Early Feeding versus Traditional Feeding in Children with Ileostomy Closure.

Context: Elective intestinal anastomosis is a frequently used surgical procedure in pediatric surgery. Aims: This study aimed to compare postoperative complications and hospital stay in children who underwent ileostomy closure with early feeding in the 1st 24 h versus those in whom the oral route was initiated traditionally. Settings and Design: Observational, comparative, cross-sectional, ambispective, and single-center study that included pediatric patients who had undergone ileostomy closure from January 2017 to August 2019. Materials and Methods: Data were analyzed in SPSS. Statistical analysis was used: the variables were analyzed using the Chi-square test or Fisher's exact test when the former could not be applied. Results: They were divided into the following two groups: group 1 included patients who started the oral route early (n = 25) and Group 2 included patients who started the oral route late (n = 20). The average in-hospital stay for Group 1 was 5.48 days and that for Group 2 was 8.35 days. In Group 1, the oral route was started with a mean of 9.32 h and in Group 2 at 146.4 h. Those in Group 1 at 32.9 h presented their first evacuation and Group 2 at 131.45 h. Group 1 reached their normal diet on average at 79.96 h and Group 2 at 172.8 h. Conclusions: This comparison between early oral feeding and traditional oral feeding suggests that various benefits exist when enteral nutrition is initiated early after ileostomy closure in pediatric patients. The benefits and importance of initiating early oral feeding in adults have been reported, but there are few studies on pediatric populations.

Sensibilidad y especificidad del índice neutrófilo/linfocito en pacientes pediátricos con apendicitis aguda complicada.

OBJECTIVE: Establish the sensibility and specificity of the neutrophil-lymphocyte rate (NLR) in pediatric patients with acute complicated appendicitis. METHOD: Transversal, observational, descriptive, and retrospective study of pediatric patients between 4 to 16 years old with diagnosis of acute appendicitis, who had appendectomy, from December 2017 to January 2019. We calculated the NLR in every patient. To analyze the variables, we used the test of Mann-Whitney and we value the sensibility and specificity of the NLR. RESULTS: There were 245 patients, 81 with simple appendicitis and 144 with complicated appendicitis. Just 27 of them were laparoscopic appendectomy. The NLR had a media of 10.48 in simple appendicitis, and 13.03 in complicated ones, with a p value of 0.02. the area under the curve was 0.622. There was a rate of 8.2 in complicated appendicitis to the NLR. CONCLUSIONS: The NLR has been poorly studied in pediatric patients with acute appendicitis. In this study the NLR had a significant value in the patients with acute complicated appendicitis, with medium sensibility and a relatively low specificity.

OBJETIVO: Determinar la sensibilidad y la especificidad del índice neutrófilo/linfocito (INL) en pacientes pediátricos con apendicitis aguda complicada. MÉTODO: Estudio transversal, observacional, descriptivo y retrospectivo. Se seleccionaron pacientes de 4 a 16 años con diagnóstico de apendicitis aguda a quienes se realizó apendicectomía de enero 2017 a diciembre 2019. Se calculó el INL de cada paciente. Para analizar las variables se utilizó la prueba de Mann-Whitney y se valoraron la sensibilidad y la especificidad del INL. RESULTADOS: Se estudiaron 245 pacientes, 81 con apendicitis simple y 144 con apendicitis complicada. Se realizaron 27 apendicectomías laparoscópicas. El INL tuvo una media de 10.48 en la apendicitis simple y de 13.03 en la complicada (p = 0.02). Con un área bajo la curva de 0.622 se estimó un punto de corte para el INL de 8.2 en los pacientes con apendicitis complicada. CONCLUSIONES: El INL ha sido poco estudiado en pacientes pediátricos con apendicitis aguda. En el presente estudio, el INL resultó con valor significativo en los casos de apendicitis aguda complicada en pacientes pediátricos, con sensibilidad intermedia y especificidad relativamente baja.

