Experiences of water immersion during childbirth: a qualitative thematic synthesis.

BACKGROUND: The increasing demand for childbirth care based on physiological principles has led official bodies to encourage health centers to provide evidence-based care aimed at promoting women's participation in informed decision-making and avoiding excessive medical intervention during childbirth. One of the goals is to reduce pain and find alternative measures to epidural anesthesia to enhance women's autonomy and well-being during childbirth. Currently, water immersion is used as a non-pharmacological method for pain relief. This review aimed to identify and synthesize evidence on women's and midwives' experiences, values, and preferences regarding water immersion during childbirth. METHODS: A systematic review and thematic synthesis of qualitative evidence were conducted. Databases were searched and references were checked according to specific criteria. Studies that used qualitative data collection and analysis methods to examine the opinions of women or midwives in the hospital setting were included. Non-qualitative studies, mixed-methods studies that did not separately report qualitative results, and studies in languages other than English or Spanish were excluded. The Critical Appraisal Skills Program Qualitative Research Checklist was used to assess study quality, and results were synthesized using thematic synthesis. RESULTS: Thirteen studies met the inclusion criteria and were included in this review. The qualitative studies yielded three key themes: 1) reasons identified by women and midwives for choosing a water birth, 2) benefits experienced in water births, and 3) barriers and facilitators of water immersion during childbirth. CONCLUSIONS: The evidence from qualitative studies indicates that women report benefits associated with water birth. From the perspective of midwives, ensuring safe water births requires adequate resources, midwives training, and rigorous standardized protocols to ensure that all pregnant women can safely opt for water immersion during childbirth with satisfactory results.

Análisis de las lesiones y hábitos más frecuentes de los triatletas durante la competición / Analysis of the Most Frequent Injuries and Habits of the Triathletes during the Competition

Los objetivos de este trabajo son determinar y analizar las lesiones y los hábitos más frecuentes en triatletas durante el desarrollo de una prueba. Se trata de un estudio descriptivo, observacional, transversal y retrospectivo. La muestra la componen 84 participantes (76 hombres y 8 mujeres) que participaron en el XVII Triatlón de Sevilla (Categorías Super Sprint, Sprint y Olímpica). Se pasaron dos cuestionarios, uno antes y otro posterior a la prueba, en los que se registraron entre otras las variables: antecedentes de lesiones deportivas, tratamientos previos, incidencias y lesiones ocurridas durante la prueba, etc. Los triatletas sufren una alta incidencia de lesiones podológicas dérmicas durante la práctica deportiva, el 65% sufrió lesión en el pie, de las que 27,5% fueron ampollas y el 30% fueron heridas. El 72,4% de los participantes en la distancia Olímpica presentó ampollas en los pies. El 50% de los participantes sufrieron lesiones deportivas a lo largo de su trayectoria como triatleta, siendo el pie, la rodilla y la pierna, las zonas más lesionadas. Según estos datos es necesario desarrollar un Programa de Salud podológica para triatletas

The objectives of this study are to determine and analyze the most frequent injuries and habits of triathletes during the development of a test. It is a descriptive, observational, transversal and retrospective study. The sample is composed of 84 participants (76 men and 8 women). Two questionnaires were administered, pre and post test, and recorded: history of sports injuries, previous treatments, injuries during the test, etc. Triathletes suffer a high incidence of dermal foot injuries during sports practice. 88% of adults and 90% of young people suffered sports-related injuries. In terms of previous foot care, the most common reason for podiatric consultation was foot orthoses; 25% and 80% of the youngsters and adults, respectively, received advice on the care of their feet. According to these data, it is necessary to implement a foot care program for triathletes

Impacto de la pandemia por SARS-CoV-2 sobre la actividad y profesionales de un Servicio de Cirugía General y del Aparato Digestivo en un hospital terciario / SARS-CoV-2 pandemic on the activity and professionals of a General Surgery and Digestive Surgery Service in a tertiary hospital

