Una plaga citadina peligrosa: los murciélagos / A dangerous urban pest: bats

Los murciélagos son mamíferos vertebrados presentes en la Ciudad de Buenos Aires, estimándose una población de 4 animales por habitante. Son portadores de varias enfermedades importantes y además empeoran las condiciones respiratorias de enfermos crónicos. En el campo cumplen una interesante función, ya que se alimentan de insectos perjudiciales para las siembras. El guano puede ser útil en el abono de la tierra debido al aporte de carbono y nitrógeno. En las ciudades su presencia tiene consecuencias diferentes. Se encuentran en los taparrollos de las habitaciones, así como también en todas las oquedades de muros, árboles, grietas, etc. Se exponen aquí los peligros y los cuidados que deben tenerse en la Ciudad de Buenos Aires ante la invasión de estos quirópteros. (AU)

Bats are vertebrate mammals present in the City of Buenos Aires, with an estimated population of 4 animals per inhabitant. They are carriers of several important diseases and also worsen the respiratory conditions of the chronically ill. In rural areas they fulfill an interesting function, since they feed on insects harmful to crops. Guano can be useful in soil fertilization due to its contribution of carbon and nitrogen. In cities their presence has different consequences. They are found in the roll covers of the rooms as well as in all the hollows of walls, trees, cracks, etc. The dangers and precautions to be taken in the city of Buenos Aires in the face of the invasion of these chiroptera are described here. (AU)

Arthropod diversity in phytotelmata of Calathea capitata (Zingiberales; Marantaceae) host plants from Peru

Cryptic habitats are often overlooked in biodiversity surveys. Phytotelmata, or plant pools, are one type of cryptic habitat that supports diverse fauna in a miniature ecosystem. This study surveys the arthropod community of two types of phytotelmata, bracts and leaf rolls, on a single species, Calathea capitata (Ruiz and Pav.) Lindl. (Zingiberales: Marantaceae), from one Amazon site in Peru. Specimens were collected from eight bracts and eight leaf rolls. A total of 55 arthropods (36 adults, 19 juveniles) were found in both phytotelmata types. In the bract samples were found: spiders (Araneae: Corinnidae), beetles (Coleoptera: Carabidae, Erotylidae, Staphylindae), flies (Diptera: Limoniidae), a leafhopper nymph (Hemiptera: Cicadellidae), ants (Hymenoptera: Formicidae), and unidentified larvae. In leaf roll samples were found: Leaf beetles (Coleoptera: Chrysomelidae), an earwig (Dermaptera: Spongiforidae), flies (Diptera: Drosophilidae), and an adult leafhopper (Hemiptera: Cicadellidae). A similar survey of Calathea lutea Schultes in Peru revealed a community dominated by Coleoptera in leaf rolls and Diptera in bracts, with a few Dermaptera and Hymenoptera, but no Araneae or Hemiptera. This study demonstrates that phytotelmata host diverse taxa and serve as a nursery to immature stages thus impacting the life cycles of local fauna, which in turn affect local biodiversity.

Los hábitats crípticos a menudo son ignorados en los estudios de biodiversidad. fitotelmata, o piscinas de plantas, son un tipo de hábitat críptico que sustenta una fauna diversa en un ecosistema en miniatura. Este estudio examina la comunidad de artrópodos de dos tipos de fitotelmata, brácteas y hojas enrolladas presentes en una sola especie, Calathea capitata (Ruiz y Pav.) Lindl. (Zingiberales: Marantaceae), de un sitio de la Amazonia peruana. Se recolectaron artrópodos de ocho brácteas y ocho rollos de hojas. Se encontraron un total de 55 artrópodos (36 adultos, 19 juveniles) en ambos tipos de fitotelmata. En los fitotelmata de brácteas se encontraron: arañas (Araneae: Corinnidae), escarabajos (Coleoptera: Carabidae, Erotylidae, Staphylindae), moscas (Diptera: Limoniidae), una ninfa saltahojas (Hemiptera: Cicadellidae), hormigas (Hymenoptera: Formicidae) y larvas no identificadas se encontraron en muestras de brácteas. En los fitotelmata de hojas enrolladas, se encontraron escarabajos de las hojas (Coleoptera: Chrysomelidae), una tijereta (Dermaptera: Spongiforidae), moscas (Diptera: Drosophilidae), y un saltahojas adulto (Hemiptera: Cicadellidae). Un estudio similar de Calathea lutea Schultes en Perú reveló una comunidad dominada por Coleoptera en fitotelmatas de hojas enrolladas y Diptera en brácteas, con algunos Dermaptera e Hymenoptera, pero sin Araneae o Hemiptera. Este estudio demuestra que los fitotelmata albergan diversos taxones y sirven como vivero para las etapas inmaduras, lo que impacta en los ciclos de vida de la fauna local, lo que a su vez afecta la biodiversidad local.

