Study of TiO2/Ti4O7 photo-anodes inserted in an activated carbon packed bed cathode: Towards the development of 3D-type photo-electro-Fenton reactors for water treatment.

In this work, commercially available Polymethyl-meta-acrylate (PMMA) spectroscopy cells were modified on the external walls with films of TiO2, Ti4O7 or TiO2/Ti4O7 mixtures. Film characterization was carried out using SEM and UV-vis spectroscopy. The results of photocatalytic (PC), electro-oxidation (EO), and photoelectrochemical (PEC) experiments on the decolorization of a methyl orange (MO) model dye solution showed that while anatase provides better photocatalytic properties and the partially reduced Ti4O7 larger electronic conductivity, the TiO2/Ti4O7 composite film behaves as a semiconductor substrate that combines the advantages of both materials (for PEC experiments for instance, decolorization values for the model dye solution using TiO2, Ti4O7 and a TiO2/Ti4O7 mixed film, corresponded to 35%, 46% and 53%, respectively). In order to test this film as an effective photoanode material in a 3-D type reactor for water treatment processes, a TiO2/Ti4O7 modified PMMA spectroscopy cell was inserted in an activated carbon (AC) bed so that the semiconductor material could be illuminated using an external UV source positioned inside the PMMA cell. The connected AC particles that were previously saturated with MO dye were used as cathode sites for the oxygen reduction reaction so that the photoelectrochemical reactions that take place in the anode could be complemented with coupled electro-Fenton processes in the cathode. As expected, the combination resulted in an effective decolorization of the dye solution that results from a complex combination of processes. The experimental decolorization data was successfully fitted to a pseudo-first order kinetic model so that a deeper understanding of the contribution of each process in the reactor could be obtained.

Is Segmental Colon Resection an Alternative Treatment for Splenic Flexure Cancer?

Background: Optimal elective surgery for splenic flexure cancer is unclear. Three types of surgical treatment methods are commonly used, subtotal colectomy (STC), left hemicolectomy (LHC), and segmental colon resection (SCR), but consensus is lacking as to which is the optimal method. Materials and Methods: We retrospectively compared clinicopathological and operative results, morbidity, mortality, and long-term survival in patients with splenic flexure cancer who underwent surgery between 1998 and 2018. Results: The study included 124 patients in the study. Following retrospective evaluation of the database, patients were classified into one of three groups according to the surgical approach: (1) STC (n: 41), (2) LHC (n: 55), and (3) SCR (n: 28). No statistically significant differences were found between groups regarding operative results, hospital stay, pathological data, mortality, recurrence, or long-term survival outcomes. Conclusion: Our results suggest that surgical procedures such as STC and LHC have no statistically significant clinical benefits over less aggressive approaches such as SCR. We thus conclude that SCR seems both a safe and effective alternative for splenic flexure tumors.

Influence of pretreatments on oil absorption of plantain and cassava chips.

The objective was to evaluate the effect of pretreatments of CaCl2 and osmotic dehydration (OD) on oil absorption in plantain and cassava chips. Plantain and cassava slices (1 mm thickness and 35 mm diameter) were prepared. Pretreatment with and without 5% CaCl2 solution before applying OD with sucrose solutions at 30 and 45%, and NaCl at 3 and 6% in a product/solution ratio of 1:25, at 40 °C were employed. OD kinetics and diffusivity were estimated by Page's model and Fick's law, respectively. Best OD treatments for plantain chips were 45% sucrose with CaCl2 and 6% NaCl without CaCl2. However, for cassava chips, the best OD treatments were 45% sucrose without CaCl2 and 3% NaCl with CaCl2. Page's model predicted the OD experimental results with an R2 = 0.94-0.97. Effective diffusivity of water (EDW) and effective diffusivity of solids (EDS) for osmo-dehydrated cassava samples, with and without CaCl2, decreased as the concentration of the osmotic solutions was increased. However, in general, the inverse effect was obtained for plantain samples for EDW and EDS. Use of CaCl2 when applying OD reduced EDW and EDS in plantain and cassava chips. In general, it was observed that when increasing the concentration of the osmotic solution, oil absorption capacity decreased. Treatments that showed the lowest oil absorption were 45% sucrose OD in plantain chips pretreated with CaCl2 (11.49%) and fresh cassava chips with 45% sucrose OD (10.72%). The results and effectiveness will depend on food, process conditions and type of osmotic agent.