INTRODUCCIÓN: La rápida expansión de la infección por SARS-CoV-2 ha supuesto una radical reorganización de los recursos sanitarios y la exposición de profesionales al contagio. Los servicios de Cirugía General y del Aparato Digestivo también necesitan adaptarse a este cambio. PACIENTES Y MÉTODOS: Se realiza un estudio observacional descriptivo prospectivo de los casos de COVID-19 en pacientes y cirujanos de un Servicio de Cirugía General en un área de alta incidencia de infección entre el 1 y el 31 de marzo de 2020. RESULTADOS: Pacientes: La incidencia de infección por SARS-CoV-2 en los pacientes programados con hospitalización en el postoperatorio inmediato fue del 7%. Su edad media fue de 59,5 años y todos evolucionaron satisfactoriamente en planta. De 36 pacientes intervenidos de urgencia, dos fueron SARS-CoV-2+ y uno altamente sospechoso de COVID-19 (11,1%). Los tres pacientes fallecieron por insuficiencia respiratoria, su edad media era de 81 años. Cirujanos: Hubo un total de 12 casos SARS-CoV-2 + confirmados (24,4%) (8 de 34 adjuntos y 4 de 15 residentes).Actividad asistencial: El número medio de intervenciones quirúrgicas urgentes diarias bajó de 3,6 en febrero a 1,16 en el mes de marzo. El 42% de los pacientes intervenidos a partir de la entrada en vigor de las primeras medidas de aislamiento a nivel regional, presentaban cuadros evolucionados. CONCLUSIONES: El aumento de casos en la población general de COVID-19 debe alertar a los Servicios de Cirugía General de la necesidad de tomar de medidas de forma precoz que garanticen la seguridad de los pacientes y de los cirujanos

INTRODUCTION: The rapid spread of SARS-CoV-2 infection has led to a radical reorganization of healthcare resources. Surgical Departments need to adapt to this change. PATIENTS AND METHODS:We performed a prospective descriptive observational study of the incidence of COVID-19 in patients and surgeons of a General Surgical Department in a high prevalence area, between the 1st and 31st of March 2020. RESULTS:Patients: The incidence of SARS-CoV-2 infection in elective surgery patients was 7% (mean age 59.5 years). All survived.Of 36 patients who underwent emergency surgery, two of them were SARS-CoV-2 positive and one was clinically highly suspicious of COVID-19 (11.1%). All three patients died of respiratory failure (mean age 81 years). Surgeons: There were a total of 12 confirmed SARS-CoV-2+ cases among the surgical department staff (24.4%) (8 out of 34 consultants and 4 out of 15 residents).Healthcare activity: The average number of daily emergency surgical interventions declined from 3.6 in February to 1.16 in March. 42% of the patients who underwent emergency surgery had peritonitis upon presentation. CONCLUSIONS: The fast pace of COVID-19 pandemia, should alert surgical departments of the need of adopting early measures to ensure the safety of patients and staff

Amiloidosis vítrea como manifestación primaria de enfermedad: reporte de caso / Vitreous amyloidosis as primary manifestation of disease: case report

Mujer de 35 años con disminución progresiva de visión en ambos ojos sin otros síntomas asociados manifestó como único antecedente la muerte de su hermano por amiloidosis. La agudeza visual fue de cuenta dedos a 30 centímetros en el ojo derecho y 20/70 en el ojo izquierdo. En la oftalmoscopia del ojo derecho se observó un vítreo blanco, homogéneo que no permitió valorar detalles y en el ojo izquierdo un vítreo blanquecino con opacidades en forma de bandas en la región cortical. Se realizó vitrectomía en el ojo derecho y estudio con inmunotinciones que fueron positivos para material amiloide. Publicamos un caso de amiloidosis diagnosticada con tinciones específicas en muestra vítrea cuya manifestación inicial y única fue la presencia de opacidades vítreas. El procesamiento de estas muestras debe considerarse en pacientes con antecedentes familiares, opacidades vítreas tempranas, resultados negativos de biopsia sistémica o curso atípico de la enfermedad

A 35-year-old woman with progressive decrease of vision in both eyes and with no other associated symptoms, manifested as the only antecedent, the death of her brother due to amyloidosis. The visual acuity was counting fingers at 30 centimetres in the right eye and 20/70 in the left eye. In ophthalmoscopy of the right eye, a white, homogeneous vitreous, that was difficult to assess in detail, was observed, and in the left eye a whitish vitreous with band-like opacities in the cortical region. Vitrectomy was performed in the right eye, and a study with specific stains showed positive for amyloid material. A case is reported of amyloidosis diagnosed with specific stains in a vitreous sample for which the initial and only manifestation was the presence of vitreous opacities. The processing of these samples should be considered in patients with family history, early vitreous opacities, negative results of systemic biopsy, or atypical course of the disease

Vitreous amyloidosis as primary manifestation of disease: case report. / Amiloidosis vítrea como manifestación primaria de enfermedad: reporte de caso.