Key points to execute internal horizontal mattress suture in tissue augmentation / 口腔疾病防治

@#Ideal sutures can provide great fixation, wound closure and a stable environment for healing of the surgical site. Tension-free apposition sutures are important for tissue regeneration and could tackle insufficient amounts of soft and hard tissue, especially in missing tooth sites that require implantation. The internal horizontal mattress suture, similar to the conventional horizontal mattress suture, forms a rectangle that can be bisected by the incision with both intrusion and extrusion of the needle on each side. On the basis of the rectangle, the internal horizontal mattress suture emphasizes that the suture should be located below the incision, so the eversion of the wound margin is the highlight of this procedure. The internal horizontal mattress suture could stabilize the graft on the targeting tissue, realize the fixation of the collagen membrane, apically repositioned flap and soft tissue graft, reduce the tension on the incision, and further release the tension of the incision margin. Beyond the primary need for fixation and wound closure, internal horizontal mattress sutures can also achieve stress interruption that reduces the interference of the surrounding muscle and can better master wound tension with the assistance of interrupted sutures. Given the above advantages, horizontal internal mattress sutures have great potential in the application of implant-related regenerative surgery. In this review, according to our experience in clinical practice and the literature, we summarize the advantages of internal horizontal mattress sutures in tissue augmentation. In addition, the sites and sequence to insert the needle and the spatial relationship between the suture and incision are clarified with the rationale of the naming pattern, which is conducive to experience exchange and clinical practice.

The influence of additional roll test on the repositioning procedure by SRM-vertigo diagnosis system for horizontal canal benign paroxysmal positional vertigo / 临床耳鼻咽喉头颈外科杂志

Objective:To evaluate the influence of an additional roll test on the repositioning procedure by SRM-vertigo diagnosis system for horizontal canal benign paroxysmal positional vertigo（HC-BPPV）. Methods:A total of 713 patients diagnosed with HC-BPPV in Department of Otolaryngology Head and Neck Surgery，the First Affiliated Hospital of Xi'an Jiaotong University from Jan 2020 to Feb 2022 were enrolled. The patients were divided into two groups by hospital card numbers, in which the number is odd were considered as group A, and the number is even were considered as group B. The group A underwent two circles of Barbecue repositioning procedure by SRM-vertigo diagnosis system, while the group B first performed an additional roll test and then underwent two circles of Barbecue repositioning procedure by SRM-vertigo diagnosis system, to observe the cure rate and compare influence of HC-BPPV by an additional roll test. The quality of life and sleep of patients before and one-month after the treatment were assessed by the dizziness handicap inventory（DHI） and the pittsburgh sleep quality（PSQI）. Results:The cure rate of group A was 63.21%, and the cure rate of group B was 87.68%，the difference between the two groups was statistically significant（P<0.05）; The DHI score of patients after the repositioning was significantly lower than that before the repositioning（P<0.05）. The PSQI score after the repositioning was significantly lower than that before the repositioning（P<0.05）. The DHI and the PSQI scores after the repositioning were significantly lower than that before the repositioning, with a statistically significant difference （P< 0.05）. The total score of DHI in group B after treatment was lower than that in group A, with a statistically significant difference（P<0.05）. The total score of PSQI in group B after treatment was lower than that in group A, with non-statistically significant difference （P< 0.05）. Conclusion:An additional roll test before the repositioning procedure by SRM-vertigo diagnosis system can significantly improve the cure rate of HC-BPPV, relieve anxiety, and improve the quality of life.

