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Sample records for tratamiento mediante shunt

  1. Encefalopatía hepática secundaria a la existencia de un shunt portosistémico tratada satisfactoriamente mediante radiología intervencionista Hepatic encephalophaty secondary to porto-systemic shunt satisfactorily treated with interventionist radiology

    Directory of Open Access Journals (Sweden)

    L. Crespo

    2007-11-01

    Full Text Available La encefalopatía hepática es un estado reversible de alteración en la función cognitiva, que puede ocurrir en pacientes con enfermedad hepática aguda o crónica o shunts porto-sistémicos, en el que puede aparecer cualquiera de los signos neurológicos o psiquiátricos conocidos. Las sustancias nitrogenadas procedentes de la digestión intestinal alcanzan el cerebro sin la depuración que supone su paso por el hígado, debido a las derivaciones porto-sistémicas, y dan lugar a los signos característicos de la encefalopatía hepática. A continuación presentamos dos casos clínicos de pacientes con shunt porto-sistémicos, diagnosticados de encefalopatía hepática crónica recurrente refractaria al tratamiento médico convencional, tratados satisfactoriamente con embolización de dicho shunt mediante técnicas de radiología intervencionista.Hepatic encephalopathy is a reversible state of altered cognition that may occur in patients with acute or chronic liver disease or porto-systemic shunt, and in which known neurological or psychiatric signs may develop. Nitrogenated substances from intestinal digestion reach the brain without being cleared by their passage through the liver due to the presence of porto-systemic shunt. We report two cases of patients with porto-systemic shunt diagnosed with recurrent chronic hepatic encephalopathy refractory to conventional medical treatment. They were satisfactorily treated with shunt embolization using interventionist radiology techniques.

  2. Tratamiento de aguas residuales textiles mediante un biorreactor de membrana

    OpenAIRE

    Lorena Salazar Gámez; Martí Crespi Rosell; Roberto Salazar

    2009-01-01

    En la actualidad, los investigadores dedicados al tratamiento de agua residual se han esforzado por obtener mejores rendimientos de depuración, reducción de costos de operación y mantenimiento en la generación de procesos que posean una elevada flexibilidad para soportar las variaciones en el afluente, que generen una mínima producción de lodos y que sean diseñados en condiciones mínimas de área. En este trabajo se expone una nueva tecnología en el tratamiento de agua residual, la de los Bior...

  3. Resultado comparativo del tratamiento de la epicondilitis subaguda del codo mediante infiltración esteroidea y el tratamiento convencional.

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    George Noel García Rodríguez

    2009-10-01

    Full Text Available La epicondilitis lateral del codo es una entidad de etiología controvertida, un problemade salud que causa discapacidad laboral además de disminuir la calidad de vida de lospacientes. El objetivo del trabajo fue mostrar los resultados de la terapia esteroidea encomparación con la terapéutica convencional. Se realizó un estudio prospectivolongitudinal aleatorizado, la población estuvo conformada por 50 pacientes tratados enla consulta de ortopedia del Hospital Universitario Camilo Cienfuegos y la PoliclínicaUniversitaria Rudesindo García de Sancti Spíritus, con el diagnóstico de epicondilitislateral subaguda del codo. El diseño quedó dividido en 25 casos para el grupo contratamiento convencional (grupo A y 25 casos para la infiltración esteroidea (grupo B.Se observó el predominio del sexo femenino n=31 para el 62% y una edad promedio de37.8 años. Los resultados del tratamiento mostraron un alivio del dolor significativo (p <0.5 para la terapéutica esteroidea en relación con el tratamiento convencional, lafrecuencia acumulada de resultados excelentes y buenos fue de un 88% con el uso delesteroide y del 70% para el grupo comparado. Similar fue la rápida reincorporaciónlaboral en la comparación de ambos grupos: 5.3/10.1 días grupo B y Arespectivamente. La despigmentación de la piel fue la única complicación de laterapéutica esteroidea, para el grupo de tratamiento convencional la discontinuidad enla asistencia a la terapia y la gastritis medicamentosa fueron las más frecuentes. Espertinente el uso de la terapia mediante infiltración esteroidea en la epicondilitis lateralsubaguda del codo.

  4. Tratamiento de un efluente textil mediante electrooxidación-Salix babylonica

    OpenAIRE

    Sánchez Sánchez, Hilda Alejandra

    2016-01-01

    A nivel mundial, la industria textil es considerada una de las principales fuentes de descarga que afectan la calidad del agua debido al gran volumen que emplea en sus procesos y al uso de una amplia gama de colorantes sintéticos. En esta investigación se evaluó el tratamiento de un agua residual textil mediante un sistema acoplado de electrooxidación-Salix babylonica usando electrodos DDB. En el estudio, se construyó una celda electroquímica en batch, utilizando 5 electrodos paralelos vertic...

  5. Tratamiento de aguas industriales mediante reactor biológico de membranas

    OpenAIRE

    Aznar Jiménez, Antonio

    2008-01-01

    El Laboratorio de Ingeniería para el Tratamiento de Aguas de la Universidad Carlos III de Madrid, de investigación y servicios en el tratamiento de aguas residuales, optimiza el diseño y puesta a punto de reactores biológicos de membranas (MBR), indicados para obtener agua depurada de alta calidad y/o aumentar la capacidad de tratamiento.