A 35-year-old woman with progressive decrease of vision in both eyes and with no other associated symptoms, manifested as the only antecedent, the death of her brother due to amyloidosis. The visual acuity was counting fingers at 30 centimetres in the right eye and 20/70 in the left eye. In ophthalmoscopy of the right eye, a white, homogeneous vitreous, that was difficult to assess in detail, was observed, and in the left eye a whitish vitreous with band-like opacities in the cortical region. Vitrectomy was performed in the right eye, and a study with specific stains showed positive for amyloid material. A case is reported of amyloidosis diagnosed with specific stains in a vitreous sample for which the initial and only manifestation was the presence of vitreous opacities. The processing of these samples should be considered in patients with family history, early vitreous opacities, negative results of systemic biopsy, or atypical course of the disease.

Sacral nerve stimulation for constipation: long-term outcomes.

BACKGROUND: There has been some controversy regarding the efficacy of sacral nerve stimulation (SNS) for the treatment of chronic constipation, due to less positive outcomes and concerns about cost-effectiveness in the long term. The aim of the present study was to evaluate the long-term outcomes of SNS in patients with chronic constipation. METHODS: A retrospective study was conducted on patients who had SNS for chronic constipation in 2008-2017 at our institution. Clinical factors, profile of constipation, physiology studies, and patient satisfaction with SNS therapy were investigated during a follow-up period up to 10 years after the implantation. RESULTS: Twenty-nine patients [86% female, median age 49 years (range 17-86)] were tested for SNS, and 24 received implants after a positive test phase [median 47 days (range 21-56 days)]. There were 27 bilateral and 2 unilateral implants, in S3 or S4 depending on best response. Mean follow-up was 59 months. Efficacy was considered as a score > 5 (on a scale of 1-10) in general symptom improvement. Nine (37.9%) implanted patients had a satisfaction score > 5. In 6 cases (25%), patient satisfaction was higher than 9. Due to the small sample size, there were no statistically significant variables considered as predictors of response. CONCLUSIONS: Our results agree with current studies which describe around a 30% response of SNS for refractory constipation. However, there is a small group of patients highly satisfied with SNS therapy. More studies are needed to better understand this profile and optimize outcomes.

Potential Biomarkers with Plasma Cortisol, Brain-derived Neurotrophic Factor and Nitrites in Patients with Acute Ischemic Stroke.

BACKGROUND: Acute Ischemic Stroke (AIS) represents an economic challenge for health systems all over the globe. Changes of neuroactive steroids have been found in different neurological diseases. We have previously demonstrated that old patients with AIS show changes of plasma cortisol and estradiol concentrations, in that increased steroid levels are associated with a deterioration of neurological status and a worse cognitive decline. OBJECTIVE: The present study assessed in patients with AIS if changes of behavior, Brain-Derived Neurotrophic Factor (BDNF) and Nitrites (NO-2) bear a relationship with the degree of hypercortisolism. METHODS: We recruited patients hospitalized within the first 24 hours of AIS. Subjects were divided into two groups, each one composed of 40 control subjects and 40 AIS patients, including men and women. The neurological condition was assessed using the National Institute of Health Stroke Scale (NIHSS) and the cognitive status with the Montreal Cognitive Assessment (MoCA). The emotional status was evaluated using the Montgomery-Asberg Depression Rating Scale (MADRS), whereas the Modified Rankin Scale (MRS) was used to determine the functional condition. BDNF and NO-2 plasma levels were measured by ELISA and the Griess reaction method, respectively. RESULTS: We found that in AIS patients, increased plasma cortisol was negatively correlated with plasma BDNF and NO-2 levels, neurological condition, cognition, functional responses and emotional status, suggesting a relationship between the declines of clinical, behavioral and blood parameters with stress-induced cortisol elevation. CONCLUSION: Nitrites and BDNF may represent potential biomarkers for cortisol negative effects on the area of cerebral ischemia and penumbra, potentiating ischemic cell damage.