Reverse Swiss Roll technique for diabetic vitreous membranes

Background: Diabetic membranes are always a challenge for a surgeon because of sticky nature and chances of iatrogenic break while removing. Purpose: To demonstrate a safe reverse swiss roll technique to dissect diabetic vitreous membranes. Synposis: Approaches and techniques for membrane dissection are segmentation, delamination and en-bloc dissection using various types of instruments and illumination. With vitreous cutte, picks and scissors, surgical steps are traditionallu performed by using classic lift and shave technique. After identifying the plane, tissue is lifted and then cut, which puts the retina at risk of break because of traction and active suction. Such a threat can be reduced by placing the cutter above the membrane thereby having the membrane itseld acting as a protective cushion to the retina. Port here, unlike lift and shave technique, doesn抰 face the edge of membrane but is exactly 180 degree opposite and membrane curls into port because of suction. Also, hemostasis is maintained by continuous aspiration and cutting as the instrument is moved side to side, retracting from the edge. Highlights: Reverse swiss roll technique is safer compared to lift and shave because of the safety cushion of the membrane between the port and the retina. There is inherently less chances of retinal break because the active suction from the port is directed away from the retina. The technique also minimises traction and localised pull on the atrophic macula

Body asymmetries in dancers of different dance disciplines / Asimetrías corporales en bailarines de diferentes disciplinas de baile

SUMMARY: Dance is an attractive sport discipline in which participation is increasing every year, unfortunately, the prevalence of injuries is also increasing. Various dance disciplines and dance techniques require body control, often in extreme anatomical positions that place a heavy strain on the musculoskeletal system. The aim of this research was to analyze body asymmetries of four different dance disciplines (standard and Latin American dance - STLA, acrobatic rock and roll - RNR, breakdance - BD and hip hop - HH), by using anthropometric (InBody 720; Biospace Co., Ltd) and 3D body measurements (NX-16; TC2) to establish possible later discomforts and injuries. T-test was performed to find differences between left and right extremities in all four dance disciplines. Results of the study showed that asymmetries are present in all of the studied dance disciplines. When comparing dance disciplines, we found out that STLA dancers are the most prone to develop body asymmetries (six out of nine paired variables), mainly because of the closed position. The position itself is the asymmetry and in which dancers remain for a very long time while training the technique of each dance. As dance is known for its asymmetrical movement of the body and it is expected that some of the asymmetries will appear after a few years of training. For a better understanding of possible consequences of asymmetries in dancers' bodies, further and more detailed analysis within each dance discipline is required.

RESUMEN: El baile es una disciplina deportiva atractiva cuya participación aumenta cada año, sin embargo también aumenta la prevalencia de lesiones. Varias disciplinas de baile y las técnicas de baile requieren el control del cuerpo en posiciones anatómicas extremas las cuales ejercen una gran presión sobre el sistema musculoesquelético. El objetivo de esta investigación fue analizar las asimetrías corporales de cuatro disciplinas de baile diferentes (baile estándar y latinoamericano - STLA, rock and roll acrobático - RNR, breakdance - BD y hip hop - HH), utilizando técnicas antropométricas (InBody 720; Biospace Co., Ltd) y mediciones corporales en 3D (NX-16; TC2) para establecer posibles molestias y lesiones posteriores. Se realizó la prueba T para determinar diferencias entre los miembros izquierdo y derecho en las cuatro disciplinas de baile. Los resultados de este estudio mostraron que las asimetrías se encontraron en todas las disciplinas de baile. Al comparar las disciplinas de baile, descubrimos que los bailarines de STLA son los más propensos a desarrollar asimetrías corporales (seis de nueve variables pareadas), principalmente debido a la posición cerrada. La posición en sí es asimétrica y en la que los bailarines permanecen durante mucho tiempo mientras entrenan la técnica de cada baile. Como el baile es conocido por el movimiento asimétrico del cuerpo, es posible que algunas de las asimetrías aparezcan después de algunos años de entrenamiento. Se requiere un análisis más profundo y detallado dentro de cada disciplina de danza para una mejor comprensión de las posibles consecuencias de las asimetrías en los cuerpos de los bailarines.

Roll-Over Test as Predictive Value of Pre-eclampsia / La Prueba de Roll-Over Como Predictor de Pre-eclampsia

ABSTRACT Objective: To determine the effectiveness of the roll-over test as a predictor of pre-eclampsia. Methodology: The studied population had a size of 272, with a sample of 262 pregnant women, between 28 and 32 weeks of gestational age, who obtained pre-natal care at the Guillermo Almenara Irigoyen National Hospital, between January and September of 2017. The ROC curve, and the sensitivity and specificity of the roll-over test to predict pre-eclampsia, were calculated. Results: The prevalence of the roll-over test in this study was 9%, with a 95% confidence interval (5.43 - 12.22). In this study, the ROC curve was determined (0.725 and 0.734, for the first and second measurements, respectively) and found to be statistically significant at the p <0.05 level. The sensitivity of the roll-over test for a cutoff point of 20 mmHg was 60%, and the specificity of 95% also had a PPV of 37% and a NPV of 98%. Differences between the first and second measurements suggest that the second measurement is more sensitive than the first one. Conclusions: The roll-over test is a simple, cost-effective test with potential application in initial evaluation of pre-eclampsia in pregnant women with a history of pre-eclampsia and/ or other risk factors.