  6. Tratamiento superficial de materiales mediante luz solar concentrada: una opción mediante energías renovables

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    Martínez, D.

    1998-04-01

    Full Text Available The possible applications of solar furnaces to materials surface treatment are explained in an illustrative manner. A brief description of these systems is exposed, as well as an overview of the feasible industrial or testing applications for which their validity has been proven.

    En este artículo se explica de manera ilustrativa la posible aplicación de los hornos solares al tratamiento superficial de materiales. Se realiza una breve descripción de estos sistemas y se da un repaso a las posibles aplicaciones industriales ó de ensayo para las que se ha demostrado su aptitud.

  7. Tratamiento de las osteitis diafisarias de tibia mediante sinostosis tibioperonea y resección ósea

    OpenAIRE

    Fernández Sabaté, Alfons; Riu Labrador, R.; Moreta Munujos, D.; Cáceres Palou, Enrique

    1984-01-01

    El tratamiento de las osteítis crónicas de la diáfisis tibial obliga a menudo a practicar una amplia resección para alcanzar el tejido óseo sano y esta exigencia operatoria debilita la diáfisis. Para obviar la fractura operatoria o posterior por fatiga y para facilitar la resección sin temor se ha utilizado una táctica quirúrgica consistente en una solidarización tibioperonea que construye un residente eje en la pierna ya sea mediante injerto intertibioperoneo ya con peroné protibia de Zanoli...

  8. OXIDACIÓN DE MATERIA ORGÁNICA PERSISTENTE EN AGUAS RESIDUALES INDUSTRIALES MEDIANTE TRATAMIENTOS ELECTROQUÍMICOS

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    Ivonne Linares-Hernández

    2011-01-01

    Full Text Available El objetivo de esta investigación fue implementar un sistema electroquímico, mediante tratamientos de electrocoagulación, empleando electrodos de hierro y oxidación anódica directa (OAD, empleando electrodos de diamante dopados con boro (DDB, para tratar aguas residuales provenientes de una planta de tratamiento que recibe las descargas de 144 empresas de diferentes giros, de la zona industrial Toluca-Lerma, México. Los resultados de estos tratamientos, indicaron una remoción del 99% de la demanda química de oxígeno (DQO, 99% de color y 97% de turbidez, en un tiempo de 2 h. En el sistema acoplado, la electrocoagulación removió las partículas coloidales y suspendidas y la OAD, permitió la degradación de materia orgánica persistente. Se determinó la cantidad de lodos generados en el sistema y se caracterizaron por microscopia electrónica de barrido y análisis elemental. Se concluye que los métodos electroquímicos resultan ser aplicables y eficientes en la degradación compuestos que no son fácilmente biodegradables.

  9. Tratamiento de un molar permanente inmaduro necrótico mediante pulpotomía

    OpenAIRE

    Boj Quesada, Juan Ramón; Cortés Lillo, Olga; Canalda Sahli, Carlos

    1995-01-01

    Se describe un caso que afecta al primer molar permanente inferior derecho, con tumefacción, fluctuación y fístula , con ápices no cerrados. El tratamiento de elección hubiese sido una técnica clásica de apicoformación con hidróxido de calcio. Pero por motivos de colaboración, se realizó una pulpotomía con hidróxido de calcio. Tras los controles radiológicos a los 3 meses, al año y al año y medio se comprobó que continuaba el desarrollo radicular y finalizaba el cierre apical.

  10. Fobia social : tratamiento en grupo del miedo a hablar en público de cuatro sujetos mediante un diseño n=1

    OpenAIRE

    Maciá Antón, Diego; García López, Luis Joaquín

    1995-01-01

    La fobia social es un trastorno recientemente definido del que aún se sabe poco en relación con el origen y tratamiento, y del que el miedo a hablar en público es considerado como una fobia social específica. La presentación de este trabajo tiene por objetivo exponer los resultados de un tratamiento cognitivoconductual, utilizando técnicas de exposición, discusión de pensamientos, entrenamiento en respiración y en autoinstrucciones, y biblioterapia mediante cua...

  11. Tratamiento del polvo de aluminio mediante disolución acuosa

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    López, F. A.

    2004-10-01

    Full Text Available Aluminium dust from aluminium remelting industry is a hazardous residue because of its high reactivity in the presence of water. In order to apply the new European Directive about landfill of waste, a study of its hydrolysis was carried out. The influence of temperature, time and pH on the hydrolysis of the aluminium dust was studied. The hydrolysed solids were characterized by XRD and AAS; in the aqueous solutions the pH and the ionic conductivity were determined. The evolved gases were analysed by mass spectrometry. The reactivity of the dust, before and after hydrolysis, was investigated by analysing the ammonia, hydrogen sulphide and metallic aluminium. By hydrolysis at 60 °C and 48 h a much lower reactive material was obtained which could be disposed with minimal environmental impact.

