Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension due to septic emboli.

We present the case of a 28-year-old woman with a history of tricuspid valve endocarditis leading to chronic thromboembolic pulmonary hypertension (CTEPH) with multiple pulmonary artery chronic total occlusions (CTOs) due to septic emboli. Following a multidisciplinary care discussion, the patient was brought forward for balloon pulmonary angioplasty (BPA) with successful revascularization of all chronically occluded territories. This case highlights advances in pulmonary artery CTO interventions and demonstrates the feasibility of BPA for CTEPH patients with a history of septic emboli.

Heridas por proyectil de arma de fuego. Atipicidad en orificios de entrada y el fenómeno de ''cola de cometa": Reporte de caso / Gunshot wounds. Atypicality in entry holes and the "comet tail" phenomenon: Case report

El análisis de los orificios de entrada por proyectil de arma de fuego en una autopsia médico legal representa un importante papel en la determinación de la forma y causa de muerte en casos relacionados con armas de fuego. Su valoración puede proporcionar información valiosa sobre las características del arma utilizada, la distancia entre el arma de fuego y la víctima, entre otros factores que contribuyen a la investigación. El fenómeno de ''cola de cometa" observado en ciertos orificios de entrada es poco frecuente y conocido. Por lo anterior, el objetivo de este artículo es investigar las características y mecanismos de producción de los orificios de entrada con este fenómeno, proporcionando información sobre su formación, las posibles implicaciones y consideraciones médico legales a tomar en cuenta para su diagnóstico de esta causa de muerte. Se presenta un reporte de caso que destaca la descripción del fenómeno de ''cola de cometa" en una investigación forense de la vida real, proporcionando información valiosa sobre su utilidad y potencial para mejorar la precisión del análisis de heridas de bala. Se realizó revisión de artículos científicos, sobre orificios de entrada en heridas por proyectil de arma de fuego con el fenómeno de ''cola de cometa".

The analysis of firearm projectile entry holes in a medicolegal autopsy plays an important role in determining the manner and cause of death in cases involving firearms. The assessment can provide valuable information about the characteristics of the weapon used, the distance between the firearm and the victim, among other factors that contribute to the investigation. The ''comet tail" phenomenon observed in certain entry holes is rare and well known. Therefore, the objective of this article is to investigate the characteristics and mechanisms of production of the entrance orifices with this phenomenon, providing information about their formation, the possible implications, and medical-legal considerations to be taken into account for the diagnosis of this cause of death. A case report is presented highlighting the description of the ''comet tail" phenomenon in a real-life forensic investigation, providing valuable insight into its utility and potential to improve the accuracy of gunshot wound analysis. A review of scientific articles was carried out on entry holes in gunshot wounds with the "comet tail" phenomenon.

How to perform a successful drug-coated balloon angioplasty? Tips and tricks.

Drug-coated balloons (DCB) offer an excellent alternative to stents as the antiproliferative drugs are delivered via balloons and hence there is no permanent implant of metal or polymer. This rationale applies perfectly in in-stent restenosis (ISR) as we want to avoid another layer of metal in a previously failed stent. However, their use has also been extended to de novo lesions especially in patients and lesion subsets where stents are not ideal. There is an increased desire toward expanding this further and studies are now being done which are testing DCB in large-caliber vessels. As the use of DCB is escalating, we felt the importance of writing this article whereby we aim to provide important tips and tricks when using DCB especially for the operators who are in the early phase or have the desire of embarking this technology. From our experience, the DCB-angioplasty substantially differs on several aspects from DES-angioplasty. We have provided several case bases examples including algorithm when using DCB in ISR and de novo lesions.

Sida cordifolia L.: Ethnobotany, Phytochemistry, Phytonanotechnology, and Commercial Application.

