Rehabilitación visual en baja visión / Visual rehabilitation in low vision

No disponible

Isolation of novel benzo[a]anthracene-degrading microorganisms and continuous bioremediation in an expanded-bed bioreactor.

In the present work, several samples from lab waste containers polluted with polycyclic aromatic hydrocarbons (PAHs) and heavy metals were investigated as potential sources of PAH-degrading microorganisms. After isolating, two fungal strains were selected as the best degrading microorganisms. Genetic identification by sequencing was carried out and they were identified as Trichoderma longibrachiatum and Byssochlamys spectabilis. Their degradation ability was determined in liquid cultures with 100 µM of benzo[a]anthracene. T. longibrachiatum cultures showed highest degradation values (around 97%) after 9 days, furthermore in a second batch the time was reduced to 6 days. To analyse the viability of industrial application, a continuous treatment in an expanded-bed bioreactor was developed operating at different residence times with T. longibrachiatum immobilised on cubes of nylon sponge. It is noticeable that the bioreactor working in continuous mode was able to operate without operational problems and attaining high degradation levels depending on the residence time.

Receta médica, ¿continuidad o desaparición? / Medical prescription: continuation or disappearance?

No disponible

Usefulness of reagent strips for checking cure in spontaneous bacterial peritonitis after short-course treatment.

BACKGROUND: The usefulness of reagent strips to check cure of spontaneous bacterial peritonitis have not been evaluated to date. AIM: To assess the usefulness of ascitic fluid analysis by means of reagent strips to check cure after a 5-day antibiotic course. METHODS: We prospectively included all cirrhotic patients diagnosed with spontaneous bacterial peritonitis. On day 5, conventional and reagent strip ascitic fluid analyses were performed. RESULTS: Fifty-three episodes of spontaneous bacterial peritonitis in 51 cirrhotic patients were included. Five patients died before the fifth day and in two patients, the control paracentesis yielded no ascitic fluid. In nine out of 46 cases (19.6%), spontaneous bacterial peritonitis had not resolved by day 5. In 32 out of 33 cases in which the ascitic fluid polymorphonuclear count was <250/microL at day five, the reagent strips was negative. The negative predictive value of the reagent strip at fifth day was 97% and the LR- 0.13. CONCLUSIONS: Almost 20% of episodes of spontaneous bacterial peritonitis do not resolve with a short-course of antibiotic treatment. In view of the high negative predictive value and low likelihood ratio for a negative test, reagent strips analysis may be an alternative to conventional cytology if a 5-day antibiotic therapy is planned.

Osteoporosis transitoria, diagnóstico a considerar en la patología dolorosa de la cadera / Transient osteoporosis, diagnosis to be considerate in the painful pathology of the hip

Presentamos un caso de osteoporosis transitoria de cadera, entidad clínica muy infrecuente que ocasiona osteopenia en la porción proximal del fémur. Las características clínicas del proceso dificultan inicialmente su filiación, por lo que resulta generalmente infradiagnosticada. En el proceso diagnóstico debe ser excluida patología neoplásica, así como afecciones progresivas no tumorales. Sin duda, el diagnóstico diferencial adquiere mayor dificultad en la distinción entre osteoporosis transitoria y necrosis de la cabeza femoral, resultando imprescindible la realización de estudio de imagen con resonancia magnética nuclear para alcanzar finalmente un correcto diagnóstico. Un adecuado tratamiento rehabilitador conlleva la recuperación sin secuelas en la mayoría de los casos, por este motivo es importante considerar esta entidad en el diagnóstico diferencial de la patología dolorosa de la cadera. La clínica y evolución de nuestro paciente permite analizar todos los aspectos del diagnóstico diferencial, así como revisar otras alternativas terapéuticas

We present a case report of transient osteoporosis of the hip (TOH), rare clinical entity that cause osteoporosis of the femoral head. The clinical characteristic of the TOH often difficult the diagnosis, so it is generally underdiagnosed. In the diagnose method we must excluded neoplasic pathology and no malignant progressive processes. We have no doubt that distinction TOH from necrosis of the femoral head is the most difficult topic, and MRI is essential to reach a correct diagnose. An appropriated rehabilitation program leads to a completed recuperation in the vast majority of the cases, this is the reason why it may be considered in the differential diagnose of the pathology of the hip. The clinical and the evolution of our patient allow us to analyse all aspects of the differential diagnosis and to review alternative treatments

