Taylor's power law for freshwater fishes: Functional traits beyond statistical inevitability.

Taylor's power law (TPL) describes the expected range of parameters of the mean-variance scaling relationship and has been extensively used in studies examining temporal variations in abundance. Few studies though have focused on biological and ecological covariates of TPL, while its statistical inherences have been extensively debated. In the present study, we focused on species-specific features (i.e. functional traits) that could be influential to temporal TPL. We combined field surveys of 180 fish species from 972 sites varying from small streams to large rivers with data on 31 ecological traits describing species-specific characteristics related to three main niche dimensions (trophic ecology, life history, and habitat use). For each species, the parameters of temporal TPL (intercept and slope) were estimated from the log-log mean-variance relationships while controlling for spatial dependencies and biological covariates (species richness and evenness). Then, we investigated whether functional traits explained variations in TPL parameters. Differences in TPL parameters among species were explained mostly by life history and environmental determinants, especially TPL slope. Life history was the main determinant of differences in TPL parameters and thereby aggregation patterns, with traits related to body size being the most influential, thus showing a high contrast between small-sized species with short lifespans and large-bodied migratory fishes, even after controlling for phylogenetic resemblances. We found that life history traits, especially those related to body size, mostly affect TPL and, as such, can be determinants of temporal variability of fish populations. We also found that statistical effects and phylogenetic resemblances are embedded in mean-variance relationships for fish, and that environmental drivers can interact with ecological characteristics of species in determining temporal fluctuations in abundance.

Cost-Effectiveness of Extracorporeal Photopheresis in Patients With Chronic Graft-vs-Host Disease.

Background: The mainstay first-line therapy for chronic graft-vs-host disease (cGVHD) is corticosteroids; however, for steroid-refractory patients, there is a distinct lack of cost-effective or efficacious treatment. The aim of this study was to assess the cost-effectiveness of extracorporeal photopheresis (ECP) compared with standard-of-care therapies for the treatment of cGVHD in Australia. The study formed part of an application to the Australian Government to reimburse ECP for these patients. Methods: A cost-utility analysis was conducted comparing ECP to standard of care, which modeled the response to treatment and disease progression of cGVHD patients in Australia. Mycophenolate, tacrolimus, and cyclosporin comprised second-line standard of care based on a survey of Australian clinicians. Health states in the model included treatment response, disease progression, and death. Transition probabilities were obtained from Australian-specific registry data and randomized controlled evidence. Quality-of-life values were applied based on treatment response. The analysis considered costs of second-line treatment and disease management including immunosuppressants, hospitalizations and subsequent therapy. Disease-specific mortality was calculated for treatment response and progression. Results: Over a 10-year time horizon, ECP resulted in an average cost reduction of $23 999 and an incremental improvement of 1.10 quality-adjusted life-years per patient compared with standard of care. The sensitivity analysis demonstrated robustness over a range of plausible scenarios. Conclusion: This analysis demonstrates that ECP improves quality of life, minimizes the harms associated with immunosuppressant therapy, and is a highly cost-effective option for steroid-refractory cGVHD patients in Australia. Based in part on this analysis, ECP was listed on the Medicare Benefits Schedule for public reimbursement.

Finishing Analysis of Dental Outcome (FADO) as a New Guide in Orthodontic Treatment.

OBJECTIVES: Orthodontic treatment has both functional and esthetic goals. The finishing phase is one of the most important and seeks to solve occlusal, dental, functional, and esthetic problems, offering the possibility of obtaining the best possible outcome. This paper aims to describe the Finishing Analysis of Dental Outcome (FADO) guide as a tool to improve orthodontic treatment results. METHODS: A literature review of finishing procedures and orthodontic treatment outcomes was made. Moreover, current parameters of the esthetics of the smile were considered. The information was systematized to produce a protocol applicable to practice. This guide includes the assessment of mini-esthetic, micro-esthetic, and occlusal results using the Cast Radiographic Evaluation of the American Board of Orthodontics. Treatment options for each item were also suggested. Clinical cases were used to illustrate the application of the guide. RESULTS: The FADO Guide is presented and explained to give the clinician a systematic and orderly guide to achieve the best possible results in orthodontic treatment. To fulfill the FADO Guide, cast models, a panoramic radiograph, smile photographs (frontal and lateral), and an intraoral frontal photo are needed. The FADO Guide includes four sections: mini-esthetic evaluation (the evaluation of the smile), micro-esthetic evaluation, occlusal analysis, and radiographic analysis. CONCLUSION: The FADO guide presents a systematic approach to the application of a finishing protocol in orthodontics. Furthermore, this guideline can improve clinical practice and be used as a checklist to optimize clinical outcomes.

