Anaesthetic-surgical guide in the treatment of ascending aorta and surgery of the ascending aorta and aortic arch. Consensus document of the Spanish Society of Cardiovascular and Endovascular Surgery and the Sociedad of Anaesthesiology, Resuscitation and Pain Therapy.

Aortic pathology is always a challenge for the clinician, and must be diagnosed and treated by a multidisciplinary team due to the technical and technological complexity of the resources used. Ongoing efforts to implement a systematic, protocolized approach involving "Aortic teams" made up of cardiologists, cardiac surgeons, vascular surgeons, anaesthesiologists and radiologists, among others are now leading to improved outcomes. The aim of this consensus document drawn up by the Aortic working groups of the Spanish Society of Anaesthesiology, Resuscitation and Pain Therapy (SEDAR) and the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) is to disseminate a set of working protocols. The latest consensus document of the European Association for Cardio-Thoracic Surgery (EACTS) and the European Society for Vascular Surgery (ESVS) define the concept of "AORTIC TEAM"(1). The aortic team should be closely involved from diagnosis to treatment and finally follow-up, and should be formed of cardiac and vascular surgeons working together with anaesthesiologists, cardiologists, radiologists and geneticists. Treatment of aortic pathologies should be centralised in large centres, because this is the only way to effectively understand the natural course of the disease, provide the entire range of treatment options under one umbrella and treat potential complications. A streamlined emergent care pathway (24/7 availability), adequate transportation and transfer capabilities, as well as rapid activation of the multidisciplinary team must be available. In light of the complexity and constant evolution of therapeutic options, we present this first version of the Anaesthesiology and surgical guidelines for surgery of the ascending aorta and aortic arch. Some questions will no doubt remain unanswered, and future versions will include new techniques that, though implemented in some centres, are still not widely recommended.

Guía anestésico-quirúrgica en el tratamiento de la cirugía de aorta ascendente y del arco aórtico. Documento de consenso de la Sociedad Española de Cirugía Cardiovascular y Endovascular y la Sociedad Española de Anestesiología, Reanimación y Terapeútica del Dolor / Anaesthetic-surgical guide in the treatment of ascending aorta and surgery of the ascending aorta and aortic arch. Consensus document of the Spanish Society of Cardiovascular and Endovascular Surgery and the Sociedad of Anaesthesiology, Resuscitation and Pain Therapy

La patología de la aorta siempre supone un reto para la medicina. Tanto para sudiagnóstico como para su tratamiento, dicha patología requiere ser abordada de forma multidisciplinar debido a la complejidad técnica y tecnológica de los medios empleados. Gracias a los esfuerzos durante años se están obteniendo frutos en forma de mejora de resultados, mediante un abordaje sistemático y protocolizado llevado acabo en el seno de un grupo de expertos (Comités de aorta o “Aortic team”) en el quese implican cardiólogos, cirujanos cardíacos, cirujanos vasculares, anestesiólogos y radiólogos, entre otros. Con este documento, realizado entre los grupos de trabajo de Aorta de la Sociedad Española de Anestesiología, Reanimación y Terapéutica del dolor (SEDAR) y la Sociedad Española de Cirugía Torácica y Cardiovascular (SECTCV) se busca difundir protocolos de trabajo consensuados por ambas sociedades. La EACTS y la ESVS en el último documento de consenso de expertos definen el concepto de “AORTIC TEAM”(1). El equipo debe estar estrechamente involucrado en todo el proceso de diagnóstico, tratamiento y seguimiento y debe estar compuesto por miembros de cirugía cardiovascular en colaboración con anestesiología, cardiología, radiología y genética. Se recomienda la centralización de la atención de las patologías del arco aórtico en grandes centros porque es la única forma de comprender de manera efectiva el curso natural de la enfermedad, proporcionar toda la gama de opciones de tratamiento bajo un mismo prisma y tratar las posibles complicaciones. Debe estar disponible una vía simplificada de atención de emergencias (con disponibilidad 24h al día y 7 días a la semana), una adecuada capacidad de transporte y transferencia de pacientes, así como la posibilidad de una activación rápida del equipo multidisciplinar.(AU)

