTS: Patients from both groups were similar for age, time of AIDS diagnosis, duration of diarrhea and etiology. Baseline mean bowel movements per day (9.4 +/- 2.8 in the octreotide group versus 10 +/- 3.1 in controls) and baseline mean stool volume (2753 +/- 840 versus 2630 +/- 630 ml/day, respectively) were similar in both groups before therapy (P < 0.05). Mean bowel movements per day after 10 days of therapy was 2.1 +/- 1.6 in the octreotide group versus 7 +/- 3 in controls (P < 0.05). Mean stool volume after 10 days of therapy was 485 +/- 480 in the octreotide group versus 1080 +/- 420 ml/day in controls (P < 0.05). Complete response (stool volume < 250 ml/day) was observed in two patients from the octreotide group and none from controls; partial response (decrease > 50% in stool volume) in four and two; and no response (decrease < 50% or no change) in four and eight (P < 0.05), respectively. Side-effects occurred in eight out of 10 octreotide patients and three out of 10 controls (P < 0.05), but none were significant to result in discontinuation of medication. CONCLUSION: Octreotide proved to be superior to conventional therapy in this short-term treatment of large-volume refractory AIDS-associated diarrhea.

[Primary liver cancer. Its epidemiological, clinical and biochemical characteristics]. / Cáncer hepático primario. Características epidemiológicas, clínicas y bioquímicas.

Epidemiological, clinical, biochemical and topographic features of primary hepatic cancer (PHC) were reviewed retrospective and prospectively in this study. This review consisted of 76 patients from 1971 to 1990. Forty nine males and 27 females. The mean age was 66.1 +/- 11.7 years. Hepatocellular carcinoma (HC) was the most frequent histological type (84.1%), followed by cholangiocarcinoma (87.7%). Mixed carcinoma and hepatoblastoma were 4.3 and 2.9% respectively. The prevalence af PHC among 1485 autopsies was 0.74%. The most frequent sites af metastasis were the lungs (66%) and portal vein (50%). Hepatocellular carcinoma was associated to cirrhosis in 80% of the cases. A syndrome including asthenia, weight loss, hepatomegaly and cholestasis was identified in most of the patients, and alkaline phosphatase was the most frequently disturbed laboratory test. 60% of tumors were bilateral and none of the solitary tumors had less than 5 cms in diameter. 20% of HC showed normal serum levels of AFP (< 20 ng/ml). 40% had at least one of the markers of B virus hepatitis in serum.

Guía de archivos para la historia de los pueblos indigenas en Bolivia / Guide arvchives for the history of indegenous people in Bolivia

Esta Guía de archivos recoge la información disponible hasta hoy en torno a los archivos existentes en Bolivia: sus características físicas, el estudio de su conservación. Presenta información por ciudades y al interior de cada una, por archivos, tanto civiles como eclesiásticos. Se proporciona además una bibliografía sobre los archivos de cada ciudad, así como una bibliografía sobre fuentes impresas relacionadas a los pueblos indigenas

Guía de archivos para la historia de los pueblos indigenas en Bolivia / Guide arvchives for the history of indegenous people in Bolivia

Esta Guía de archivos recoge la información disponible hasta hoy en torno a los archivos existentes en Bolivia: sus características físicas, el estudio de su conservación. Presenta información por ciudades y al interior de cada una, por archivos, tanto civiles como eclesiásticos. Se proporciona además una bibliografía sobre los archivos de cada ciudad, así como una bibliografía sobre fuentes impresas relacionadas a los pueblos indigenas

Total therapeutic paracentesis (TTP) with and without intravenous albumin in the treatment of cirrhotic tense ascites: a randomized controlled trial.

We studied 35 cirrhotic patients with tense ascites assigned at random into two groups: Group I consisted of 17 patients treated by total therapeutic paracentesis (TTP) (6-15 l) plus i.v. albumin (5 g/l of fluid) and Group II consisted of 18 patients treated by TTP (5.5-15.5 l) without albumin. On 19 patients we performed a sequential assessment of cardiac output (CO), plasma renin activity (PRA) and plasma aldosterone (PA). Both groups were similar in age, sex, and etiology of cirrhosis. CO, PRA and PA values were expressed as mean changes occurring in relation to their respective baseline values. CO changes after TTP (l/min): Group I: 2.5 after 6 h and 2.2 after 12 h; Group II: 2.2 after 6 h and -0.4 after 12 h, (p < 0.05 comparing values after 12 h between the two groups). PRA changes after TTP (ng/dl/h): Group I: -7.4 after 1 h, -7.8 after 6 h and -3.2 after 24 h; Group II: -2.4 after 1 h, -0.8 after 6 h and 3.9 after 24 h (p < 0.05 comparing values between both groups after 6 and 24 h). PA changes after TTP (ng/dl): Group I: -50.5 after 1 h, -36.7 after 6 h and -34.6 after 24 h; Group II: -18.2 after 1 h, -2.2 after 6 h and 20 after 24 h, (p < 0.05 comparing values between both groups after 1 and 6 h). Complications were minimal in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

[A comparative study between surgical section and radiofrequency ablation of the anomalous pathways in the WPW syndrome]. / Estudio comparativo entre la sección quirúrgica y la ablación con radiofrecuencia de las vías anómalas en el síndrome de W.P.W.

Radiofrequency catheter ablation is an effective alternative to medical therapy to patient with Wolff Parkinson White syndrome (WPW). The purpose of this study is to compare our results in 70 patients with WPW that underwent either surgery or ablation procedure with radiofrequency energy. Of this number of patients the surgical procedure was successful in 82%; complications were present in 15% and mortality in 8%. Average hospitalization was 6 to 10 days and cost from 2 to 10 thousand of new pesos. On the other hand, of 44 patients that underwent radiofrequency ablation, in 80% the procedure was finally successful with recurrence of 9% and no mortality. The hospitalization period was one day, the cost run from 500 to 2 thousand of new pesos in our institution. These results demonstrate the efficacy of the radiofrequency energy ablation in the treatment of WPW. This procedure is safe and less expensive than surgery.