Experiencia inicial del cierre sin sutura de la gastrosquisis. Reporte de casos en un hospital de la ciudad de Puebla, México / Initial experience of the sutureless closure of gastroschisis. Report of cases in a hospital in the city of Puebla, México

Resumen Introducción: La gastrosquisis es una de las malformaciones congénitas más frecuentes. En países subdesarrollados su mortalidad es mayor al 15% siendo la sepsis su principal causa. Su manejo implica el cierre de la pared abdominal mediante diferentes métodos, dependiendo del nivel de complejidad y del tipo de intervención. Objetivo: Describir la experiencia inicial del cierre sin sutura de la gastrosquisis, en una unidad de neonatología de Puebla, México. Materiales y métodos: Se realizó un estudio observacional, descriptivo, transversal y retrospectivo; en el cual se estudiaron 9 expedientes de recién nacidos con cierre sin sutura de gastrosquisis, en el Hospital General del Sur de Puebla. Resultados: Se estudiaron a los pacientes de Diciembre 2018 a Agosto 2019, de los cuales el 56% correspondía al sexo masculino. Se dividieron en 3 grupos: Cierre inmediatamente posterior a la cesárea (67%), retardo inmediato (11%), y retardo con uso del separador Alexis (22%). De los pacientes, el promedio fue de 25.67 + 1.56 días de estancia intrahospitalaria. Únicamente un paciente del grupo 2 presentó como complicación sepsis, el resto no manifestó complicación alguna. Conclusiones: El cierre sin sutura en nuestros pacientes resultó ser un procedimiento confiable y con buen pronóstico para su evolución, debido a resultados favorables en los días de estancia intrahospitalaria y el tiempo de inicio de la vía oral. MÉD.UIS.2020;33(3): 43-7.

Abstract Introducción: La gastrosquisis es una de las malformaciones congénitas más frecuentes. En países subdesarrollados su mortalidad es mayor al 15% siendo la sepsis su principal causa. Su manejo implica el cierre de la pared abdominal mediante diferentes métodos, dependiendo del nivel de complejidad y del tipo de intervención. Objetivo: Describir la experiencia inicial del cierre sin sutura de la gastrosquisis, en una unidad de neonatología de Puebla, México. Materiales y métodos: Se realizó un estudio observacional, descriptivo, transversal y retrospectivo; en el cual se estudiaron 9 expedientes de recién nacidos con cierre sin sutura de gastrosquisis, en el Hospital General del Sur de Puebla. Resultados: Se estudiaron a los pacientes de Diciembre 2018 a Agosto 2019, de los cuales el 56% correspondía al sexo masculino. Se dividieron en 3 grupos: Cierre inmediatamente posterior a la cesárea (67%), retardo inmediato (11%), y retardo con uso del separador Alexis (22%). De los pacientes, el promedio fue de 25.67 + 1.56 días de estancia intrahospitalaria. Únicamente un paciente del grupo 2 presentó como complicación sepsis, el resto no manifestó complicación alguna. Conclusiones: El cierre sin sutura en nuestros pacientes resultó ser un procedimiento confiable y con buen pronóstico para su evolución, debido a resultados favorables en los días de estancia intrahospitalaria y el tiempo de inicio de la vía oral. MÉD.UIS.2020;33(3): 43-7.

Creatina fosfocinasa MB como marcador diagnóstico de disfunción miocárdica en pacientes pediátricos con quemadura eléctrica / Creatine phosphokinase MB levels as a diagnostic marker of myocardial dysfunction in pediatric patients with electrical burns

