Mechanical analysis of transversal iliac fracture stabilization using dynamic compression plate or screws and PMM in polyurethane bone model / Avaliação mecânica de estabilização de fratura ilíaca transversa com placa de compressão dinâmica ou polimetilmecatrilato associado à parafusos utilizando modelo de osso sintético de poliuretano

Pelvic fractures correspond to 20 to 30 % of the fractures observed in dogs. Complete fractures, especially with bone axis deviation should be surgically treated. The mechanical study of surgical techniques is of utmost importance to assess the best way of treating these injuries. This study compared, biomechanically, the use of a dynamic compression plate (DCP) and screws (group 1) or screws and polymethylmethacrylate (PMMA) (group 2) to stabilize an iliac fracture using a static test. Sixteen canine synthetic hemi-pelvises (test specimens) with a transverse iliac osteotomy were used. After fixation with implants, a load was applied to the acetabulum until failure. Group 1 maximal compressive load was 133.9±18.60 N, displacement at yield 21.10±3.59mm and stiffness 125.22±12.25N/mm. Group 2 maximal compressive load was 183.50±27.38N, displacement at yield 16.66±5.42mm and stiffness 215.68±33.34N/mm. The stabilization with polymethylmethacrylate was stronger than dynamic compression plate since it resisted a greater load in all test specimens.(AU)

As fraturas da pelve são frequentes em cães, correspondendo a 20-30% das fraturas encontradas na espécie. A grande maioria delas é tratada cirurgicamente, principalmente aquelas que apresentam desvio ósseo. O estudo mecânico das técnicas cirúrgicas é de extrema importância para avaliação da melhor maneira de tratamento destas lesões. O objetivo deste estudo foi comparar, do ponto de vista biomecânico, a fixação das fraturas do ílio utilizando uma placa de compressão dinâmica ou parafusos associados ao polimetilmetacrilato, por meio de um teste estático. Foram utilizadas 16 hemipelves caninas de origem sintética, nas quais uma osteotomia transversa foi realizada no corpo do ílio. As fixações foram divididas em dois grupos: fixação com placa de compressão dinâmica e parafusos (grupo1) ou parafusos associados ao polimetilmetacrilato (grupo 2). Posteriormente à fixação dos implantes foi aplicada uma carga no acetábulo de cada corpo de prova até a falha. O grupo 2 apresentou força máxima de aplicação de carga a média de 133.9±18.60N, deflexão 21.10±3.59mm e rigidez 125.22±12.25N/mm. O grupo 2 apresentou força máxima de aplicação de carga a média de 183.50±27.38N, deflexão 16.66±5.42mm e rigidez 215.68±33.34N/mm. A estabilização com o polimetilmetacrilato mostrou ser mais resistente, pois resistiu a uma maior quantidade de carga em relação à placa de compressão dinâmica, em todos os corpos de prova.(AU)

Evaluation of the cardiopulmonary and antinociceptive effects of bupivacaine administered epidurally at the first lumbar vertebra in awake dogs / Estudo dos efeitos cardiopulmonares e antinociceptivos da administração epidural de bupivacaína à altura da primeira vértebra lombar em cães acordados

The aim of this study was to evaluate the effect of epidural bupivacaine administration at the first lumbar vertebra on cardiopulmonary variables, arterial blood gases and anti-nociception. Sixteen healthy female dogs were randomly assigned into two groups based on bupivacaine dose: G1 group, 1mg kg-1 or G2 group, 2mg kg-1, diluted in the same final volume (1mL4kg-1). Cardiopulmonary variables were measured and arterial blood gas was collected (T0), it was repeated 10 minutes after intravenous administration of butorphanol 0.4mg kg -1 (T1). Anesthesia was induced with intravenous etomidate at 2mg kg-1 and the epidural catheter was introduced and placed at the first lumbar vertebra. Thirty minutes later, bupivacaine was administered epidurally. Cardiopulmonary measurements and arterial blood gas analysis were recorded at 10 minute intervals (T2 to T6). Evaluation of pre surgical anti-nociception was performed at 5 minute intervals for 30 minutes by clamping the hind limbs, anus, vulva, and tail with the dogs awake. Subsequently, ovariohysterectomy was performed and adequacy of surgical anti-nociception was evaluated at 5 time points. Parametric data were analyzed using the F test with a <0.05 significance. After bupivacaine administration, there were differences between groups just for bicarbonate means (HCO3-) on T6 (P=0.0198), with 18.7±1.3 and 20.4±0.8 for G1 and G2, respectively. After T1, before bupivacaine administration, both groups presented a slightly lower pH, base excess (BE), the end-tidal carbon dioxide tension (PECO2), and partial pressure of carbon dioxide (PaCO2), suggesting mild metabolic acidosis. G2 showed better antinociceptive effect both before and during surgery. It was possible to perform ovariohysterectomy in 87.5% of the G2 bitches and 25% of the G1 bitches. The two doses of bupivacaine evaluated do not cause important alterations in the studied parameters and the dose of 2mg kg-1 results in a better antinociceptive effect.(AU)