Aortic pathology is always a challenge for the clinician, and must be diagnosed and treated by a multidisciplinary team due to the technical and technological complexity of the resources used. Ongoing efforts to implement a systematic, protocolized approach involving “Aortic teams” made up of cardiologists, cardiac surgeons, vascular surgeons, anaesthesiologists and radiologists, among others are now leading to improved outcomes. The aim of this consensus document drawn up by the Aortic working groups of the Spanish Society of Anaesthesiology, Resuscitation and Pain Therapy (SEDAR) and the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) is to disseminate a set of working protocols. The latest consensus document of the European Association for Cardio-Thoracic Surgery (EACTS) and the European Society for Vascular Surgery (ESVS) define the concept of “AORTIC TEAM”(1). The aortic team should be closely involved from diagnosis to treatment and finally follow-up, and should be formed of cardiac and vascular surgeons working together with anaesthesiologists, cardiologists, radiologists and geneticists. Treatment of aortic pathologies should be centralised in large centres, because this is the only way to effectively understand the natural course of the disease, provide the entire range of treatment options under one umbrella and treat potential complications. A streamlined emergent care pathway (24/7 availability), adequate transportation and transfer capabilities, as well as rapid activation of the multidisciplinary team must be available. In light of the complexity and constant evolution of therapeutic options, we present this first version of the Anaesthesiology and surgical guidelines for surgery of the ascending aorta and aortic arch. Some questions will no doubt remain unanswered, and future versions will include new techniques that, though implemented in some centres, are still not widely recommended.(AU)

Anaesthetic-surgical guide in the treatment of ascending aorta and surgery of the ascending aorta and aortic arch. Consensus document of the Spanish Society of Cardiovascular and Endovascular Surgery and the Sociedad of Anaesthesiology, Resuscitation and Pain Therapy. / Guía anestésico-quirúrgica en el tratamiento de la cirugía de aorta ascendente y del arco aórtico. Documento de consenso de la Sociedad Española de Cirugía Cardiovascular y Endovascular y la Sociedad Española de Anestesiología, Reanimación y Terapeútica del Dolor.

Aortic pathology is always a challenge for the clinician, and must be diagnosed and treated by a multidisciplinary team due to the technical and technological complexity of the resources used. Ongoing efforts to implement a systematic, protocolized approach involving "Aortic teams" made up of cardiologists, cardiac surgeons, vascular surgeons, anaesthesiologists and radiologists, among others are now leading to improved outcomes. The aim of this consensus document drawn up by the Aortic working groups of the Spanish Society of Anaesthesiology, Resuscitation and Pain Therapy (SEDAR) and the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) is to disseminate a set of working protocols. The latest consensus document of the European Association for Cardio-Thoracic Surgery (EACTS) and the European Society for Vascular Surgery (ESVS) define the concept of "AORTIC TEAM"(1). The aortic team should be closely involved from diagnosis to treatment and finally follow-up, and should be formed of cardiac and vascular surgeons working together with anaesthesiologists, cardiologists, radiologists and geneticists. Treatment of aortic pathologies should be centralised in large centres, because this is the only way to effectively understand the natural course of the disease, provide the entire range of treatment options under one umbrella and treat potential complications. A streamlined emergent care pathway (24/7 availability), adequate transportation and transfer capabilities, as well as rapid activation of the multidisciplinary team must be available. In light of the complexity and constant evolution of therapeutic options, we present this first version of the Anaesthesiology and surgical guidelines for surgery of the ascending aorta and aortic arch. Some questions will no doubt remain unanswered, and future versions will include new techniques that, though implemented in some centres, are still not widely recommended.

RETRACTED: Anesthesic and surgical guideline for the treatment of the thoraco-abdominal aorta. Consensus Document of the Spanish Societies of Anesthesia and Cardiovascular Surgery. / Guía anestésico-quirúrgica en el tratamiento de la patología de aorta toracoabdominal. Documento de Consenso de la Sociedad Española de Cirugía Cardiovascular Endovascular y la Sociedad Española de Anestesiología, Reanimación y Terapeútica del Dolor.