Reabsorción costal secundaria a hiperpresión causada por ortesis TLSO en paciente con escoliosis idiopática juvenil / Costal resorption secondary to overpressure due to TLSO orthosis in patient with idiopathic scoliosis

Las úlceras por presión y las neuropatías compresivas constituyen las complicaciones más frecuentemente referenciadas como derivadas del tratamiento ortésico de la escoliosis. De igual modo, es comúnmente aceptado que el número real de horas-día de uso de la ortesis es un parámetro de enorme importancia para la efectividad del corsé, y con frecuencia es inferior al tiempo pautado por el médico rehabilitador. Por este motivo, los efectos secundarios de la terapéutica ortésica suelen ocurrir en pacientes con elevada adhesión al tratamiento. Presentamos el caso de una niña con escoliosis idiopática juvenil cuya utilización continuada y con buen cumplimiento de una ortesis thoraco lumbo sacral orthosis (TLSO) ocasionó una reabsorción ósea progresiva que desembocó en una fractura costal. La retirada temporal del corsé permitió la recuperación espontánea de la lesión ósea sin repercusiones. No se ha encontrado otro caso similar en la literatura revisada

Pressures sores and compressive neuropathies were the most common complications reported from cast treatment of scoliosis. It is commonly accepted that cast compliance (hours per day of use) is an important parameter for evaluating the cast effectiveness. This is frequently used less than that prescribed by the rehabilitation specialist. For this reason, side effects of orthotic treatment were seen in patients with good compliance. This is a case report of a girl with idiopathic scoliosis, in which continued treatment with good compliance of a TLSO (thoracic lumbosacral orthosis) orthosis caused bone resorption and rib fracture secondarily. Temporary removal of the cast led to complete recovery of the lesion, without repercussion. We have not found any other similar case report in the literature

Progresión de la escoliosis idiopática tras la madurez ósea / Progression of idiopathic scoliosis after bone maturity

Objetivos. Este estudio tiene un doble propósito: primero, conocer la evolución de la escoliosis idiopática tras la madurez ósea y segundo, determinar los factores implicados en su progresión. Pacientes y métodos. Se realizó un estudio retrospectivo de 90 pacientes con escoliosis idiopática mayor de 30° vistos en este servicio en un período de 17 años (1982-1998). A todos los pacientes se les practicaron 3 estudios radiográficos (en la primera consulta, a la madurez ósea y al final del seguimiento). Se correlacionó el valor angular con los siguientes parámetros: edad, sexo, patrón de la curva, algias vertebrales y gestación. Resultados. El seguimiento medio fue de 9,27 ± 3,36 años. Las curvas que progresaron más de 5° fueron 16,70 %, tuvieron un incremento angular medio de 11° y una progresión anual media de 1,04°/año. No se encontró relación significativa entre progresión y sexo, edad, gestación o patrón de la curva. Las curvas mayores de 40° fueron dolorosas con mayor frecuencia. Las que progresaron presentaron un riesgo 5 veces superior de padecer dolor. Una de cada dos curvas dolorosas correspondió a mujeres que habían tenido algún embarazo. Conclusiones. Progresaron una de cada 6 curvas. Ningún parámetro estudiado se relacionó con una mayor progresión. Se apreció relación significativa entre progresión y dolor. La presencia de dolor se relacionó con la magnitud de las curvas y la gestación. Aunque el porcentaje de progresión es menor que en otros estudios, parece muy razonable practicar un seguimiento periódico (cada 5 años) de las escoliosis idiopáticas mayores de 30°, posteriormente a la finalización del crecimiento

Objectives. This study has a dual purpose: first, to know the evolution of idiopathic scoliosis after bone maturity; and second, to determine factors implicated in its progression. Patients and methods. A retrospective analysis of 90 patients with idiopathic scoliosis greater than 30° was conducted during 17 years (1982-1998). Three radiographs were made in every case (1st consulting, at bone maturity, and at the end of the follow-up). We had analyzed the correlation between angular value and the following parameters: age, gender, curve pattern, back pain, pregnancy. Results. The mean follow-up was 9.27 ± 3.36 years. A total of 16.70 % of curves had progressed more than 5° with a mean angle increase of 11° and a mean annual progression of 1.04°/year. We had not found significant relation between progression and gender, age, gestation or curve pattern. Curves greater than 40° have pain more frequently. And those that progressed had increased risk (five times) to have pain. Fifty percent of painful curves belong to pregnant women. Conclusions. One of 6 curves had progressed. We did not find factors related to this progression. There was a significant relation between progression and pain. The appearance of pain was associated with angulation and gestation. Although we found less progression than in previously reports, it seems to be useful to follow-up idiopathic scoliosis greater than 30° (every five years) after bone maturity