Resumen Introducción: La disminución de la fracción de eyección ventricular izquierda (FEVI) como consecuencia de una disfunción ventricular se reporta dentro de las alteraciones cardiacas secundarias a una lesión eléctrica. Como complemento de la exploración física, la ecografía cardiaca enfocada (FoCUS) permite una evaluación rápida, no invasiva, que da información para contribuir a tomar mejores decisiones terapéuticas, sobre todo en pacientes en estado crítico. El objetivo de este estudio fue explorar la utilidad de la creatina fosfocinasa MB (CPK-MB) como marcador diagnóstico de disfunción miocárdica en pacientes de 6 a 18 años con quemadura eléctrica. Métodos: Durante el periodo de noviembre de 2018 a agosto de 2019 se llevó a cabo un estudio transversal analítico de 10 pacientes, de 6 a 18 años de edad, con quemadura eléctrica, en quienes se obtuvo el porcentaje de FEVI a través del protocolo FoCUS. Posteriormente, el porcentaje de FEVI se correlacionó con los valores de CPK-MB y el porcentaje de superficie corporal quemada (SCQ) en las primeras 24 horas después de la lesión. Resultados: Se encontraron 10 casos de quemadura eléctrica, ocho de sexo masculino y dos de sexo femenino, con una media de edad de 13 años. El 80% de estos casos presentó disminución leve de la FEVI (45-59%). Al realizar el protocolo FoCUS se reportó hipocinesia miocárdica en siete pacientes. Se encontró una correlación moderada entre la FEVI y los valores de CPK-MB (r = −0.671), aunque no se observó correlación entre la FEVI y la SCQ. Conclusiones: La ecografía cardiaca influye en la toma de decisiones y mejora el pronóstico de estos pacientes.

Abstract Background: The decrease of the left ventricular ejection fraction (LVEF) as consequence of a ventricular dysfunction is reported in cardiac alterations secondary to electrical injury. The focused cardiac ultrasound (FoCUS) helps to complete the clinical examination because it allows a faster non-invasive evaluation, and provides information that contributes to make better therapeutic decisions, especially those for patients in critical condition. The objective of this study was to explore the utility of creatine phosphokinase MB (CPK-MB) as a diagnostic tool of myocardial dysfunction in patients from 6 to 18 years old with electrical burn. Methods: From November 2018 to August 2019, we conducted a transversal analytic study of 10 children with electric burn (6 to 18 years of age), in whom the percentage of LVEF was obtained through the FoCUS protocol in the first 24 hours after injury. Results: We found 10 cases of electrical burn injury, eight males and two females, with an average of 13 years of age. Eighty percent of these cases showed a slight decrease in LVEF (45-59%). When performing the FoCUS protocol, myocardial hypokinesia was reported in seven patients. We observed a moderate correlation between LVEF and CPK-MB levels (r = −0.671), and no correlation between LVEF and body surface area affected by the electrical burn. Conclusions: The cardiac ultrasound influences decision making to improve the prognosis of these patients.

Creatine phosphokinase MB levels as a diagnostic marker of myocardial dysfunction in pediatric patients with electrical burns.

Background: The decrease of the left ventricular ejection fraction (LVEF) as consequence of a ventricular dysfunction is reported in cardiac alterations secondary to electrical injury. The focused cardiac ultrasound (FoCUS) helps to complete the clinical examination because it allows a faster non-invasive evaluation, and provides information that contributes to make better therapeutic decisions, especially those for patients in critical condition. The objective of this study was to explore the utility of creatine phosphokinase MB (CPK-MB) as a diagnostic tool of myocardial dysfunction in patients from 6 to 18 years old with electrical burn. Methods: From November 2018 to August 2019, we conducted a transversal analytic study of 10 children with electric burn (6 to 18 years of age), in whom the percentage of LVEF was obtained through the FoCUS protocol in the first 24 hours after injury. Results: We found 10 cases of electrical burn injury, eight males and two females, with an average of 13 years of age. Eighty percent of these cases showed a slight decrease in LVEF (45-59%). When performing the FoCUS protocol, myocardial hypokinesia was reported in seven patients. We observed a moderate correlation between LVEF and CPK-MB levels (r = -0.671), and no correlation between LVEF and body surface area affected by the electrical burn. Conclusions: The cardiac ultrasound influences decision making to improve the prognosis of these patients.