O objetivo deste estudo foi avaliar os efeitos da administração epidural de bupivacaína à altura da primeira vértebra lombar sobre variáveis cardiopulmonares, hemogasometria arterial e antinocicepção. Dezesseis cadelas foram separadas aleatoriamente em dois grupos que se diferenciaram pela dose de bupivacaína, 1mg/kg (G1) ou 2mg/kg (G2), diluídas no mesmo volume final (1mL/4kg). As variáveis cardiopulmonares e hemogasometria arterial foram coletadas antes (T0) e após 10 minutos da administração intravenosa de 0,4mg/kg de butorfanol (T1). A anestesia foi induzida com 2mg/kg de etomidato intravenoso para introdução do cateter epidural. Após 30 minutos, a bupivacaína foi administrada e, passados 10 minutos, nova coleta de parâmetros foi feita, sendo repetida a cada 10 minutos (T2 a T6). Após cinco minutos da administração de bupivacaína, iniciou-se a avaliação da antinocicepção pré-cirúrgica, repetida a cada cinco minutos durante 30 minutos. Então, iniciou-se a cirurgia de ovário-histerectomia, na qual se avaliou a antinocicepção transcirúrgica em cinco momentos. Os resultados paramétricos foram analisados pelo software SAS 9.4 (2010), utilizando-se o teste F com significância menor que 0,05. Houve diferença entre as médias dos grupos após administração de bupivacaína apenas para bicarbonato em T6 (P=0.0198), sendo 18,7±1,3 e 20,4±0,8 as médias do G1 e G2, respectivamente. Desde T1, os grupos apresentaram valores de pH, excesso de bases, pressão parcial de gás carbônico no sangue arterial e tensão de dióxido de carbono ao final da expiração pouco abaixo do fisiológico, sugerindo acidose metabólica discreta. O G2 apresentou efeito antinociceptivo pré e transcirúrgico superior ao G1. Foi possível realizar a cirurgia em 87,5% das cadelas do G2 e em 25% das cadelas do G1. Concluiu-se que as duas doses de bupivacaína avaliadas não acarretam alterações importantes nos parâmetros fisiológicos estudados e a dose de 2mg/kg determina melhor efeito antinociceptivo que a dose de 1mg/kg.(AU)

Successful use of autogenous bone graft for the treatment of a radius-ulna nonunion in an amputee dog / Uso de enxerto ósseo autógeno no tratamento de uma não união óssea em um radioulna de um canino amputado

Fracture nonunions represent important complications in orthopedic surgeries. Nonunion repairs or bone defects are surgically challenging. Our aim was to describe a nonunion case, which was repaired with rapid bone recovery. An 8-month-old male mixed breed dog that has been previously operated was presented to the Veterinary Medical Teaching Hospital of São Paulo State University, with a right radius-ulna nonunion and an amputated contralateral forelimb. A cancellous bone graft was collected from a partially amputated limb, in order to correct the nonunion, and used in association with a locking plate. After four weeks, the bone graft had been incorporated into the original bone. Clinical union with good weight bearing was achieved after eight weeks.

As não uniões ósseas representam uma importante complicação nas cirurgias ortopédicas. Não uniões ósseas ou defeitos ósseos são um desafio na cirurgia. O objetivo do presente trabalho foi descrever um caso de não união óssea, que foi reparada de forma rápida. Um cão SRD de oito meses, macho, que havia sido operado previamente, deu entrada no Hospital Veterinário da Unesp - Jaboticabal com uma não união óssea em radioulna e o membro contralateral amputado. Um enxerto ósseo autógeno foi coletado do coto do membro contralateral amputado e utilizado junto a uma placa óssea bloqueada para o tratamento. Após quatro semanas, o enxerto ósseo estava incorporado ao osso original. A união clínica e o retorno normal à função foram alcançados após oito semanas.