RESUMEN Objetivo: determinar la efectividad de la prueba de presión supina como predictor de pre-eclampsia. Metodología: La población del estudio fue de 272 y la muestra consistió en 262 mujeres embarazadas entre 28 y 32 semanas de edad gestacional que obtuvieron atención prenatal en el Hospital Nacional Guillermo Almenara Irigoyen entre enero y septiembre de 2017. Se realizó la curva ROC y se calculó la sensibilidad y la especificidad de la prueba de vuelco para predecir la pre-eclampsia. Resultados: La prevalencia de la prueba de presión supina en este estudio fue del 9% con un intervalo de confianza del 95% (5,43 - 12,22). En este estudio, se determinó la curva ROC (0,725 y 0,734 para la primera y la segunda medición respectivamente) y se encontró que era estadísticamente significativa al nivel de p <0,05. La sensibilidad de la prueba de presión supina para un punto de corte de 20 mmHg fue del 60% y la especificidad del 95% también tuvo un VPP del 38% y un VPN del 98%. Las diferencias entre la primera y la segunda medición sugieren que la segunda medición es más sensible que la primera. Conclusiones: la prueba de presión supina es una prueba simple y rentable con una posible aplicación en la evaluación inicial de la pre-eclampsia en mujeres embarazadas con antecedentes o pre-eclampsia y / u otros factores de riesgo.

Use of radioguided surgery technique for the treatment of thyroid cancer recurrence: clinical, surgical and anatomopathological aspects

Introduction: Surgery is the treatment of choice in locoregional thyroid neoplasia recurrence. The intense tissue healing process observed after surgery changes the neck anatomy, makes reoperation difficult, and interferes with surgical success. The use of the Radioguided Occult Lesion Localization (ROLL) technique has become a viable option to localize thyroid tumors. Objective: To analyze the use of the ROLL technique for the treatment of thyroid cancer recurrence with respect to its clinical, surgical and anatomopathological aspects. Methods: A descriptive cross-sectional study that analyzed 56 medical records and anatomopathological examinations of patients of both sexes who had thyroid neoplasms, underwent previous surgeries on this topography, and were submitted to the ROLL technique for recurrence removal from March 2011 to March 2019. Results: Most patients were women aged 46.05 years, on average. Papillary thyroid neoplasm was the most prevalent histological finding. In 100% of the cases, application of the ROLL technique identified and removed the lesions marked with suspicion for malignancy. Conclusion: Radioguided surgery has proved to be a very effective and safe tool to assist with lesion localization for the treatment of thyroid cancer recurrence. This technique has brought no additional side effects to patients, required minimal radiation and made surgery less invasive, reducing postoperative complication rates.

The World Health Organizations changing goals and expectations concerning malaria, 1948-2019 / As mudanças nos objetivos e expectativas da Organização Mundial da Saúde com relação à malária, 1948-2019

Abstract From its inception, in 1948, the World Health Organization made control of malaria a high priority. Early successes led many to believe that eradication was possible, although there were serious doubts concerning the continent of Africa. As evidence mounted that eradicating malaria was not a simple matter, the malaria eradication programme was downgraded to a unit in 1980. Revived interest in malaria followed the Roll Back Malaria Initiative adopted in 1998. This article presents an historical account of the globally changing ideas on control and elimination of the disease and argues that insufficient attention was paid to strengthening health services and specialized human resources.

Resumo Desde sua origem, em 1948, a Organização Mundial da Saúde priorizou o controle da malária. Os primeiros êxitos induziram à crença na viabilidade da erradicação, apesar de sérias dúvidas quanto ao continente africano. À medida que se somavam comprovações de que a erradicação da malária não seria simples, o projeto com essa finalidade foi rebaixado a uma unidade em 1980. O reavivamento do interesse na malária ocorreu após a iniciativa Roll Back Malaria, criada em 1998. Este artigo apresenta um panorama histórico das mudanças nas ideias, em âmbito global, ligadas ao controle e à eliminação da doença e defende a tese de que a atenção dada ao fortalecimento dos serviços de saúde e a recursos humanos especializados foi insuficiente.