Fluorescence spectroscopy and parallel factor analysis as a dissolved organic monitoring tool to assess treatment performance in drinking water trains.

Fluorescence excitation emission matrix (FEEM) spectroscopy was used to evaluate its applicability as a tool to track dissolved organic matter (DOM) in a drinking water treatment plant (DWTP) that incorporates a conventional line (consisting in ozonation and GAC filtration) and a membrane-based line (consisting in ultrafiltration, reverse osmosis and mineralization) working in parallel. Seven sampling points within the different process stages were characterized monthly during 2014. A global Parallel Factor Analysis (PARAFAC) was used to pull out underlying organic fractions from the fluorescence spectra. Accordingly a five components model was selected to describe the system and the pros and cons of the model were discussed by analysis of the residuals. Among the five fluorescent components, those associated to humic-like matter (C1, C3 and C4) showed a similar season variability in the river water feeding the DWTP (which resembled that of UV254 and TOC), whereas the two components associated to protein-like matter (C2 and C5) exhibited a different behavior. The maximum fluorescence intensity values (Fmax) were used to quantify DOM removals across the plant. Compared to the conventional line, water from the UF/RO membrane-based line showed between 6 and 14 times lower fluorescence intensity signal for the humic-like components and between 1 and 3 for the protein-like components as compared to the conventional line. The differences in DOM composition due to seasonal variations and along the treatment trains point out the suitability of using fluorescence measurements over other parameters such as UV254 as a monitoring tool to help optimize operation conditions of each treatment stage and improve produced water quality in a DWTP.

Association between the sitting posture and back pain in college students / Asociación entre la postura en sentado y el dolor de espalda en estudiantes universitarios

Introduction: Back pain is a significant public health problem, its prevalence among college students is high, 30 - 70%; Its association with the sitting position in workers has been reported, but its study in university populations is limited. Objective: To evaluate the association between sitting posture with back pain among college students. Methods: Cross-sectional study. Explanatory variables: sociodemographic characteristics, adequate lighting in the classroom, sitting posture and type of chair. Outcome variables: neck or back pain the day of the survey, acute and chronic. Log-binomial regression models estimated prevalence ratios (PR) and their 95% CI. Results: 516 students from health deparment, age 21.3 ± 2.6 years, 69.2% women, 29,5% were in third year; 72,8% belong to middle socioeconomical level (3 and 4); and 18,4% of the students had an additional working activity. 87,8% of the classrooms had adequate lighting. Sitting posture with rounded back, feet supported on another chair and crossed legs was associated with neck pain the day of the survey (PR: 2.84), acute (PR: 2.41) and chronic (PR: 4.13). Other sitting posture with rounded back and crossed leg was associated with back pain the day of the survey (PR: 1.81) and acute (PR: 2.0). The screen time at the computer was associated with the outcome variables (PR 1.01 - 2.08). Conclusion: The results support the implementation of policies and institutional projects in order to prevent and control the back pain in college students.