Green Spaces with Fewer People Improve Self-Reported Affective Experience and Mood.

Calm and quiet green spaces provide health benefits for urban residents. Yet as cities become more densely populated, increasing public users to green spaces may reduce or moderate these benefits. We examine how increased pedestrian density in a green street changes self-reported wellbeing. We use a between subject experimental design that added public users as confederates in randomly selected periods over three weeks. We collect data on mood and affective response from pedestrians moving through the green street (n = 504), with and without our public user treatment in randomly selected periods. Mood and affective response are improved when experiencing the green street with fewer people. We find that an increased number of public users in the green space has a negative effect on mood, especially among women. We provide experimental evidence that self-reported wellbeing in urban green spaces depends on social context, and that there are gender inequities associated with changes in affective response. Although we only measure immediate impacts, our results imply that the health benefits of green spaces may be limited by the total number of users. This research contributes additional evidence that greener cities are also healthier cities, but that the benefits may not be equally shared between women and men and will depend on the social context of use.

Cost-Effectiveness of Extracorporeal Photopheresis for the Treatment of Patients With Erythrodermic (Stage T4, M0) Cutaneous T-Cell Lymphoma in the Australian Setting.

OBJECTIVES: Cutaneous T-cell lymphoma (CTCL) is a rare and incurable disease, and patients currently experience a lack of treatment options in Australia. This analysis evaluated the cost-effectiveness of extracorporeal photopheresis (ECP) compared with standard of care therapy for the treatment of patients with erythrodermic (stage T4, M0) CTCL, who are refractory to previous systemic treatment. METHODS: A Markov model was developed from the perspective of the Australian government. Health states were treatment specific and transition probabilities were modeled from time-to-next-treatment data from a published Australian observational study of ECP and comparator treatments. Quality of life utility values were based on psoriasis as a proxy for CTCL, which was validated by consultation with local clinicians. The time horizon for the model was 5 years. The ECP treatment regimen was compared with a weighted treatment comparator based on results of a treatment survey and Australian prescribing data. RESULTS: ECP as a second-line treatment option for CTCL was less costly and more effective than other treatment strategies. ECP had an average cost saving of $37 592 and incremental quality-adjusted life-year gained of 0.20 to 0.21, attributed to patients being able to better tolerate ECP thus avoiding subsequent treatment with high-cost alternatives. CONCLUSIONS: This is the first published cost-utility analysis of ECP for CTCL. This analysis demonstrates that ECP is a cost-effective option for the treatment of patients with erythrodermic CTCL in Australia.

Assessment of therapeutic strategies for management of impulse control disorder in Parkinson's disease.

BACKGROUND: Impulse control disorders (ICD) occur frequently in individuals with Parkinson's disease. So far, prevention is the best treatment. Several strategies for its treatment have been suggested, but their frequency of use and benefit have scarcely been explored. OBJECTIVE: To investigate which strategy is the most commonly used in a real-life setting and its rate of response. METHODS: A longitudinal study was conducted. At the baseline evaluation, data on current treatment and ICD status according to QUIP-RS were collected. The treatment strategies were categorized as "no-change", dopamine agonist (DA) dose lowering, DA removal, DA switch or add-on therapy. At the six-month follow-up visit, the same tools were applied. RESULTS: A total of 132 individuals (58.3% men) were included; 18.2% had at least one ICD at baseline. The therapeutic strategy most used in the ICD group was no-change (37.5%), followed by DA removal (16.7%), DA switch (12.5%) and DA lowering (8.3%). Unexpectedly, in 20.8% of the ICD subjects the DA dose was increased. Overall, nearly 80% of the subjects showed remission of their ICD at follow-up. CONCLUSIONS: Regardless of the therapy used, most of the subjects presented remission of their ICD at follow-up Further research with a longer follow-up in a larger sample, with assessment of decision-making processes, is required in order to better understand the efficacy of strategies for ICD treatment.