BACKGROUND: After a period of prolonged indifference, where synthetic drugs were preferred, interest in the biological aspects and bioactive ingredients of plants accountable for therapeutic potential has been explored eminently. Sida cordifolia L. is a perennial herb that has been widely utilized in Indian (Ayurveda, Unani, and Siddha), American, and Chinese folk medicine and herbalism practice for curing a wide range of ailments in human beings. OBJECTIVE: The goal of this review is to elucidate indigenous knowledge parallelly with the pharmacotherapeutics potential of Sida cordifolia L. against various diseases. It is also intended to display pertinent information related to nanoparticle profiling. METHODS: In the current comprehensive study, web-based searches were performed by using several databases, such as Google Scholar, PubMed, ResearchGate, Science Direct, and Scopus, to figure out relevant research work and data published in academic journals from 1930 to July, 2023 using single or combination of keywords listed herewith. RESULTS: More than 50 chemical constituents, including quinazoline and phenethylamine alkaloids, flavones, flavonol, phytosterol, fatty acids, etc., were reported to be found in different parts of healthy plants. Apart from traditional claims and pharmacological aspects, several marketed herbal formulations and granted patents were also described. CONCLUSION: Several in-vitro and in-vivo studies validated the usage of S. cordifolia as antiinflammatory, antibacterial, antifungal, antiprotozoal, anthelmintic, anticancer, antiulcer, cardioprotective, hypoglycemic, etc. agent. Few patents are also related to S. cordifolia, and more research work needs to be carried out for its potential granted to use as an antiviral agent and other new drug discovery molecules.

Barium Lanthanum Oxide Nanosheets in Photocatalytic and Forensic Applications: One-Pot Synthesis and Characterization.

The present work elucidates the fabrication of Barium Lanthanum Oxide nanosheets (BaLa2O4 NSs) via a simple one-pot precipitation method. The acquired results show an orthorhombic crystal system with an average crystallite size of 27 nm. The morphological studies revealed irregular-shaped sheets stacked together in a layered structure, with the confirmation of the precursor elements. The diffused reflectance studies revealed a strong absorption between 200 nm and 350 nm, from which the band-gap energy was evaluated to be 4.03 eV. Furthermore, the fluorescence spectrum was recorded for the prepared samples; the excitation spectrum shows a strong peak at 397 nm, attributed to the 4F7/2→4G11/2 transition, while the emission shows two prominent peaks at 420 nm (4G7/2→4F7/2) and 440 nm (4G5/2→4F7/2). The acquired emission results were utilized to confirm the color emission using a chromaticity plot, which found the coordinates to be at (0.1529 0.1040), and the calculated temperature was 3171 K. The as-prepared nanosheets were utilized in detecting latent fingerprints (LFPs) on various non-porous surfaces. The powder-dusting method was used to develop latent fingerprints on various non-porous surfaces, which resulted in detecting all the three ridge patterns. Furthermore, the as-synthesized nanosheets were used to degrade methyl red (MR) dye, the results of which show more than 60% degradation at the 70th minute. It was also found that there was no further degradation after 70 min. All the acquired results suggest the clear potential of the prepared BaLa2O4 NSs for use in advanced forensic and photocatalytic applications.

Reduction and Diffusion of Cr-Oxide Layers into P25, BaLa4Ti4O15, and Al:SrTiO3 Particles upon High-Temperature Annealing.

Chromium oxide (Cr2O3) is a beneficial metal oxide used to prevent the backward reaction in photocatalytic water splitting. The present work investigates the stability, oxidation state, and the bulk and surface electronic structure of Cr-oxide photodeposited onto P25, BaLa4Ti4O15, and Al:SrTiO3 particles as a function of the annealing process. The oxidation state of the Cr-oxide layer as deposited is found to be Cr2O3 on the surface of P25 and Al:SrTiO3 particles and Cr(OH)3 on BaLa4Ti4O15. After annealing at 600 °C, for P25 (a mixture of rutile and anatase TiO2), the Cr2O3 layer diffuses into the anatase phase but remains at the surface of the rutile phase. For BaLa4Ti4O15, Cr(OH)3 converts to Cr2O3 upon annealing and diffuses slightly into the particles. However, for Al:SrTiO3, the Cr2O3 remains stable at the surface of the particles. The diffusion here is due to the strong metal-support interaction effect. In addition, some of the Cr2O3 on the P25, BaLa4Ti4O15, and Al:SrTiO3 particles is reduced to metallic Cr after annealing. The effect of Cr2O3 formation and diffusion into the bulk on the surface and bulk band gaps is investigated with electronic spectroscopy, electron diffraction, DRS, and high-resolution imaging. The implications of the stability and diffusion of Cr2O3 for photocatalytic water splitting are discussed.