Introducción: El dolor de espalda es un problema importante de salud pública, su prevalencia en estudiantes universitarios está entre el 30 al 70%; su asociacion con la postura sentada en trabajadores ha sido reportada, pero en poblacion universitaria su estudio es limitado. Objetivo: Evaluar la asociación entre la postura en sentado con el dolor de espalda en estudiantes universitarios. Métodos: Estudio de corte transversal. Variables explicatorias: características sociodemográficas, iluminación del salón de clase, postura en sedente y tipo de silla. Variables de salida: dolor de cuello o espalda el día de la encuesta, agudo y crónico. Modelos de regresión log-binomial estimaron las razones de prevalencia (RP) y sus IC95%. Resultados: Participaron 516 estudiantes de la facultad de salud, edad 21,3±2,6 años, 69,2% mujeres, 29,5% estaban en tercer año; y el 72,8% pertenecía a los estratos socioeconómicos 3 y 4, con un 18,4% de los estudiantes, que además de estudiar desarrollaban actividades laborales. El 87,8% de los salones de clase presentan iluminación adecuada. La postura en sedente con espalda redondeada, pies en otra superficie y pierna cruzada se asoció con dolor de cuello el día de la encuesta (RP: 2,84), agudo (RP: 2,41) y crónico (RP: 4,13). Otra postura sentada con espalda redondeada y una pierna cruzada se asoció con dolor de espalda el día de la encuesta (RP: 1,81) y agudo (RP: 2,0). El tiempo en computador se asoció con las variables de salida (RP 1.01 - 2,08). Conclusión: Los resultados apoyan la implementación de políticas y proyectos institucionales dirigidos a prevenir y controlar el dolor de espalda en universitarios.

Freshwater fish faunas, habitats and conservation challenges in the Caribbean river basins of north-western South America.

The remarkable fish diversity in the Caribbean rivers of north-western South America evolved under the influences of the dramatic environmental changes of neogene northern South America, including the Quechua Orogeny and Pleistocene climate oscillations. Although this region is not the richest in South America, endemism is very high. Fish assemblage structure is unique to each of the four aquatic systems identified (rivers, streams, floodplain lakes and reservoirs) and community dynamics are highly synchronized with the mono-modal or bi-modal flooding pulse of the rainy seasons. The highly seasonal multispecies fishery is based on migratory species. Freshwater fish conservation is a challenge for Colombian environmental institutions because the Caribbean trans-Andean basins are the focus of the economic development of Colombian society, so management measures must be directed to protect aquatic habitat and their connectivity. These two management strategies are the only way for helping fish species conservation and sustainable fisheries.

Potamodromous migrations in the Magdalena River basin: bimodal reproductive patterns in neotropical rivers.

Magdalena River basin potamodromous fishes have two annual reproductive seasons: the subienda in the first half of the year and the mitaca in the second. Both upstream migrations are c. 30-45 days long; after that, with the onset of the rainy season, fishes spawn and remain in the river (resident individuals) or start a downstream movement (the bajanza) to return to the Magdalena floodplain lakes (nursery, shelter and feeding grounds). Due to their particular gonad development the bocachico Prochilodus magdalenae and probably the comelón Leporinus muyscorum are physiologically able to undertake two annual basin migrations. In the presence of dams or hydropower structures, fishes are able to find alternative migration routes. Some species should be re-classified in their migratory behaviour.

Estudio comparativo de los hallazgos clínicos en la enfermedad orbitaria asociada a IgG4 con afectación unilateral vs. bilateral / Comparative study of clinical features between unilateral and bilateral orbital IgG4-related disease

OBJETIVO: Análisis descriptivo y comparativo de los pacientes diagnosticados de enfermedad orbitaria asociada a IgG4. MATERIAL Y MÉTODOS: Se revisaron y analizaron todos los casos diagnosticados de inflamación orbitaria asociada a IgG4 por el servicio de Patología del Hospital Dr. Luis Sánchez Bulnes. RESULTADOS: Encontramos un total de 9 casos. El 66% fueron mujeres, con una edad media de 48 años y tiempo medio de evolución al diagnóstico de 2 años. El 56% de los casos presentaron afectación unilateral: el 100% eran mujeres con clínica de dolor al ingreso y una respuesta óptima al tratamiento corticoideo en el 100% de los casos que precisaron tratamiento médico (un caso mostró resolución espontánea). En los casos bilaterales (44%) solo el 25% fueron mujeres y ninguno refirió dolor como síntoma de presentación. Además, el 25% de estos pacientes precisó de la combinación con inmunosupresores para conseguir el control del cuadro. CONCLUSIONES: La presentación clínica de los pacientes con inflamación orbitaria asociada a IgG4 difiere según sea una afectación uni- o bilateral

