To compare the efficacy and safety outcomes of bimanual microincision cataract surgery (MICS) versus 2.2-mm coaxial phacoemulsification assisted by Femtosecond LenSx (Alcon-LenSx Inc., Aliso Viejo, ...CA).
This prospective, randomized, observational, comparative case series comprised 50 cataractous eyes of 50 patients receiving femtosecond laser refractive lens surgery followed by a bimanual MICS technique with two 1-mm incisions (25 patients) (FemtoMICS group) and a coaxial phacoemulsification technique with a 1-mm paracentesis and a 2.2-mm principal incision (25 patients) (FemtoCoaxial group). The main outcomes measures were: ultrasound power, effective phacoemulsification time, postoperative spherical equivalent, higher-order aberrations (corneal and internal), corneal thickness, endothelial cell count, macular thickness, and complications during and after surgery. Both groups were absolutely comparable for all variables preoperatively.
Mean ultrasound power was 1.8% ± 0.9% for MICS and 14.7% ± 4.9% for 2.2-mm incisions (P < .001). Effective phacoemulsification time values for MICS and 2.2-mm incisions were 1.5 ± 0.9 and 4.5 ± 2.9 sec, respectively (P = .002). Mean postoperative spherical equivalent was −0.26 for FemtoMICS and −0.33 for FemtoCoaxial (P > .05). The efficacy index at 1 month postoperatively was 160.2% for FemtoMICS and 149% for FemtoCoaxial. No significant differences were found in corneal thickness, endothelial cell count, and macular thickness. Complications included posterior capsule rupture (4%) and anterior capsule rupture with no posterior capsule tear (4%) for FemtoMICS and bridges due to incomplete capsulorhexis (4%) for FemtoCoaxial.
MICS and coaxial phacoemulsification techniques assisted by the Femtosecond LenSx achieved excellent safety and efficient outcomes. The FemtoMICS technique was surgically and statistically more efficient than the FemtoCoaxial technique.
Se presenta una propuesta en la que se realiza el análisis energético respectivo para la caracterización del poder calorífico de las gasolinas comerciales en Ecuador como: Super, Extra y Ecopaís. ...Este estudio se realiza en el laboratorio de motores de combustión interna de la Universidad de las Fuerzas Armadas-ESPE, con el propósito de obtener modelos matemáticos que relacionan los parámetros energéticos y de calidad de las gasolinas. Modelos que se obtendrán a través de herramientas computacionales como Red Neuronal Artificial (RNA), las mismas que utilizarán un conjunto de datos históricos proporcionados por la Agencia de Regulación y Control Hidrocarburífera (ARCH) del Ecuador, para su validación.
The study region is one of the most endangered area from wind erosion in the country. This process, coupled with recurrent droughts in last decades and the mishandling of productive practices have ...generated desertification. This study presents a review of the interaction of these processes based on literature, field survey and perception of producers. Recommendations for rehabilitation are proposed. The area covers 6.5 million hectares, hosting in 2002: 550,000 people and 7,825 farms in irrigated and non-irrigated lands. Irrigated lands are devoted to agricultural production. Non-irrigated have a mixed production system (beef cattle-wheat). Mean annual rainfall in 1940-2014 was 407 mm. In 60% of these years, rainfall was below the mean. Desertification in the area is a consequence of drought and mismanagement. In wet cycles, producers increase stocking rate and wheat-sown area using the same practices of the humid pampa. As a consequence of dry cycles, land is abandonment and fields covered by sand and invasive plants. Over 20 cm of soil has blown away and sand accumulates in fences and stays suspended in the atmosphere, reaching Bahía Blanca city and up to 400 km into the Atlantic Ocean. The area requires deep structural changes in production systems and their management. Emphasis should be on sustainable management, which involves a mentality change of producers and decision makers. Recommendations were made for cleared and non-cleared lands.
To analyze the mortality rate at one-year follow-up of patients with hip fracture who underwent surgery at the university hospital of this institution.