Programa multicéntrico para la atención integral del recién nacido con agresión hipóxico-isquémica perinatal (ARAHIP) / Multicenter program for the integrated care of newborns with perinatal hypoxic-ischemic insult (ARAHIP)

INTRODUCCIÓN: El recién nacido con indicadores de potencial evento hipóxico-isquémico perinatal precisa de una atención integral que detecte precozmente si necesita tratamiento con hipotermia y el control de los factores agravantes del da˜no cerebral en las primeras 6 h de vida. PACIENTES Y MÉTODOS: Aplicación de un programa prospectivo de ámbito poblacional que ordena y sistematiza la atención durante las primeras 6 h de vida en los ≥ 35 semanas nacidos con indicadores de agresión hipóxico-isquémica perinatal. El programa involucra 12 hospitales (91.217 m2), 7 de nivel asistencial i-ii y 5 de nivel III. Se establecen 4 protocolos: a) detección del recién nacido con potencial agresión hipóxico-isquémica; b) vigilancia de la repercusión neurológica y en otros órganos; c) control y tratamiento de complicaciones, y d) vigilancia y acciones durante el transporte. RESULTADOS: Entre junio del 2011 y junio del 2013, de 32.325 recién nacidos ≥ 35 semanas, 213 cumplieron criterios de potencial agresión hipóxico-isquémica perinatal (7,4 por 1.000). El 92% siguió la monitorización establecida en el programa; 33 recién nacidos tuvieron encefalopatía hipóxico-isquémica moderada-grave (1 por 1.000) y 31/33 (94%) recibieron tratamiento con hipotermia. CONCLUSIONES: El programa Atención integral al Recién nacido con Agresión Hipóxico-Isquémica Perinatal ha permitido ofrecer atención integral al recién nacido con indicadores de agresión hipóxico-isquémica perinatal. Se han controlado factores comórbidos agravantes de la lesión cerebral y se han detectado aquellos con encefalopatía hipóxico-isquémica moderadagrave, permitiendo iniciar la hipotermia dentro de las primeras 6 h de vida. Programas de ámbito poblacional son cruciales para disminuir la morbimortalidad asociada a la encefalopatía hipóxico-isquémica

INTRODUCTION: Newborns with perinatal indicators of a potential hypoxic-ischemic event require an integrated care in order to control the aggravating factors of brain damage, and the early identification of candidates for hypothermia treatment. PATIENTS AND METHODS: The application of a prospective, populational program that organizes and systematizes medical care during the first 6 hours of life to all newborns over 35 weeks gestational age born with indicators of a perinatal hypoxic-ischemic insult. The program includes 12 hospitals (91,217 m2); two level I centers, five level II centers, and five level III hospitals. The program establishes four protocols: a) detection of the newborn with a potential hypoxic-ischemic insult, b) surveillance of the neurological repercussions and other organ involvement, c) control and treatment of complications, d) procedures and monitoring during transport. RESULTS: From June 2011 to June 2013, 213 of 32325 newborns above 35 weeks gestational age met the criteria of a potential hypoxic-ischemic insult (7.4/1000), with 92% of them being cared for following the program specifications. Moderate-severe hypoxic-ischemic encephalopathy was diagnosed in 33 cases (1/1,000), and 31 out of the 33 received treatment with hypothermia (94%). CONCLUSIONS: The program for the Integrated Care of Newborns with Perinatal Hypoxic-Ischemic Insult has led to providing a comprehensive care to the newborns with a suspected perinatal hypoxic-ischemic insult. Aggravators of brain damage have been controlled, and cases of moderate-severe hypoxic-ischemic encephalopathy have been detected, allowing the start of hypothermia treatment within the first six hours of life. Populational programs are fundamental to reducing the mortality and morbidity of hypoxic-ischemic encephalopathy

[Multicenter program for the integrated care of newborns with perinatal hypoxic-ischemic insult (ARAHIP)]. / Programa multicéntrico para la atención integral del recién nacido con agresión hipóxico-isquémica perinatal (ARAHIP).