Assessment of therapeutic strategies for management of impulse control disorder in Parkinson's disease / Evaluación de las estrategias terapéuticas en trastornos del control de impulsos en enfermedad de Parkinson

ABSTRACT Background: Impulse control disorders (ICD) occur frequently in individuals with Parkinson's disease. So far, prevention is the best treatment. Several strategies for its treatment have been suggested, but their frequency of use and benefit have scarcely been explored. Objective: To investigate which strategy is the most commonly used in a real-life setting and its rate of response. Methods: A longitudinal study was conducted. At the baseline evaluation, data on current treatment and ICD status according to QUIP-RS were collected. The treatment strategies were categorized as "no-change", dopamine agonist (DA) dose lowering, DA removal, DA switch or add-on therapy. At the six-month follow-up visit, the same tools were applied. Results: A total of 132 individuals (58.3% men) were included; 18.2% had at least one ICD at baseline. The therapeutic strategy most used in the ICD group was no-change (37.5%), followed by DA removal (16.7%), DA switch (12.5%) and DA lowering (8.3%). Unexpectedly, in 20.8% of the ICD subjects the DA dose was increased. Overall, nearly 80% of the subjects showed remission of their ICD at follow-up. Conclusions: Regardless of the therapy used, most of the subjects presented remission of their ICD at follow-up Further research with a longer follow-up in a larger sample, with assessment of decision-making processes, is required in order to better understand the efficacy of strategies for ICD treatment.

Resumen Antecedentes: Los trastornos del control de impulsos (TCI) son frecuentes en personas con enfermedad de Parkinson. A la fecha, la prevención es el mejor tratamiento. Existen varias estrategias sugeridas para su tratamiento, pero su frecuencia de uso y beneficio ha sido escasamente explorada. Objetivo: Investigar qué estrategia es la más utilizada en un entorno de la vida real y su tasa de respuesta. Métodos: Se realizó un estudio longitudinal. En la evaluación inicial, se recopiló el tratamiento actual y el estado del TCI de acuerdo con el QUIP-RS. La estrategia de tratamiento se clasificó como "sin cambios", reducción de la dosis de agonista de la dopamina (AD), eliminación de AD, cambio de AD o terapia complementaria. En la visita de seguimiento a los 6 meses, se aplicaron las mismas herramientas. Resultados: Se incluyeron un total de 132 (58.3% hombres) personas. El 18.2% tenía al menos un TCI al inicio del estudio. La estrategia terapéutica más utilizada en el grupo de TCI fue sin cambios (37.5%), seguida de eliminación de DA (16.7%), cambio de AD (12.5%) y reducción de DA (8.3%). En el 20.8% de los sujetos con TCI se aumentó la dosis de AD. Casi el 80% de los sujetos tuvieron una remisión del TCI al seguimiento. Conclusiones: Independientemente de la terapia utilizada, la mayoría de los sujetos tuvieron una remisión del TCI. Se requiere más investigación con un seguimiento y una muestra mayor para evaluar l proceso de toma de decisiones para comprender mejor la eficacia de las estrategias.

Association between cardiometabolic comorbidities and Parkinson's disease in a Mexican population.

BACKGROUND: The prevalence of Parkinson's disease (PD) increases as the population ages. Studies have shown that some cardiometabolic comorbidities could be associated with risk or protection against developing PD. A retrospective case-control study was carried out to analyze the relationship between PD and cardiometabolic comorbidities. MATERIAL AND METHODS: Subjects with PD and controls without PD were consecutively recruited. Data on type 2 diabetes mellitus, systemic arterial hypertension (SAH), dyslipidemia and body mass index were collected. Logistic regression analyses were carried out. RESULTS: A total of 781 subjects with PD (56.5% males) and 1,000 controls (44.4% males) were included. After adjusting for age and gender, SAH was found as an independent risk factor (OR: 1.32; 95% CI: 1.05-1.67; p = 0.02), and obesity as a protective factor (OR: 0.72; 95% CI: 0.56-0.93; p = 0.01). CONCLUSIONS: Subjects with SAH had a higher risk of having PD, while obese subjects had a lower risk of having PD. The relationship between cardiometabolic disease, its treatment, and PD etiopathogenesis appears to be extremely complex given the amount of contradictory data.

