[Spinal neuronavigation. Our experience]. / Neuronavegación raquídea. Nuestra experiencia.

The spinal column has been considered ideal for guided surgery due to its stable anatomical structure and notable reference points which are perfectly distinguishable both in computer tomography (C.T.) images and in the surgical field. Our main objective was to apply this technique to the conventional transpedicular fusion surgery. During the last year (1999), 13 males and 26 females, with an average of 47.1, + 14.1 years were operated because of degenerative discopathy (9 cases) degenerative discopathy associated to listhesis (7 cases) and spinal canal stenosis (8 cases). All of them were operated according to a preestablished protocol using the Brain Lab Image Guided System. The preestablished protocol could not be applied in 3 patients. Of the 36 patients, only in 22 cases (61%), a properly navigation was obtained. In these cases 116 screws were used: 108 (93%) strictly intrapediculars. In the other 14 patients, without Guided Surgery, it was used 76 screws: 65 (86%) were strictly intrapediculars. In our opinion Guided Spine Surgery, offers an accuracy and reliability to reduce the margin of error in the Transpedicular location of the Spine Fusion Systems.

[Peritoneal tuberculosis: evaluation of the response to treatment by analysing the CA 125 levels]. / Tuberculosis peritoneal: valoración de la respuesta al tratamiento mediante los niveles de CA 125.

A case of a 32 years old woman with fever and exudative ascites is described. Tuberculous peritonitis was confirmed by abdominal laparoscopy, peritoneal biopsy and Lowënstein culture. A serum CA 125 level was 861 U/ml before therapy. The CA 125 level decreased a 30% after three weeks of antituberculous treatment. This tumor marker may be used to follow disease activity in tuberculous ascites.

[Evaluation of hepatic encephalopathy using computerized electroencephalography]. / Evaluación de la encefalopatía hepática mediante electroencefalografía computarizada.

Spectral EEG analysis techniques were used to evaluate the degree of hepatic encephalopathy in a group of 69 cirrhotic patients, as compared to the results obtained in a group of healthy controls. With respect to controls, the cirrhotics had stronger delta and theta bands, and a weaker alpha band, as well as a reaction of the alpha band to opening the eyes. The use of strength ratios between different bands of frequency increments the sensitivity and diagnostic reliability of this technique, particularly the delta/alpha and theta/alpha indices, and permits the detection of cases with subclinical encephalopathy, which is particularly useful for clinical follow-up and for the evaluation of different therapeutic regimens.

[Evaluation of the therapeutic effect of flumazenil in hepatic encephalopathy using cerebral cartography]. / Evaluación del efecto terapéutico del flumazenil en la encefalopatía hepática mediante cartografía cerebral.

We investigated the therapeutic effect of flumanezil on acute and chronic hepatic encephalopathy in a group of cirrhotics; its efficacy was evaluated using clinical data and neurophysiologic examination, e.g. brain mapping. Flumazenil was not found to induce significant changes in the clinical status or in maps of the cerebral activity of patients with chronic encephalopathy. In acute encephalopathy, flumazenil improved clinical status, as was confirmed neurophysiologically by improved cerebral activity on brain mapping.