Sclerosis, injection of cianoacrylate and rubber band ligation are the most commonly used endoscopic techniques for the treatment of bleeding esophageal varices.
To assess the effectiveness of ...cianoacrylate and polidocanol in the treatment of bleeding esophageal varices.
Sixty eight patients with active variceal bleeding were studied. Bleeding varices were classified as thin, thick or gastric. Bleeding from thin varices was treated with polidocanol. Bleeding from thick or gastric varices was treated with cianoacrylate. Variceal eradication was done with polidocanol.
Bleeding came from thin esophageal varices in 23% of patients and endoscopic treatment stopped bleeding in 95% of them, from thick esophageal varices in 62% and endoscopic treatment was successful in 94% of these, and from gastric varices in 12% and treatment stopped bleeding in 87% of these (in 3% bleeding was considered subcardial). Twenty-five percent of patients bled again during variceal eradication, 12% died due to uncontrollable bleeding and 20% died due to liver failure. During variceal eradication 59% of patients classified as Child Pugh C, died.
Treatment of bleeding esophageal varices with cianoacrylate or polidocanol is effective. Patients classified as Child Pugh C have a had prognosis.
To study the prevalence os smoking in school children in Sevilla and the influence of personal and social environment on smoking patterns.
This study was part of a preventative anti-smoking campaign ...in schools. Students filled in anonymous questionnaires based on the World Health Organization survey instrument for population attitudes and habits.
We surveyed 3385 students between 10 and 19 years of age at 47 schools in Seville and 28 villages in the surrounding province. Current smoking was reported by 19.1% of the students; slightly more girls (19.8%) than boys (18.3%) smoked. Smoking was related to having an older brother or sister who smoked and particularly to having friends who smoked (OR 20.5). The adolescents reported that parents were less permissive than the rest of their environment. Smokers associated tobacco with values such as independence and freedom; they believed that smoking might have an impact on health, although their conviction was less strong than that of non-smokers, regular smokers had high expectations of continuing.
We found a high proportion of smokers among students of both sexes. Starting and continuing to smoke during adolescence is considerably influenced by the social environment of peers and is possibly affected by messages of independence and freedom transmitted through tobacco industry advertising.
It is known that the spin-chain compound Ca3Co2O6 exhibits very interesting plateaus in the magnetization as a function of the magnetic field at low temperatures. The origin of them is still ...controversial. In this paper we study the thermal behavior of this compound with a single-flip Monte Carlo simulation on a triangular lattice and demonstrate the decisive influence of metastable states in the splitting of the ferrimagnetic 1/3 plateau below 10 K. We consider the Co2O6n chains as giant magnetic moments described by large Ising spins on planar clusters with open boundary conditions. With this simple frozen-moment model we obtain stepped magnetization curves which agree quite well with the experimental results for different sweeping rates. We describe particularly the out-of-equilibrium states that split the low-temperature 1/3 plateau into three steps. They relax thermally to the 1/3 plateau, which has long-range order at the equilibrium. Such states are further analyzed with snapshots unveiling a domain-wall structure that is responsible for the observed behavior of the 1/3 plateau. A comparison is also given of the exact results in small triangular clusters with our Monte Carlo results, providing further support for our thermal description of this compound.
El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.
Objective: Present different flap alternatives ...when performing microvascular free-flap reconstruction in acute hard-to-heal wounds. Method: A retrospective review of patients whose acute hard-to-heal wounds were treated with microvascular free-flap reconstruction. Data on demographics, wound aetiology, diagnostic, previous treatment, free-flap type, free-flap size, complications and follow up were analysed. Results: A total of 20 patients received microvascular free-flap reconstruction. The median age was 39.5 years. Twenty free-flap reconstructions were performed. These included: 3 cross-leg free flap, 1 cross-leg vascular cable bridge flap, 2 fibula osteocutaneous flap, 6 anterolateral thigh (ALT) flap, 3 thoracodorsal artery perforator (TDAP) flap, 3 fasciomyocutaneous flap, and 2 femoral artery fasciocutaneous flap. A patient required microvascular anastomosis due to hematoma; the rest did not present complications during their postoperative. Previous treatment included negative pressure wound therapy (12 patients) and surgical debridement with silver hydrogel dressings (8 patients). Conclusion: Hard-to-heal wounds can be unresponsive to traditional wound healing practices or local flaps. They often require free-flap reconstruction, using tissues similar to those compromised. Microvascular techniques can be an effective alternative. CONFLICT OF INTEREST None.
Geography has played a critical role in Costa Rica’s Caribbean lowlands with respect to initial origin of the landmass, climate, patterns of vegetation, sites of early human settlement, colonial ...expansion, the construction of access roads, colonial and postcolonial exploitation of natural resources, conservation efforts, and current political and environmental issues. In this chapter, the authors offer a brief overview of these topics, encapsulate major biological research efforts in the Caribbean lowlands over the past 50 years, and look into the future—always within the framework of geography at different scales. First, the authors provide a historical overview of the Costa Rican Caribbean lowlands, a region which here includes Province of Limón, plus portions of the Provinces of Heredia, Alajuela, and Guanacaste, from 70 million years ago to the present. The authors then summarize the physical environment, giving descriptions of climate, weather, and soils in the region, as well as the biodiversity in plant and animal life, and the interactions therein. The chapter ends with a discussion of the relationship between humans and nature in the region, including effects of agriculture and pesticides and the efforts of conservationists.
A method is described based on the passage of air across the diaphragm to detect pathological diaphragmatic orifices in autopsies. This method was used in 65 post-mortem studies; orifices were ...detected in 7 cases. Only one of these appears histologically to be a real spontaneous orifice. This was found in the post-mortem study of a cirrhotic patient with ascites and massive and recurrent hydrothorax. In eight patients with cirrhotic ascites and pleural effusions, radioisotopes were introduced into the ascites fluid, and only in two of them, both with right massive and recurrent pleural effusion, was radioactivity detected in the pleural cavity within the 1st h after injection. The radioisotopic method for detecting in vivo these orifices avoids the repeated taps that are necessary when dyes are used.
The distribution of 16 antigens of the HLA-A and 15 antigens of the HLA-B series of HLA system, the blood groups ABO, and Rh antigens were studied in 40 alcoholics with cirrhosis, 18 alcoholics ...without cirrhosis, and in normal control subjects. The group of alcoholics with cirrhosis showed a significantly high frequency of HLA-B13 (corrected P less than 0.01) when compared with normal subjects, while the frequency of HLA-B13 was similar to normal in alcoholics without cirrhosis. On the basis of these findings, its seems that the carriers of HLA-B13 are more susceptible to liver damage caused by alcohol. Both groups of alcoholics and the normal controls had a similar distribution of ABO blood groups and Rh antigens.
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