Este artículo ha sido retirado por indicación del Editor Jefe de la revista, después de constatar que parte de su contenido había sido plagiado, sin mencionar la fuente original: European Heart Journal (2014) 35, 2873 926.: https://academic.oup.com/eurheartj/article/35/41/2873/407693#89325738 El autor de correspondencia ha sido informado de la decisión y está de acuerdo con la retirada del artículo. El Comité Editorial lamenta las molestias que esta decisión pueda ocasionar. Puede consultar la política de Elsevier sobre la retirada de artículos en https://www.elsevier.com/about/our-business/policies/article-withdrawal

Detection of antibodies and risk factors for infection with bovine respiratory syncytial virus and parainfluenza virus-3 in beef cattle of Yucatan, Mexico.

We collected blood samples from 756 > or =2-year-old cattle in 54 herds in Yucatan, Mexico, and used all of those to determine the antibody seroprevalences (in an indirect enzyme-linked inmunosorbance assay) to bovine respiratory syncytial virus (BRSV) and risk factors for animal-level seropositivity. We used 728 of the same samples (from 52 of the same herds) to do the same for parainfluenza virus-3 (PIV3). Cattle were selected by two-stage cluster sampling. Herd-level and animal-level risk factors were obtained through a personal interview. We analyzed the data by using a random-effects multivariable logistic regression model for clustered observations. All herds had at least 3 (BRSV) or 5 (PIV3) seropositive animals. The animal-level true seroprevalences were: 90.8% (86.5, 95.2%) and 85.6% (80.9, 90.4%) for BRSV and PIV3, respectively. Animals in large herds and old animals had the highest odds of being seropositives to BRSV, and those risk factors plus animals born on the farm for PIV3 infection.

Bovine viral diarrhoea virus in beef cattle herds of Yucatan, Mexico: seroprevalence and risk factors.

A survey of bovine viral diarrhoea virus (BVDV) infection was carried out from June 2001 to July 2002 in a non-vaccinated beef cattle population from the livestock region of Yucatan, Mexico, to assess seroprevalence and identify risk factors related to seroprevalence. The aim was also to estimate the intra-herd correlation (r(e)) and design effect (D) of BVDV seropositivity. Cattle were selected by a two-stage cluster sampling. Blood samples were collected from 560 animals originating from 40 herds. Sera were tested for antibodies against BVDV using an indirect ELISA test. The sensitivity and specificity of the test was 97.9 and 99.7%, respectively. Risk factors regarding the herd and each animal sampled were recorded through a personal interview at the time of blood sampling. Twenty-four of the 40 herds had at least one seropositive animal. The animal true seroprevalence was estimated as 14%. The marginal logistic regression model used to describe the data found a significant (p<0.05) association of herd size-cow-origin interaction. The interaction was due to a higher risk of seropositivity in the category of herds with 196 animals. The r(e) and D values were 0.17+/-0.05 and 3.16+/-0.57, respectively.

Seroprevalence of and risk factors for leptospiral antibodies among cattle in the state of Yucatan, Mexico.

Sera obtained from cattle in the state of Yucatan, Mexico, were screened using the microscopic agglutination test against 13 serovars of Leptospira interrogans. A total of 62.8% (461/734) cows were positive for one or more serovars. This seroprevalence probably reflects infection because vaccination against leptospirosis has not been practised in Yucatan. The most common antibodies detected were those against antigens of serovars hardjo (54.1%) and tarassovi (53.3%). Region was the only risk factor associated with the seroprevalence of leptospirosis (p < 0.05).

Seroprevalence of and risk factors for infectious bovine rhinotracheitis in beef cattle herds of Yucatan, Mexico.

The main objective of this cross-sectional study was to estimate the seroprevalence of infectious bovine rhinotracheitis (IBR) in a population of non-vaccinated beef cattle in the livestock region of Yucatan, Mexico and to determine potential risk factors related to the seroprevalence. Also, we estimated the intraherd correlation (r(e)) and design effect (D) of IBR seropositivity. Cattle were selected by two-stage cluster sampling. Blood samples were collected from 564 animals from 35 herds. Sera were tested for antibodies against IBR using the serum-neutralisation test. Information regarding the herd and each animal sampled were recorded through a personal interview with the farmer or farm manager. The data were analysed using fixed-effects logistic multiple regression. Thirty-four of the 35 herds had at least one seropositive animal. The animal true seroprevalence was 54.4%. Animals in large herds or in production had higher odds of seropositivity than those in small herds or growing. The r(e) and D were 0.17 and 3.62, respectively.