INTRODUCTION: Newborns with perinatal indicators of a potential hypoxic-ischemic event require an integrated care in order to control the aggravating factors of brain damage, and the early identification of candidates for hypothermia treatment. PATIENTS AND METHODS: The application of a prospective, populational program that organizes and systematizes medical care during the first 6 hours of life to all newborns over 35 weeks gestational age born with indicators of a perinatal hypoxic-ischemic insult. The program includes 12 hospitals (91,217 m(2)); two level i centers, five level ii centers, and five level iii hospitals. The program establishes four protocols: a) detection of the newborn with a potential hypoxic-ischemic insult, b) surveillance of the neurological repercussions and other organ involvement, c) control and treatment of complications, d) procedures and monitoring during transport. RESULTS: From June 2011 to June 2013, 213 of 32325 newborns above 35 weeks gestational age met the criteria of a potential hypoxic-ischemic insult (7.4/1000), with 92% of them being cared for following the program specifications. Moderate-severe hypoxic-ischemic encephalopathy was diagnosed in 33 cases (1/1,000), and 31 out of the 33 received treatment with hypothermia (94%). CONCLUSIONS: The program for the Integrated Care of Newborns with Perinatal Hypoxic-Ischemic Insult has led to providing a comprehensive care to the newborns with a suspected perinatal hypoxic-ischemic insult. Aggravators of brain damage have been controlled, and cases of moderate-severe hypoxic-ischemic encephalopathy have been detected, allowing the start of hypothermia treatment within the first six hours of life. Populational programs are fundamental to reducing the mortality and morbidity of hypoxic-ischemic encephalopathy.

Soluble guanylate cyclase beta1-subunit expression is increased in mononuclear cells from patients with erectile dysfunction.

The aim was to determine in circulating mononuclear cells from patients with erectile dysfunction (ED), the level of expression of endothelial nitric oxide synthase (eNOS), soluble guanylate cyclase (sGC) beta1-subunit and phosphodiesterase type-V (PDE-V). Peripheral mononuclear cells from nine patients with ED of vascular origin and nine patients with ED of neurological origin were obtained. Fourteen age-matched volunteers with normal erectile function were used as control. Reduction in eNOS protein was observed in the mononuclear cells from patients with ED of vascular origin but not in those from neurological origin. Although sGC beta1-subunit expression was increased in mononuclear cells from patients with ED, the sGC activity was reduced. However, only the patients with ED of vascular origin showed an increased expression of PDE-V. This work shows for the first time that, independently of the aetiology of ED, the expression of sGC beta1-subunit was increased in circulating mononuclear cells; however, the expression of both eNOS and PDE-V was only modified in the circulating mononuclear cells from patients with ED of vascular origin.

Morning cortisol production in coronary heart disease patients.

BACKGROUND: The circadian cycle of the endogenous anti-inflammatory system (EAIS) is characterized by a morning increase in cortisol production. Circulating interleukin-6 (IL-6) activates the EAIS. A circadian variation in the onset of myocardial infarction, sudden death, stable angina (SA) and unstable angina (UA) has been reported. The aim of this study was to determine morning cortisol production in coronary heart disease (CHD) patients. MATERIALS AND METHODS: Serum cortisol and IL-6 were measured in 129 patients with either SA (n = 65) or UA (n = 64) and 40 healthy volunteers. Blood samples were taken between 9 : 00 h and 12 : 00 h. The upper normal range of cortisol (25 microg dL-1) was used as a reference to classify patients. RESULTS: Forty-eight patients had elevated cortisol levels (ECL) (32.5 +/- 5.4 microg dL-1), while 81 patients had normal cortisol levels (NCL) (15.7 +/- 5.9 microg dL-1). In NCL patients, IL-6 levels (26.6 pg mL-1, ranged from 0.2 to 183.7) were significantly higher (P < 0.004) than in ECL patients (9.70 pg mL-1, range 0.07-56.5). Forty-eight patients with UA belonged to the NCL group of patients, while only 16 UA patients belonged to the ECL group (chi(2) = 0.000). Thirty-two patients with SA belonged to the ECL group, and 33 to the NCL group (chi(2) = 0.08). CONCLUSIONS: Patients with 'inappropriately' normal morning cortisol production had high IL-6 levels. 'Inappropriately' normal cortisol, detected in 75% of UA and 50% of SA patients, may be insufficient for limiting inflammation. These findings have novel clinical implications and suggest new therapeutic approaches in the treatment of these patients.

[Effect of cAMP on the function of endothelial cells and fibromuscular proliferation after the injury of the carotid and coronary arteries in a porcine model]. / Efecto del AMPc sobre la función de las células endoteliales y la proliferación fibromuscular tras la lesión de las arterias carótida y coronaria en un modelo porcino.

