Una versión reducida y modificada del Inventario de Personalidad para el DSM-5 (PID-5) en la Argentina / A reduced and modified version of the Personality Inventory for the DSM-5 (PID-5) in Argentina

Resumen El modelo dimensional alternativo para los trastornos de personalidad incluye 25 facetas (rasgos patológicos) organizadas en cinco dominios de orden superior (Desapego, Afectividad Negativa, Psicoticismo, Antagonismo y Desinhibición). Para evaluar este modelo, se desarrolló el Personality Inventory for DSM-5 (PID-5), que posee dos versiones: una extensa (220 ítems) que evalúa dominios y facetas, y una breve (25 ítems) que evalúa solo los dominios. En un trabajo anterior, se brindó evidencia favorable para una versión breve (31 ítems) adaptada para ser utilizada en población argentina. En el presente trabajo se estudian las propiedades psicométricas de una versión reducida y modificada del PID-5 que permite evaluar ambos componentes por medio de una cantidad de ítems (108). La validez convergente se evaluó a través de la relación con una medida de rasgos de personalidad normal del Modelo de los Cinco Grandes Factores. Se trabajó con una muestra de tipo no probabilística de n = 525 sujetos de población general, que respondieron la versión adaptada del PID-5 y el Listado de Adjetivos para Evaluar la Personalidad. Los resultados brindaron evidencia de validez y confiabilidad para el instrumento. El Análisis Factorial Exploratorio y Confirmatorio sugirió un buen ajuste de la estructura pentafactorial. La consistencia interna resultó adecuada y los ítems presentaron buenos índices de discriminación. Se observaron diferencias de género y edad, y correlaciones con los factores correspondientes de los cinco grandes. Esta versión puede ser utilizada para evaluar el modelo, con fines tanto clínicos como de investigación, y con ventajas respecto al tiempo de administración respecto a la versión extensa original.

Abstract The official classification of personality disorders in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) remains categorical. However, a dimensional alternative for personality disorders is presented as an emerging model. The model is organized in five higher order domains (Negative Affectivity, Detachment, Antagonism, Disinhibition and Psychoticism), with relationships with the Big Five Model of Personality, strongly established within the Personality Psychology. The proposal also includes 25 facets or second-order traits, included within the main domains. Domains and facets represent psychopathological traits with clinical relevance. To assess this model, the Personality Inventory for DSM-5 (PID-5) was developed. PID-5 has two forms: extensive (220 items) that assesses domains and facets, and brief (25 items) that assesses only the domains. In a previous study, evidence for a short version (31 items) adapted to the Argentine population was provided, that overcomes some of the limitations of the original one. In this work, the psychometric properties of a reduced and modified version of the PID-5 are studied, which allows evaluating five domains and 25 facets, through a reduced number of items (108). We worked with a non-probabilistic sample of n = 525 subjects from the general population, who answered the adapted version of the PID-5 and the Adjectives Checklist to Assess the Big Five Personality Factors (AEP), a Big Five Model measure. The following data analyses were performed: (1) Exploratory and Confirmatory Factor Analysis to evaluate the internal structure of PID-5; (2) reliability analysis to assess the internal consistency of the PID-5 scales; (3) item analysis to assess discriminating power; (4) multivariate analysis of variance (MANOVA) to examine significant differences due to gender and age; and (5) bivariate correlation analysis to analyze PID-5 convergent validity. The results provided evidence of validity and reliability. Exploratory and Confirmatory Factor Analysis suggested a five-factor structure. The facets presented factor loadings in the domain theoretically expected, with some exceptions: Suspiciousness (loaded in Psychoticism), Hostility (loaded in Disinhibition), Depressivity (loaded in Detachment) and Insensitivity (loaded in Detachment). CFA also suggested a good model fit (CFI = .98; RMSEA = .04; SRMR = 0.083). Psychoticism, Detachment, and Disinhibition facets had their higher factor loadings in the expected domain. Negative affectivity showed higher correlations with the rest of the scales. Internal consistency was satisfactory, especially at the domain level, and the items had good discrimination indices. Correlations with the corresponding of the Big Five factors were observed, similar to previous studies. The five PID-5 domains were also found positively correlated. Additionally, gender and age differences were found. In line with previous literature, results suggest that some facets scales are "pure" markers of these domains (e. g., Psychoticism and Antagonism facets), whereas others (e. g., Negative Affectivity facets such as Depressiveness, Suspicion, Hostility), are located "in between" domains since they share features of more than one domain. Psychoticism facets presented higher loadings in their domains and lower in the rest. This is not surprising; although most of psychopathology cannot be understood as categories, schizophyte and Schizotypal Personality Disorder are exceptions, and Psychoticism would be the representation of these categories in the APA model. Findings also provide evidence of convergent validity for the instrument, as well as theorical evidence regarding the relationship between normal and pathological personality traits. This version can be used to evaluate the model, both in research and clinical practice. It has advantages over the original longer version, in terms of administration time and participants' fatigue, while maintaining its psychometric properties. The results are also expected to contribute to the recent literature on the dimensional approach to personality psychopathology. However, complementary studies, particularly with a clinical population, are needed.