Background: Introducción">La disminución de la fracción de eyección ventricular izquierda (FEVI) como consecuencia de una disfunción ventricular se reporta dentro de las alteraciones cardiacas secundarias a una lesión eléctrica. Como complemento de la exploración física, la ecografía cardiaca enfocada (FoCUS) permite una evaluación rápida, no invasiva, que da información para contribuir a tomar mejores decisiones terapéuticas, sobre todo en pacientes en estado crítico. El objetivo de este estudio fue explorar la utilidad de la creatina fosfocinasa MB (CPK-MB) como marcador diagnóstico de disfunción miocárdica en pacientes de 6 a 18 años con quemadura eléctrica. Métodos: Durante el periodo de noviembre de 2018 a agosto de 2019 se llevó a cabo un estudio transversal analítico de 10 pacientes, de 6 a 18 años de edad, con quemadura eléctrica, en quienes se obtuvo el porcentaje de FEVI a través del protocolo FoCUS. Posteriormente, el porcentaje de FEVI se correlacionó con los valores de CPK-MB y el porcentaje de superficie corporal quemada (SCQ) en las primeras 24 horas después de la lesión. Resultados: Se encontraron 10 casos de quemadura eléctrica, ocho de sexo masculino y dos de sexo femenino, con una media de edad de 13 años. El 80% de estos casos presentó disminución leve de la FEVI (45-59%). Al realizar el protocolo FoCUS se reportó hipocinesia miocárdica en siete pacientes. Se encontró una correlación moderada entre la FEVI y los valores de CPK-MB (r = −0.671), aunque no se observó correlación entre la FEVI y la SCQ. Conclusiones: La ecografía cardiaca influye en la toma de decisiones y mejora el pronóstico de estos pacientes.

Valoración del dolor neonatal: una experiencia clínica / Neonatal Pain Assessments a Clinical Experience

El propósito del estudio fue aplicar la escala de valoración de la intensidad de dolor de Susan Givens Bell en la UCI Neonatal. Se valoró la intensidad del dolor de 47 neonatos de la Unidad Neonatal de la Fundación Cardio Infantil, sometidos a punciones arteriovenosas y de talón utilizando la escala antes y después de los procedimientos. La información se procesó por medio del paquete estadístico SPSS, y se utilizaron las pruebas estadísticas Anova 1 Factor y la U Mann Whithey para variables no paramétricas, que generó una significancia estadística de p < 0,05. Encontrándose una relación entre los signos fisiológicos y conductuales sobre el total de la escala. Se concluyó que la escala de Susan Givens es adecuada para la valoración del dolor en neonatos, ya que se obtienen probabilidades significativas del 95,7 por ciento.

Ion channel proteins in mouse and human vestibular tissue.

BACKGROUND AND OBJECTIVE: Electrical activity in hair cells and neurons of the inner ear is necessary for the transduction and modulation of stimuli that impinge on the cochlea and vestibular endorgans of the inner ear. The underlying basis of this activity is pore-forming proteins in the membrane of excitable cells that allow the influx and efflux of various ions, including Na + , Ca 2+ , and K + , among others. These channels are critical to both electrical activity as well as the development of excitable cells because they may initiate long-term signals that are important in the maintenance and survival of these cells. We investigated the expression of several Shaker potassium ion channel proteins and an accessory beta subunit in the vestibular endorgans of mouse and human. METHODS: Vestibular tissue consisting of cristae ampullares was harvested from adult and neonatal mice as well as from human subjects undergoing vestibular surgery. Western blot analysis and immunoprecipitation were used to identify the presence or absence, in mouse, of alpha subunits Kv1.2, Kv1.4, and Kv1.5 and of beta subunit Kvbeta1.1 in mouse. Coimmunoprecipitation was used to identify interactions between alpha and beta subunits. Immunohistochemistry was used to localize Kv1.2 in mouse and human tissues. RESULTS: The presence of Kvalpha1.2 and Kvbeta1.1 was confirmed in adult mouse crista ampullaris by Western blotting. Coimmunoprecipitation experiments showed that Kv1.2 and Kvbeta1.1 interact in these tissues. Immunostaining localized Kv1.2 to regions within and extraneous to the sensory epithelium of mouse and human cristae ampullares. In comparison, Kv1.4 and Kv1.5 were not found in the crista ampullaris. CONCLUSIONS: We describe the presence, location, and interaction of various potassium ion channel alpha subunits and a beta subunit. These data are initial descriptions of potassium ion channels in the mammalian vestibular system and begin to provide an understanding of the protein subunits that form ion channels of the mammalian inner ear. In addition, our data show that there are interactions that occur that may regulate the biophysical properties of these channels, thereby contributing to the diversity of channel function. This knowledge is critical to understanding the genes that encode these channels and finding cures for pathologies of hearing and balance. SIGNIFICANCE: We detail initial characteristics of potassium ion channel proteins including alpha subunits Kv1.2, Kv1.4, and Kv1.5 and beta subunit Kvbeta1.1 in mammalian vestibular tissue. This knowledge is critical to understanding the processing of vestibular stimuli and the regulation of endolymphatic function. Mutations of ion channels can cause neurological pathologies including auditory and vestibular disorders in humans.