The authors reviewed 213 medical records of ...hospitalized patients aged 65 years or older, following to the order they were admitted to the orthopedics and traumatology service from January 2012 to August 2013.
One-year mortality rate was 23.6%. Mortality was higher among women, with a 3:1 ratio. Anemia (p=0.000) and dementia (p=0.041) were significantly associated with the death group. Patients who remained hospitalized for less than 15 days and who were discharged within seven days after surgery showed increased survival.
In the present sample of patients with hip fracture who underwent surgery, one-year mortality rate was 23.6%, and the main comorbidities associated with this outcome were anemia and dementia.
Analisar a mortalidade, em um ano de seguimento, de pacientes com fratura da extremidade proximal do fêmur submetidos a procedimento cirúrgico no hospital universitário da nossa instituição.
Foram revisados 213 prontuários de pacientes internados com 65 anos ou mais, conforme a ordem de admissão no Serviço de Ortopedia e Traumatologia de janeiro de 2012 a agosto de 2013.
A taxa de mortalidade em um ano foi de 23,6%. A mortalidade foi maior em mulheres, numa proporção 3:1. Anemia (p=0,000) e demência (p=0,041) estiveram significativamente associadas ao grupo óbito. Pacientes que permaneceram internados por até 15 dias e os que tiveram alta hospitalar em até sete dias após a cirurgia apresentaram um aumento na sobrevida.
Em nossa amostra de pacientes com fratura de fêmur submetidos a procedimento cirúrgico, a taxa de mortalidade foi de 23,6%; as principais comorbidades associadas a esse desfecho foram anemia e demência.
Background/Aims: Capsule endoscopy is a diagnostic method for evaluating the small bowel lumen and can detect undiagnosed lesions. The aim of this study was to evaluate the diagnostic yield and ...clinical impact of capsule endoscopy in patients with refractory diarrhea-predominant irritable bowel syndrome and functional abdominal pain.
Methods: This study involved a retrospective analysis of prospectively collected data, maintained in a database. Patients with refractory diarrhea-predominant irritable bowel syndrome and functional abdominal pain within the period of March 2012 to March 2014 were included. Capsule endoscopy was used to detect small bowel pathologies in both groups.
Results: Sixty-five patients (53.8% female) fulfilled the inclusion criteria and had a mean (±standard deviation) age of 50.9±15.9 years. Clinically significant lesions were detected via capsule endoscopy in 32.5% of the patients in the abdominal pain group and 54.5% of the patients in the diarrhea group. Overall, 48% of patients had small bowel pathologies detected during the capsule endoscopy study. Inflammatory lesions and villous atrophy were the most frequent lesions identified in 16.9% and 15.3% of patients in the abdominal pain and the diarrhea groups, respectively.
Conclusions: Routine use of capsule endoscopy in patients with irritable bowel syndrome should not be recommended. However, in patients with refractory conditions, capsule endoscopy may identify abnormalities. Clin Endosc 2018;51:570-575
En este trabajo se comparó la efectividad de la vacuna contra la COVID-19 (EV) durante agosto de 2021, en personas nacidas entre 1962
y 1971 y vacunadas durante junio, según la marca utilizada. La ...protección frente a infección por SARS-CoV-2 sintomática fue menor
para la vacuna de Janssen (56%; IC95%: 53-59) y AstraZeneca Vaxzevria (68%; IC95%: 65-70), en comparación con Pfizer Comirnaty
(78%; IC95%: 77-78), AZ/Pfizer (86%; IC95%: 80-90) y Moderna Spikevax (89%; IC95%: 88-90). La EV contra la hospitalización
osciló entre el 86% de Janssen y el 97%-98% de las demás vacunas.
In this paper we compared brand-specific COVID-19 vaccine effectiveness (VE) during August 2021 in persons born 1962-1971 and vaccinated
during June. For SARS-CoV-2 symptomatic infection, protection was lower for Janssen (56%; CI95%: 53-59) or AstraZeneca Vaxzevria
(68%; CI95%: 65-70), compared to Pfizer-BioNTech Comirnaty (78%; CI95%: 77-78), AstraZeneca/Pfizer (86%; CI95%: 80-90) or Moderna
Spikevax (89%; CI95%: 88-90). VE against hospitalization was ranged 86% for Janssen to 97%-98% for other vaccines.