[Cardiac failure due to traumatic aortic valve rupture]. / Insuficiencia cardíaca secundaria a rotura traumática de la válvula aórtica.

Cardiac failure due to valvular dysfunction is frequent as a complication of acute myocardial infarction, endocarditis or penetrating thoracic trauma affecting the heart and large vessels. Less frequently it is associate with nonpenetrating chest trauma. We presented a 69-year-old male with acute left heart failure after nonpenetrating thoracic trauma and sternum fracture. Transesophageal echocardiogram confirmed severe aortic regurgitation. A bilateral tear in the right coronary and non-coronary cusp was found. The aortic valve was removed and replaced with a number 27 Carpentier Edwards prosthesis. The postoperative course was uneventful.

[Embolism in the right heart chambers: the diagnostic and therapeutic aspects]. / Embolia en cavidades cardiacas derechas: aspectos diagnósticos y terapéuticos.

Deep venus thrombosis may result in pulmonary embolism. In rare instances, embolization has occurred, not directly to the pulmonary arterial tree, but to the right heart chambers. Although the value of echocardiography in the diagnosis is well recognised, their is no consensus for the appropriate treatment. We report herein six cases of floating right atrial thrombi, diagnosed by echocardiography, in patients with pulmonary embolism, or unexplained shock or syncope. Surgical embolectomy was carried out in 4 patients, and thrombolytic therapy in 2, without in-hospital mortality. The high mortality associated to this entity may be improved by rapid echocardiographic recognition and emergency treatment with thrombolysis or surgery. Our data suggest the possible use of thrombolysis as a first-choice therapy in selected patients.

[Serum monitoring of IgG and IgM Babesia bigemina (Haemosporidia: Babesiidae) antibodies in calves from the Mexican tropics]. / Monitoreo serológico de anticuerpos (IgG e IgM) contra Babesia bigemina (Haemosporidia: Babesiidae) en becerros del trópico mexicano.

Antibody dynamics (IgG and IgM) against Babesia bigemina was studied on 41 under 15 days of age from three ranches (R1, R2 and R3) in Yucatan, Mexico. Blood samples were collected every 30 days, for eight months. Sera were tested by the indirect fluorescent antibody method to detect IgG and IgM. Overall IgM seroprevalence during the calves first eight months of life was 17.1% without relation to age. Overall IgG seroprevalence was 66.8%, increasing with age. Seroprevalence in R1, R2 and R3 were 87.5%, 77.1% and 31.8% respectively. Ranches 1 and 2 were in enzootic stability. In Yucatan, the modification of management factors in ranches with enzootic instability, could increase the risk of clinical babesiosis. Cattle mobilization from ranches with enzootic instability must be strictly controlled.

Effect of progesterone on the activity of occupied nuclear estrogen receptor in vitro.

In previous studies, we have demonstrated that progesterone administration in vivo can selectively alter estrogen receptor levels and distribution in the rat anterior pituitary. The present study represents an attempt to extend these observations to an in vitro model. Cytosolic and nuclear preparations of uterine homogenates from ovariectomized adult rats were shown to be capable of temperature-dependent estrogen-mediated receptor activation and translocation from cytosol to nuclei upon recombination. Addition of progesterone to isolated cytosol did not diminish estrogen receptor binding capacity over at least a 2 h period at 22 degrees C. Preincubation of the subcellular fractions with progesterone, followed by removal of free progesterone prior to cytosol-nuclear recombination, resulted in dramatic reduction in nuclear estrogen receptor activity. This action was equally apparent whether progesterone was introduced to the cytosolic or nuclear fraction, and was confined to the steroid-occupied subpopulation of nuclear receptors. The ability of this in vitro system to mimic the estrogen receptor-suppressive effect of progesterone provides a good model in which to analyze the biochemical basis for a direct estrogen-inhibitory effect of progesterone on estrogen action.