Minimally invasive retrieval of a bullet settling into the thoracic spinal canal in a pediatric patient: A case report / Recuperación mínimamente invasiva de una bala que se asienta en el canal espinal torácico en un paciente pediátrico: reporte de un caso

A 10-year-old boy presented to neurosurgery department after a gunshot wound to the upper thoracic spine. The bullet entered through the right deltoid muscle and lodged inside the spinal canal at T1 level. The patient arrived conscious and obeying commands; however, he experienced a loss of sensation below T3 level, loss of reflexes below the injured T1 level, loss of anal sphincter tone and paraplegia in the lower limbs (American Spinal Injury Association grade-A). Imaging studies revealed an intra-canalicular metallic bullet at the T1 level. The patient underwent urgent operation using a tubular retractor system and the microscope. Subsequently, the bullet was successfully retrieved. Postoperatively, the patient made a significant recovery and by the end of the 6th month, he was able to walk independently despite some gait instability. A minimally invasive approach for intra-canalicular bullet removal in the thoracic region is a safe and effective technique in pediatric patients. (AU)

Un niño de 10 años se presentó al departamento de neurocirugía después de una herida de bala en la columna torácica superior. La bala entró por el músculo deltoides derecho y se alojó dentro del canal espinal a nivel T1. El paciente llegó consciente y obedeciendo órdenes; sin embargo, experimentó una pérdida de sensibilidad por debajo del nivel T3, pérdida de reflejos por debajo del nivel T1 lesionado, pérdida del tono del esfínter anal y paraplejía en las extremidades inferiores (American Spinal Injury Association grado-A). Los estudios de imagen revelaron una bala metálica intracanalicular a nivel T1. El paciente fue intervenido de urgencia mediante un sistema retractor tubular y el microscopio. Posteriormente, la bala se recuperó con éxito. En el postoperatorio, el paciente se recuperó significativamente y, al final del sexto mes, podía caminar de forma independiente a pesar de cierta inestabilidad en la marcha. Un enfoque mínimamente invasivo para la extracción de balas intracanaliculares en la región torácica es una técnica segura y eficaz en pacientes pediátricos. (AU)

Minimally invasive retrieval of a bullet settling into the thoracic spinal canal in a pediatric patient: A case report.

A 10-year-old boy presented to neurosurgery department after a gunshot wound to the upper thoracic spine. The bullet entered through the right deltoid muscle and lodged inside the spinal canal at T1 level. The patient arrived conscious and obeying commands; however, he experienced a loss of sensation below T3 level, loss of reflexes below the injured T1 level, loss of anal sphincter tone and paraplegia in the lower limbs (American Spinal Injury Association grade-A). Imaging studies revealed an intra-canalicular metallic bullet at the T1 level. The patient underwent urgent operation using a tubular retractor system and the microscope. Subsequently, the bullet was successfully retrieved. Postoperatively, the patient made a significant recovery and by the end of the 6th month, he was able to walk independently despite some gait instability. A minimally invasive approach for intra-canalicular bullet removal in the thoracic region is a safe and effective technique in pediatric patients.

Layered Perovskites BaM2In2O7 (M = La, Nd): From the Structure to the Ionic (O2-, H+) Conductivity.

The design of new oxide compounds that can be used as oxygen- or proton-conducting electrolytes for solid oxide fuel cells is actively in progress. Despite the intensive research activities regarding electrolytes with perovskite/fluorite structures, the search for other structural alternatives is of paramount importance. In this study we focus on a novel material with significantly improved properties for the electrochemical purposes. The two-layered BaNd2In2O7 perovskite with a Ruddlesden-Popper structure was investigated as a protonic conductor for the first time. In detail, its local structure, water uptake, and the ionic (O2-, H+) conductivity were comprehensively studied. The nature of rare-earth elements (M = La, Nd) in the structure of BaM2In2O7 on the structural and transport properties was revealed. The presented analysis showed that the composition of BaNd2In2O7 is nearly pure proton conductor below 350 °C. This work opens up a new way in the design of protonic conductors with double-layered perovskite structure.