Infección periprotésica de rodilla ¿influye la estrategia quirúrgica en el resultado funcional? / Total knee arthroplasty infection, what is the best strategy for better functional outcomes?

Resumen: Introducción: La estrategia quirúrgica al enfrentarnos a las infecciones periprotésicas de rodilla sigue siendo controvertida. Los objetivos del tratamiento son la erradicación de la infección, la mejoría del dolor y de la función articular. El manejo quirúrgico incluye el desbridamiento y retención del implante, el recambio protésico en un tiempo o el recambio en dos tiempos. Esta última estrategia quirúrgica se considera el «gold standard¼, alcanzando unas tasas de curación hasta de 80%-100%, aunque poco se ha publicado acerca de los resultados funcionales. Material y métodos: Estudio retrospectivo de 65 pacientes, con infección periprotésica de rodilla. En 20 pacientes se realizó un recambio en un tiempo y en 45 pacientes fueron recambios en dos tiempos. Evaluación pre- y postoperatoriamente con la escala modificada HSS. Todos los pacientes fueron tratados con antibioterapia intravenosa, evaluamos la respuesta analítica y clínica para confirmar la erradicación o no de la infección. Resultados: La infección se resolvió en 39 de 65 pacientes, 12 en el grupo de recambio en un tiempo y 27 para el grupo de dos tiempos. Sin diferencia significativa entre los grupos en relación con curación ni resultado funcional. Sin embargo, hay una diferencia estadísticamente significativa entre aquellos pacientes que recibieron tratamiento antibiótico vía oral antes del diagnóstico y aquéllos que no lo recibieron. Conclusión: La tasa de curación es similar en los tratados con recambio en un tiempo y recambio en dos tiempos. No pudimos demostrar superioridad en los resultados funcionales entre los dos grupos.

Abstract: Introduction: Surgical strategy in dealing with periprosthetic knee infections remains controversial. The goals of treatment are to eradicate infection, improve pain and joint function. Surgical management includes implant debridement and retention, prosthetic replacement in one-time, or two-stage replacement. This latest surgical strategy is considered the «gold standard¼, reaching healing rates up to 80%-100%, although little has been published about functional results. Material and methods: Retrospective study of 65 patients with periprosthetic knee infection. In 20 patients a replacement was made in a time and in 45 patients were in two stages. Pre- and post-operative evaluation with the modified HSS scale. All patients were treated with intravenous antibiotherapy, we evaluated the analytical and clinical response to confirm the eradication or not of the infection. Results: The infection was resolved in 39 out of 65 patients, 12 in the replacement group in a time and 27 for the two-stages group. No significant difference between the groups in relation to healing or functional result. However, there is a statistically significant difference between those patients who received oral antibiotic treatment prior to diagnosis and those who did not. Conclusions: The healing rate is similarly treated with replacement in a time and replacement in two times. We were unable to demonstrate superiority in the functional results between the two groups.