    El polvo de aluminio es un residuo generado en la metalurgia secundaria del aluminio y considerado peligroso como consecuencia de su elevada reactividad en presencia de humedad. Con objetivo de buscar un procedimiento de pretratamiento de dicho residuo, de acuerdo con la Directiva Europea sobre vertederos, se ha realizado el estudio del comportamiento del polvo de aluminio en medio acuoso. Para ello, se han analizado la influencia de la temperatura, el tiempo y el pH de reacción en su hidrólisis. Los sólidos hidrolizados se caracterizaron mediante EAA y DRX, mientras que en las soluciones acuosas resultantes se determinaron el pH y la conductividad iónica. Los gases liberados durante el proceso de hidrólisis se analizaron mediante espectrometría de masas. Asimismo, se ha determinado la reactividad del residuo antes y después de la hidrólisis, analizando amoniaco, sulfuro de hidrógeno y aluminio metálico. La hidrólisis, a 60 °C y después de 48 h, permite obtener material de muy baja reactividad que podría ser almacenado en vertedero.

  12. Tratamiento quirúrgico de las lesiones intradurales extramedulares mediante hemilaminectomía

    Science.gov (United States)

    Villalonga, Juan F.; Cervio, Andrés

    2017-01-01

    Resumen Objetivo: Evaluar la utilidad de la hemilaminectomía como abordaje quirúrgico en pacientes con tumores intradurales-extramedulares. Material y métodos: Estudio descriptivo retrospectivo que incluye a 53 pacientes en los que se utilizó la hemilaminectomía como abordaje a tumores intradurales-extramedulares durante el periodo junio de 2006 a diciembre de 2015. Se analizaron datos demográficos, signo-sintomatología preoperatoria, características imagenológicas, hallazgos intraoperatorios, estirpe histológico y complicaciones post-quirúrgicas. El periodo de seguimiento promedio fue de 48.9 meses (6-120 meses). Resultados: Cincuenta y tres pacientes con tumores intradurales-extramedulares fueron intervenidos mediante hemilaminectomía. La serie incluyó 5 tumores cervicales, 24 dorsales y 24 lumbares. El análisis histológico reveló 28 neurinomas, 11 meningiomas, 7 ependimomas y 7 “lesiones varias”. En el 96% de los casos se efectuó una exéresis total sin causar déficit neurológico agregado. No se evidenció recidiva en ninguno de los casos durante el periodo de seguimiento. Conclusión: La hemilaminectomía constituye una vía efectiva para la resección de tumores intradurales-extramedulares lateralizados a nivel cervicodorsal. Mientras que a nivel lumbar esta técnica puede ser también útil en lesiones de línea media. PMID:29142776

  13. Tratamiento de quemaduras mediante plasma rico en plaquetas (PRP: parte I

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    G. Rossani

    2014-06-01

    Full Text Available El objetivo del presente trabajo es determinar la eficacia clínica del plasma rico en plaquetas (PRP en las quemaduras de segundo grado. Estudiamos el tiempo requerido en la reepitelización del tejido dañado, la estancia hospitalaria asociada a la curación de las lesiones y la satisfacción del paciente. Realizamos un estudio prospectivo, observacional y longitudinal, en una muestra de 115 pacientes con quemaduras de segundo grado según la clasificación de Converse-Smith. Las lesiones fueron de menos de 48 horas de evolución, en diferentes zonas de cara y cuerpo. A todos los pacientes se les aplicó de forma ambulatoria PRP por goteo, completándose el tratamiento con la aplicación de gasas parafinadas. El estudio se realizó entre marzo de 2011 y agosto de 2013. Las quemaduras que evolucionaron mejor y de forma más rápida fueron las de cara, seguidas por las de abdomen y, por último, las de extremidades inferiores. En todas, el tiempo de epitelización fue un 30 % inferior que en quemaduras de similar extensión, profundidad y localización, en pacientes anteriormente tratados sin PRP. Los pacientes fueron atendidos ambulatoriamente cuando las lesiones lo permitieron, y si presentaban lesiones más extensas fueron hospitalizados. El tiempo de internamiento en estos casos se redujo como promedio 18 días con respecto al grupo no tratado con PRP. El tiempo de reepitelización, estancia hospitalaria y la satisfacción de los pacientes, alcanzaron significación estadística p< 0,05. En conclusión, creemos que el uso de PRP acorta el tiempo de recuperación en quemaduras de segundo grado, reduce el tiempo de hospitalización y conlleva un alto grado de satisfacción de los pacientes por los resultados obtenidos.

  14. Evaluación del comportamiento mecánico y superficial de materiales metálicos sometidos a tratamientos de compresión mediante ondas de choque generadas por láser

    OpenAIRE

    Gutiérrez González, Javier

    2016-01-01

    El presente trabajo de fin de grado se ha desarrollado en el Centro Láser de la Universidad Politécnica de Madrid y ha consistido en la caracterización mecánica y superficial del acero AISI 316L tras haber sido tratado mediante el tratamiento “Laser peening” y el estudio de la estabilidad de las tensiones residuales inducidas al ser sometido a un tratamiento a 500ºC durante dos horas. El tratamiento LSP es un tratamiento mecánico superficial que consiste en la creación de ondas de choque ...

  15. Adicción a los videojuegos en línea: Tratamiento mediante el programa PIPATIC

    OpenAIRE

    Torres-Rodríguez, Alexandra; Carbonell, Xavier

    2015-01-01

    El desarrollo de las Tecnologías de la Información y la Comunicación (TIC) ha propiciado investigaciones sobre la adicción a Internet, a los videojuegos y teléfonos móviles y su tratamiento. El objetivo del presente estudio es presentar la aplicación de un programa de tratamiento psicoterapéutico para la adicción a las TIC (PIPATIC) y la evaluación de su efectividad en un estudio de caso único de un paciente con trastorno dual: Internet Gaming Disorder (IGD) y trastorno obsesivo-compulsivo (T...