[Establishment of An Animal Model of Acute B Lymphoblastic Leukemia with Minimal Residual Disease].

OBJECTIVE: To establish an animal model of acute B lymphoblastic leukemia (B-ALL) with minimal residual disease. METHODS: The transplanted tumor was formed by subcutaneous injection of 2×107 Nalm-6 cells, and the body weight, activity status and tumor formation status of nude mice were observed. Peripheral blood, bone marrow, liver and spleen and other tissues of nude mice were taken for pathological examination to understand whether the success of subcutaneous modeling was accompanied by systemic metastasis. RESULTS: There were 2×107 Nalm-6 cells injected subcutaneously in nude mice, (11.0±2.5) days later, the tumors of (3-4) × (3-4) mm were observed, the body weight of the nude mice was reduced and activity showed no limited. Infiltration of tumor cells in liver, spleen and bone marrow were observed in pathological sections. CONCLUSION: The animal model of subcutaneous tumor of B-ALL was successfully established in nude mice.

Supravalvular pulmonary stenosis: A risk factor for reintervention in Noonan syndrome with pulmonary valve stenosis.

OBJECTIVES: To assess the short- and long-term outcomes of balloon pulmonary valvuloplasty (BPV) in children with Noonan syndrome (NS). BACKGROUND: Pulmonary stenosis (PS) is the most common congenital heart lesion in NS. BPV is the accepted first line treatment in PS. However, BPV in NS patients has been reported to be less effective, without specific factors for the need for reintervention being identified. METHODS: Retrospective case-note review of all patients with NS who underwent BPV between 1985 and 2020. Patients were divided into 2 groups: those with supravalvular pulmonary stenosis (SPS) in addition to valvar PS, and those with isolated valvar PS. RESULTS: A cohort of 54 patients with NS underwent BPV at a median of 275 (interquartile range [IQR]: 108-575) days of age. SPS was present in 32 (59%) patients whereas 22 had (41) isolated PS. The preprocedural invasive gradient was 47 (IQR: 35-69) mmHg, and 44 (IQR: 35-48) mmHg in those with SPS and those without respectively (p = 0.88). Reintervention was required in 22 patients (41%): 17 (77%) with SPS and 5 (23%) without (p = 0.017). Fourteen patients (11 with SPS) required surgical reintervention and 8 (6 with SPS) required further BPV. There was no significant difference in the age at initial BPV, pre- and postprocedural gradients and interval until reintervention between groups. CONCLUSION: This is the largest reported cohort of patients with NS undergoing BPV. Although BPV is often successful, the reintervention rates are high. SPS was a risk factor for reintervention.

Immune status determined as per guidelines of Ayurveda found associated with clinical outcomes of COVID-19 disease - Results of a cross-sectional pilot study.

BACKGROUND: A key public health priority during the emergence of a novel pathogen is probing the factors contributing in clinical severity of the disease COVID-19. Moreover, analysis of the determined clinical outcomes is required and thus, modifiable predictor values need to identified. In Ayurveda, outcome of a disease is a multivariate function and this exploratory work is an attempt to identify one such factor "Vyadhiksamatwa" (immune status). MATERIALS AND METHODS: A questionnaire-based, cross-sectional study was conducted in fifty diagnosed cases of COVID-19. Study participants were subjected to a questionnaire to assess relationship between the three determinants of the disease - exposure, clinical severity, and Vyadhiksamatwa. RESULTS: Clinical severity was found strongly correlated with Vyadhiksmatwa with the value of Pearson Correlation - 0.740 significant at the 0.01 level (2-tailed). CONCLUSION: In the determination of clinical severity of disease, there are two epidemiological factors responsible - extrinsic (exposure) and intrinsic (Vyadhiksamatwa). It has been observed that higher the value of Vyadhiksamatwa of an individual, lesser will be the clinical severity of the disease in that individual. Vyadhiksamatwa can alter the host response to infections.