environmental deposition of influenza virus from patients infected with influenza A [H1N1] pdm09: Implications for infection prevention and control

In a multi-center, prospective, observational study over two influenza seasons, we sought to quantify and correlate the amount of virus recovered from the nares of infected subjects with that recovered from their immediate environment in community and hospital settings. We recorded the symptoms of adults and children with A [H1N1] pdm09 infection, took nasal swabs, and sampled touched surfaces and room air. Forty-two infected subjects were followed up. The mean duration of virus shedding was 6.2 days by PCR [Polymerase Chain Reaction] and 4.2 days by culture. Surface swabs were collected from 39 settings; 16 [41%] subject locations were contaminated with virus. Overall, 33 of the 671 [4.9%] surface swabs were PCR positive for influenza, of which two [0.3%] yielded viable virus. On illness Day 3, subjects yielding positive surface samples had significantly higher nasal viral loads [geometric mean ratio 25.7; 95% Cl 1.75, 376.0, p = 0.021] and a positive correlation [r = 0.47, ' p = 0.006] was observed between subject nasal viral loads and viral loads recovered from the surfaces around them. Room air was sampled in the vicinity of 12 subjects, and PCR positive samples were obtained for five [42%] samples. Influenza virus shed by infected subjects did not detectably contaminate the vast majority of surfaces sampled. We question the relative importance of the indirect contact transmission of influenza via surfaces, though our data support the existence of super-spreaders via this route. The air sampling results add to the accumulating evidence that supports the potential for droplet nuclei [aerosol] transmission of influenza

The reproductive biology of Pinguipes brasilianus Cuvier, 1829 (Osteichthyes: Pinguipedidae) in temperate rocky reefs of Argentina

Pinguipes brasilianus is a conspicuous and abundant rocky-reef fish inhabiting the Northern Patagonian gulfs of Argentina, Southwest Atlantic. This study describes its reproductive biology in this region. We made macroscopic and histological descriptions of the testis and ovary development, analyzed the evolution of the gonadosomatic index (GSI) in both sexes throughout the year, and estimated fecundity and length at 50% maturity for females. Pinguipes brasilianus is a multiple spawner with indeterminate annual fecundity and an extended reproductive season, encompassing austral spring and summer. Low GSI values in males (monthly means ranged between 0.11% and 0.75%) and low relative fecundity in female fish (between 2 and 44 oocytes/g) are consistent with a need of close proximity between male and female during oocyte fertilization, sexual courtship and with spawning in pairs and/or within reef crevices. The estimated length at 50% maturity (± SD) for females was 15.22 ± 0.43 cm total length. Although P. brasilianus shares the main reproductive features of its congeneric species Pinguipes chilensis , male GSI and female length at 50% maturity in P. brasilianus were markedly lower than those reported for P. chilensis , while relative and batch fecundity were greater in fish of the same size.

Pinguipes brasilianus es una especie abundante en los arrecifes rocosos de los golfos norpatagónicos de Argentina, en el Atlántico Sudoccidental. En este trabajo estudiamos su biología reproductiva, incluyendo la descripción macroscópica e histológica del desarrollo de testículos y ovarios, el análisis de la evolución del índice gonadosomático (IGS) para ambos sexos a lo largo del ciclo anual, y la estimación de la fecundidad y la talla de primera madurez para las hembras. Pinguipes brasilianus es un desovante múltiple con fecundidad indeterminada y una estación reproductiva extensa que abarca la primavera y el verano australes. Los bajos valores de IGS en machos (el promedio mensual varió entre 0,11% y 0,75%), y la baja fecundidad relativa en las hembras (entre 2 y 4 oocitos/g) son consistentes con un sistema de apareamiento que involucra una estrecha proximidad entre machos y hembras durante la fertilización de los oocitos, cortejo y desove en parejas y/o en áreas confinadas (ej .: refugios). La talla de primera madurez (± DE) estimada para las hembras fue de 15,22 ± 0,43 cm de largo total. Aunque P. brasilianus comparte los principales rasgos reproductivos con Pinguipes chilensis , tanto los valores promedio de IGS en machos como la talla de primera madurez en hembras fueron menores que los reportados para P. chilensis , mientras que la fecundidad (parcial y relativa) fue mayor.