OBJECTIVE: Descriptive and comparative study of patients with orbital IgG4-related disease. MATERIAL AND METHODS: A review and analysis of the cases diagnosed with inflammatory orbital lesion related to IgG4 by the Ophthalmic Pathology Service in the Dr. Luis Sánchez Bulnes Hospital. RESULTS: A total of 9 cases were found, in which 66% were women, and with a mean age of 48 years and time to diagnosis of 2 years. Unilateral involvement was observed in 56% of cases. All the females experienced pain, and there was an optimal response to corticosteroid treatment in 100% of patients who required medical treatment (one case showed spontaneous resolution). In bilateral cases (44%), only 25% were female, and none had pain as a presenting symptom. Furthermore, 25% of these patients required a combination with immunosuppressants to control inflammation. CONCLUSIONS: Clinical presentation of patients with unilateral orbital IgG4-related disease differs from those with bilateral involvement

Direct ultrafiltration performance and membrane integrity monitoring by microbiological analysis.

The feasibility of substituting a conventional pre-treatment, consisting of dioxi-chlorination, coagulation/flocculation, settling and sand filtration, of a drinking water treatment plant (DWTP) by direct ultrafiltration (UF) has been assessed from a microbiological standpoint. Bacterial indicators, viral indicators and human viruses have been monitored in raw river, ultrafiltered and conventionally pre-treated water samples during two years. Direct UF has proven to remove bacterial indicators quite efficiently and to a greater extent than the conventional process does. Nevertheless, the removal of small viruses such as some small bacteriophages and human viruses (e.g. enteroviruses and noroviruses) is lower than the current conventional pre-treatment. Membrane integrity has been assessed during two years by means of tailored tests based on bacteriophages with different properties (MS-2, GA and PDR-1) and bacterial spores (Bacillus spores). Membrane integrity has not been compromised despite the challenging conditions faced by directly treating raw river water. Bacteriophage PDR-1 appears as a suitable microbe to test membrane integrity, as its size is slightly larger than the considered membrane pore size. However, its implementation at full scale plant is still challenging due to difficulties in obtaining enough phages for its seeding.

[Comparative study of clinical features between unilateral and bilateral orbital IgG4-related disease]. / Estudio comparativo de los hallazgos clínicos en la enfermedad orbitaria asociada a IgG4 con afectación unilateral vs. bilateral.

OBJECTIVE: Descriptive and comparative study of patients with orbital IgG4-related disease. MATERIAL AND METHODS: A review and analysis of the cases diagnosed with inflammatory orbital lesion related to IgG4 by the Ophthalmic Pathology Service in the Dr. Luis Sánchez Bulnes Hospital. RESULTS: A total of 9 cases were found, in which 66% were women, and with a mean age of 48 years and time to diagnosis of 2 years. Unilateral involvement was observed in 56% of cases. All the females experienced pain, and there was an optimal response to corticosteroid treatment in 100% of patients who required medical treatment (one case showed spontaneous resolution). In bilateral cases (44%), only 25% were female, and none had pain as a presenting symptom. Furthermore, 25% of these patients required a combination with immunosuppressants to control inflammation. CONCLUSIONS: Clinical presentation of patients with unilateral orbital IgG4-related disease differs from those with bilateral involvement.

Lesión linfoproliferativa del saco lagrimal: caso clínico / Lacrimal sac lymphoproliferative lesion: Case report

CASO CLÍNICO: Se presenta el caso de una mujer de 51 años con tumoración firme a nivel del canto interno del ojo derecho de 5 años de evolución. La biopsia excisional mediante dacriocistectomía estableció el diagnóstico de lesión linfoproliferativa de bajo grado (hiperplasia linfoide reactiva). DISCUSIÓN: Los tumores del saco lagrimal son muy raros, con un pico de incidencia en la quinta década de la vida. La clínica en fases iniciales es parecida a la obstrucción lagrimal por otras causas, de ahí que hasta un 40% de estos tumores no se sospechen y sean diagnosticados durante la realización de una dacriocistorrinostomía

CASE REPORT: The case is presented of a 51 year-old woman with a firm mass at the medial canthus of the right eye of five years onset. A low-grade lymphoproliferative lesion (reactive lymphoid hyperplasia) was diagnosed from an excisional biopsy. DISCUSSION: Lacrimal sac tumors are rare, with a peak incidence in the fifth decade of life. The initial clinical features are epiphora and medial canthus swelling. As it mimics nasolacrimal duct obstruction, up to 40% of these tumors are misdiagnosed until undergoing surgery

Lacrimal sac lymphoproliferative lesion: case report.