ANTECEDENTES: La prevalencia de la enfermedad de Parkinson (EP) aumenta a medida que la población envejece. Los estudios han demostrado que algunas comorbilidades cardiometabólicas pudieran estar asociadas con el riesgo o la protección de desarrollar la EP. Se realizó un estudio retrospectivo de casos y controles para analizar la relación entre la EP y las comorbilidades cardiometabólicas. MATERIAL Y MÉTODOS: Se reclutaron sujetos con EP y controles sin EP de forma consecutiva. Se recolectaron datos sobre diabetes mellitus tipo 2, hipertensión arterial sistémica (HTA), dislipidemia e índice de masa corporal. Se llevó a cabo análisis de regresión logística. RESULTADOS: Se incluyeron un total de 781 personas con EP (56,5% hombres) y 1,000 controles (44,4% hombres). Después de ajustar por edad y sexo, la HTA se encontró como factor de riesgo independiente (OR 1.32, IC 95% 1.05-1.67, p = 0.02) y la obesidad como factor protector (OR 0.72, IC 95% 0.56-0.93, p = 0.01). CONCLUSIONES: Los sujetos con HTA tienen un mayor riesgo de tener EP; mientras que los sujetos obesos tienen un menor riesgo de tener EP. La relación entre la enfermedad cardiometabólica, su tratamiento y etiopatogenia de la EP parece ser extremadamente compleja dada la cantidad de datos contradictorios.

Hemorragia uterina anormal / Uterine abnormal hemorrhage

La hemorragia uterina anormal (HUA) es un signo y síntoma clínico frecuente en el consultorio de ginecología, manifestándose en cualquier etapa de la vida de la mujer. Se presenta en el 25% de adolescentes y en el 50% en mayores de 40 años; además represen-ta un 25% de las cirugías ginecológicas. Tiene como factores predisponente la raza, gemelar, agregación familiar, asociación a enfermedades geneticas. La cantidad y duración de las menstruaciones es muy subjetiva, por lo que hay problemas para valorar las pérdidas sanguíneas de las pacientes. El diagnóstico de hemorragia uterina disfuncional es por exclusión, primero se debe descartar las causas orgánicas. Por ello la HUA es un problema frecuente que se puede presentar a cualquier edad repercutiendo en varios aspectos como el sanitario y social, su tratamiento debe ser multidisciplinario, ya que no debemos olvidar que es una de las principales causas de anemia en la mujer y también de histerectomías. (AU)

The HUA is a common clinical signs and symptoms in gynecology clinic, being a disorder in the female genital tract, can occur at any age of life of women. It comes in a 25% in adolescents and 50% older than 40 years and 25% of gynecological surgeries. It has an ethnic predisposition, twins, familial aggregation, association with genetic diseases. The amount and duration of menses is very subjective, so there are problems in assessing blood loss of patients. The diagnosis of dysfunctional uterine bleeding is by exclusion, you must first rule out organic causes. Thus the HUA is a common problem that can occur at any age impacting several aspects such as health and social, treatment should be multidis-ciplinary, and we must not forget that it is a major cause of anemia in women and hysterectomy. (AU)

Influence of Facial and Occlusal Characteristics on Gummy Smile in Children: A Case-Control Study

Objective: To determine the association between occlusal and soft tissue characteristics with the presence of gingival smile (GS) in a pediatric population with inter-transitional mixed dentition. Material and Methods: Case-control study was performed with a probabilistic sample of 163 children in inter-transitional mixed dentition (age:8.8 years ±0.8). Cases were 37 children with GS, and controls were 126 children without GS. Occlusal variables were assessed through clinical examination, and soft tissue variables were assessed through photograms. Kappa test and intraclass correlation coefficient were done (0.87-0.96). The association between malocclusion, gender, and types of smile was assessed using a Chi square test. Comparison of quantitative variables in smile groups was made by Student t test. A multivariate binary logistic regression was performed. Results: Class II malocclusion, short upper lip at smile and short incisor clinical crown, were risk factors for gummy smile (OR= 10.4, 95%CI 3.07- 34.95, OR= 2.1, 95%CI 1.44- 3.13 and OR= 2.5 95%CI 1.34- 4.54 respectively). Lower facial height was a protective factor against GS (OR= 0.76; 95%CI 0.69- 0.85). The logistic regression model explains 48% of GS variability. Conclusion: Class II malocclusion is considered a risk factor for gummy smile. Other variables associated to gummy smile were short upper lip and short incisor clinical crown. Clinicians should considered these aspects in clinical examination of each patient to provide an adequate diagnostic and plan of treatment to control and/or correct a GS.