Efficacy of Electronic Foramen Locators in Controlling Root Canal Working Length during Rotary Instrumentation

Abstract: The present study evaluated the efficacy of electronic foramen locators (EFLs) to control root canal working length during rotary instrumentation and to assess possible reliability variations of different working lengths. Forty-eight human mandibular bicuspids were randomly divided in 2 groups according to the used device, Root ZX II (RZX) and Propex II (PRO). They were further subdivided in 2 subgroups according to the root canal preparation level (0.0 and -1.0). Preparation was performed with the Protaper rotary system using a crown-down technique. RZX was employed on its automatic auto-reverse mode (AAR) and PRO was used with the MPAS-10R contra-angle to monitor the preparation. The last used file (F3) was fixed, and the apical portion of the teeth was worn buccolingually, allowing to measure the extent between the file tip and the apical foramen (AF). The precision values of 0.0 mm and -1.0 mm were 100% and 0.0% for RZX, and 100% and 66.7% for PRO, respectively, with a range of ±0.5 mm. Statistical analysis showed no differences between the groups at 0.0 mm. However, at -1.0 mm, RZX showed the poorest results (0.96±0.11 mm), followed by PRO (0.43±0.23 mm). The difference between RZX and PRO was statistically significant. The EFLs were precise in maintaining the working length during rotary preparation when reaching the AF, but when their penetration was limited, both devices showed decreased precision; the RZX AAR failed in all instances.

Resumo: O presente estudo avaliou a eficiência de localizadores eletrônicos foraminais (LEFs) em controlar o limite apical de instrumentação durante o preparo com instrumentos rotatórios. Adicionalmente, determinou-se possíveis variações quando do emprego de diferentes comprimentos de trabalho. Quarenta e oito pré-molares inferiores humanos foram randomicamente divididos em 2 grupos de acordo com o aparelho empregado, Root ZX II (RZX) e Propex II (PRO). Em seguida foram subdivididos em 2 subgrupos em função do limite de preparo (0,0 e -1,0 mm). O preparo dos canais foi realizado com o sistema Protaper em sentido coroa-ápice. O RZX foi utilizando em sua função auto-reverso automático (ARA) e o PRO associado ao contra-angulo MPAS-10R, foi empregado como ferramenta de monitoramento durante o preparo. O último instrumento utilizado (F3) foi fixado em posição, após o que a porção apical dos dentes foi desgastada permitindo a determinação da distância entre a ponta dos instrumentos e o forame apical (FA). A precisão a 0,0 mm e -1,0 mm foi de 100% e 0,0% para o RZX, e de 100% e 66,7% para o PRO, respectivamente, considerando uma margem de ±0,05 mm. A análise estatística não encontrou diferenças entre os grupos a 0,0 mm, todavia, a -1,0 mm, o RZX ofereceu os piores resultados (0,96±0,11 mm), seguido do PRO (0,43±0,23 mm). Esta diferença foi estatisticamente significante. Os LEFs foram precisos na manutenção do comprimento de trabalho durante o preparo rotatório quando se atingiu o FA, todavia, quando esta penetração foi limitada, ambos os aparelhos perderam em precisão; o sistema ARA do RZX falhou em todos os casos.