INTRODUCTION AND OBJECTIVE: Reendothelization of damaged blood vessels protects against the vascular injury response. We evaluated in vivo whether a systemic increase in cAMP accelerates reendothelization and attenuates intimal hyperplasia in injured swine carotid and coronary arteries. METHODS: Both carotid arteries of 10 swines were subjected to balloon injury. Five animals had been treated with 2 ml (10 mg) of Forskolin, an activator of the adenylate cyclase, and another 5 with 2 ml of saline solution. These animals were sacrificed at day 8, and carotid artery reendothelization was evaluated. The descendent coronary (DC) artery of another 19 pigs was injured by atherotome. Nine animals had been treated with 2 ml of Forskolin, and another 10 with 2 ml of saline solution. These animals were sacrificed at day 28, with myointimal proliferation and arterial geometric remodelation being evaluated. Likewise, in these animals intracellular cAMP levels were measured at baseline and 28 and 60 minutes after saline solution or Forskolin administration and 90 min after arterial injury. RESULTS: Eight days after balloon injury, carotid artery reendothelization was greater in the Forskolin-treated group compared with the control group (p = 0.02), and the number of CD31 positive cells was statistically increased in the treated group (38 +/- 11 cells) versus controls (11 +/- 9 cells). Although the degree of vascular injury caused by atherotome was similar in all of the arteries in the control group, restenosis was only observed in 40% of these animals. Correlation analysis demonstrated that intracellular cAMP may condition arterial geometric remodeling and the diameter of the lumen after vascular injury. CONCLUSION: Our results suggest that cAMP may promote reendothelization and attenuate fibromuscular proliferation.

Endogenous anti-inflammatory response after coronary injury in a porcine model.

BACKGROUND: Corticotropin-releasing hormone (CRH)/adrenocorticotropic hormone (ACTH)/cortisol is the major anti-inflammatory system. After percutaneous translumenal angioplasty, an inflammatory process is triggered. We investigate whether CRH/ACTH/cortisol axis is activated after deep vessel wall injury (DVWI). MATERIALS AND METHODS: Plasma and leukocyte CRH and ACTH, serum cortisol and IL-1beta, and leukocyte cAMP were measured (ELISA) in 16 pigs after anaesthesia (baseline), 60 min into anaesthesia without causing vascular injury and 90 min after DVWI of the left anterior descending (LAD) coronary artery induced by percutaneous directional atherectomy (Atherocath GTO 7F; DVI, Inc., Temecula, USA). Biochemical variables were also measured at baseline, 60 and 180 min into anaesthesia in six additional pigs without coronary intervention. RESULTS: MANOVA showed that CRH/ACTH/Cortisol, cAMP and IL-1beta production was not modified during anaesthesia. Post-DVWI plasma CRH (0.077 +/- 0.046 ng mL-1), and cellular cAMP (0.14 +/- 0.067 pmol 10(-6) cells) increased significantly (P = 0.001) with respect to their baseline values (CRH = 0.036 +/- 0.013 ng mL-1; cAMP = 0.081 +/- 0.034 pmol 10-6). There was also a statistically significant increase (P = 0.02) in post-DVWI IL-1beta (from 46.6 +/- 12.8 to 64.05 +/- 13.5 pg mL-1), and in serum cortisol (P = 0.05) compared to its baseline values (8.98 +/- 3.2 microgr dL-1 vs. 6.57 +/- 2.3 microgr dL-1, respectively). CONCLUSION: In our experimental model, coronary vessel wall injury-activated CRH/ACTH/cortisol axis caused a significant increase in plasma CRH, cortisol and cellular cAMP levels, which may influence the response of coronary arteries to injury.

Infección nosocomial en la Unidad de Cuidados Intensivos Médicos de la Fundación Santafé de Bogotá / Frecuency of nosocomial infections in the Medical Intensive Care Unit at Fundación Santafé de Bogotá

Este es un estudio descriptivo, retrospectivo, basado en las historias clínicas de 43 pacientes hospitalizados en la UCIM de la Fundación Santafé de Bogotá, en el periodo comprendido entre Enero de 1992 y Diciembre de 1994, de ambos sexos, con edades desde los 17 a los 88 años de edad, con diagnósticos de infección nosocomial con respecto a un total de 1912 egresados en el período anotado. Esto con el propósito de encontrar la frecuencia de infección nosocomial en la unidad de cuidados intensivos médicos, su localización mas frecuente y sus características microbiológicas, como gérmenes causales y susceptibilidad a los antimicrobianos. Se pudo observar que el porcentaje y la proporción de infección fué de 2.25 por ciento y 3.2 por ciento respectivamente, que la infección mas frecuente fué bacteremia (42.5 por ciento, seguida por neumonía (23 por ciento), e infección de vías urinarias (11.5 por ciento). El gérmen más frecuente fué el S.aureus (26 por ciento), pero sumando los diferentes gram negativos, estos últimos fueron mayoría. Los gérmenes causales de infección nosocomial fueron los tradicionalmente reportados: S.aureus, E. coli, P. aeruginosa, S. marcescens y K. neumoniae. La resistencia estuvo encabezada por gram negativos como la X. maltophila y el C. freundi.