Optimization Of Roll Compactor Variables And Formulation Of Anti-Retroviral Tablet By Roll Compaction Method

Objective: This study emphasis on roll compaction variable and how the processing parameters influence the formation of granules in process of formulations of antiretroviral IR Tablet with help of optimization technique. Methods: In this present work we aimed to develop a stable pharmaceutical dosage form with anti-retroviral drug tenofovir disoproxil fumarate. % retention of granules over # 60 mesh in roll compaction method by sizing with 50G co-mill screen was assessed by optimization and results were evaluated by Design expert 12.0 software. Various parameters and optimization of the parameter for formulation for better product was done by using 23 factorial design and dry granulation technique for manufacturing tablets. Three operating parameters the roller speed, the hydraulic pressure and the gap width on the Chamunda CPMRC-200/150 Roll Compactor were varied. The planned response variable for study was % retention over #60 ASTM mesh. % retention of granules was calculated by weighing granules on digital electronic balance with respect to how much premix material was taken for compaction. Results: Excipients compatibility study gave positive way showing no change in physical appearance of drug-excipients mix. It reviled that drug was compatible with excipients used. By formation of granules with required ratio, the value of Compressibility index changed from 29 to 21.89, showed that flow properties were improved i.e. from poor to passable. Design expert 12.0 gave optimized solution for formation of required quantity of granules. Pareto chart showed envaulted positive and negative impact of factors on response as explained in results. The results clearly indicate that how granules manufacturing in roll compaction process are influenced by roller pressure, roller gap and speed. 70 % flakes formation and granules retention were observed with 4000 kg/cm2 pressure, 1 mm roller gap width and 6 rpm speed of roller. Pareto chart clearly indicate major impact is of roller pressure. Comparative dissolution profile graph showed that drug release pattern is similar with the innovator tablet. A stable, robust tablets were formed at the end of process. Conclusion: In this study, by optimizing processing variables stable antiretroviral immediate release oral solid dosage form was formed.

Modelo matemático simplificado para determinar a capacidade erosiva de um escoamento lamoso em regime laminar pulsante / A simplified mathematical model to estimate the erosive capacity of a pulsating laminar muddy flow

RESUMO Neste artigo foi proposto um modelo matemático simplificado para inferir sobre a capacidade erosiva de um escoamento lamoso em regime laminar com presença de roll waves (efeito pulsante) na superfície livre. Na perspectiva de aplicação de resultados no contexto de desastres naturais (corridas de lama), foi determinada a evolução da velocidade média e da tensão de cisalhamento no fundo do canal. O modelo proposto é baseado nas equações de águas rasas e na reologia de Herschel-Bulkley, como representativa das lamas. A validação e a aplicação do modelo foram feitas a partir de dados experimentais de roll waves geradas em canal no laboratório confrontados com resultados de simulações numéricas. Os resultados obtidos mostram um incremento na capacidade erosiva, na presença de roll waves, da ordem de 12% em relação ao escoamento base, valor este em concordância com os 10% apontados por Ng e Mei (1994) para uma reologia mais simplificada.

ABSTRACT In this paper, we proposed and validated a simplified mathematical model to estimate the erosive capacity of a muddy laminar flow with roll waves (pulsating effect) on the free surface. From the perspective of applying results in the context of natural disasters (mudflows), the evolution of mean velocity and bottom shear stress in the channel were determined. The proposed model is based on shallow water equations and Herschel-Bulkley rheology as representative of the muds. The model was validated by comparison with results of numerical simulations and experimental data of roll waves generated in a channel. In-depth comparative analyses were made for inferring the erosive capacity of this sort of flow. The obtained results show an increase of erosive capacity (12%) due to the presence of roll waves in relation to the uniform flow's. Similar values (10%) were found by Ng and Mei (1994) for a more simplified rheology model.