Population growth and within-plant distribution of the striped mealybug Ferrisia virgata (Cockerell) (Hemiptera, Pseudococcidae) on cotton

Population growth and within-plant distribution of the striped mealybug Ferrisia virgata (Cockerell) (Hemiptera, Pseudococcidae) on cotton. The striped mealybug, Ferrisia virgata (Cockerell) (Hemiptera, Pseudococcidae), is a widely distributed and polyphagous pest species, which naturally occurs on cotton plants in Brazil. This study evaluated the establishment and population growth as well as the within-plant distribution of F. virgata on four cotton cultivars: CNPA 7H (white fibers), BRS Verde, BRS Safira, and BRS Rubi (colored fibers). The experiment was conducted in a complete randomized design with four treatments (cultivars) and 18 replications of each. Thus, cotton plants of each cultivar were infested with 100 newly hatched nymphs of F. virgata. The number of adult female mealybugs and the total number of mealybugs per plant were quantified, respectively, at 25 and 50 days after infestation. The developmental and pre-reproductive periods were also determined. Furthermore, we verified the distribution of F. virgata on the plant parts at 25 and 50 days after infestation. Ferrisia virgata showed similar growth of 412-fold in the four cotton cultivars studied. Also, the nymphs were spread on infested leaves; the secondgeneration nymphs were spread and established in all plant parts. Our results characterize F. virgata as having much potential as an important cotton pest in Brazil.

Evolución del uso de opioides como indicador centinela en cuidados paliativos adulto y pediátrico en el Hospital Clínico Guillermo Grant Benavente / Opoid use evolution as a sentinel indicator in adult and pediatric palliative care at Hospital Guillermo Gran Benavente

La investigación tuvo por objetivo cuantificar el uso de opioides para responder a las preguntas: ¿hay alguna evidencia que permita afirmar un incremento en el uso de opioides? y ¿el incremento observado se debe a un mayor uso de morfina? Tener claridad en este tema permitirá realizar intervenciones que fortalezcan el PAD y CP a nivel terciario en el HGGB. Para responder la primera pregunta se convirtió a gramos de morfina todos los opioides utilizados en el programa, los débiles y los fuertes, más los opioides utilizados para tratar los pacientes portadores de dolor crónico no oncológico. Los datos fueron analizados a nivel descriptivo con prograna EXCEl. Se confirmó la sospecha que se ha perdido paulatinamente el miedo a utilizar una herramienta tan eficaz como los opioides para control de dolor crónico. El hallazgo más importante fue la utilización cada vez más frecuente de otros opioides, en desmedro de la morfina.

The research aimed to quantify the use of opioids to answer the questions: is there any evidence to say an increase in the use of opioids? and the observer increase is due to increased use of morphine? Clarity on this issue will allow level in HGGB. To answer the first question was converted to grams of morphine all opioids used in the program, the weak and strong, most opioids used to treat patients with chronic non cancer pain. Data were analized with descriptive at EXCEL program. We confirmed the suspicion that has gradually lost fear of using a tool as effective as opioids for chronic pain control. The most important finding was the increasingly frequent use of other opiods, to the detriment of morphine.

Sudden cardiac death under anesthesia in pediatric patient with williams syndrome: A case report and review of literature.

Williams syndrome is a complex syndrome characterized by developmental abnormalities, craniofacial dysmorphic features, and cardiac anomalies. Sudden death has been described as a very common complication associated with anesthesia, surgery, and procedures in this population. Anatomical abnormalities associated with the heart pre-dispose these individuals to sudden death. In addition to a sudden and rapid downhill course, lack of response to resuscitation is another significant feature seen in these patients. The authors report a five-year-old male with Williams syndrome, hypothyroidism, and attention deficit hyperactivity disorder. He suffered an anaphylactic reaction during CT imaging with contrast. Resuscitation was unsuccessful. Previous reports regarding the anesthetic management of patients with Williams are reviewed and the potential for sudden death or peri-procedure related cardiac arrest discussed in this report. The authors also review reasons for refractoriness to defined resuscitation guidelines in this patient population.