Establishment of An Animal Model of Acute B Lymphoblastic Leukemia with Minimal Residual Disease / 中国实验血液学杂志

OBJECTIVE@#To establish an animal model of acute B lymphoblastic leukemia (B-ALL) with minimal residual disease.@*METHODS@#The transplanted tumor was formed by subcutaneous injection of 2×107 Nalm-6 cells, and the body weight, activity status and tumor formation status of nude mice were observed. Peripheral blood, bone marrow, liver and spleen and other tissues of nude mice were taken for pathological examination to understand whether the success of subcutaneous modeling was accompanied by systemic metastasis.@*RESULTS@#There were 2×107 Nalm-6 cells injected subcutaneously in nude mice, (11.0±2.5) days later, the tumors of (3-4) × (3-4) mm were observed, the body weight of the nude mice was reduced and activity showed no limited. Infiltration of tumor cells in liver, spleen and bone marrow were observed in pathological sections.@*CONCLUSION@#The animal model of subcutaneous tumor of B-ALL was successfully established in nude mice.

An experimental study to evaluate Gunasankarya (combination of properties).

Introduction: Gunasankarya implies the combination or admixture of different Guna (properties) in a Dravya (substance). Every Dravya in this world is composed of different Guna varying in their quantity and potency. The final resultant action of the Dravya depends on the combination of Guna and their interaction with each other. Aim: The present study was aimed to explain the manifestation of Karma (action) of a Dravya through its Guna (properties) and to evaluate the effect of the combination of Sheeta Guna (cool property) with different other Guna on digestion and metabolism in an animal model. Materials and methods: The test drugs Usheera (Vetiveria zizanioides Linn.) and Bala (Sida cordifolia Linn.) were dried and powdered. A total of 18 adult healthy male and female Wistar strain albino rats were grouped randomly into three groups out of which the first was the control group and administered with distilled water. The second and third groups were fed with powder of Usheera and Bala, respectively, in the suspended form in distilled water. Test drugs were administered daily for 12 consecutive days. During the experimental phase, relative food intake, relative water intake, relative urine output, relative stool output, and food conversion ratio were recorded on the 3rd, 6th, 9th, and 12th day among which the 3rd day was considered as the initial day for the assessment, whereas body weight was measured from the 1st day of the study. Throughout the study, the main focus was on how these parameters change in Usheera and Bala-treated rats which are having different combinations of Guna with reference to the control group. Results: Both Usheera and Bala groups showed a nonsignificant increase in relative food and water intake, nonsignificant increase in relative urine output, significant decrease in relative stool output, and significant increase in food conversion ratio. Body weight was nonsignificantly increased in Usheera group, whereas it was nonsignificantly decreased in Bala group. This study aimed to show how the Guna are interacting and resulting in Karma either by dominating or suppressing or giving a combined effect of Guna. This study provides initial data regarding the concept of Gunasankarya (combination of properties). Conclusion: The study concludes that all the Guna in a Dravya interact and exhibit their resultant action, i.e., Karma based on Gunasankarya, with emphasis on example of assessment of the effects of Sheeta Guna Dravya, namely, Usheera and Bala on physiological parameters (digestion and metabolism) have been assessed experimentally in animal models to evaluation of the combination of Guna.

Análisis electromiográfico de la actividad muscular de tronco durante el lanzamiento de bala paralímpico / Electromyographic analysis of trunk muscle activity during the Paralympic shot put / Análise electromiográfica da actividade muscular do tronco durante o lançamento de balas paraolímpicas

RESUMEN La estabilidad de la pelvis y el tronco, dada por la actividad de los músculos de la región, representa un factor importante para la correcta ejecución de la técnica deportiva y la prevención de lesiones en lanzadores paralímpicos. El objetivo de este estudio fue analizar a través de electromiografía de superficie, la actividad muscular del recto abdominal, oblicuo externo del abdomen y erector de la columna, vientres longuísimo e iliocostal, durante el lanzamiento de bala desde silla, en 4 atletas paralímpicos (2 con lesión en miembros inferiores y 2 con lesión medular). La electromiografía evidenció variaciones en los patrones de activación, el tiempo de ejecución y la amplitud de la señal, acorde a la condición de discapacidad y el grado de afectación del tronco. Esto permitió tener un panorama más real de las acciones musculares durante el gesto deportivo y la detección de opciones de mejora para los deportistas.