Bipolar disorder in school-age children.

This article examines the individual components of bipolar disorder in children and the behaviors that can escalate as a result of misdiagnosis and treatment. The brain/behavior relationship in bipolar disorders can be affected by genetics, developmental failure, or environmental influences, which can cause an onset of dramatic mood swings and dysfunctional behavior. School is often the site where mental health disorders are observed when comparing behaviors with other children. Assessing the emotional, academic, and health needs of a student with a bipolar disorder is a critical step in designing effective interventions and school accommodations. Without appropriate medical, psychological, pharmaceutical, and academic interventions, a child is at risk for uncontrolled mania, depression, substance abuse, or suicide. The school nurse is part of the multidisciplinary team and plays a key role in facilitating case management to potentially reverse this possible negative trajectory. Successful case management provides children with bipolar disorder the opportunity to reach their academic potential.

Transdermal selegiline: targeted effects on monoamine oxidases in the brain.

BACKGROUND: The oral administration of monoamine oxidase (MAO) inhibitors has the potential to cause a hypertensive reaction after the ingestion of tyramine-containing compounds. Because transdermal drug administration bypasses gastrointestinal absorption, it is possible that inhibition of MAO-A in brain may be achieved without enzyme inhibition in the gastrointestinal system, thereby eliminating the possibility of this drug interaction. These studies determined whether the transdermal administration of selegiline has differential effects on MAOs in brain versus the gastrointestinal system. METHODS: Rats were exposed to various doses of selegiline via a transdermal patch for up to 30 days, and MAO-A and MAO-B activities were determined in brain regions and gastrointestinal tissue. RESULTS: In all brain regions, transdermal selegiline, at doses that produced maximal MAO-B inhibition, led to a dose- and time-dependent MAO-A inhibition. The inhibition of MAOs in gastrointestinal tissue was less than that in brain, and doses that produced maximal MAO-A inhibition in brain inhibited MAO-A in gastrointestinal tissue by only 30%-40%. CONCLUSIONS: Results suggest that transdermal selegiline preferentially inhibits MAO-A in brain relative to the gastrointestinal system. As a consequence, transdermal selegiline should be devoid of the potential to cause a hypertensive reaction after the ingestion of tyramine-containing compounds.

Phosphorylation of the alpha4 subunit of human alpha4beta2 nicotinic receptors: role of cAMP-dependent protein kinase (PKA) and protein kinase C (PKC).