Production of reactive oxygen species from photosensitizers activated with visible light sources available in dental offices.

OBJECTIVES: The aim of this study was to assess the ability of commonly available red- or blue-light dental sources to generate reactive oxygen species (ROS) from photosensitive chemicals that might be useful for photodynamic antimicrobial chemotherapy (PACT). BACKGROUND: Although the use of red diode lasers is well documented, there is limited information on how useful blue-light sources might be for PACT in dental contexts. MATERIALS AND METHODS: A diode laser (Periowave; see Table 1 for material and equipment sources) emitting red light (660-675 nm) was used to activate toluidine blue; riboflavin and pheophorbide-a polylysine (pheophorbide-a-PLL) were photoactivated using an Optilux 501 curing unit emitting blue light (380-500 nm). Ozone gas (generated by OzoTop, Tip Top Tips, Rolle, Switzerland), sodium hypochlorite, and hydrogen peroxide were used for comparison. ROS production was estimated using an iodine-triiodide colorimetric assay, and ROS levels were plotted versus concentration of chemicals to determine each chemical's efficiency in ROS production. One-way ANOVA with Tukey post hoc analysis (alpha = 0.05) was used to compare the efficiencies of ROS production for the various chemicals. RESULTS: Sodium hypochlorite, hydrogen peroxide, and ozone gas produced ROS spontaneously, whereas pheophorbide-a-PLL, riboflavin, and toluidine blue required light exposure. The efficiency of ROS production was higher for pheophorbide-a-PLL and toluidine blue than for ozone gas or riboflavin (p < 0.05). Hydrogen peroxide was the least efficient ROS producer. CONCLUSIONS: The results of the current study support the use of blue- or red-light-absorbing photosensitizers as candidates to produce ROS for clinical applications. Blue-light photosensitizers were as efficient as red-light photosensitizers in producing ROS and more efficient than the oxidant chemicals currently used for dental disinfection.

Correlación entre los niveles séricos de dehidroepiandrosterona sulfato con los estadios de maduración esquelética: informe final / Correlation between the seric levels of dehidroepiandrosterone sulphate with the skeletal maturation stages: final paper

Con el fin de detectar un indicador del inicio del brote puberal se correlacionaron los niveles séricos de DHEAS con la edad, el peso, la talla, el estadio de desarrollo esquelético (Hãgg y Taranger) y el de la maduración sexual (Tanner y orquidiometría de Prader). Se estudiaron 33 pacientes, 18 de sexo masculino y 15 de sexo femenino, entre los 8 y los 11 años de edad; el criterio de inclusión fue el de niños sanos con un estadio de maduración sexual de Tanner I. La toma de muestras se realizó cada seis meses durante tres años (2000-2002). El comportamiento de las variables antropométricas de la población general se publicó en el artículo de IGF-1 previo. En el grupo de niños no se observó ninguna correlación significativa entre el nivel de DHEAS con ninguna variable, excepto para el peso al inicio del estudio. En el grupo de niñas, la correlación se dio con el sesamoideo, aunque no fue a largo plazo y con el peso en la mitad del estudio. Sin embargo, ninguna de estas asociaciones y correlaciones confirma nuestra hipótesis inicial, ya que todas estas asociaciones fueron aisladas.

In order to detect an indicator of the onset of pubertal spurt, the DHEAS serie levels were correlated with age, weight, height, skeletal maturity stage (Hägg and Taranger) and sexual maturity (Tanner and, Prader). 33 patients; 18 males and 15 females, between 8 and 12 years old were studied. Healthy children in Tanner I sexual maturity stage was the research criteria for inclusion. The data were taken every six months during three years (2000-2002). The behavior of the anthropometric variables of the general population was published in a previous paper. In the group of males, we did not found any significant correlation between the seric levels of DHEAS with the studied variables, except for the weight at the beginning of the study. In the female group, a correlation was found with the ulnar sesamoid although not in the long term, and with the weight in the middle of the study. However, none of these associations and correlations confirmed our initial hypothesis because the correlations found were considerate such as isolated facts.