Sida y sus sindromes relacionados: experiencia clinico-epidemiologica en un hospital colombiano / Aids and its related syndromes: clinico-epidemiological experience in a colombian hospital

Con el fin de investigar las caracteristicas clinico-epidemiologicas del SIDA en Colombia, establecimos dos grupos de estudio prospectivos: el primero, un estudio clinico, iniciado en enero , 1984 y el segundo un estudio serepidemiologico iniciado en septiembre, 1985. El grupo 1 estuvo compuesto de 25 portadores asintomaticos y 51 pacientes con SIDA o sus sindromes relacionados (15 con SIDA florido, 9 con CRS y 27 con LPG). El grupo II por 294 homosexuales y bisexuales que deseaban una serologia para VIH y que voluntariamente respondiernon un cuestionario sobre practicas sexuales. El estudio clinico (GrupoI), demostro que la infeccion mas frecuente fue neumonia por P. carinii (20%), seguida de enteritis por Criptosporidium (12%), M. avium intracellularae diseminado, meningitis por C. neoformans y herpes anogenital persistente (8%). Sarcoma de Kaposi se presento en 4 pacientes. Hubo un caso de linfoma primario de cerebro y otro de carcinoma nasofaringeo. El descenso del promedio del recuento total CD4 fue altamente significativo en SIDA florido cuando se comparo con LPG y CRS (p 0.0001 y p. 0.05) respectivamente. Igual sucedio con el promedio de la relacion CD4/CD8 en SIDA florido cuando se comparo con LPG (p.0.003). En el grupo II la tasa de seropositividad para VIH fue 21%. Los que informaron un rol anal pasivo (anal predominante o mixto activo-pasivo) tuvieron una seropositividad del 24%, significativamente mas alta que los anal activos (11%) (p=0.02, RR=2.31). En sujetos que tuvieron relacion anal pasiva con turistas extranjeros el riesgo fue tambien...

Manifestaciones neurologicas del sindrome de inmunodeficiencia adquirida / Neurological manifestations of adquired immunodeficiency syndrome

Se estudiaron 43 pacientes con SIDA y sus sindromes relacionados en un periodo de cuatro anos en el Centro Medico de los Andes (CMA). De estos 43 pacientes, 25 tenian linfadenopatia generalizada persistente, cinco complejo relacionado con SIDA y 13 sindrome florido del SIDA. De los 13 pacientes con sindrome florido de SIDA; nueve (69.2%) presentaron manifestaciones neurologicas. No hubo complicaciones del sistema nervioso en pacientes con sindromes relacionados. Entre los pacientes efectados los diagnosticos fueron: complejo demencia-SIDA, criptococosis meningea, toxoplasmosis cerebral, linfoma primario del SNC y herpes zoster. Un paciente presento una monoparesia de origen central cuya etiologia no fue posible determinar mediante escanografia cerebral. Otro paciente presento un cuadro vertiginoso probablemente relacionado con la inmunodeficiencia. Este informe constituye la primera descripcion en Colombia de nueve pacientes con diferentes manifestaciones neurologicas de este sindrome.

El lavado quirurgico de las manos: revision de un metodo inveterado / Scrubing for surgery: review of an inveterated method

Se realizo un estudio para evaluar el metodo inveterado de lavado quirurgico de las manos con cepillo y por 10 minutos de duracion. Los resultados demuestran que existe diferencia en el crecimiento bacteriano entre usar y no usar el cepillo reesterilizable, y entre 5 y 10 minutos de lavado, cuando se usa yodo polivinil pirrolidona (o yodo povidona) al 8% como jabon antiseptico. La no utilizacion del cepillo reesterilizable y el menor tiempo de lavado resultan en menor trauma para la piel, menor crecimiento bacteriano y considerable ahorro economico. La yodo polivinil pirrolidona en forma de espuma es un agente desinfectante eficaz cuando se utiliza para el lavado quirurgico de las manos sin cepillo por cinco minutos en el primer lavado del dia y por 3 a 5 minutos en lavados subsiguientes.