Optimization and characterization of an extruded snack based on taro flour (Colocasia esculenta L.) enriched with mango pulp (Mangifera indica L.).

The aim of this study was to optimize and characterize an extruded snack made with taro flour and mango pulp. A central experimental design composed of the following three variables was used: mango pulp proportion (MPP = 0-10 g/100 g) in taro flour, feed moisture content (FMC = 16-30 g/100 g) and extrusion temperature (zone 4 of extruder) (T = 80-150 °C) using a single-screw extruder with a compression screw ratio of 3:1. Increasing FMC values decreased the torque, pressure, specific mechanical energy (SME), expansion index (EI), water solubility index and pH values and increased the residence time, bulk density (BD), hardness and total colour difference. Increasing T values led to a decrease in the torque, pressure, BD and hardness values, while increasing MPP values only caused a significant increase in the hardness values and ß-carotene content and a decrease in the pressure value. The optimal extrusion conditions were T = 135.81 °C, FMC = 18.84 g/100 g and MPP = 7.97 g/100 g, with a desirability value of 0.772, to obtain a snack with EI = 1.52, BD = 0.66 g/cm3, hardness = 24.48 N, ß-carotene content = 99.1 µg/g and SME = 428.54 J/g. The mango pulp is an available and economical source of ß-carotene for the enrichment of extruded expanded taro snacks.

Effect of enzymatic pretreatment on the physical quality of plantain (Musa ssp., group AAB) employing airflow reversal drying.

This work aimed to evaluate the effect of enzymatic pretreatment on the color and texture of plantain (Musa ssp., group AAB) dried by airflow reversal drying. Plantain slices 1.0 cm thick were used. Pretreatment with two commercial enzymes, Pectinex Ultra SPL (Aspergillus aculeatus) and Pectinex 3XL (Aspergillus niger), was performed. Drying kinetics were determined with and without pretreatment at temperatures of 50, 65 and 80 °C using a fixed bed convective dryer. An air speed of 6 m/s, a bed height of 5 cm and either unidirectional flow or airflow reversal (every 15 min) were used for drying. Color and texture were analyzed, and consumer acceptance of the results of the best treatments was determined. Pretreatment with the enzyme A. niger and airflow reversal gave the best drying kinetics and showed the greatest reduction in drying time (59.0%) at 80 °C. The best hardness results were found at 80 °C with A. niger enzymatic pretreatment with both types of air flow. Brightness and hue angle showed that samples pretreated with enzymes and dried at 65 °C had a lighter yellow color compared to non-pretreated samples. Plantain samples enzymatically pretreated and dried at 65 and 80 °C were the most accepted by consumers. This kind of enzymatic pretreatment on plantain could allow the conservation of some physical properties and reduction of drying times relative to the current methodology.

Neumoconiosis por aglomerados de cuarzo: hallazgo de autopsia en un suicidio / Pneumoconiosis quartz agglomerates: autopsy finding of suicide

La silicosis sigue siendo un problema de salud actual renovado por al aumento en la demanda del uso en el hogar de encimeras de aglomerados de cuarzo en nuestro país. Dichas encimeras contienen cuarzo (sílice cristalina), provocando que dicho polvo inorgánico dé lugar a su depósito en el intersticio pulmonar de los trabajadores que no realicen las medidas de protección adecuadas en el ámbito laboral. Es trabajo de las empresas encargadas de la prevención de riesgos laborales la información de la problemática futura en la salud de aquellos que no opten por utilizar los medios de prevención, así como responsabilidad directa de los encargados de dichas empresas facilitar el material y los medios adecuados para llevarlas a cabo. Presentamos el caso de un varón cuya autopsia reveló el hallazgo casual de neumoconiosis por sílice, confirmándose con posterioridad en la entrevista con la familia que desempeñaba su trabajo en una empresa de mármol artificial y la producción de una enfermedad profesional (AU)

Silicosis is still a current health problem by the renewed increase in demand for use in the home countertops quartz agglomerates in Spain. These countertops contain quartz (crystalline silica), causing said inorganic powder from place to deposit in the lung interstitium of workers not performing the appropriate protection measures in the workplace. It is a work of the companies in charge of the prevention of labor risks the information of the future problematics in the health of those that they do not choose to use the means of prevention as well as direct responsibility of the managers of the above mentioned companies of facilitating the material and the means adapted to carry out them. We report the case of a man whose autopsy revealed the incidental finding of pneumoconiosis silica, confirming later in the interview with the family who held his job at a company producing artificial marble and an occupational disease (AU)

Preparation of betulinic acid nanoemulsions stabilized by ω-3 enriched phosphatidylcholine.