CASE REPORT: The case is presented of a 51 year-old woman with a firm mass at the medial canthus of the right eye of five years onset. A low-grade lymphoproliferative lesion (reactive lymphoid hyperplasia) was diagnosed from an excisional biopsy DISCUSSION: Lacrimal sac tumors are rare, with a peak incidence in the fifth decade of life. The initial clinical features are epiphora and medial canthus swelling. As it mimics nasolacrimal duct obstruction, up to 40% of these tumors are misdiagnosed until undergoing surgery.

Tumores del saco lagrimal que se presentan como obstrucción de la vía lagrimal. Estudio retrospectivo en la población mexicana durante 2007-2012 / Lacrimal sac tumors presenting as lacrimal obstruction. Retrospective study in mexican patients 2007-2012

OBJETIVO: Conocer las características demográficas y clínicas de los tumores primarios del saco lagrimal, que debutan clínicamente como obstrucción de la vía lagrimal. MÉTODOS: Estudio retrospectivo y descriptivo de los pacientes operados por obstrucción baja de la vía lagrimal en el Hospital Dr. Luis Sánchez Bulnes, Asociación para evitar la Ceguera en México I AP, entre los años 2007-2012. RESULTADOS: Los tumores primarios del saco lagrimal representaron el 2,5% de todas nuestras obstrucciones lagrimales, siendo más frecuentes en mujeres (8:1). El 89% fueron de estirpe no epitelial, siendo las más frecuentes las lesiones de naturaleza linfoide. Los tumores benignos se presentaron a edades más tempranas (50 años) que los malignos (70 años). El 33% de nuestros casos resultaron hallazgos inesperados durante el procedimiento quirúrgico (100% lesiones benignas).El 55% se correspondían a tumores malignos (1,4% de las obstrucciones), todos ellos lesiones linfoproliferativas. La clínica más frecuente fue tumoración en canto interno asociada o no a epifora. El tiempo de evolución varió en función del grado de agresividad del linfoma (3 meses-10 años). CONCLUSIONES: Los tumores del saco lagrimal son raros pero debemos tenerlos en cuenta ante la clínica de obstrucción de la vía lagrimal para un tratamiento adecuado

OBJECTIVE: To determine the demographic and clinical data of primary tumors of the lacrimal sac presenting as lacrimal obstruction. METHODS: Retrospective and descriptive study was conducted between the years 2007 to 2012 on all patients undergoing surgery for low lacrimal obstruction at Dr. Luis Sanchez Bulnes Hospital, an Association for the prevention of blindness in Mexico IAP. RESULTS: Primary tumors of the lacrimal sac represented 2.5% of all lacrimal obstructions, being more common in women than in men (8:1). The large majority (89%) of the cases were non-epithelial, with lymphoid lesions being the most frequent. Benign tumors were presented at a younger age (50 years old) than malignant (70 years old). One-third (33%) of cases were unexpected findings during surgery (100% benign). Just over half (55%) were malignant tumors (1.4% of obstructions), all of them lymphoproliferative lesions. The most frequent clinical tumor was in the inner edge, either with or without epiphora. The progression time varied according to the degree of aggressiveness of the lymphoma (3 months-10 years). CONCLUSIONS: Lacrimal sac tumors are rare, but they must be taken into account in patients with an unusual clinical presentation of lacrimal obstruction

[Lacrimal sac tumors presenting as lacrimal obstruction. Retrospective study in Mexican patients 2007-2012]. / Tumores del saco lagrimal que se presentan como obstrucción de la vía lagrimal. Estudio retrospectivo en la población mexicana durante 2007-2012.