  16. Tratamiento de las hipoplasias severas del pulgar mediante modificaciones a la técnica de Buck-Gramcko

    OpenAIRE

    Peña Marrero, Liván

    2008-01-01

    En este trabajo se evalúa la efectividad de una modificación diseñada por el autor a la técnica de pulgarización del dedo índice descrita por Dieter Buck-Gramcko para el tratamiento de las hipoplasias y aplasias del pulgar. Se realizó un estudio prospectivo longitudinal en 17 pacientes distribuidos en dos grupos. El grupo A estuvo constituido por 9 pacientes (10 manos operadas) a quienes se le aplicó como tratamiento la técnica original de Buck-Gramcko. El grupo B estuvo integrado por 8 pacie...

  17. Efectividad del tratamiento mediante ultrasonido y ejercicios terapéuticos en la tendinitis del supraespinoso sin calcificar

    OpenAIRE

    Vírseda García, Ángela

    2011-01-01

    Introducción: La tendinitis del músculo supraespinoso en una de las causas más frecuentes de consulta en Atención Primaria. En el caso del Centro de Salud Daroca supone un 43,80 % del total de patologías de hombro. Debido a la frecuencia de dicha patología y a la repercusión de la misma es necesario presentar un método de tratamiento lo más efectivo posible. Objetivo: Comprobar la efectividad del tratamiento fisioterapéutico combinado de ultrasonido y ejercicios terapéuticos en pacientes ...

  18. Tratamiento del maxilar posterior atrófico mediante técnica de reconstrucción tridimensional con elevación de seno y abordaje «en tunel»

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    Andrés Restoy

    2015-01-01

    Conclusiones: El tratamiento del sector posterior maxilar atrófico mediante reconstrucción tridimensional con autoinjerto óseo, elevación sinusal y abordaje por tunelización es una técnica que proporciona resultados predecibles y estables, permitiendo la rehabilitación con coronas sobre implantes dentales de dimensiones adecuadas.

  19. Extracción de ADN de Trypanosoma cruzi mediante tratamiento con bromuro de hexadecil-trimetil-amonio

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    Marcela Escalante

    1997-06-01

    Full Text Available En el presente trabajo se describe un método rápido, sencillo y eficaz para la obtención de ADN genómico de Trypanosoma cruzi, libre de impurezas y fácil de manipular. Dicho procedimiento se basa en la lisis del parásito con SDS y remoción de proteínas mediante la digestión con proteinasa K, seguida de la precipitación selectiva de carbohidratos y proteínas residuales con bromuro de hexadecil-trimetil-amonio (CTAB. Finalmente, el ADN se extrae con cloroformo: alcohol isoamílico y se recupera de la fase acuosa mediante precipitación con isopropanol.

  20. Tratamiento del cáncer de cabeza y cuello en estadio avanzado inoperable mediante quimioterapia intraarterial y radioterapia concomitante

    OpenAIRE

    García Sevilla, Alba

    2017-01-01

    La quimioterapia intraarterial y radioterapia concomitante fue descrita por Robbins en 1994 en el tratamiento de pacientes con tumores irresecables de cabeza y cuello, consistiendo en una infusión supraselectiva intraarterial de cisplatino en la arteria nutricia del tumor y una infusión sistémica de tiosulfato sódico, un agente quelante que protege al resto del organismo de la toxicidad del cisplatino. Se consigue una dosis alta del quimioterápico en la zona tumoral minimizando los efectos tó...

  1. Tratamiento de disoluciones que contienen cromo hexavalente mediante electrocoagulación con ánodos de hierro

    OpenAIRE

    ARROYO NÚÑEZ, MARÍA GUADALUPE

    2011-01-01

    Los residuos de cromo hexavalente y sus compuestos se originan en industrias tales como la fabricación de coches, el refino del petróleo, el tratamiento de superficies, la preparación de cromato, las industrias de fertilizantes y las industrias que emplean componentes de Cr(VI) como inhibidores de la corrosión. Los compuestos derivados del Cr(VI) son muy contaminantes, tienen un efecto altamente oxidante y facilidad para penetrar en membranas biológicas, además de ser cancerígenos para los...

  2. Valoración del tratamiento mediante radiofrecuencia en dolor lumbar de orígen facetario

    OpenAIRE

    Correas Alguacil, Noemi; Muniesa Portoles, Josep Maria; Universitat Autònoma de Barcelona. Departament de Medicina

    2012-01-01

    Evaluar la eficacia de la técnica de radiofrecuencia facetaria guiada por TAC en el síndrome facetario lumbar refractario a tratamiento conservador. II. Materiales y métodos. Analizamos la respuesta a la radiofrecuencia guiado por TAC en 32 pacientes. El análisis incluyo una evaluación clínica previa, al mes, a los 3, 6 meses y al año. III. Resultados y conclusiones. El análisis demuestra una disminución notable y significativa de la puntuación media del EVA y mejoría en la valoración funcion...

  3. Polvos de Al-Al3Ti obtenidos mediante aleado mecánico y tratamiento térmico

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    Gallardo, J. M.