ABSTRACT The stability of the pelvis and trunk, given by the activity of the muscles in the region, represents an important factor for the correct execution of the sports technique and the prevention of injuries in Paralympic throwers. The objective of this study was to analyze, through surface electromyography the muscular activity of the rectus abdominis, external oblique of the abdomen and erector spinae, longuissimus and iliocostal bellies, during the shot put from a chair; in 4 Paralympic athletes (2 with lower limb injury and 2 with spinal cord injury). Electromyography showed variations in activation patterns, execution time and amplitude of the signal, according to the disability condition and the degree of trunk involvement. This allowed to have a more realistic panorama of the muscular actions during the sport gesture and the detection of improvement options for the athletes.

RESUMO A estabilidade da pélvis e do tronco, dada pela actividade dos músculos da região, representa um factor importante para a correcta execução da técnica desportiva e a prevenção de lesões nos lançadores paraolímpicos. O objectivo deste estudo foi analisar; através da electromiografía de superfície, a actividade muscular do recto abdominal, oblíquo externo do abdómen e erector da coluna vertebral, barriga muito comprida e iliocostal, durante o tiroteio em 4 atletas paraolímpicos (2 com lesão nos membros inferiores e 2 com lesão na medula espinal). A electromiografía mostrou variações nos padrões de activação, tempo de execução e amplitude do sinal, de acordo com a condição de incapacidade e o grau de envolvimento do tronco. Isto permitiu-nos ter uma imagem mais real das acções musculares durante o gesto desportivo e a detecção de opções de melhoria para os atletas.

Efficacy of Brimhana Nasya and Ashwagandha (Withania somnifera (L.) Dunal) root powder in primary insomnia in elderly male: A randomized open-label clinical study.

Background: Decreased ability to fall asleep and/or stay asleep with daytime effects of sleep deprivation is identified as primary insomnia. Elderly due to the predominant Vata Dosha in the body are easily affected by this problem. Brimhana Nasya (nourishing nasal drop) with Ksheera Bala Taila and oral administration of Ashwagandha (Withania somnifera (L.) Dunal) root powder both are indicated in Ayurvedic classics for the management of insomnia. Aim: To determine the combined efficacy of oral administration of Ashwagandha root powder along with Brimhana Nasya with Ksheera Bala Taila in primary insomnia in geriatric. Materials and methods: This was randomized, open-label clinical study conducted at the hospital of Pt. Khushilal Sharma Government Ayurveda College and Institute Bhopal. Randomly selected 60 elderly patients with primary insomnia were randomly divided into two groups (30 in each group). Pittsburgh Sleep Quality Index was used to assess the symptoms of primary insomnia. Relief in the subjective symptoms was assessed in percentage. Then, the statistical significance of result within the group was assessed using Wilcoxon matched-pairs signed-ranks test and the comparative effect of therapy in both groups was assessed using Mann-Whitney test. Graph Pad InStat-3 software was used for statistical analysis. Results: On subjective sleep quality 86.66% relief with P < 0.0001, on sleep latency 60.02% improvement with P < 0.0001, improvement in sleep duration was reported in 89.15% of patients with P < 0.0001 and improvement in sleep efficiency was reported in 90.14% of patients with statistically extremely significant P < 0.0001 were observed in combined therapy group (Ksheera Bala Taila Brimhana Nasya along with oral administration of Ashwagandha root powder). While 38.66% improvement in sleep efficiency, 40.39% relief in sleep disturbances and 37.05% improvement on subjective sleep quality was reported in group B patients, i.e., Ashwagandha root powder group. Conclusion: In 30 days treatment combined therapy was found more effective in the management of primary insomnia in the elderly compared with Ashwagandha root powder alone.