Relación entre tres métodos de evaluación de maduración esquelética con la maduración sexual / Relationship between three methods for the evaluation of skeletal maturation with sexual maturation

Con el fin de determinar cuál de los métodos con los que se establece la maduración esquelética se relaciona mejor con la madurez del paciente y por tanto, es más práctico y aplicable en la clínica, se buscó la relación entre tres diferentes métodos de evaluación de la maduración esquelética mediante el carpograma (Taranger y Hãgg, Greulich y Pyle, y Fishman), con la maduración sexual (Tanner, orquidiometría de Prader). Se estudiaron 33 pacientes, 18 de sexo masculino y 15 de sexo femenino, entre los 8 y los 13 años de edad; el criterio de inclusión fue el de niños sanos con un estadio de maduración sexual de Tanner I. El 100 por ciento de la muestra tanto femenina como masculina se ubicó en el estadio F del desarrollo esquelético. La toma de registros se realizó cada seis meses durante tres años (2000-2002). En la población masculina no se encontraron asociaciones entre la maduración esquelética evaluada de acuerdo con los métodos de Greulich y Pyle, y de Fishman con la maduración sexual; sin embargo sí se encontró relación entre algunos parámetros que integran el método de Taranger y Hãgg y la maduración sexual (sesamoideo-Tanner general durante la cuarta muestra y falange media del tercer dedo-volumen testicular derecho durante la misma, al igual que falange media con ambos volúmenes testiculares durante la quinta muestra). En la población femenina se presentaron asociaciones estadísticamente significativas entre el método de Fishman y la maduración sexual durante la segunda y sexta muestras; también, entre la evaluación según Greulich y Pyle y la maduración sexual durante la sexta muestra y entre el método de Taranger y Hãgg en la segunda, tercera y sexta muestras (sesamoideo-Tanner, falange media-Tanner y sesamoideo-Tanner respectivamente).

[Psoas muscle abscess: bibliographic review]. / Absceso de psoas: revisión de la bibliografía.

OBJECTIVES: To report the clinical characteristics, diagnosis and treatment of psoas abscess. METHODS/RESULTS: We report the case of a 77 year old female patient who was diagnosed of psoas abscess. Due to the unspecific symptoms, she was initially treated as a renal colic. Ultrasound was the test that oriented us to the diagnosis. Percutaneous drainage was effective, checking the resolution using CT Scan. CONCLUSIONS: Psoas abscess is an uncommon pathology the presenting features of which are usually unspecific. CT Scan is the astronomer diagnostic tests and percutaneous drainage has good results and is less aggressive therapeutic option for this disease.

Absceso de psoas: revisión de la bibliografía / Psoas muscle abscess: bibliographic review

OBJETIVO: Presentar las características clínicas,diagnostico y tratamiento del absceso de psoas.MÉTODO / RESULTADOS: Presentamos el caso de una mujer de 77 años diagnosticada de absceso de psoas. Debido a la inexpecificidad de sus síntomas se trató al inicio como un cólico nefrítico complicado, siendo la ecografíala prueba diagnóstica que nos orientó en el diagnóstico.Mediante drenaje percutáneo el tratamiento fue eficaz, comprobándose la resolución mediante TAC.CONCLUSIONES: El absceso de psoas es una patología poco común cuyas características de presentación son normalmenteinespecíficas. El TAC es el método estándar de diagnóstico y el drenaje percutáneo tiene buenos resultadosy es la opción terapéutica menos agresiva para esta enfermedad

OBJETIVES: To report the clinical characteristics, diagnosis and treatment of psoas abscess.METHODS/RESULTS: We report the case of a 77 year old female patient who was diagnosed of psoas abscess. Due to the unspecific symptoms, she was initially treated as a renal colic. Ultrasound was the test that oriented us to the diagnosis. Percutaneous drainage was effective, checking the resolution using CT Scan.CONCLUSIONS: Psoas abscess is an uncommon pathology the presenting features of which are usually unspecific. CT Scan is the astronomer diagnostic tests and percutaneous drainage has good results and is less aggressive therapeutic option for this disease

[Transurethral resection with saline solution: a technological achievement not yet assimilated by the urological community]. / La resección transuretral con solución sauna: un logro tecnológico aún no asimilado por la urología.