    2005-12-01

    Full Text Available Mixed powders of aluminium and titanium (10 wt % have been mechanically alloyed in an Attritor mill. A metastable solution of titanium in an aluminium matrix is obtained. Changes produced on shape and particle size, structure and microstructure, have been studied when milling time varies between 2 and 10 h. The final processing is carried out for a milling time of 10 h, with approximately 9 wt % of titanium dissolved in the matrix. Finally, a heat treatment is carried out at different temperatures, up to a maximum of 625 °C, which produces the precipitation of different phases such as different structures of Al3Ti and Al4C3. The appearance of these second phases is characterized according to the selected heat treatment temperature.Polvos mezclados de aluminio y titanio (10 % en peso han sido aleados mecánicamente en un molino Attritor, obteniéndose una solución metaestable de titanio en la matriz de aluminio. Se han estudiado los cambios producidos en la forma y tamaño de las partículas, estructura y microestructura, al variar el tiempo de molienda entre 2 y 10 h. El procesado final se realiza para un tiempo de 10 h, habiéndose disuelto aproximadamente un 9 % en peso de titanio. Finalmente, se realiza un tratamiento térmico a diversas temperaturas, hasta un máximo de 625 °C, lo que produce la precipitación de diversas fases, como distintas estructuras de Al3Ti y Al4C3. La aparición de estas segundas fases es caracterizada en función de la temperatura de tratamiento utilizada.

  4. Morbilidad, mortalidad y costes sanitarios evitables mediante una estrategia de tratamiento del tabaquismo en España

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    González-Enríquez J.

    2002-01-01

    Full Text Available Objetivo: Se valoran los efectos que tendría una intervención destinada a reducir el uso de tabaco en la población española de fumadores sobre la morbilidad, la mortalidad y los costes asociados al consumo de tabaco. Método: Se ha adaptado el modelo Health and Economic Consequences of Smoking patrocinado por la OMS y desarrollado por The Lewin Group. La intervención propuesta incluye el acceso a asistencia farmacológica de un 35% de los fumadores que intentan dejar de fumar, y obtienen una tasa global de cesación al año del 7,2%. Las enfermedades estudiadas son: cáncer de pulmón, enfermedad coronaria, enfermedad cerebrovascular, EPOC, asma y bajo peso al nacer. Se estiman los casos de enfermedad y muerte atribuibles al consumo de tabaco evitados y la reducción en el coste sanitario debidos a la intervención, proyectados a 20 años. Resultados: Sin intervención, en el año 1 del modelo 2.136.094 fumadores padecen alguna de las condiciones clínicas atribuibles al consumo de tabaco, el coste asistencial es de 4.286 millones de euros y las muertes atribuibles son 26.537. La intervención propuesta evita 2.613, 9.192, 17.415 y 23.837 casos de enfermedad atribuible al consumo de tabaco en los años 2, 5, 10 y 20 del modelo, respectivamente. Los costes asistenciales acumulados evitados son 3,5 millones de euros en el año 2 y 386 millones de euros a los 20 años. Las muertes acumuladas evitadas son 284 en el año 2 y 9.205 a los 20 años de la intervención. La intervención añade un total de 78.173 años de vida al final del período considerado. Conclusiones: La disponibilidad de nuevas intervenciones eficaces en el tratamiento del tabaquismo y el incremento de la accesibilidad a las mismas pueden contribuir de forma relevante a la reducción de la morbilidad, la mortalidad y los costes sanitarios asociados al tabaquismo en España.

  5. Tratamiento metalúrgico de los óxidos Waelz mediante lixiviación alcalina utilizando carbonato amónico

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    Meseguer, V.

    1997-04-01

    Full Text Available A method to carry out the treatment of the Waelz oxides is proposed, and the principal stages implicated are studied laboratory-scale. The process consists of the oxides leaching with an ammonium carbonate/ammonia solution, followed the recovery of the zinc leached by means of its precipitation as zinc basic carbonate. The process stages that have been studied are: Waelz oxides leaching, loaded leach purification, zinc precipitation, zinc basic carbonate washing and zinc basic carbonate transformation. The designed treatment presents a null environmental impact, and more than 90 % of the zinc contained in the Waelz oxides, as well as 80 % of the copper and cadmium contents could be recovered. Also, the process presents great flexibility as soon as zinc could be recovered in the most convenient form (zinc metal, oxide or salt.

    Se propone un método para el tratamiento de los óxidos Waelz, y se estudian, a nivel de laboratorio, las principales etapas implicadas en el mismo. El proceso consiste básicamente en la lixiviación de los óxidos con una disolución de carbonato amónico/amoniaco, y posterior recuperación del cinc lixiviado mediante su precipitación como carbonato básico de cinc. Las etapas que constituyen el proceso y que han sido objeto de estudio son: lixiviación de los óxidos Waelz, purificación de la lejía concentrada de lixiviación, precipitación del cinc, lavado del carbonato básico de cinc precipitado y transformación del carbonato básico de cinc. El tratamiento diseñado presenta un impacto ambiental prácticamente nulo, y con el mismo se puede recuperar más del 90 % del cinc contenido en los óxidos Waelz, así como el 80 % del cobre y del cadmio. Además, el proceso presenta gran versatilidad en cuanto que el cinc se puede recuperar en el estado más conveniente (cinc metal, óxido o sal.