This study determined whether the alpha4 subunit of human alpha4beta2 neuronal nicotinic receptors is phosphorylated in situ by cyclic AMP-dependent protein kinase (PKA) or protein kinase C (PKC). To accomplish this, human cloned epithelial cells stably transfected with the human alpha4beta2 nicotinic receptor (SH-EP1-halpha4beta2) were incubated with 32P-orthophosphate to label endogenous ATP stores, and the phosphorylation of alpha4 subunits was determined in the absence or presence of PKA or PKC activation. Autoradiographs and immunoblots indicated that alpha4 subunits immunoprecipitated from a membrane preparation of SH-EP1-halpha4beta2 cells exhibited a single 32P-labeled band corresponding to the alpha4 subunit protein; no signals were associated with untransfected SH-EP1 cells. The alpha4 subunits from SH-EP1-halpha4beta2 cells incubated in the absence of the activators exhibited a basal level of phosphorylation that was decreased in the presence of the PKA inhibitor H-89 (5 microM), but unaltered in the presence of the PKC inhibitor Ro-31-8220 (0.1 microM). Activation of PKA by forskolin (10 microM), dibutyryl-cAMP (1 mM), or Sp-8-Br-cAMP (1 mM) enhanced phosphorylation nearly threefold; the inactive isomer, Rp-8-Br-cAMP (1 mM) had no effect. In addition, the forskolin effect was totally blocked by the PKA inhibitor H-89 (5 microM). Activation of PKC by the phorbol esters PDBu (200 nM) or PMA (200 nM) increased alpha4 subunit phosphorylation approximately twofold, and the PDBu effect was blocked by the selective PKC inhibitor Ro-31-8220 (0.1 microM). These findings indicate that the alpha4 subunit of human alpha4beta2 nicotinic receptors is phosphorylated in situ by PKA and PKC.

Gating properties of GIRK channels activated by Galpha(o)- and Galpha(i)-coupled muscarinic m2 receptors in Xenopus oocytes: the role of receptor precoupling in RGS modulation.

'Regulators of G protein Signalling' (RGSs) accelerate the activation and deactivation kinetics of G protein-gated inwardly rectifying K(+) (GIRK) channels. In an apparent paradox, RGSs do not reduce steady-state GIRK current amplitudes as expected from the accelerated rate of deactivation when reconstituted in Xenopus oocytes. We present evidence here that this kinetic anomaly is dependent on the degree of G protein-coupled receptor (GPCR) precoupling, which varies with different Galpha(i/o)-RGS complexes. The gating properties of GIRK channels (Kir3.1/Kir3.2a) activated by muscarinic m2 receptors at varying levels of G protein expression were examined with or without the co-expression of either RGS4 or RGS7 in Xenopus oocytes. Different levels of specific m2 receptor-Galpha coupling were established by uncoupling endogenous pertussis toxin (PTX)-sensitive Galpha(i/o) subunits with PTX, while expressing varying amounts of a single PTX-insensitive subunit (Galpha(i1(C351G)), Galpha(i2(C352G)), Galpha(i3(C351G)), Galpha(oA(C351G)), or Galpha(oB(C351G))). Co-expression of each of the PTX-insensitive Galpha(i/o) subunits rescued acetylcholine (ACh)-elicited GIRK currents (I(K,ACh)) in a concentration-dependent manner, with Galpha(o) isoforms being more effective than Galpha(i) isoforms. Receptor-independent 'basal' GIRK currents (I(K,basal)) were reduced with increasing expression of PTX-insensitive Galpha subunits and were accompanied by a parallel rise in I(K,ACh). These effects together are indicative of increased Gbetagamma scavenging by the expressed Galpha subunit and the subsequent formation of functionally coupled m2 receptor-G protein heterotrimers (Galpha((GDP))betagamma). Co-expression of RGS4 accelerated all the PTX-insensitive Galpha(i/o)-coupled GIRK currents to a similar extent, yet reduced I(K,ACh) amplitudes 60-90 % under conditions of low Galpha(i/o) coupling. Kinetic analysis indicated the RGS4-dependent reduction in steady-state GIRK current was fully explained by the accelerated deactivation rate. Thus kinetic inconsistencies associated with RGS4-accelerated GIRK currents occur at a critical threshold of G protein coupling. In contrast to RGS4, RGS7 selectively accelerated Galpha(o)-coupled GIRK currents. Co-expression of Gbeta5, in addition to enhancing the kinetic effects of RGS7, caused a significant reduction (70-85 %) in steady-state GIRK currents indicating RGS7-Gbeta5 complexes disrupt Galpha(o) coupling. Altogether these results provide further evidence for a GPCR-Galphabetagamma-GIRK signalling complex that is revealed by the modulatory affects of RGS proteins on GIRK channel gating. Our functional experiments demonstrate that the formation of this signalling complex is markedly dependent on the concentration and composition of G protein-RGS complexes.