Bioactive compounds such as ω-3 fatty acids and terpenes, have been associated with beneficial health effects; however, their solubility in the gastrointestinal tract and its bioavailability in the body are low. Nanoemulsions offer a viable alternative to disperse lipophilic compounds and improve their dissolution, permeation, absorption and bioavailability. Enzyme modified phosphatidylcholine (PC) with ω-3 fatty acids was used as emulsifier to stabilize oil-in-water nanoemulsions generated using ultrasound device. These systems were used as carriers of betulinic acid, which has reported anti-carcinogenic activity. Phospholipase-catalyzed modification of PC allowed the incorporation of 50 mol% of ω-3 fatty acids. Formation variables such as oil type and ultrasound amplitude had effects on nanoemulsion characteristics. Incorporation of betulinic acid affected globule size; however, betulinic acid nanoemulsions below 200 nm could be prepared. The conditions under which betulinic acid nanoemulsions were obtained using the modified phosphatidylcholine with the smaller globule size (91 nm) were 10% PC, 25% glycerol, medium chain oil and 30% amplitude for 12 min in the sonicator. Storage temperature had an effect on the stability of the nanoemulsions, at 5°C we observed the smallest growth in globule size. The use of olive oil decreased the globule size growth during storage of the nanoemulsion stabilized with modified phosphatidylcholine, although globule size obtained was greater than 200 nm. Medium pH had a significant effect on the nanoemulsions; alkaline pH values improved storage stability. These results provide useful information for using this type of carrier system on the formulation of products in the pharmaceutical or food industry.

Estudio retrospectivo de pilomatricomas: 261 tumores en 239 pacientes / Retrospective Study of Pilomatricoma: 261 Tumors in 239 Patients

INTRODUCCIÓN Y OBJETIVOS: El pilomatricoma es la segunda neoformación cutánea más frecuente en la infancia y la juventud, con un amplio diagnóstico diferencial. El objetivo principal del estudio fue determinar la incidencia de pilomatricomas en nuestro hospital y sus características en relación con: edad, sexo, localización, síntomas, traumatismo previo, diagnóstico clínico, enfermedades asociadas, casos múltiples, características ecográficas, tratamiento quirúrgico y técnica anestésica y complicaciones posteriores. MATERIAL Y MÉTODO: Se recogieron de forma retrospectiva los pilomatricomas extirpados quirúrgicamente en nuestro hospital de enero de 2004 a diciembre de 2012 a partir de la base de datos de anatomía patológica. RESULTADOS: Se estudiaron 261 pilomatricomas en 239 pacientes, 120 eran mujeres y 119 varones de edades comprendidas entre 1 y 83 años, con una media de 26,4 años. La forma de presentación más frecuente fue como un nódulo firme, subcutáneo, asintomático en el 82% de los casos. La localización más frecuente fue la cabeza y el cuello (49,81%). El diagnóstico clínico preoperatorio fue acertado en el 54,4%. Cincuenta y nueve pacientes tenían otras enfermedades y 7 recordaban traumatismo previo en la zona. Se registraron 17 casos múltiples, uno familiar, y 2 en pacientes con enfermedad de Steinert. En 57 lesiones se realizó ecografía de partes blandas, con imágenes compatibles con pilomatricoma en 48. Ciento ochenta y cinco pilomatricomas se extirparon con anestesia local y 76 con anestesia local y general. Como complicaciones posquirúrgicas hubo un caso de cicatriz hipertrófica y otro de dehiscencia. CONCLUSIONES: El nuestro es el estudio retrospectivo que recoge el mayor número de casos en nuestro país y uno de los que comunica mayor incidencia de casos. Además, se estudian variables no recogidas en otras series