Localización radioguiada de lesiones no palpables y ganglio centinela en estadios iniciales de Cáncer de Mama (snoll). Primera experiencia en el Hospital Italiano de Buenos Aires / Radioguided non-palpable lesion localization and sentinel lymph node mapping (snoll) at early breast carcinoma. First experience at Hospital Italiano de Buenos Aires

Introducción Actualmente, entre un 25 y un 35% de los cánceres de mama se diagnostican como lesiones no palpables. La detección de lesiones cada vez más pequeñas exige el desarrollo de nuevas técnicas prequirúrgicas de marcación y localización. Presentamos la experiencia del Hospital Italiano de Buenos Aires con la técnica de localización radioguiada de lesiones no palpables y ganglio centinela (snoll). Objetivos El objetivo de este trabajo es describir las características clínico-patológicas de las pacientes sometidas a dicha técnica y las ventajas, desventajas, complicaciones y resultados en términos de márgenes libres, tasa de retumorectomías, volumen tumoral resecado y tiempo quirúrgico. Material y método Se trata de un estudio observacional, retrospectivo. Se incluyeron todas las pacientes con carcinomas no palpables en quienes se llevó a cabo la técnica de snoll entre el 1 de agosto de 2016 y el 4 de mayo de 2017. Resultados Se incluyó un total de 25 pacientes, todas con diagnóstico previo de carcinoma de mama invasor a través de una punción histológica. Utilizando la técnica snoll, se logró identificar la lesión de mama en el 96% de las pacientes. En el 100% de las pacientes, los márgenes quirúrgicos estaban libres de lesión, por lo que no se realizaron retumorectomías. Se identificó el 100% de los ganglios centinelas, 76% mediante la técnica snoll y 24% mediante la inyección previa del colorante Azul Patente. Conclusiones La técnica snoll demostró ser una técnica sencilla, que mejora el confort de la paciente y que presenta resultados comparables con las técnicas tradicionales. Si bien se trata de una primera experiencia, son alentadores los resultados en términos de márgenes libres, tiempo quirúrgico y volumen resecados.

Introduction Currently, about 25 to 35% of all breast tumors are diagnosed at a nonpalpable stage. The increasing ability to detect small lesions consequently demands the development of novel technology for preoperative lesion identification and intraoperative localization. In this study, we present our initial experience using Sentinel Node Occult Lesion Localization (snoll) at the Hospital Italiano de Buenos Aires. Objectives The objective of this study is to describe clinical and pathological characteristics of patients who were submitted to snoll technique and the advantages and disadvantages, complications and results in terms of tumor-free margins, subsequent surgery rate, total specimen volume and surgical time. Materials and method This is a retrospective, observational study. We included all patients with non-palpable breast cancer who were submitted to surgery and snoll technique between August 1st, 2016 and March 14th, 2017. Results A total of 25 patients were included in this study. All patients had previous diagnosis of invasive breast cancer by core needle biopsy. The breast lesion was correctly identified in 96% of patients through snoll. Surgical margins were tumor-free in all patients. No patients required subsequent surgery. All sentinel nodes were correctly identified. In 76% of cases, snoll was sufficient and in 24% additional injection of patent blue was required. Conclusions In our experience, snoll has proven to be a simple technique that improves patient comfort and shows comparable results when compared to traditional identification methods. Although these are our initial results, we believe our findings to be promising in terms of adequacy of margins, surgical time and total specimen volume.

The Light Cupula: An Emerging New Concept for Positional Vertigo

Benign paroxysmal positional vertigo (BPPV) is the most common type of positional vertigo. A canalolithiasis-type of BPPV involving the lateral semicircular canal (LSCC) shows a characteristic direction-changing positional nystagmus (DCPN) which beats towards the lower ear (geotropic) on turning the head to either side in a supine position. Because geotropic DCPN in LSCC canalolithiasis is transient with a latency of a few seconds, the diagnosis can be challenging if geotropic DCPN is persistent without latency. The concept of “light cupula” has been introduced to explain persistent geotropic DCPN, although the mechanism behind it requires further elucidation. In this review, we describe the characteristics of the nystagmic pattern in light cupula and discuss the current evidence for possible mechanisms explaining the phenomenon.

Validity study of the roll-over test and risk factors for Preeclampsia in four health districts of Surigao City, Philippines