Estrés y vitaminas antioxidantes en pacientes diabeticos tipo 2 / Stress and antioxidant vitamins in patients with type 2 diabetes

La hiperglicemia incrementa la producción de radicales libres, sobrepasando la capacidad defensiva antioxidante. Determinar el estrés oxidativo, defensa antioxidante y el consumo de alimentos ricos en vitaminas A y E, en 24 pacientes de 35-55 años con diagnóstico reciente de diabetes tipo 2, que acudieron a la Consulta de Diabetes del HUAL en el 2004 y del HVS en el 2005. Se determinó la concentración de malondialdehido (MDA) para evaluar el estrés oxidativo, a través del método de sustancias reactivas al ácido tiobarbitúrico (TBARS). La defensa antioxidante mediante la determinación sérica de vitamina A y E por cromatografía líquida de alta eficiencia. El colesterol total (CT) y los triglicéridos (TG) por el método enzimático colorimétrico y el consumo de alimentos ricos en antioxidantes a través de un cuestionario de consumo. El MDA estuvo dentro de límites normales (1,617±1,520mm/l), las vitaminas antioxidantes A, E y E estandarizada a los lípidos se encontraron por debajo del punto de corte antioxidante (44,372 ± 25,411µg/dl y 1051,704 ± 499,805 µg/dl y 1.090,041 ± 665,89 µg/dl respectivamente), el consumo de vitamina E fue 16.432,02 ±22.552,55 µg, mientras que el de vitamina A alcanzó valores de 1.863,325 ± 1.559,677 µg. En conclusión, no se encontró estrés oxidativo en etapas tempranas de la Diabetes, pero sí una disminución de los niveles séricos de las vitaminas A y E que puede ser atribuida a la disminución del consumo de la vitamina E, ya que la vitamina A se encontraba por encima de los niveles antioxidantes

Methacholine and PDGF activate store-operated calcium entry in neuronal precursor cells via distinct calcium entry channels

Neurons are a diverse cell type exhibiting hugely different morphologies and neurotransmitter specifications. Their distinctive phenotypes are established during differentiation from pluripotent precursor cells. The signalling pathways that specify the lineage down which neuronal precursor cells differentiate remain to be fully elucidated. Among the many signáis that impinge on the differentiation of neuronal cells, cytosolic calcium (Ca2+) has an important role. However, little is known about the nature of the Ca2+ signáis involved in fate choice in neuronal precursor cells, or their sources. In this study, we show that activation of either muscarinic or platelet-derived growth factor (PDGF) receptors induces a biphasic increase in cytosolic Ca2+ that consists of reléase from intracellular stores followed by sustained entry across the plasma membrane. For both agonists, the prolonged Ca2+ entry occurred via a store-operated pathway that was pharmacologically indistinguishable from Ca2+ entry initiated by thapsigargin. However, muscarinic receptor-activated Ca2+ entry was inhibited by siRNA-mediated knockdown of TRPC6, whereas Ca2+ entry evoked by PDGF was not. These data provide evidence for agonist-specific activation of molecularly distinct store-operated Ca2+ entry pathways, and raise the possibility of privileged communication between these Ca2+ entry pathways and downstream processes.

Awareness about the persons with disability act among leprosy patients and other disabled persons.