BACKGROUND AND OBJECTIVES: Pilomatricoma is the second most common skin tumor in childhood and youth and it has a broad differential diagnosis. The main objective of the present study was to determine the incidence of pilomatricomas in our hospital and to analyze the following variables: patient age and sex, tumor site, symptoms, previous trauma, clinical diagnosis, associated diseases, number of cases of multiple tumors, ultrasound findings, anesthetic and surgical techniques, and postoperative complications. MATERIAL AND METHOD: This was a retrospective study of the pilomatricomas surgically excised between January 2004 and December 2012 and registered in the database of the pathology department of our hospital. RESULTS: We found 261 pilomatricomas in 239 patients (120 female and 119 male) between 1 and 83 years of age (mean age, 26.4 years). The most common presentation was as a firm subcutaneous nodule, which was asymptomatic in 82% of cases. Tumors most commonly affected the head and neck (49.81%). Preoperative diagnosis was correct in 54.4% of cases, concomitant diseases were present in 59 cases, and 7 patients reported a history of trauma in the area of the tumor. There were 17 cases of multiple tumors, 1 case in a patient with familial disease and 2 in patients with Steinert disease. Soft-tissue ultrasound was performed on 57 lesions; images were compatible with pilomatricoma in 48 cases. Tumor excision was performed under local anesthesia in 185 cases and under local and general anesthesia in 76. The postoperative complications were hypertrophic scarring and wound dehiscence (1 case each). CONCLUSIONS: This was a retrospective study with the largest series recorded in Spain and with one of the highest incidences. In addition, we report on variables not described in other studies

Retrospective study of pilomatricoma: 261 tumors in 239 patients.

INTRODUCTION AND OBJECTIVES: Pilomatricoma is the second most common skin tumor in childhood and youth and it has a broad differential diagnosis. The main objective of the present study was to determine the incidence of pilomatricomas in our hospital and to analyze the following variables: patient age and sex, tumor site, symptoms, previous trauma, clinical diagnosis, associated diseases, number of cases of multiple tumors, ultrasound findings, anesthetic and surgical techniques, and postoperative complications. MATERIAL AND METHOD: This was a retrospective study of the pilomatricomas surgically excised between January 2004 and December 2012 and registered in the database of the pathology department of our hospital. RESULTS: We found 261 pilomatricomas in 239 patients (120 female and 119 male) between 1 and 83 years of age (mean age, 26.4 years). The most common presentation was as a firm subcutaneous nodule, which was asymptomatic in 82% of cases. Tumors most commonly affected the head and neck (49.81%). Preoperative diagnosis was correct in 54.4% of cases, concomitant diseases were present in 59 cases, and 7 patients reported a history of trauma in the area of the tumor. There were 17 cases of multiple tumors, 1 case in a patient with familial disease and 2 in patients with Steinert disease. Soft-tissue ultrasound was performed on 57 lesions; images were compatible with pilomatricoma in 48 cases. Tumor excision was performed under local anesthesia in 185 cases and under local and general anesthesia in 76. The postoperative complications were hypertrophic scarring and wound dehiscence (1 case each). CONCLUSIONS: This was a retrospective study with the largest series recorded in Spain and with one of the highest incidences. In addition, we report on variables not described in other studies.

Network efficient power control for wireless communication systems.

We introduce a two-loop power control that allows an efficient use of the overall power resources for commercial wireless networks based on cross-layer optimization. This approach maximizes the network's utility in the outer-loop as a function of the averaged signal to interference-plus-noise ratio (SINR) by considering adaptively the changes in the network characteristics. For this purpose, the concavity property of the utility function was verified with respect to the SINR, and an iterative search was proposed with guaranteed convergence. In addition, the outer-loop is in charge of selecting the detector that minimizes the overall power consumption (transmission and detection). Next the inner-loop implements a feedback power control in order to achieve the optimal SINR in the transmissions despite channel variations and roundtrip delays. In our proposal, the utility maximization process and detector selection and feedback power control are decoupled problems, and as a result, these strategies are implemented at two different time scales in the two-loop framework. Simulation results show that substantial utility gains may be achieved by improving the power management in the wireless network.

[Pharmacologic reperfusion in acute myocardial infarction]. / Reperfusión farmacológica en el infarto agudo del miocardio.

Reperfusion therapy is fundamental in the treatment of the acute myocardial infarct and can be accomplished either through pharmacological methods or through direct angioplasty. Undoubtedly, pharmacological reperfusion is the most available and it has modified the natural history of the acute myocardial infarct. Reperfusion therapy must be as dynamic and multifactorial as the physiopathology per se of the acute myocardial infarct. Reperfusion is defined as: to reestablish blood flow after an obstruction has been caused and to be useful it must be close to normal both in the epicardial and transmyocardial vessels.