  6. Tracción de la base de la lengua mediante fijación para el tratamiento de la apnea del sueño

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    J.L. Cebrián Carretero

    2003-12-01

    Full Text Available El síndrome de apnea obstructiva del sueño (SAOS constituye en la actualidad un problema de salud importante, tanto por su prevalencia como por la morbilidad que provoca sobre el aparato cardiovascular y la calidad de vida del paciente. Actualmente, la base del tratamiento es la administración de presión positiva continua durante el sueño (CPAP que, si bien tiene una elevada eficacia, no es tolerada en muchos casos. Los tratamientos quirúrgicos han sido variados. En un principio se centraron en el sistema velofaríngeo con mejorías no superiores al 50% a largo plazo. En nuestro planteamiento terapéutico identificamos, mediante pruebas funcionales y de imagen, las regiones implicadas en cada caso. Entre ellas destaca la base de la lengua. La técnica que presentamos constituye una modificación a las ya descritas para el avance de la base lingual. Consiste en una fijación controlada de la misma a la cortical vestibular de la mandíbula con un punto de hilo de monofilamento pasado a través de dos orificios, sin necesidad de aditamentos especiales. Conseguimos una estabilización permanente con buenos resultados clínicos y polisomnográficos a largo plazo. Las complicaciones estuvieron en relación con problemas deglutorios en el postoperatorio inmediato.Sleep apnoea síndrome constitutes an important health problem because of its prevalence and impact over the cardiovascular system and quality of life of the patient. The classic conservative treatment remains to be the CPAP. Although it has a high efficacy, it is not well tolerated by the patient in many cases. The surgical treatments were initially devoted to the velopharyngeal complex, being definitive in only 50% of the cases. Our therapeutical approach consists on a thorough examination of the different areas affected in every case, one of which is the tongue base. The surgical technique we present constitutes a modification of others already described to advance the tongue base. It

  7. Proyecto de ampliación del tratamiento secundario mediante humedales artificiales de macrofitas en flotación en la EDAR Novelda-Monforte del Cid

    OpenAIRE

    Tresserras Herrero, Alba

    2015-01-01

    El proyecto en cuestión trata de la construcción de humedales artificiales de flujo superficial con macrófitas en flotación, para solventar el problema producido por el aumento de la población servida en la EDAR Novelda-Monforte del Cid. Mientras que el pretratamiento y el tratamiento primario de la EDAR son suficientes para soportar esta demanda, el tratamiento secundario necesita una ampliación para poder soportarla. Por tanto, las actuaciones a realizar en el presente proyecto se citan a c...

  8. Comparación de distintos escenarios de tratamiento de residuos urbanos en la ciudad de Madrid mediante la metodología de la huella de carbono

    OpenAIRE

    Montejano Nares, Elena

    2018-01-01

    El objeto del proyecto es el análisis de la huella de carbono (HC) de los distintos tratamientos de valorización y eliminación de los residuos municipales de la ciudad de Madrid, con el fin de determinar el impacto sobre el cambio climático (CC). A través de la metodología de Análisis de Ciclo de Vida (ACV) se cuantifican las emisiones de los gases de efecto invernadero (GEI) correspondientes a cada uno de los tratamientos de gestión de residuos que se realizan actualmente en el Parque Tecnol...

  9. Tratamiento Actual del Pie Zambo

    OpenAIRE

    Salom Taverner, M.; Mínguez Rey, María Fe

    2015-01-01

    El pie zambo es una deformidad congénita en la que el pie presenta una deformidad en equino, varo de retropié, aductus del antepié y cavo. Su tratamiento ha variado con el tiempo. Clásicamente se trataba mediante distintas técnicas quirúrgicas que permitían corregir todas las deformidades pero que se acompañaban de frecuentes complicaciones a corto y largo plazo. Actualmente el tratamiento más extendido de esta deformidad es el tratamiento conservador mediante la técnica de Ponset...

  10. Remoción de nutrientes mediante coagulantes naturales y químicos en planta de tratamiento de aguas residuales, Valledupar Colombia

    Directory of Open Access Journals (Sweden)

    Damileth Dearmas Duarte

    2015-12-01

    Full Text Available Se evaluó desempeño y eficiencia de dos coagulantes químicos: sulfato de aluminio y policloruro de aluminio (PAC, y dos naturales: moringa (Moringa oleífera y cardón guajiro (Lemaireoreus griseus en la remoción de nutrientes y sedimentos del efluente de la planta de tratamiento de aguas residuales conformado por lagunas de estabilización El Salguero ubicada en el municipio de Valledupar, Cesar, Colombia. Los ensayos se llevaron a cabo con muestras de agua procedentes del río Cesar recogidas en el efluente del sistema de tratamiento. La turbidez varía desde 25 NTU hasta 67 NTU durante la época de desarrollo de la investigación. Se obtuvo que el sulfato de aluminio pese a no alcanzar la turbidez exigida por la normatividad colombiana (Decreto 3930/2010, Articulo N°72 Turbidez ≥ 5 NTU es un coagulante que remueve más del 80% de los parámetros de DQO, DBO y algas. El policloruro de aluminio es adecuado para disminuir significativamente la turbidez y los SST en un 92%, además presentó la mejor viabilidad económica de los tratamientos; y para la disminución de fosforo total resultaron efectivos los tratamientos con coagulantes naturales moringa y cardón, los cuales presentaron una remoción de 90.35%. Se concluye que los coagulantes evaluados presentan un potencial de remoción de los parámetros analizados, los resultados avalan a la Moringa oleífera como una posible alternativa natural en la potabilización de las aguas, ya que garantiza no sólo lograrcon éxito el proceso de coagulación, sino también, la ausencia de residuos

  11. Protección contra la corrosión en agua de mar de la aleación AA5083 mediante tratamientos basados en sales lantánidas

    Directory of Open Access Journals (Sweden)

    Aballe, A.

