Reducción amigdalar por radiofrecuencia en pediatría / No disponible

Introducción: Se ha realizado un estudio preliminar donde se evalúa la radiofrecuencia como nueva técnica disponible para tratar casos seleccionados de hipertrofia amigdalar. Objetivos: El objetivo principal es determinar los beneficios y seguridad de la reducción amigdalar por radiofrecuencia mediante punción en pacientes pediátricos. Como objetivos secundarios se expondrán las implicaciones quirúrgicas y anestésicas de la técnica. Material y métodos: Estudio retrospectivo y descriptivo de todos los pacientes pediátricos intervenidos de hipertrofia amigdalar mediante radiofrecuencia por punción durante el periodo junio2010-febrero 2011 en nuestra Unidad. Los pacientes seleccionados se incluyeron dentro de un protocolo de actuación. Se ha estudiado: edad, sexo, sintomatología previa, dispositivo mantenimiento vía aérea, tiempo quirúrgico, asociación de adenoidectomía,complicaciones, estancia hospitalaria, dolor postoperatorio, recuperación actividad normal y resultado final. Resultados: Durante el periodo señalado 15 pacientes han sido sometidos a dicha técnica, nueve niñas (60%) y seis niños(40%), con edad media de 3,9 años. Los síntomas de indicación quirúrgica más frecuentes fueron mala respiración, ronquido y alteraciones de deglución. En todos los casos se utilizó mascarilla laríngea reforzada como único dispositivo de mantenimiento de la vía aérea. Se asoció adenoidectomía en el 80% de los pacientes. El tiempo medio de la intervención fue de 14 minutos. No se constataron complicaciones intraoperatorias ni postoperatorias. Como tratamiento del dolor postoperatorio inmediato se emplearon antiinflamatorios no esteroideos y paracetamol y tras el alta hospitalaria sólo requirieron paracetamol. La (..) (AU)

Introduction: We performed a preliminary study where puncture radiofrequency was evaluated as a new technique, available to treat selected cases of tonsillar hypertrophy. Objectives: The main objective is to determine the benefits and safety of puncture radiofrequency tonsil reduction in pediatric patients. Secondary we evaluated the implications of surgical and anesthetic techniques. Material and methods: Retrospective and descriptive study of all pediatric patients who underwent radiofrequency tonsil hypertrophypuncture during June 2010-February 2011 in our unit. The selected patients were included in a protocol including: age, sex, previous symptoms, airway maintenance device, surgical time, adenoidectomy association, complications, hospital stay, postoperative pain, recovery and outcome. Results: During the reported period 15 children have undergone this technique, nine girls (60%) and six boys (40%), with a mean age of 3.9 years. The most frequent symptoms for surgery were breathing difficulties, snoring and swallowing disorders. In allcases reinforced laryngeal mask was used as the sole device for airway maintenance. Adenoidectomy was associated in 80% of patients. The average time for surgery was 14 minutes. There were neither intraoperative nor postoperative complications. NSAIDs and acetaminophen were used as postoperative analgesia. At home, patients only used acetaminophen for pain control. Hospital stay was less than 24 hours, with 48-72 hours of recovery time. No patient came back to our emergency units. After two months, there was tonsillar reduction demonstrated in 14 of the 15 cases (93%).Conclusions: Puncture Radio frequency tonsils reduction, inpediatric selected cases can be a safe, effective and a low morbidity technique (AU)

Guía de aplicaciones clínicas de medicina nuclear / Es

El documento presenta: endocrinoligía nuclear, glándulas paratiroides, cardiología nuclear, sistema vascular, neumología nuclear, gastroenterología nuclear, nefrourología nuclear, oncología nuclear (AU)

Differences on post-thawing survival between ovine morulae and blastocysts cryopreserved with ethylene glycol or glycerol.

