Reducción del tiempo quirúrgico y de las complicaciones en el tratamiento endovascular con láser / Reduction of surgical times and complications with endovascular laser treatment

Introducción. En los últimos años se han realizado avances signifi cativos en el tratamiento de lapatología varicosa mediante la utilización del láser endovenoso. Esta técnica se realiza mediantela inserción de una fi bra láser en el interior de la vena safena provocando su oclusión pordescarga térmica previa aplicación de anestesia tumescente en todo el territorio a tratar. Entrelas ventajas de esta técnica se encuentran no requerir anestesia general o raquídea, presentarun tiempo de intervención corto, y que es mejor tolerada por los pacientes.Objetivo. Reducir el tiempo quirúrgico de esta técnica sin modifi car su efi cacia ni efectividad,utilizando un método de protección del tejido perivenoso mediante la aplicación de frío externoevitando así la utilización de anestesia tumescente.Material y método. Se han tratado un total de 12 pacientes. En todos ellos se registró su temperaturabasal previa al tratamiento y durante la descarga láser. También registramos el tiempoquirúrgico medio y las complicaciones.Resultados. La media de la temperatura basal previa a la descarga láser fue de 33 ºC y la mediade la temperatura durante el tratamiento láser fue de 40 ºC. En cuanto al tiempo quirúrgico,obtuvimos una media de 30 minutos. No tuvimos ninguna complicación derivada del tratamiento.Por último, en el seguimiento a un año, se demostró una oclusión total del eje safeno tratadoen todos los pacientes.Conclusión. La aplicación de nuestra modalidad de protección del tejido perivenoso safeno nospermite acortar el tiempo quirúrgico del tratamiento con láser(AU)

Introduction. In recent years there have been signifi cant advances in the use of endovenouslaser in the treatment of varicose pathology. This technique is performed by prior application oftumescent anesthesia in the whole area to treat and then inserting a laser fi ber inside thesaphenous vein provoking its thermal occlusion. The advantages of this technique is that it doesnot require general or spinal anesthesia, has a short intervention time, and is better toleratedby patients.Objective. To reduce operating time of this technique without changing its efficacy andeffectiveness, we used a method of perivenous tissue protection through the application ofexternal cold, thus avoiding the use of tumescent anesthesia.Methods. We have treated a total of 12 patients. In all, basal temperature was recorded beforetreatment and during laser discharge. We also recorded the average surgical time andcomplications.Results. The average baseline temperature before laser discharge was 33 ºC, with an average of40 ºC during laser treatment. In terms of surgical time, an average of 30 minutes was achieved.There were no treatment-related complications. Finally, in the follow-up to one year, totalocclusion of saphenous vein was demonstrated in all patients.Conclusion. The application of our method of perivenous saphenous tissue protection canshorten the operating time of laser treatment(AU)

Laser techniques associated with facial aesthetic and reparative surgery.

Chronological aging is a natural biological event that is seen particularly in the face. Attempts to correct the results of this facial loss of structural form are sometimes successful. The skin itself is usually neglected, and surgery sometimes fails to achieve the goals expected by the patient. The surgical laser offers an extremely elegant and powerful solution to this problem to complement or enhance the results of selected surgical facial aesthetic procedures as follows: (1) ablative full-face CO2 laser resurfacing in combination with facelifting; (2) laser surgical technique for upper eyelid ptosis; (3) lower eyelid blepharoplasty with the aid of the CO2 laser; (4) full-face resurfacing following minilifting of the lower part of the face; (5) endoscopic eyebrow lifting combined with laser resurfacing; (6) perioral CO2 laser resurfacing in combination with facelifting; and (7) several miscellaneous procedures (e.g., treatment of upper and lower xanthelasma with laser upper blepharoplasty, laser resurfacing in combination with fillers, and laser resurfacing of periocular wrinkles after surgical blepharoplasty). In the hands of the authors, the combination of laser and standard surgical procedures presented herein has consistently produced good results and high patient satisfaction. The complication rate is low and the recovery rate is excellent. Laser treatment enhances the natural look obtained by conventional surgeries.

[Fastrach intubation in patients with cervical disease]. / Intubación con Fastrach en pacientes con enfermedad cervical.

The Fastrach laryngeal mask for intubation is a new device designed for blind orotracheal intubation in patients with criteria predictive of difficult airway control. The new device looks like the conventional laryngeal mask but offers a series of design changes that allow orotracheal intubation to be accomplished without visualization of the glottis. The rigid metal tube is bent and incorporates a metal handle; the two fixed bars that prevent the epiglottis from falling and blocking the opening have been replaced by a moveable bar that rises with the passage of the endotracheal tube and the exit of the V-shaped metal tube guides the endotracheal tube that was specially designed for this use. We describe three patients with cervical disease, one with advanced ankylosing spondylitis, one with traumatic luxation of the C6-C7 articulation and one diagnosed of two cervical disk hernias. All their tracheas were intubated without difficulty through the Fastrach mask with the patients' heads in neutral position. Although fiberoptic bronchoscopy is the method of choice in patients with cervical problems, the non-availability of the technique and the need for training in its use make the Fastrach mask an alternative worth considering for such patients.

Infrared optical filters for the infrared atmospheric sounding interferometer meteorological space instrument.

Optical coatings are designed and produced for the Infrared Atmospheric Sounding Interferometer meteorological space instrument operating in the spectral range 3.5 15.5 m. First we discuss the choice of substrates and determine the complex refractive indices of thin-film materials. Then several theoretical solutions are studied for optimizing the efficiency of the instrument. To allow us to study the feasibility of the coatings, a specific mid-infrared optical monitoring system has been developed. This system is validated by the successful manufacture of two-cavity Fabry Perot filters.

[Incidence of typhoid fever in our environment. Analysis in Guipúzcoa]. / Incidencia de la fiebre tifoidea en nuestro medio. Análisis en Guipúzcoa.

Based in 184 cases of Typhoid Fever bacteriologically demonstrated in the past 14 years (greater than 90% of all cases registered in the whole province), we have observed that, with the exception of some epidemic outbreaks, the disease has been constantly present during all these years, with a higher incidence between August and November. Salmonella typhi infected primarily young adults, its distribution being similar to the one among the general population. 49% of cases were males. The estimated incidence rate of the disease during this period was 2-3 per 100,000 population. A seroepidemiological study among healthy women with ages between 20 and 40 years showed a seroprevalence of anti-H:d antibodies greater than or equal to 1/40 of 1%. Although the epidemiological situation of Typhoid fever in our environment is not as bad as it has been referred in reports and textbooks, an effort is needed to situate the problem at the appropriate level, given our geographical situation and our economical development.