    1998-05-01

    Full Text Available AA5083 sheet samples have been pre-treated by full immersion in aqueous solutions of different lanthanide trichlorides salts, namely CeCl3, LaCl3 and SmCl3 The inhibition against uniform and pitting corrosión, in 3.5 % NaCl solutions, provided by such surface treatments has been estimated using electrochemical techniques. Protection against pitting has been quantified in terms of the percentage of increase observed for the pitting nucleation resistance. Among all the pretreatments tested, optimum performances have been observed for those carried out in 500 ppm CeCl3 aqueous solutions for fifteen days. However, acceptable protection degrees are observed even after 48 h in this solution.

    Se ha estudiado el poder protector de diferentes tratamientos superficiales obtenidos por inmersión total de muestras de la aleación AA5083 en disoluciones acuosas de CeCl3, LaCl3 y SmCl3. Su comportamiento frente a la corrosión en disoluciones de NaCl al 3,5 % se ha evaluado con ayuda de técnicas electroquímicas. Para ello, se ha determinado el grado de protección contra la corrosión uniforme y a la corrosión por picaduras, en términos del porcentaje de aumento de la resistencia a la nucleación de picaduras. A partir de estos resultados, se ha encontrado que las condiciones óptimas de protección se obtienen a partir de los 15 días de tratamiento en la disolución que contiene CeCl3, si bien mediante tratamientos de 48 h de inmersión se alcanzan grados de protección aceptables.

  12. Simulación del efecto de la irradiación mediante el trabajado en frío y los tratamientos térmicos en dos aceros inoxidables austeníticos

    Directory of Open Access Journals (Sweden)

    de Diego, G.

    1998-10-01

    Full Text Available In the present study, annealed type 304 SS was cold worked and heat treated to simúlate irradiation hardening, ductility loss and grain boundary segregation. Constant Extension Rate Tensile (CERT tests were conducted to reproduce Irradiation Assisted Stress Corrosion Cracking (IASCC in BWR (Boiling Water Reactor environment.

    En este trabajo se simulan los efectos que produce la irradiación, pérdida de ductilidad y segregación de impurezas en borde de grano, mediante trabajado en frío y posterior tratamiento térmico, para aceros inoxidables austeníticos AISI 304. Mediante ensayos de velocidad de extensión constante y en medios similares a los de los reactores de agua en ebullición se intenta relacionar la susceptibilidad a la corrosión bajo tensión con la susceptibilidad a la corrosión asistida por irradiación.

  13. Diseño basado en técnicas de fiabilidad del tratamiento de mejora del terreno mediante columnas de grava

    OpenAIRE

    Alonso Pollán, José Antonio

    2014-01-01

    El proyecto geotécnico de columnas de grava tiene todas las incertidumbres asociadas a un proyecto geotécnico y además hay que considerar las incertidumbres inherentes a la compleja interacción entre el terreno y la columna, la puesta en obra de los materiales y el producto final conseguido. Este hecho es común a otros tratamientos del terreno cuyo objetivo sea, en general, la mejora “profunda”. Como los métodos de fiabilidad (v.gr., FORM, SORM, Monte Carlo, Simulación Direc...

  14. Análisis de la funcionalidad de los sistemas de tratamiento de lixiviados provenientes de vertederos mediante evaporación natural, para los municipios de Ecuador

    OpenAIRE

    Garzón Alvear, Isabel Margarita

    2014-01-01

    El manejo y tratamiento de lixiviados es uno de los principales desafíos a resolver en las temáticas de los residuos domiciliarios a nivel mundial, siendo esta situación más grave en los países del tercer mundo, entre ellos los latinoamericanos. En el caso particular de Ecuador, se sabe que la problemática es de base, ya que aún se tienen 144 botaderos a cielo abierto, en los cuales los lixiviados se encuentran recogidosen piscinas esperando su evaporación. La evaporación de lixiviado ocurre ...

  15. Presentación del dossier Evaluación y tratamiento psicológico mediante realidad virtual y otras nuevas tecnologías

    OpenAIRE

    Gutiérrez Maldonado, José

    2009-01-01

    Pese a lo que pudiera parecer a primera vista, la realidad virtual no es una tecnología exótica. Las aplicaciones de la realidad virtual se hallan presentes ya en gran cantidad de campos, desde las simulaciones con las que se entrena en el manejo de diferentes tipos de máquinas, hasta sistemas de visualización que ayudan a comprender complejos sistemas conceptuales matemáticos. En medicina existen desde hace años aplicaciones mediante las que es posible aprender y practicar técnicas quirúrgic...