Sleep-disordered breathing, psychiatric distress, and quality of life impairment in sexual assault survivors.

Using American Academy of Sleep Medicine research criteria, sleep-disordered breathing (SDB) was assessed in a pilot study of 187 sexual assault survivors with posttraumatic stress symptoms. Nightmares, sleep quality, distress, and quality of life were also assessed along with historical accounts of prior treatments for sleep complaints. Presumptive SDB diagnoses were established for 168 patients. Twenty-one of 168 underwent sleep testing, and all met objective SDB diagnostic criteria. There were no clinically meaningful differences in age, body-mass index, sleep quality, distress, or quality of life measures between 21 confirmed SDB cases and 147 suspected cases not tested. Compared with 19 women without SDB, 168 women with diagnosed or suspected SDB reported significantly worse nightmares, sleep quality, anxiety, depression, posttraumatic stress, and impaired quality of life. Despite suffering from sleep problems for an average of 20 years, which had not responded to repeated use of psychotropic medications or psychotherapy, few of these women had been referred to sleep specialists. SDB appears widespread among sexual assault survivors seeking help for nightmares. Research is needed to clarify the associations among SDB, distress, and physical and mental health impairment in trauma patients.

Seguridad y eficacia de la biopsia hepática percutánea ambulatoria dirigida por ultrasonido, comparada con biopsia hepática a ciegas y a través de laparascopia en pacientes con enfermedades difusas del hígado / Safety and efficacy to the ambulatory percutaneous biopsy hepatic to blinds to the laparoscopy in patients with diffuse liver diseases

Para evaluar la seguridad y eficacia de la biopsia hepática (BH) percutánea ambulatoria dirigida por ultrasonido (US) comparándola con el método a ciegas y a través de laparascopia. Se estudiaron 259 pacientes con diagnóstico de hepatopatía difusa y se seleccionaron 45 pacientes de las historias clínicas del hospital a los cuales se les había realizado la BH sin la utilización del ultrasonido ("a ciegas"). La BH dirigida por US y por laparoscopia poseen menor porcentaje de complicaciones mayores y mejor eficacia, estadísticamente significativas (X²=98,8; P=0,00007 y X²=30,4; P<0,0001 respectivamente) en la obtención de la muestra con relación a la biopsia "a ciegas". Al comparar la BH por US y la BH por laparoscopia observamos que las diferencias tanto en complicaciones como en la eficacia no son estadísticamente significativas. Tampoco lo fueron las complicaciones entre sí. La biopsia por US es el método de elección en pacientes con enfermedades difusas de hígado, por su excelente balance riesgo/beneficio, sencillez y bajo costo. EL método por la laparascopia es igualmente efectivo y seguro pero representa una alternativa más costosa y complicada

El tatuaje como factor de riesgo para la transmisión de la infección por el virus de la hepatitis C / The tattooing practice how risk factors for the hepatitis C

Para investigar el tatuaje corporal como factor de riesgo para la hepatitis C, se tomaron muestras de sangre a 88 miembros del personal de la Armada Venezolana, destacados en la base naval "Agustin Armario" en Puerto Cabello. De este personal 76 presentaban tatuajes, 11 de ellos resultaron positivos para el VHC, y dos tenían factores de riesgo conocidos, de los nueve positivos restantes (17,30 por ciento) el único factor de riesgo encontrado fue el tatuaje. Concluimos que la práctica de el tatuaje corporal es un factor de riesgo para la infección por el VHC