Radiofrequency ablation for thyroid and parathyroid disease.

Radiofrequency ablation is a well-known, safe, and effective method for treating benign thyroid nodules and recurring thyroid cancer as well as parathyroid adenomas that has yielded promising results in recent years. Since the Korean Society of Thyroid Radiology introduced the devices and the basic techniques for radiofrequency ablation in 2012, radiofrequency ablation has been approved all over the world and both the devices and techniques have improved. This review aims to instruct interventional radiologists who are doing or intend to start doing radiofrequency ablation of thyroid and parathyroid lesions, as well as thyroid and parathyroid specialists who provide pre- and post-operative care, in the training, execution, and quality control for radiofrequency ablation of thyroid nodules and parathyroid adenomas to optimize the efficacy and safety of the treatment.

Ablación por radiofrecuencia en la enfermedad tiroidea y paratiroidea / Radiofrequency ablation for thyroid and parathyroid disease

La ablación por radiofrecuencia (ARF) es un método bien conocido, seguro y eficaz para tratar los nódulos tiroideos benignos, los cánceres tiroideos recurrentes, así como los adenomas de paratiroides, con resultados prometedores en los últimos años. Los dispositivos empleados y las técnicas básicas para la ARF fueron introducidos por la Sociedad Coreana de Radiología de Tiroides (KSThR) en 2012, si bien la ARF se ha aprobado en todo el mundo, con avances posteriores tanto en dispositivos como en técnica.El objetivo de esta revisión es instruir a los radiólogos intervencionistas que pretendan realizar, o que ya estén realizando, intervenciones de ARF, así como especialistas en tiroides y paratiroides que brinden atención pre y postoperatoria, acerca de la capacitación, la ejecución y el control de calidad de la ARF de los nódulos tiroideos y adenomas paratiroideos, para optimizar la eficacia del tratamiento y la seguridad del paciente.(AU)

Radiofrequency ablation is a well-known, safe, and effective method for treating benign thyroid nodules and recurring thyroid cancer as well as parathyroid adenomas that has yielded promising results in recent years. Since the Korean Society of Thyroid Radiology introduced the devices and the basic techniques for radiofrequency ablation in 2012, radiofrequency ablation has been approved all over the world and both the devices and techniques have improved.This review aims to instruct interventional radiologists who are doing or intend to start doing radiofrequency ablation of thyroid and parathyroid lesions, as well as thyroid and parathyroid specialists who provide pre- and post-operative care, in the training, execution, and quality control for radiofrequency ablation of thyroid nodules and parathyroid adenomas to optimize the efficacy and safety of the treatment.(AU)

Síndrome compartimental tras bypass cardiopulmonar / Compartment syndrome after cardiopulmonary bypass

El síndrome compartimental de las extremidades inferiores es una complicación secundaria a isquemia y a daño por reperfusión. El diagnóstico y tratamiento precoces son esenciales para evitar la progresión de las lesiones. Se presenta una paciente con síndrome compartimental de la extremidad inferior izquierda tras la canalización de arteria y vena femorales izquierdas para la realización de bypass cardiopulmonar (AU)

Compartment syndrome of the lower leg is an occasional complication of prolonged ischemia and reperfusion. We present a patient with compartment syndrome of the ipsilateral thigh after femoral arterial and venous cannulation for cardiopulmonary bypass (AU)

[Compartment syndrome after cardiopulmonary bypass]. / Síndrome compartimental tras bypass cardiopulmonar.

Compartment syndrome of the lower leg is an occasional complication of prolonged ischemia and reperfusion. We present a patient with compartment syndrome of the ipsilateral thigh after femoral arterial and venous cannulation for cardiopulmonary bypass.

A porous PCL scaffold promotes the human chondrocytes redifferentiation and hyaline-specific extracellular matrix protein synthesis.

The redifferentiation, proliferation, and hyaline-specific extracellular matrix (ECM) protein synthesis of chondrocytes cultured in a polycaprolactone (PCL) scaffold were analyzed. Gene expression of the type II collagen and aggrecan was assessed by real-time PCR in cells from PCL scaffolds, monolayer, and pellet cultures. The proliferative activity was assessed using Ki-67 immunodetection, and the chondrocytic differentiation was evaluated using S-100 immunodetection. The synthesis and deposition into scaffold pores of type II collagen and glycosaminoglycan were analyzed by immunohistochemistry and Alcian blue staining, respectively. All parameters were assessed throughout 28 days of cultures maintained in either fetal bovine serum-containing medium (FCM) or Insulin-Transferrin-Selenium-containing medium (ICM). Expression of the type II collagen gene was lower in FCM cultures than in ICM cultures for all culture systems (p < 0.05). Moreover, PCL scaffolds cultured in ICM were able to induce collagen gene expression more efficiently than pellet and monolayer cultures. Aggrecan gene expression did not vary significantly between mediums and three-dimensional system cultures, but in ICM cultures, the monolayer cultures had significantly higher levels of aggrecan gene expression than did either the PCL or pellet cultures. Chondrocytes cultured in PCL scaffolds or pellets with FCM did not proliferate to a great extent but did maintain their differentiated phenotype for 28 days. Levels of cartilage ECM protein synthesis and deposition into the scaffold pores were similar among PCL and pellet cultures grown in FCM and in ICM. In conclusion, chondrocytes seeded into PCL scaffolds, cultured in ICM, efficiently maintained their differentiated phenotype and were able to synthesize cartilage-specific ECM proteins.