Trans-apical systemic tricuspid valve-in-ring replacement.

Transcatheter valve replacement offers a safe and effective alternative to traditional surgical techniques in patients with congenital heart disease, especially those at high surgical risk. The most common causes of morbidity and mortality in patients with D-transposition of the great arteries status post Senning or Mustard repair is severe tricuspid valve (TV) regurgitation. Replacement of the systemic TV may be useful in those without severe systemic ventricular dysfunction. We present a case of a patient with D-loop transposition of the great arteries status post Mustard repair and TV ring placement with subsequent severe systemic TV regurgitation, at high surgical risk, who underwent a transcatheter valve replacement via a trans-apical approach using an Edwards Sapien XT valve.

Adolescentes heridos por arma de fuego y sus factores biosocioeconómicos relacionados / Adolescents injured by firearm and their related biosocioeconomic factors

Antecedentes: En los últimos años las heri-das por arma de fuego (HPAF) se han incre-mentado a nivel mundial; son la segunda causa de muerte traumática en adolescentes en los Estados Unidos. En Honduras se ha incrementado esta patología probablemente debido a factores de diversa índole tales como: desintegración familiar, desempleo, incorporación temprana a grupos delictivos, experiencias con drogas, difusión no contro-lada de actos violentos a través de medios de comunicación masivos y facilidad para adqui-sición de armas. Objetivo: Determinar los factores biológicos, sociales y económicos relacionados con HPAF en pacientes adoles-centes atendidos en la Emergencia de Pedia-tría del Hospital Mario Catarino Rivas (HMCR), en el período de julio 2015 -junio 2017. Pacientes y métodos: estudio des-criptivo, observacional, prospectivo, con muestreo no probabilístico por conveniencia. Resultados: la prevalencia fue de 4.1%. Entre los adolescentes con HPAF los factores biosocioeconómicos identificados a deser-ción escolar fueron: desintegración familiar, emancipación, pobreza, dependencia econó-mica familiar, asociación a grupos delictivos, uso de alcohol y tabaco. Conclusiones: En este estudio predomino el sexo masculino y el grupo etario mas afectado fueron los ado-lescentes. Una gran parte residían en San Pedro Sula y también hubo relación con el sitio geográfico del trauma el cual fue el mismo. Cabe señalar que no predominaron las complicaciones médicas, pero el principal móvil del trauma fueron los asaltos...(AU)

Adverse outcome of coarctation stenting in patients with Turner syndrome.

OBJECTIVES: This study examines the outcome and procedural outcomes of percutaneous stent angioplasty for aortic coarctation in patients with Turner syndrome (TS). BACKGROUND: TS occurs in 1 in 2,500 live-born females and is associated with aortic coarctation. METHODS: In this multicenter, retrospective cohort study, all patients with TS and a coarctation of the aorta, treated with percutaneous stent implantation were included. The procedural strategies were dictated by local protocols. Adverse events at short- and long-term follow-up and qualitative parameters concerning the stent implantation were assessed. RESULTS: In the largest study to date of TS patients receiving aortic stents, a total of 19 patients from 10 centers were included. Twelve patients were treated for native and 7 for recurrent coarctation. Age at intervention was 16.9 (7-60) years (median; min-max). The coarctation diameter increased significantly from 8.0 mm (2-12) pre-intervention to 15.0 mm (10-19) post-intervention (P < 0.001). Three (15.8%) adverse events occurred within 30 days of the procedure, including two dissections despite the use of covered stents, one resulting in death. At long-term follow-up (6.5 years, min-max: 1-16), two additional deaths occurred not known to be stent-related. CONCLUSIONS: Though percutaneous treatment of aortic coarctation in TS patients is effective, it is associated with serious morbidity and mortality. These risks suggest that alternative treatment options should be carefully weighed against percutaneous stenting strategies. © 2016 Wiley Periodicals, Inc.