[Influence of the pericardium in the pathophysiology of ventricular dysfunction in acute infarct of the right ventricle. Experimental study] . / La influencia del pericardio en la patofisiología de la disfunción ventricular en el infarto agudo del ventrículo derecho. Estudio experimental.

UNLABELLED: To obtain more information about the role of the pericardium in the setting of acute right ventricular infarction (ARVI) we studied the behaviour of the ventricular function curves (VFC) and the relationship of the ventricular end-diastolic pressures (R-VEDP-RV:LV) in two groups of dogs. Group A. (n = 12) Control (C), ARVI, Pericardiectomy (P). A parabolic behaviour of the C VFC was noted (r2 = 071) and it's flexion point (FP) was found in 13. +/- 2 mmHg. After the ARVI the right (R) VFC was shifted downwards and to the right and the FP was documented in 18 +/- 2 mmHg (p < 0.05) in relation to C VFC. After P the RVFC was displaced upwards and to the left in relation to ARVIC RVFC (p < 0.05). The C R-VEDP-RV:LV = 0.75 and only a trend to equalization after the ARVI and after P were noted (0.91, 0.84, respectively) (p = ns). Group B (n = 12). Control (C), P, ARVI. The RVFC after P was shifted up and to the left in relation to the C RVFC (p < 0.05) and the FP = 10 +/- 2 mmHg. After P in the setting of ARVI the RVFC was shifted downward and to the right in relation to P RVFC (p < 0.05). After P the R-VEDP-RV:LV = 0.45 and statistical significant equalized in the condition of ARVI without pericardium (0.95, p < 0.05). CONCLUSION: Ours results support a partial restrictive role of the pericardium in the origin of the low cardiac output (LCO) in ARVI. Because, equalization of the R-VEDP-RV:LV is not only due to the restraining pericardial effect but is also due to right ventricular myocardial ischemia. The FP (18. +/- 2 mmHg) found seems to be the top value of RVEDP for volume infusion in experimental ARVI. Hemodynamic finding that could be useful in the preload volume management for humans with ARVI and LCO or systemic hypotension.

[Ventricular function curves with and without pericardium: analysis of pericardial pressures]. / Las curvas de función ventricular con y sin pericardio: análisis de las presiones pericárdicas.

Simultaneous right and left ventricular function curves (VFC, R, L) were obtained in a canine model, (open chest preparation), with and without pericardium. Preload and afterload conditions for the right and left ventricles were controlled. VFC were constructed from zero to 25 mmHg of ventricular end-diastolic pressures and by increasing the cardiac output from 50 to 250 mL/kg-1min-1. Both, right and left VFC showed an initial steep rise at low filling pressures and then flattened off to a plateau at high filling pressures. The best mathematical model that fitted with the VFC, with and without the pericardium was the parabola (r2 = 0.71, 0.72 respectively). After pericardiectomy R and L VFC were displaced to the left of the VFC with pericardium and a decrease in filling pressures were noted at the same points of cardiac output, findings that suggest a restraining effect of the pericardium. By subtracting the filling pressures obtained with pericardium from those without pericardium at the same levels of cardiac output, pericardial pressures were derived. In all the range of the VFC the pericardial pressures were positive, and this pressure increase as cardiac output increase. Thus the transmural pressure was never cero, for both right and left ventricles. The observed relation for the R and L filling pressures, derived from a polynomial equation of second order suggest a small although not unimportant effect of the pericardium at normal filling pressures, and a very substantial influence at high levels of cardiac output. The demarcation between small and major effects appears in the upper range of normal filling pressures in this dynamic approach of the pericardial pressures.

[Comparative analysis of reperfusion time in primary angioplasty vs thrombolysis. Success vs time]. / Análisis del tiempo de reperfusión entre angioplastía primaria y trombolisis: éxito vs tiempo.