OBJECTIVES: To objectively demonstrate the advantages provided by TURP with saline solution (an adjustment made possible thanks to the technological development of new high frequency current generators), although it surprisingly has been received with scepticism in the urological community. METHODS: A first group of 51 patients (group A) underwent low hydraulic pressure TURP with a pulsed bipolar system (Gyrus Plasmakinetic, with large loop) using physiologic saline solution as irrigation. A second group of 49 patients underwent low hydraulic pressure TURP with a conventional monopolar system (Erbe 350) using glycine-ethanol solution. RESULTS: A better surgical performance was obtained in the first group, as well as a lower degree of bleeding. No intraoperative complications appear in either group. Only one case of late hematuria was registered one month after surgery in a patient of group A. CONCLUSIONS: Pulsed bipolar TURP has a minimal thermal in-depth diffusion, achieves vessel hemostasis by dessication instead of charring, has an extremely precise cutting quality, does not produce neuromuscular stimulation, and makes the use of saline solution irrigation possible. All these translate to lower tissue injury, null risk of sequelae secondary to electric current leak, a finer technique, a lower risk of accidental perforation, and the possibility of duplicate or triplicate the surgical time without risk, especially when working with low hydraulic pressure.

Correlación entre los niveles séricos de factor de crecimiento insulinoide tipo I (IGF-I) con el estadio de maduración esquelética / Correlation between the seric levels of insulinoid growth factors type I (IGF-I) and the skeletal maturation stages

Con el fin de detectar un indicador del inicio del brote puberal se correlacionaron los niveles séricos del IGF-I con la edad, el peso, la talla, el estadio de desarrollo esquelético (Hãgg y Taranger) y el de la maduración sexual (Tanner y orquidiometría de Prader), se estudiaron 33 pacientes, 18 de sexo masculino y 15 de sexo femenino, entre los ocho y los once años de edad; el criterio de inclusión fue el de niños sanos con un estadio de maduración sexual de Tanner I. La toma de muestras se realizó cada seis meses durante tres años (2000-2002). La población general, mestiza, con una edad promedio de 9,48 ± 0,65 años, se ubicó en los percentiles 25-50 para peso (29,17 ± 6,41 kg) y talla (131,5 ± 6,91 cm) y en el estadio I de la maduración sexual. El 100 por ciento de la muestra tanto femenina como masculina se ubicó en el estadio F del desarrollo esquelético. No hubo diferencia, por sexo, con respecto a la concentración sérica del IGF-I (175,00 ± 77,06 en hombres y 175,80 ± 88,39 en mujeres), a pesar de lo cual en el sexo femenino se encontraron correlaciones, estadísticamente significativas, entre IGF-I y edad (r = 0,56, p = 0,031) y peso (r = 0,58, p = 0,023). Tanto en hombres como en mujeres se observaron correlaciones estadísticamente significativas entre la edad y el peso, la edad y la talla, y la talla y el peso. Los volúmenes testiculares derechos e izquierdos presentaron correlación con el peso (r = 0,60, p = 0,009; r = 0,55, p = 0,017, respectivamente) y con la talla (r = 0,53, p = 0,023; r = 0,51, p = 0,030, respectivamente). El volumen testicular derecho se correlacionó con el factor de crecimiento insulinoide (r 0,48, p = 0, 045). Finalmente, se observó correlación entre ambos volúmenes testiculares (r = 0,86, p = < 0,001). Los tamaños mamarios derecho e izquierdo presentaron correlación entre sí (r = 1,0, p = < 0,001). En conclusión, la muestra en estudio se encontró en un estadio prepuberal de maduración sexual y desarrollo esquelético y como...

La resección transuretral con solución salina: un logro tecnológico aún no asimilado por la urología / Transurethral resection with saline solution: a technological achievement not yet assimilated by the urological community