Acrylic scaffolds with interconnected spherical pores and controlled hydrophilicity for tissue engineering.

Polymer scaffolds are obtained in which the geometric characteristics (pore size, connectivity, porosity) and the physico-chemical properties of the resulting material can be controlled in an independent way. The interconnected porous structure was obtained using a template of sintered PMMA microspheres of controlled size. Copolymerization of hydrophobic ethyl acrylate and hydrophilic hydroxyethyl methacrylate comonomers took place in the free space of the template, different comonomer ratio gave rise to different hydrophilicity degrees of the material keeping the same pore architecture. The morphology of the resulting scaffolds was investigated by scanning electron microscopy (SEM), the porosity of the material calculated, and the mechanical properties compared with those of the bulk (non porous) material of the same composition.

Interacción indinavir-fenitoina en un paciente VIH+: a propósito de un caso / HIV+ patient phenytoin-indinavir interaction: a case report

Indinavir y fenitoína son metabolizados en el hígado por el citocromo P450 isoforma CYP3A4. La administración concomitante de indinavir y fenitoína podría producir una disminución en el metabolismo de estos fármacos debido a la competición por este enzima. Describimos el caso de un paciente de cuarenta y ocho años VIH+ que presentó concentraciones séricas de fenitoína muy altas (39,32 pg/ml) dos meses después de la reintroducción de indinavir en su tratamiento (AU)

[Treatment of overweight. Use of a program]. / Tratamiento del sobrepeso. Aplicación de un programa.

This article publicizes the results of an overweight treatment program carried out as a working model under the auspices of Primary Health Care. This program placed special emphasis on educational aspects, preventive as well as promoting healthy ways of living; and one in which activities planned towards establishing means of conduct which play a direct role in their users health factors are focused on. This treatment program occurred as a group activity. The 27 participating subjects, 23 women and 4 men, were recommended by their doctor/nurse. Their average age was 37.6 years, +/- 11.3. 19 subjects were overweight with an IMC between 25 and 30; the other 8 had been diagnosed as obese with an IMC over 30. This program took place in the Health Center meeting hall over 4 months, from February through June. Among the elements of this program, these deserve special mention: the use of a vocabulary exempt of adverse connotations, for example, instead of diet we spoke of menus; the establishment of behavioral goals before weight loss goals; the practice of elaborating and designing hypercaloric menus; providing positive reinforcement for those behaviors which increased the level of physical activity which was objectively measured by means of podometers; the practice of eating slowly; etc. At the end of the program, the results showed an average weight loss of 4.2 kilograms, a range of 0.9 to 6.12 K, with respect to the average weight at the start of the program. One can foresee that this loss will continue to occur, especially in those cases where the subject had modified some habits such as eating rapidly or performing physical exercise related to overweightness. These results are open to discussion regarding the efficiency of the program and with regards to this program as an example of a coordinated effort between the Mental Health Unit and a Primary Health Care Team in relation to the design and implementation of health programs directed towards the attention of people with overweight problems.

[Skin fragments carried by spinal needles in cadavers]. / Arrastre de fragmentos epidérmicos mediante agujas espinales en cadáveres.

Epidural or intradural puncture with inappropriately stiffened or improperly placed needles can carry cells or fragments of epithelial tissue into the epidural or intradural space. These skin fragments feed by imbibition, possibly leading to the development of epidermoid cysts. We aimed to study the ability of today's needles to transport cells or epithelial fragments. We studied 120 needles in 6 groups of 20, as follows: group 1, Touhy G-16; group 2, Touhy G-17; group 3, Quincke G-22; group 4, Quincke G-26; group 5, Sprotte G-22, and group 6, Sprotte G-24. These needles were used to make intradural and epidural insertions, as indicated, with stiffeners fully in place. Insertions were made into 3 cadavers, epidermal cells or skin fragments were then isolated from the solutions used to wash the needles, and the samples were studied under an optical microscope. We identified groups of cells or epidermal tissues in 45% of the Touhy G-16 samples and in 30% of the Touhy G-17 samples. Squamous epithelial cells were found in 15% of the Quincke G-22 samples and in 30% of the Sprotte G-22 samples. There was a significant difference between the amount of tissue transported by the Touhy needles in comparison with the Quincke (p < 0.01) and Sprotte (p < 0.05) needles. Needles from some manufacturers transport epithelial fragments during lumbar puncture. We believe that better quality control during manufacture of epidural and intradural needles can help to eradicate the rare neurological complications derived from the removal of epithelial cells and their subsequent deposit inside the spinal channel.