Síndrome pseudobulbar en mujer joven con múltiples ictus y aneurisma interatrial / Pseudobulbar syndrome in young woman with multiple stroke and interatrial aneurysm

Los aneurismas interatriales pueden ser fuente de embolias pulmonares y sistémicas. Poco frecuentes y subestimados como causa de ictus isquémicos, son diagnosticados mediante ecocardiografía transesofágica. Su presencia ha sido asociada de forma significativa a lesiones encefálicas isquémicas en pacientes jóvenes. Presentamos el caso de una mujer joven con múltiples ictus isquémicos atribuidos a la presencia de un aneurisma del septo auricular, que presentaba un cuadro de tetraparesia, alteraciones sensitivas y disartria pseudobulbar

Interatrial aneurysm can be a source of pulmonary and systemic emboli. Uncommon and underestimated as cause of stroke, are usually diagnosed by transesophageal echocardiography. Its presence has been significantly associated with cerebral isquemic lesions in young patients. We report a case of a young woman with multiple isquemic stroke attributed to an interatrial septal aneurysm, who developed tetraparesis, sensory disturbances and psudobulbar dysarthria

Sexual issues in a sample of women with spinal cord injury.

STUDY DESIGN: Semistructured interview. OBJECTIVES: To assess the degree of participation in sexual intercourse of a sample of women with spinal cord injury (SCI) in our community, to establish to what extent their sexual lives have been affected in comparison to before the injury, and to search for those factors that may have a major influence on both aspects. SETTING: Spinal Cord Injuries Unit, A Coruna, Spain. PARTICIPANTS: A total of 37 women, average age 40 years, time since onset average 10 years. RESULTS: In all, 62% claimed regular sexual activity after the injury. The women who suffered the injury before reaching the age of 18 years run a higher risk of not having physical relationships than those who were above that age when they incurred the SCI (P=0.04, OR 4.75). We discovered a significant drop in the frequency of intercourse (P=0.003) and the ability to reach an orgasm (P=0.008), after the injury. Of these women, 69% were satisfied with their current sexual activity and 77.4% considered the information they received from their doctors on the changes the SCI would cause in their sexuality to be either insufficient or nonexistent. CONCLUSIONS: There is a noticeable decrease in the frequency of intercourse as well as a significant reduction in the capability of reaching orgasm. Despite these changes and problems that ensue during intercourse as a result, most show satisfaction with their current sexual lives. On the other hand, the occurrence of the injury before the age of 18 years may imply a greater risk of not having an active sex life in adult years. We consider it is essential to provide the appropriate sexual information during the process of rehabilitation, aimed at helping women with SCI to adapt to their new situation.

Una conjuntivitis alérgica

La alergia ocular es una de las afecciones más frecuentes en la práctica oftalmológica diaria. La inflamación de la conjuntiva de etiología alérgica raramente se presenta aislada, y suele hacerlo junto con afección de las estructuras anejas oculares, como la córnea y los párpados, por lo que suelehablarse genéricamente de "enfermedad ocular alérgica" (AU)

Human chorionic gonadotropin immunoreactivity in serum of patients with malignant neoplasms.

The beta-human chorionic gonadotropin (HCG) radioimmunoassay was used to determine the presence of HCG immunoreactivity in serum of patients (n = 71) with diagnosis of cancer. Of patients with active neoplasia, 60.5% showed HCG immunoactivity above controls (greater than 5 mIU/ml). An apparent degree of correlation was observed with tumor activity in that a case with widespread metastases due to a colonic carcinoma exhibited the highest HCG levels while, in one patient, the level of HCG decreased progressively according to therapeutic response. A high frequency of immunoactive HCG was found in patients with carcinomas of the cervix, breast, gonad, and digestive system and in patients with melanoma. Trophoblastic cells were not evident in the tumors biopsied. Immunologic similarity of HCG secreted by tumors and that contained in serum of pregnant women, of patients with hydatidiform mole, and of males injected with exogenous HCG was shown by parallel inhibition curves in the radioimmunoassay. The positivity of HCG was predominant in cases of cervix carcinoma.