Background@#The roll-over test is a simple, easily available clinical test using the sphygmomanometer to predict pregnancy-induced hypertension starting at 20 weeks age of gestation (AOG). However, the roll-over test is not part of the standard prenatal care in government health facilities even if health workers can easily perform the test.@*Objectives@#To validate the roll-over test at the 20th weeks of gestation and to determine the risk factors for preeclampsia in 4 health districts of Surigao City, a province in the CARAGA Region of the Philippines.@*Methods@#A total of 190 pregnant women without history of hypertension during their previous pregnancies from 4 health districts in Surigao City, Philippines were consecutively enrolled from May 2014 to October 2014 in a cross-sectional study design. The roll-over test was done using the method described in Williams Obstetrics and the validity of the roll-over test was measured. Bivariate and multivariate analyses were done to determine risk factors for preeclampsia.@*Results@#Seven of the 190 women developed preeclampsia. The sensitivity of the rollover test done at 20 weeks AOG was 43% and the specificity was 81%. Maternal age, history of urinary tract infection (UTI) and a positive roll-over test were associated with preeclampsia.@*Conclusion@#Pregnant women whose ages are <20 years or >29 years old, or who had a history of UTI, or a positive roll-over test are more likely to develop preeclampsia. Roll-over test has a low sensitivity at 20 weeks AOG. More studies are warranted to explore the improvement of its predictive value in other AOG.

El SPECT/CT optimiza la técnica ROLL en cáncer tiroideo recurrente / SPECT/CT optimises the ROLL technique in recurrent thyroid cancer

Resumen El cáncer de tiroides es una enfermedad cada vez más frecuente. Uno de los factores que contribuye, es el uso de las imágenes de radiología para evaluar dolencias del área de cabeza y cuello. Una vez se completa el manejo, se continúa con el seguimiento usando la tiroglobulina y los anticuerpos tiroideos tiroglobulínicos, acompañados de ecografía de alta resolución. Esta puede detectar recaídas de escasos milímetros que no son palpables, y que en zonas ya operadas son difíciles de resecar. La técnica ROLL (radioguided occult lesion localization) ha sido usada en los últimos años con gran éxito en estos casos. Para optimizar la cirugía radioguiada en cáncer tiroideo recurrente, aplicamos la ventaja que tienen los estudios tomográficos en medicina nuclear denominados SPECT/CT (single photon emision tomography, por su sigla en inglés) fusionados con técnicas de imágenes anatómicas de tomografía (CT) para refinar la localización anatómica precisa de las lesiones radiomarcadas.

Abstract Differentiated thyroid cancer is an increasingly diagnosed disease. One of the contributing factors is the routine use of high-resolution imaging techniques to assess patients with head and neck symptoms. Serum thyroglobulin monitoring and neck ultrasound are the cornerstone of early detection of recurrent disease after surgery and radioiodine remnant ablation. Resection of non-palpable small tumour foci in previously operated sites is difficult. In recent years, the use of a radioguided technique for locating lesions (ROLL) has shown to be useful for optimising recurrent thyroid cancer surgery. SPECT/CT has also been added to refine the anatomical location of the radio-marked tumour foci.

Absceso gingival después de aumento de reborde alveolar con técnica en rollo modificada. Reporte de caso / Gum Abscess after an Alveolar Ridge Augmentation with the Modified Roll Technique. A Case Report

Antecedentes: La técnica en rollo modificado se ha utilizado ampliamente para mejorar el aspecto estético de las deficiencias de los rebordes alveolares durante el tratamiento de rehabilitación y, así, disminuir el dolor posoperatorio. Objetivo: Describir un caso clínico en el que se realizó un aumento del reborde alveolar por medio de una técnica en rollo modificada que presentó un absceso durante las primeras semanas posoperatorias. Se describe también manejo clínico del caso. Resultados: Después del diagnóstico clínico y microbiológico, se realizó tratamiento antibiótico. En el control a los cuatro meses se observó resolución completa del absceso.

Background: The modified roll technique has been widely used to improve the aesthetics of the alveolar ridge deficiencies during the rehabilitation treatment and, in turn, to reduce the postoperative pain. Objective: To describe a clinical case of an alveolar ridge augmentation with the modified roll technique in which an abscess appeared during the first postoperative weeks. The clinical management of the case is also detailed herein. Results: After a clinical and microbiological diagnosis, the patient was indicated an antibiotic treatment. In the postoperative four-month checkup, a full solution of the abscess was observed.