OBJECTIVE: To determine the demographic and clinical data of primary tumors of the lacrimal sac presenting as lacrimal obstruction. METHODS: Retrospective and descriptive study was conducted between the years 2007 to 2012 on all patients undergoing surgery for low lacrimal obstruction at Dr. Luis Sanchez Bulnes Hospital, an Association for the prevention of blindness in Mexico IAP. RESULTS: Primary tumors of the lacrimal sac represented 2.5% of all lacrimal obstructions, being more common in women than in men (8:1). The large majority (89%) of the cases were non-epithelial, with lymphoid lesions being the most frequent. Benign tumors were presented at a younger age (50 years old) than malignant (70 years old). One-third (33%) of cases were unexpected findings during surgery (100% benign). Just over half (55%) were malignant tumors (1.4% of obstructions), all of them lymphoproliferative lesions. The most frequent clinical tumor was in the inner edge, either with or without epiphora. The progression time varied according to the degree of aggressiveness of the lymphoma (3 months-10 years). CONCLUSIONS: Lacrimal sac tumors are rare, but they must be taken into account in patients with an unusual clinical presentation of lacrimal obstruction.

Novel bone adhesives: a comparison of bond strengths in vitro.

Fracture fixation using adhesive is a promising alternative in craniofacial surgeries, replacing the plates and screws system. The advantages include the ease of application and avoidance of drilling holes that may weaken the bone and cause fractures. In this study the bond strengths of selected adhesives were evaluated and compared with resorbable plates and screws. Four adhesives, octyl-cyanoacrylate, N-butyl-cyanoacrylate, a novel methyl-methacrylate, and a novel cyanoacrylate derivative, were tested for their microtensile and shear bond strengths. The bone samples were cut into rectangular bars and bonded with selected adhesives for microtensile testing. For the shear bond test, paired bars were bonded at the overlap, while two other sets of bars were attached by a Lactosorb plate using either adhesive or screws. Data were analysed by analysis of variance (ANOVA). The microtensile bond strengths of N-butyl-cyanoacrylate, novel cyanoacrylate derivative, and novel methyl-methacrylate derivative were significantly greater than octyl-cyanoacrylate. When bone sections were fixed with resorbable plates and adhesives, shear bond strength was significantly greater for N-butyl-cyanoacrylate than plate and screws, while the bond strengths of other adhesives were comparable with the plate and screws. N-Butyl cyanoacrylate was shown to have the greatest potential for fixation of fractured bone in craniofacial surgical applications.

Allopregnanolone and puberty: modulatory effect on glutamate and GABA release and expression of 3α-hydroxysteroid oxidoreductase in the hypothalamus of female rats.

The hypothalamic release of glutamate and GABA regulates neurosecretory functions that may control the onset of puberty. This release may be influenced by neurosteroids such as allopregnanolone. Using superfusion experiments we examined the role of allopregnanolone on the K(+)-evoked and basal [(3)H]-glutamate and [(3)H]-GABA release from mediobasal hypothalamus and anterior preoptic area in prepubertal, vaginal opening and pubertal (P) rats and evaluated its modulatory effect on GABAA and NMDA (N-methyl-d-aspartic acid) receptors. Also, we examined the hypothalamic activity and mRNA expression of 3α-hydroxysteroid oxidoreductase (3α-HSOR) - enzyme that synthesizes allopregnanolone - using a spectrophotometric method and RT-PCR, respectively. Allopregnanolone increased both the K(+)-evoked [(3)H]-glutamate and [(3)H]-GABA release in P rats, being the former effect mediated by the modulation of NMDA receptors - as was reverted by Mg(2+) and by the NMDA receptor antagonist AP-7 and the latter by the modulation of NMDA and GABAA receptors - as was reverted by Mg(2+) and the GABAA receptor antagonist bicuculline. The neurosteroid also increased the basal release of [(3)H]-glutamate in VO rats in an effect that was dependent on the modulation of NMDA receptors as was reverted by Mg(2+). On the other hand we show that allopregnanolone reduced the basal release of [(3)H]-GABA in P rats although we cannot elucidate the precise mechanism by which the neurosteroid exerted this latter effect. The enzymatic activity and the mRNA expression of 3α-HSOR were both increased in P rats regarding the other two studied stages of sexual development. These results suggest an important physiological function of allopregnanolone in the hypothalamus of the P rat where it might be involved in the 'fine tuning' of neurosecretory functions related to the biology of reproduction of the female rats.