UNLABELLED: We studied 398 patients with diagnosis of acute myocardial infarction who arrived within the first six hours of symptom onset that were treated with thrombolysis or primary angioplasty, they were divided in two groups: Group 1 (n = 198), those treated with 1.5 million U of streptokinase over 60 min and Group 2 (n = 200), those treated with primary angioplasty. In Group 1 the "pain-door" time was 3.7 +/- 1.7 hs vs 3.8 +/- 2.4 hs in group 2 (p = NS). The "door-needle" time was 48 +/- 12 min. compared with the "door-balloon" time of 84 +/- 30 min (p < 0.001). In Group 1, 154 (77.6%) of the patients had clinical of reperfusion after thrombolysis, 58 of them underwent coronary angiography and had an infarct related artery (IRA) patency rate of 45.3%. In Group 2 the IRA patency rate was 85.5% (p < 0.005). CONCLUSION: Thrombolysis was achieved in a lesser period of time but our findings showed that primary angioplasty was more effective obtaining a TIMI 3 flow.

[Myths, prejudices and reality about dental treatment during pregnancy. A medical opinion]. / Mitos, prejuicios y realidades del tratamiento odontológico durante el embarazo. Opinión médica.

The education and assistance strategies aimed al preserving oral health must play an important role in the overall care of the pregnant woman. It has been demonstrated that there are beliefs and practices in our culture that relegate, odontologic care in this stage, where attitudes and behaviors on the health-disease process are influenced by the prevailing medical culture, which includes the physician's opinion. The objective was To obtain the physician's opinion on the odontologic care during pregnancy. A previously validate survey which included 15 questions, was applied to a randomly selected sample of 700 physicians. Of the 650 surveys analyzed, 57% were applied to general practitioners, 24% to gynecologists and obstetrician, and 19% to other medical specialist regularly consulted by women during their prenatal care. There is low referral of pregnant women to the regularly check their patients teeth of gums 53% physicians said that the odontologist did not need to consult them about dental treatment, while 593 thought otherwise, 362 surveyed practitioners point out the convenience of using the lead apron when taking periapical x-ray. These results point out the importance of establishing a good communication channel between the physician and dentist. It is clear that there is a lack of truth in the oral health specialist's ability to provide treatment to pregnant patients, and that the physician ignores many of the odontological procedures and their low risk.

[The utility of rapid qualitative determination of troponin T, the MB fraction of creatine phosphokinase and myoglobin in acute ischemic coronary syndromes]. / Utilidad de la determinación cualitativa rápida de troponina-T, fracción MB de creatina fosfocinasa y mioglobina en los síndromes isquémicos coronarios agudos.

The objective of our study was to validate the diagnostic utility of cardiac troponine T in acute ischemic syndromes, and also in cases of difficult diagnosis. We analyzed its concordance and compare them with conventional enzymatic quantitative methods. We determined sensitivity, specificity, positive and negative predictive values and likelihood ratio. Kappa index was used to know the concordance grade between T troponin and the positive or negative results of the quantitative enzymatic curve. Stochastic significance was valued by Chi square of Mcnemar test. In seventy patients who arrived to the hospital with chest pain who were assigned to five different groups. The sensitivity in quantitative markers was higher than qualitative methods, however the specificity, likelihood ratio was lower. In the total group the concordance analysis between qualitative and quantitative markers was adequate, (kappa index 0.65 p < 0.05). This study suggest that the rapid bedside qualitative test by cardiac Troponin T is a good diagnostic marker compared with conventional quantitative markers to evaluate chest pain in acute ischemic syndromes.

[Late thrombolysis and electrical stability in acute myocardial infarction. Role of the collateral flow]. / Trombolisis tardía y estabilidad eléctrica en el infarto agudo del miocardio: importancia del flujo colateral.

We evaluated 249 patients (pts) with first acute myocardial infarction: 1. Pts without thrombolysis, n = 119, 2. Pts treated with thrombolysis within 6 hours following MI, n = 80 and 3. Pts treated with thrombolysis between 6-12 hours after MI. Arrhythmic events were evaluated during follow up. All underwent heart rate variability studies and coronary angiogram where anterograde flow (TIMI) and collateral flow (Rentrop scale 0-2 = poor collateral flow and 3 = good collateral flow) were determined. Pts in group 2 and 3 showed a better anterograde and collateral flow than group 1 (p < 0.001). A lower spectral power in the high frequency band and a higher ratio low/high frequency band were observed in group 1 (p < 0.05). Conjunctive consolidation analysis showed more malignant arrhythmias in TIMI 0-2 with poor collateral flow than TIMI 0-2 with good collateral flow (17/138-12.3% vs 0/14-0%). Kaplan Meier analysis was able to demonstrate more cardiac sudden death events in TIMI 0-2 with poor collateral flow than TIMI 0-2 with good collateral flow or TIMI 3 (x2 = 7.22, p = 0.028), independently of thrombolytic treatment.