Receptor-mediated interrelationships between progesterone and estradiol action on the anterior pituitary-hypothalamic axis of the ovariectomized immature rat.

The ovariectomized immature rat was used as a model for analysis of action of progesterone as a modulator of receptor-mediated functional responsiveness in the anterior pituitary and hypothalamus. In response to estrogen exposure, cytosolic progesterone receptors appear rapidly, rise in concentration to a peak at 12 h, then fall to a plateau level well above control, which is maintained for at least an additional 20 h. Progesterone administration at the peak 12-h interval induces maximal nuclear accumulation of its own receptor within 1-2 h, with apparent extensive processing occurring thereafter. To this point, no differences were seen between anterior pituitary and hypothalamic responses. If animals were administered progesterone (0.8 mg/kg BW) at the 12-h peak interval, subsequent nuclear accumulation of anterior pituitary estrogen receptor by an injection of estradiol was suppressed if, and only if, the interval between progesterone and estradiol injection did not exceed 2 h; at no time interval did progesterone have an effect in the hypothalamus. In both tissues, estradiol readministration at 12 h after an initial injection stimulates a second wave of progesterone receptor activity, again peaking 12 h later. A single injection of progesterone 1 h before the second estradiol administration blocks the second peak of progesterone receptor in the anterior pituitary, but not in the hypothalamus. If the interval between the progesterone and second estradiol injections is extended to 4 h, the second progesterone receptor peak appears as though no progesterone had been introduced. The results indicate a critical temporal reliance of the inhibitory effects of progesterone on estrogen receptor activity and estrogen function in a well defined animal model. The effect is progesterone receptor-mediated and is manifested in the anterior pituitary, but not in the hypothalamus, even though the kinetics of estrogen-induced progesterone receptor activity are indistinguishable between the two tissues.

Salpingitis associated with the presence of nonmedicated IUDs.

Fallopian tube tissue obtained at Pomeroy sterilization of 75 normally cycling women, 75 women 2 to 3 days postpartum, and 75 asymptomatic women who had used a nonmedicated IUD for at least a year was examined histologically. There was an increased frequency of tissue edema and congestion in the postpartum group only. The frequency and extent of acute inflammatory changes in the three groups was not significantly different.

PIP: The histology of the Fallopian tubes in asymptomatic women using an IUD for at least 1 year was studied, using asymptomatic postpartum women and normally menstruating women scheduled for Pomeroy sterilization as controls. 225 patients, 75 with inert IUD in place, 75 undergoing salpingectomy 2-3 days after delivery, and 75 normally menstruating women undergoing elective salpingectomy, provided tissue samples. There was no difference in the frequency of edema and congestion in tissue of control vs. those with an IUD (P .05); on the other hand, the higher frequency of this alteration in postpartum subjects was statistically significant (P .02). The frequency of acute inflammatory infiltrate ranged from 29 in controls-37% in IUD subjects, but these differences were not statistically significant (P .05). The distribution of patchy, moderate, or marked acute inflammatory infiltrate was 68, 27, and 4.5%, respectively, in the control group. There was no statistically significant difference between this distribution and that observed in the IUD or postpartum subjects.

Ovarian morphologyy after prolonged use of steroid contraceptive agents.

PIP: To assess the effect of oral contraceptives on ovarian morphology, 125 users (average age 30) and 42 controls (average age 24) were studied histologically. The duration of the steroid treatment in the 125 subjects varied from 2 to 91 months. 60 used combination oral contraceptives, 28 used sequential, 21 received depot progestins, and 16 used continuous low dose progestin. Investigation was directed to the presence or absence of the various ovarian structures. In all specimens primary follicles were seen. Women using combined and depot progestins showed disturbance in the secondary follicles development. Tertiary follicles were common in the low dose progestin, occurring occasionally with sequential and combination treatment, and never with depot progestin. Ovaries from steroid treated patients appeared to have a large number of atretic follicles with cystic dilatations. An increase in ovarian connective tissue occurred in half of the cases using combined preparations, one third of those using sequential, and almost all of those using depot progestin.^ieng