Literature lacks clear evidence regarding the optimal treatment for non-muscle-invasive micropapillary bladder cancer (MPBC) due to its rarity and the presence of only small sample size and ...single-centre studies.
To assess cancer-specific mortality (CSM) and overall mortality (OM) between immediate radical cystectomy (RC) and conservative management among T1 high-grade (HG) MPBC.
We retrospectively analysed a multicentre dataset including 119 T1 HG MPBC patients treated between 2005 and 2019 at 15 tertiary referral centres. The median follow-up time was 35 mo (interquartile range: 19-64).
Patients underwent immediate RC versus conservative management with bacillus Calmette-Guérin.
Cumulative incidence functions and Kaplan-Meier methods were applied to estimate survival outcomes. Multivariable Cox analyses were performed to assess independent predictors of disease recurrence and disease progression after conservative management; covariates consisted of pure MPBC, concomitant lymphovascular invasion (LVI), and carcinoma in situ at initial diagnosis.
Immediate RC and conservative management were performed in 27% and 73% of patients, respectively. CSM and OM did not differ significantly among patient treated with immediate RC versus conservative management (Pepe-Mori test p = 0.5 and log-rank test p = 0.9, respectively). Overall, 66.7% and 34.5% of patients experienced disease recurrence and disease progression after conservative management, respectively. At multivariable Cox analyses, concomitant LVI was an independent predictor of disease recurrence (p = 0.01) and progression (p = 0.03), while pure MPBC was independently associated with disease progression (p = 0.03). The absence of a centralised re-review and the retrospective design represent the main limitations of our study.
Conservative management could achieve satisfactory results among T1 HG MPBC patients with neither pure MPBC nor LVI at initial diagnosis.
Bacillus Calmette-Guérin seems to be an effective therapy for T1 micropapillary bladder cancer patients with neither pure micropapillary disease nor lymphovascular invasion at initial diagnosis.
Introduction
Mural infective endocarditis (MIE) is a rare type of endovascular infection. We present a comprehensive series of patients with mural endocarditis.
Methods
Patients with infectious ...endocarditis (IE) from 35 Spanish hospitals were prospectively included in the GAMES registry between 2008 and 2017. MIEs were compared to non-MIEs. We also performed a literature search for cases of MIE published between 1979 and 2019 and compared them to the GAMEs series.
Results
Twenty-seven MIEs out of 3676 IEs were included. When compared to valvular IE (VIE) or device-associated IE (DIE), patients with MIE were younger (median age 59 years,
p
< 0.01). Transplantation (18.5% versus 1.6% VIE and 2% DIE,
p
< 0.01), hemodialysis (18.5% versus 4.3% VIE and 4.4% DIE,
p
= 0.006), catheter source (59.3% versus 9.7% VIE and 8.8% DIE,
p
< 0.01) and
Candida
etiology (22.2% versus 2% DIE and 1.2% VIE,
p
< 0.01) were more common in MIE, whereas the Charlson Index was lower (4 versus 5 in non-MIE,
p
= 0.006). Mortality was similar.
MIE from the literature shared many characteristics with MIE from GAMES, although patients were younger (45 years vs. 56 years,
p
< 0.001), the Charlson Index was lower (1.3 vs. 4.3,
p
= 0.0001), catheter source was less common (13.9% vs. 59.3%) and there were more IVDUs (25% vs. 3.7%).
S. aureus
was the most frequent microorganism (50%,
p
= 0.035). Systemic complications were more common but mortality was similar.
Conclusion
MIE is a rare entity. It is often a complication of catheter use, particularly in immunocompromised and hemodialysis patients. Fungal etiology is common. Mortality is similar to other IEs.
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