Embryos were collected on Days 5 and 6 after breeding to investigate the effectiveness of ethylene glycol (ETG) and glycerol (GLY) as cryoprotectants of sheep morulae and blastocysts and to determine their optimum stage of development for cryopreservation. Only excellent (grade 1) and good (grade 2) embryos (196 morulae and 188 blastocysts) were incubated in increasing concentrations of GLY or ETG and submitted to a slow-freezing and quick-thawing procedure. Both cryoprotectants were removed using 0.25 M sucrose solution, and then embryos were cultured or transferred to determine their viability. Freezing medium containing ETG yielded higher in vitro survival rates (P < 0.01) than medium containing GLY (64.6% vs 16.0%); the difference between cryoprotectants was greater when morulae were used (57.9% vs 4.2%, P < 0.005) as compared with blastocysts (70.4% vs 21.5%, P < 0.05). There was a strong interaction between type of cryoprotectant and embryo stage (P < 0.005). After transfer of morphologically viable embryos, the in vivo development rate of embryos frozen with ETG was also higher than that of embryos frozen with GLY (45.5% vs 27.7%, P < 0.05). There were no significant differences in the number of lambs born among procedures and embryo stage, though the lowest lambing rate was obtained with morulae frozen with GLY (21.4%). Similar lambing rates were produced when blastocysts were frozen with either GLY or ETG (36.6% vs 43.0%). The best embryo survival after thawing was observed when blastocysts were frozen with ETG as cryoprotectant.

Effects of LH administration at the end of an FSH superovulatory regimen on ovulation rate and embryo production in three breeds of sheep.

In 3 experiments, 168 ewes of Manchega (n = 72), Churra (n = 62), and Merina (n = 34) breeds were used to test the hypothesis that administration of pure LH, coincident with progestogen removal during superovulation with FSH, causes an increase in the ovulation rate and number of embryos. This administration of LH can further interact with genotype, resulting in breed differential response. In each experiment, the animals were randomly assigned to 1 of 3 treatments. Estrus in all sheep was synchronized with intravaginal sponges of 30 mg of FGA for 12 d, then 270 microg of FSH were administered in 6 injections at 12-h intervals in decreasing doses, starting 48 h before sponge removal. The FSH/LH ratio of the original preparation was 3, and remained constant throughout the treatment in the control group (C). In Treatment 1, (T1) and Treatment 2, (T2), pure LH was administered coincident with progestogen removal-5th FSH injection, and with the 6th FSH injection, at 2 dose levels: 60 and 120 microg, (T1), and 120 and 240 microg (T2). Mating occurred 36 and 48 h after the progestogen removal, and the embryos were surgically collected and morphologically evaluated on Days 7 and 8 after sponge withdrawal. Overall, the results showed that LH administration at the end of the FSH treatment did not increase the ovulation rate and number of embryos in Merino (5.9 +/- 1.4 and 5.6 +/- 1.4, respectively, T1; 7.0 +/- 1.0 and 5.7 +/- 1.2, T 2; 4.9 +/- 1.1 and 2.6 +/- 0.7, C), Churra (6.8 +/-1.4 and 5.2 +/- 1.4, T1; 8.1 +/- 1.5 and 6.3 +/- 1.4, T2; 6.1 +/- 1.5 and 5.4 +/- 1.3, C) and Manchega (6.0 +/- 1.0 and 4.4 +/- 1.0, T1; 5.0 +/- 0.8 and 4.2 +/- 0.8, T2; 4.8 +/- 1.5 and 3.8 +/- 1.0, C). Administration of LH induced a significant (P < 0.05) increase in the frequency of multiple ovulations (72.3 +/- 4.3 %, T1; 74.1 +/- 11.5 %, T2; 55.6 +/- 5.9 %, C) paralleled to a decrease in the occurrence of ewes with no ovulations (8.7 +/- 2.6 %, T1; 7.6 +/- 4.6 % T2; 17.3 +/- 3.2 %, C) or 1 to 2 ovulations (18.7 +/- 4.6 %, T1; 18.1 +/- 7.5 %, T2; 26.8 +/- 5.8 % C), regardless of breed or dose of LH. No increase in the mean number of viable embryos was observed, probably due to both the high individual variability and the lower fertilization rates observed in sheep showing multiple ovulations.