A Salmonella Typhimurium outbreak linked to Vietnamese bread rolls in South Western Sydney, Australia, 2015

Introduction: In September 2015, the South Western Sydney (SWS) Public Health Unit was notified of a cluster of Salmonella Typhimurium (STm) cases with a common multiple-locus variable-number tandem repeats analysis (MLVA) pattern. An investigation was conducted to identify a source and contain the outbreak. Methods: The cluster was initially identified through routine geographic information system cluster scanning applied to the New South Wales Notifiable Conditions Management System. Additional cases were identified through a complaint to local council about a bakery. The bakery was inspected and 48 environmental and food swabs were collected for analysis. Results: A total of 26 suspected cases were identified, of which 14 were interviewed. STm MLVA type 3-16-9-11-523 was identified in 19 of 26 case stool specimens. Most cases (12/14) consumed bread rolls containing pork or chicken with chicken liver pâté and raw egg mayonnaise filling. Five cases identified a common bakery exposure. Environmental and food samples from the bakery isolated STm with an identical MLVA pattern. Discussion: An STm cluster in SWS was investigated and found to be linked to Vietnamese bread rolls containing pork or chicken with chicken liver pâté and raw egg mayonnaise filling. Confirmation of a distinct MLVA pattern among STm isolates from clinical, food and environmental samples provided evidence to establish an epidemiological link between the cases and the implicated premises and informed public health action to contain the outbreak.

<i>In Situ </i>Ascending Aorta Replacement with Bovine Pericardial Roll Graft for MRSA Graft Infection / 日本心臓血管外科学会雑誌

<p>We report an interesting case of thoracic vascular graft infection treated by <i>in situ </i>replacement using bovine pericardial roll. A 65-year-old man who had undergone graft replacement of ascending aorta for acute type A aortic dissection 9 months prior was admitted to our hospital with purulent discharge from his chest wound. Fluid accumulation surrounding the vascular graft was detected by chest CT, and methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) was positive from his blood culture. These findings led to a diagnosis of aortic graft infection. We gave the antibiotics intravenously, opened the abscess cavity around the infected graft, and irrigated with 0.04% gentian violet solution for 6 months, but failed to control the graft infection. Then we did redo replacement of the ascending aortic vascular graft using a bovine pericardial roll graft with a concomitant omental flap wrapping and obtained successful healing of the graft infection. During follow-up, no recurrent infection occurred, however he died of acute subdural hematoma 8 months after surgery. <i>In situ </i>replacement of the infected vascular grafts using a bovine pericardial roll graft with a concomitant omental flap wrapping may be an option for treating infected aortic grafts.</p>

Combined application of roll flap and combination onlay-interpositional graft to enhance esthetics of maxillary anterior fixed partial denture: A case report

In the maxillary anterior region, reconstruction of the localized alveolar ridge defect is very important in enhancing the esthetics of fixed partial denture. A 40-year-old female patient presented with a chief complaint of the inconvenience and unesthetic problem of 3-unit maxillary anterior prosthesis due to alveolar ridge resorption. After removal of old prosthesis, intraoral examination revealed moderate (buccolingually 4 mm) ridge deficiency in missing tooth region, leading to the diagnosis of Class I alveolar ridge defect. One of the reconstruction techniques to overcome this problem might be a technique that combines two types of soft tissue augmentation techniques. The purpose of this paper was to demonstrate the new combined technique of roll flap and combination onlay-interpositional graft utilized to acquire sufficient dimension of recipient area by one time of operation and to present the esthetic improvement of fixed partial denture by using this procedure in case of maxillary anterior localized ridge defect.

Therapeutic Observation of Thunder-fire Moxibustion at Dazhui (GV14) and Shenshu (BL23) plus Cognitive Training for ;Mild Cognitive Impairment Due to Ischemic Cerebral Stroke / 上海针灸杂志

Objective To observe the clinical efficacy of thunder-fire moxibustion at Dazhui (GV14) and Shenshu (BL23) in treating mild cognitive impairment (MCI) due to ischemic cerebral stroke. Method Sixty patients with MCI due to ischemic cerebral stroke were randomized into a treatment group and a control group, 30 cases each. The control group was intervened by joint treatment plus cognitive training, while the treatment group was by thunder-fire moxibustion in addition to that given to the control group. The two groups were evaluated by the Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE) and Wechsler Memory Scale (WMS), the major symptoms were observed, and the clinical efficacies were compared between the two groups. The two groups were both treated for 8 weeks. Result The total effective rate was 80.0%in the treatment group, versus 70.0% in the control group, and the difference was statistically significant(P<0.05). Conclusion The selected acupoints can improve the cognition and activities of daily living (ADL) in MCI patients;thunder-fire moxibustion at Dazhui and Shenshu plus cognitive training can produce a better clinical efficacy than dry cognitive training. Therefore, we can combine thunder-fire moxibustion with modern rehabilitation to enhance the therapeutic efficacy in preventing and treating MCI.