OBJETIVO: Demostrar objetivamente lasventajas que reporta el uso de la R.T.U.P. con soluciónsalina (logro posible gracias al desarrollo tecnológicode los los nuevos generadores de corrientes de alta frecuencia),pero que curiosamente ha sido recibida porlos urólogos con cierto escepticismo.MÉTODOS: A un primer grupo de 51 pacientes (grupoA) se les sometió a R.T.U.P., a baja presión hidráulica,con un sistema bipolar por pulsos (Gyrus Plasmakinetic,con asa large loop) y empleando suero fisiológicocomo líquido irrigante. A un segundo grupo, de 49pacientes se les practicó una R.T.U.P., a baja presiónhidráulica, con un sistema monopolar convencional(Erbe 350) y empleando solución de glicina con etanolcomo líquido irrigante.RESULTADOS: En el primer grupo de pacientes se obtuvoun mejor rendimiento quirúrgico y menor grado dehemorragia. No se produjeron complicaciones intraoperatoriasen ambos grupos. Solo se registró un casode hemorragia tardía al mes de la intervención en unpaciente del grupo A.CONCLUSIONES: La R.T.U. bipolar por pulsos, tieneuna mínima inercia térmica en profundidad, es capazde hemostasiar los vasos por desecación en vez de carbonización,dispone de una calidad de corte extremadamentepreciso, no provoca estímulo neuromuscular yhace posible el uso de una solución salina como mediode irrigación. Todo ello se traduce en un menor dañotisular, nulo riesgo de secuelas por fugas de corriente,una técnica más depurada, un menor riesgo de perforacionesaccidentales, y la posibilidad de duplicar o triplicarsin riesgo el tiempo quirúrgico, especialmente sise trabaja con baja presión hidráulica

OBJECTIVES: To objectively demonstrate ;;the advantages provided by TURP with saline solution ;;(an adjustment made possible thanks to the technological ;;development of new high frequency current generators), ;;although it surprisingly has been received with scepticism ;;in the urological community. ;;METHODS: A first group of 51 patients (group A) ;;underwent low hydraulic pressure TURP with a pulsed ;;bipolar system (Gyrus Plasmakinetic, with large loop) ;;using physiologic saline solution as irrigation. A second ;;group of 49 patients underwent low hydraulic pressure ;;TURP with a conventional monopolar system (Erbe 350) ;;using glycine-ethanol solution. ;;RESULTS: A better surgical performance was obtained ;;in the first group, as well as a lower degree of bleeding. ;;No intraoperative complications appear in either ;;group. Only one case of late hematuria was registered ;;one month after surgery in a patient of group A. ;;CONCLUSIONS: Pulsed bipolar TURP has a minimal ;;thermal in-depth diffusion, achieves vessel hemostasis ;;by dessication instead of charring, has an extremely ;;precise cutting quality, does not produce neuromuscular ;;stimulation, and makes the use of saline solution irrigation ;;possible. All these translate to lower tissue injury, null ;;risk of sequelae secondary to electric current leak, a ;;finer technique, a lower risk of accidental perforation, ;;and the possibility of duplicate or triplicate the surgical ;;time without risk, especially when working with low ;;hydraulic pressure

[Laparoscopic treatment of varicocele]. / Tratamiento del varicocele por laparoscopia.

OBJECTIVES: Current trends in the treatment of varicocele are focused on outpatient procedures of high and complete ligature of the spermatic vascular pedicle or percutaneous embolization. Laparoscopic varicocelectomy competes with them and other minimally invasive techniques such as chemical or thermal sclerosing therapy of the spermatic veins. METHODS: We perform a bibliographic review of the Spanish and Anglo-Saxon literature with the aim of evaluating the real weight of the laparoscopic technique, and at the same time show our personal experience. RESULTS: We found 8 papers in Spanish and 187 in English. Although the interest for laparoscopic varicocelectomy among Spanish urologists is very low, in other countries there is moderate interest for it, being in competition, though in disadvantage, with other outpatient minimally invasive techniques performed under local or regional anesthesia. CONCLUSIONS: Microlaparoscopy improves the overall position of this technique, mainly in cases of bilateral varicocele whenever an "en bloc" ligature of the spermatic artery and vein is performed.

[Intraurethral foreign bodies]. / Cuerpos extraños intrauretrales.

OBJECTIVES: We report a case of urethral foreign bodies in a patient with posttraumatic psychiatric disorders. METHODS: The patient presents with clinical signs of scrotal abscess. Many foreign bodies were removed from the bulbar urethra; one urinary stone formed around one of them required lithotripsy. RESULTS: Treatment included removal of the foreign bodies, abscess drainage, and administration of wide spectrum antibiotics. CONCLUSIONS: Urethral foreign bodies are exceptional, and may present with many symptoms making diagnosis difficult. We noted symptoms and diagnosis in our case, and additionally the therapeutic options proposed in the literature.