Incidencia de punción accidental de duramadre en un hospital universitario. Estudio prospectivo observacional / Incidence of accidental dura mater punctures in a university hospital: a prospective observational study

Objetivo. La punción accidental de duramadre es una complicación potencial durante el bloqueo epidural y se puede relacionar con múltiples factores. Nuestro objetivo fue determinar la prevalencia y factores de riesgo de punción dural accidental en un hospital terciario, evaluando las diferencias que existen en el número de complicaciones durante los distintos horarios de trabajo. Material y métodos. Se realizó un estudio observacional prospectivo de todas las mujeres que solicitaron analgesia regional a la Unidad de Analgesia Epidural y cumplían los criterios de inclusión, entre el 1 de enero de 2009 y el 1 de enero de 2011. La técnica empleada para el control del dolor del trabajo del parto fue la analgesia epidural. Resultados. Se incluyeron 12.480 embarazadas. La prevalencia de punción dural accidental fue de 0,4% (50 pacientes). De ellas, 28% correspondieron a médicos residentes. Se observaron más punciones durales accidentales en septiembre y en el turno de trabajo de tarde. Conclusiones. La prevalencia de PAD es similar a otras series. En nuestra serie, el cansancio o la falta de sueño parecen no influir en la incidencia de complicaciones en la analgesia para el trabajo de parto en una unidad de atención 24 horas, quizás por la distribución de lo turnos en las guardias no trabajando más de 6 horas seguidas(AU)

Objective. Accidental dura mater puncture is a potential complication during epidural block, and may be associated with multiple factors. Our objective was to determine the prevalence and risk factors of accidental dural puncture in a university hospital, evaluating the differences in the number of complications during different working hours. Material and methods. A prospective observational study was conducted on all women who requested regional anaesthesia in the Epidural Analgesia Unit between 1 January 2009 and 1 January 2011, and who fulfilled the inclusion criteria. The technique employed to control labour pains was epidural analgesia. Results. A total of 12,480 pregnant women were included. The prevalence of accidental dura mater puncture was 0.4% (50 patients). Of these, 28% were due to medical residents. More accidental dura mater punctures were observed during September and in the afternoon shift. Conclusions. The prevalence of accidental dura mater puncture is similar to other patient series. In ours, tiredness or lack of sleep did not influence the incidence of complications in analgesia for labour pains in a 24 hour care unit. This may be due to the distribution of on-call shifts not exceeding more than 6hours(AU)

[Incidence of accidental dura mater punctures in a university hospital: a prospective observational study]. / Incidencia de punción accidental de duramadre en un hospital universitario. Estudio prospectivo observacional.

OBJECTIVE: Accidental dura mater puncture is a potential complication during epidural block, and may be associated with multiple factors. Our objective was to determine the prevalence and risk factors of accidental dural puncture in a university hospital, evaluating the differences in the number of complications during different working hours. MATERIAL AND METHODS: A prospective observational study was conducted on all women who requested regional anaesthesia in the Epidural Analgesia Unit between 1 January 2009 and 1 January 2011, and who fulfilled the inclusion criteria. The technique employed to control labour pains was epidural analgesia. RESULTS: A total of 12,480 pregnant women were included. The prevalence of accidental dura mater puncture was 0.4% (50 patients). Of these, 28% were due to medical residents. More accidental dura mater punctures were observed during September and in the afternoon shift. CONCLUSIONS: The prevalence of accidental dura mater puncture is similar to other patient series. In ours, tiredness or lack of sleep did not influence the incidence of complications in analgesia for labour pains in a 24 hour care unit. This may be due to the distribution of on-call shifts not exceeding more than 6 hours.

Minisatellite variant repeat (MVR) analysis of the HRAS1 minisatellite locus.

Two alternative electrophoretic strategies were used to study the internal variation of the HRAS1 minisatellite after minisatellite variant repeat mapping (MVR-PCR) was carried out. While the use of automated sequencers with fluorescent based technology is ideal for analyzing fragment size, and therefore, for analyzing the repeat number, the use of polyacrylamide gels and silver staining is more appropriate for the analysis of internal variation. Thirteen different fragments ranging from 27 to 80 repeats were found in a sample from 80 healthy Caucasian individuals. By using MVR mapping we were able to detect heterozygotes which appear as homozygotes when fragment length analysis was used. As a result of this, the 13 alleles, which we had detected, increased to 16 alleles when MVR sequences were analyzed. The extremely conservative arrays of repeats allow us to infer the theoretical origin of rare alleles from a major group of specific alleles. The HRAS1 minisatellite has been extensively studied due to its association with cancer. However, the methodology used up to now has limited the scope of previous research. Our approach permits the identification of alleles in a fast and reliable way using their MVR codes, thus allowing association studies with cancer.

Comparison of different electrophoretic methods for digital typing of the MS32 (D1S8) locus.

Minisatellite variant repeat mapping by polymerase chain reaction (MVR-PCR) is a new and powerful approach for individual identification from human DNA. This method has been successfully applied to the hypervariable human minisatellite MS32 (locus D1S8). In this work, we further investigate this locus using different electrophoretic techniques which include: agarose gels and nonradioactive hybridization, miniaturized polyacrylamide gels, followed by silver staining, and automatic detection of fluorescent labeled alleles. The advantages and disadvantages of each method are described. Also, MVR codes from a Galician population (NW Spain) are provided.

Population data on the loci LDLR, GYPA, HBGG, D7S8, and GC in three southwest European populations.

Three Southwest European populations: Galicia (NW Spain), a mixed Spanish population from the rest of Spain (outside Galicia), and a population sample from the Coimbra area (Centre of Portugal) have been studied for the Low Density Lipoprotein Receptor (LDLR), Glycophorin A (GYPA), Hemoglobin G Gammaglobin (HBGG), D7S8 and Group Specific Component (GC). The allele and genotype frequencies found have been compared with other previously published data. All loci meet Hardy-Weinberg expectations in the three sampled populations. There was no evidence of association in any of the three population samples, between the five loci studied. No significant differences were found with Caucasian populations, nevertheless, significant differences were observed between our three population studies and the US SW Hispanic and African populations. The AmpliType PM DNA test greatly facilitates DNA testing in forensic laboratories, providing quick results and a good discrimination power from a single test.