[Results of treatment of acute myocardial infarction with thrombolytic therapy. Experiences in 437 patients in the coronary care unit of the National Institute of Cardiology "Ignacio Chavez"]. / Resultados del enfermo con infarto agudo del miocardio con terapia trombolítica. Experiencia en 473 enfermos de la unidad coronaria del instituto nacional de cardiología ignacio chávez.

OBJECTIVE: To review the results and complications of thrombolysis in patients with acute myocardial infarction (AMI) and its complications. METHODS: Since june 1989 to august 1994 we studied patients with AMI, who underwent thrombolysis. Clinical characteristics, complications and angiographic results are described. RESULTS: Of the total population 86.3% patients received Streptokinase (SK) and 13.7% recombinant tissue plasminogen activator (rt-PA). In 20 patients the age was under 40 years, 373 between 40-70 years, and 80 patients over 70 years. 84% were men and 16% women. 72% had smoking habit; 21% diabetes mellitus, 43% hypertension, 54% had previous angina and previous AMI in 22%. The location of AMI was anterior in 234 patients and 239 inferior. In 63% enzyme washout was observed, and rapid electrocardiographic evolution in 81%. Postthrombolisis arrhythmias was observed in 64.7%. Major bleeding in 11.8% and central nervous system hemorrhage in 0.4% only with rt-PA. Postinfarction angina in 22%, and re-infarction in 4%. Cardiac rupture in 1.4%, with shock and death. Mitral insufficiency in 2.1% demonstrated by echocardiogram. Coronary angiography was done in 373 patients (80%), of which 50.7% was made in the first 5 days. The culprit artery was anterior descending in 273 patients and right coronary in 95. Left ventricular dysfunction was seen in 23% in patients with anterior AMI, and 5% with inferior AMI. Cardiogenic shock was seen in 7%. Coronary artery bypass grafting was undertaken in 106 patients and coronary angioplasty in 67. The ten days mortality was 8.8%, principally due to cardiogenic shock, ventricular arrhythmias and ventricular rupture. CONCLUSIONS: The usefull permeability in the culprit artery was obtained in 40%, who had coronary angiography done 145 hours posthrombolysis. Mortality was under 10% in this study.

[Analysis of reperfusion by thrombolysis of the artery responsible for acute myocardial infarction]. / Análisis de la permeabilidad por trombolisis de la arteria responsable de infarto miocárdico agudo.

OBJECTIVE: To analyze the role of the culprit coronary artery in myocardial infarction, its evolution and mortality. And to correlate with clinical criteria of reperfussion. MATERIALS AND METHODS: We included patients with clinical diagnosis of acute myocardial infarction (MI) treated with thrombolytic therapy, and coronariography. We used the TIMI study angiographic scale to evaluate the level of permeability of the culprit artery. RESULTS: Of 473 patients with of acute MI; coronariography was made in 377. The most frequent culprit vessel was anterior descending artery in 168 patients (45%) and right coronary artery in 139 patients (36%). In 276 patients the culprit vessel was permeable (73%). Of them in 30 patients, had TIMI 1 alterations, TIMI 2 in 97 patients, had TIMI 3 in 148 patients, only 102 patients had TIMI 0. In anterior MI the most frequent reperfussion arrhythmia was ventricular ectopic beats followed by slow ventricular tachycardia and ventricular tachycardia in 54%, ventricular fibrillation was observed only in six patients, of whom TIMI scale was 2 and 3 in five patients. In inferior MI, ventricular ectopic beats and slow ventricular tachycardia was seen in 25% of patients. In patients with permeable culprit artery we observed significant depression of ST segment, (159 patients, 42%), and significant increase in CK-MB levels, seen in 191 patients (51%). In the group of patients with total occlusion of the culprit artery, twenty-one (30%) had left ventricular disfuntion, and only six of them were in cardiogenic shock. In the group of patients with permeable culprit artery only two percent had cardiogenic shock. Therefore the analysis of the clinical evolution is the maia marker to take into consideration to send patients to early coronary arteriography with the objective to look for other therapeutic alternatives.