To assess the level of awareness about the different provisions of the Persons with Disability Act (PWD Act) among leprosy patients and other disabled, 233 disabled persons from the self-help groups formed by Vadathorasalur Leprosy Control Unit have been interviewed using a structured interview checklist. The results show that 74.7% of the respondents were aware that identity cards are available for the disabled, 56.2% were aware of the free education benefit to the disabled, as low as 35.6% were aware of the scholarships, 33% knew about the employment reservations, 24.9% heard about the housing scheme of the government for the disabled, but 24.5% only knew about law against discrimination, 31.8% came in contact with institutions for the severely disabled and only 16% were aware of the unemployment allowance to the disabled. The level of awareness is low among women with regard to all components of the Act. It was found that students studying up to secondary level were not aware of the availability of scholarships and free education, which needs to be seriously looked into, especially by educational institutions. The level of formal education played a significant role in increasing awareness about the Act among literates. The knowledge is low among persons of all occupations. The study showed that there is a great need for an educational intervention programme to publicize the provisions of the Act among the disabled and their families.

Inositol 1, 4, 5-trisphosphate receptors in the heart

Inositol 1,4,5-trisphosphate (InsP3) is an established calcium-mobilizing messenger, which is well-known to activate Ca2+ signaling in many cell types. Contractile cardiomyocytes express hormone receptors that are coupled to the production of InsP3. Such cardioactive hormones, including endothelin, may have profound inotropic and arrhythmogenic actions, but it is unclear whether InsP3 underlies any of these effects. We have examined the expression and localization of InsP3 receptors (InsP3Rs), and the potential role of InsP3 in modulating cardiac excitation-contraction coupling (EC coupling). Stimulation of electrically-paced atrial and ventricular myocytes with a membrane-permeant InsP3 ester was found to evoke an increase in the amplitudes of action potential-evoked Ca2+ transients and to cause pro-arrhythmic diastolic Ca2+ transients. All the effects of the InsP3 ester could be blocked using a membrane-permeant antagonist of InsP3Rs (2-aminoethoxydiphenyl borate; 2-APB). Furthermore, 2-APB blocked arrhythmias evoked by endothelin and delayed the onset of positive inotropic responses. Our data indicate that atrial and ventricular cardiomyocytes express functional InsP3Rs, and these channels have the potential to influence EC coupling.

Endoftalmitis por acremonium kiliense / Fungal endophthalmitis for acremonium kiliense

Se presenta un caso de endoftalmitis micótica del ojo derecho en un paciente de 26 años, que había sufrido una úlcera traumática la cual se perforó a pesar del tratamiento local y general con antimicóticos. Se debieron realizar sucesivos colgajos conjuntivales para lograr curación, también se utilizó como último recurso una lente de contacto terapéutica. Del material obtenido por raspado de la úlcera de córnea y del humor vítreo se aisló Acremonium kiliense. El tratamiento médico-quirúrgico fue prolongado debido a la agresividad del hongo; se logró salvar la integridad del globo ocular

La colangiografía operatoria en el paciente sin signos de litiasis coledociana / The operative cholangiography in the patient without choledeco lithiasis

Con el propósito de investigar si la colangiografía operatoria puede ser utilizada en forma selectiva en la litiasis biliar, obviándola en los casos sin indicadores preestablecidos de patología coledociana, se estudiaron prospectivamente 330 pacientes con litiasis biliar, operados consecutivamente por laparotomía. Doscientos quince (65,1%) no presentaban ningún indicador de litiosis coledociana. En 135 de éstos se realizó colangiografía operatoria, y se halló litiasis coledociana insospechada (0,75%). En los 80 sin colangiografía no hubo complicaciones quirúrgicas y postoperatorias por la ausencia del estudio, y no se detectaron signos de litiasis residual en ninguno de los 78 casos seguidos durante 1 a 2 años. Se concluye que la colangiografía operatoria en la litiasis biliar puede utilizarse con ventajas en forma selectiva, siempre que se siga un criterio estricto en la selección de casos, evitándola en los pacientes sin ningún parámetro indicador de patología coledociana

Anesthesia and neuromuscular diseases

This presentation presents a short review of some disease entities affecting the neuromuscular system. Most of these diseases are rare, but many have a direct implication for anesthetic management and the anesthesiologist should be aware of them and the interaction of the patient's disease and the physician's drugs