  16. Evaluación del tratamiento de agua para consumo humano mediante filtros Lifestraw® y Olla Cerámica

    OpenAIRE

    Pérez-Vidal, Andrea; Díaz-Gómez, Jaime; Salamanca-Rojas, Karen L; Rojas-Torres, Leidy Y

    2016-01-01

    Objetivo Evaluar la eficiencia de dos sistemas de filtración casera: LifeStraw® family (FM) y Filtro de Olla Cerámica (FOC) en el tratamiento del agua para consumo humano bajo condiciones controladas de laboratorio y en términos de remoción de Turbiedad y E.coli. Métodos Ambos sistemas se operaron durante 6 meses tratando diariamente 7,5 litros de sustrato sintético. La turbiedad del sustrato se ajustó con Caolín y la concentración de E.coli con la réplica de la cepa ATCC 95922. Los resultado...

  17. Producción y tratamiento de películas de Si1-xGex mediante técnicas asistidas por láser de excímero

    Directory of Open Access Journals (Sweden)

    Castro, J.

    1998-04-01

    Full Text Available Heterostructures of Si1-xGex alloys on Si (100 have been achieved using two different excimer laser techniques. The first one, the Laser Induced Chemical Vapour Deposition (LCVD, was used in order to deposit germanium on Si (100 substrates via photolysis of GeH4 as precursor gas. The resulting films show a very homogeneous and amorphous structure as determined by HREM, XRD and Raman analysis. These deposited amorphous germanium films and a part of their underlaying Si (100 substrate were melted using the second technique, the Pulsed Laser Induced Epitaxy (PLIE, inducing an epitactic recrystallization of a Si-Ge alloy. The analysis of the obtained alloys by HREM, XRD, and XPS, reveals a strong dependence of the crystal quality and of the germanium concentration profile from the number of pulses.

    El creciente interés que suscita la búsqueda de nuevas técnicas para la obtención de materiales semiconductores, compatibles con la tecnología del silicio, ha llevado a desarrollar un sistema de depósito y postprocesado en alto vacío (HV de Si-Ge mediante técnicas asistidas por láser excímero. Se han obtenido películas amorfas de germanio mediante el depósito químico en fase vapor inducido por láser (LCVD, que posteriormente han sido recristalizadas con uso de la inducción de epitaxia por medio de láser pulsado (PLIE. Las películas depositadas sobre substratos de silicio fueron caracterizadas mediante XRD, HREM y Raman, revelándose que son amorfas con un alto grado de homogeneidad. Se ha estudiado la morfología y la estequiometría de las muestras por medio de XRD, HREM y XPS tras el tratamiento para inducir la cristalinidad de la aleación sobre el substrato de silicio, observándose la dependencia del grado de heteroepitaxia y variación de la composición en la aleación, con el número y la energía de los pulsos del láser.

  18. Recuperación de los metales de catalizadores agotados mediante tratamiento térmico y posterior cloruración selectiva

    Directory of Open Access Journals (Sweden)

    Gaballah, I.

    1995-08-01

    Full Text Available An experimental procedure for the recovery of the metallic values contained in spent catalysts, such as cobalt, chromium, copper, nickel, molybdenum, titanium, vanadium, tungsten, etc. is described. The procedure is based both on a thermal treatment carried out prior to another one performed at 600 °C and on the selective chlorination of the samples, using different gaseous mixtures, at a temperature between 300 and 600 °C. From the chlorination residues, and as chlorides, it is possible to recover up to 98 % nickel, cobalt molybdenum, titanium and tungsten and 80 % of the vanadium compounds contained in the condensation products. The oxygen partial pressure in the gaseous mixture seems to be a determining factor in the chlorination selectivity.

    Se describe un trabajo experimental dirigido a la recuperación de los valores metálicos de los catalizadores agotados, tales como el cobalto, cromo, cobre, níquel, molibdeno, titanio, vanadio, volframio, etc. El procedimiento se basa en un tratamiento térmico previo a otro inferior a 600 °C, y en la cloruración selectiva de las muestras, por diferentes mezclas gaseosas, entre 300 y 600 °C. Es posible recuperar en forma de cloruros, a partir de los residuos de cloruración, hasta el 98 % de níquel, cobalto, molibdeno, titanio y volframio, y el 80 % de los compuestos de vanadio en los productos de condensación. La presión parcial de oxígeno en la mezcla gaseosa parece ser un factor determinante en la selectividad de la cloruración.

  19. Nuestra experiencia en el tratamiento de úlceras crónicas mediante PRF-Vivostat®: Serie de 10 casos Our experience in the treatment of chronic ulcers by PRP-Vivostat®: Series of 10 cases

    Directory of Open Access Journals (Sweden)

    E. Monclús Fuertes

    2009-06-01

    Full Text Available Pretendemos mostrar nuestra experiencia clínica en el manejo de úlceras crónicas de distinta etiología, mediante tratamiento conservador con gel rico en fibrina autóloga más factores de crecimiento plaquetarios o PRP, experiencia que reafirma los buenos resultados obtenidos en estudios anteriores referentes a Cirugía Plástica, Estética y Reparadora El hecho diferencial de nuestro estudio es el trato de las lesiones única y exclusivamente con PRP, sin otros tratamientos adyuvantes como es habitual en otros estudios acerca de este tema Entre los años 2002 y 2007 tratamos con PRP 10 pacientes con historia de fallo en los tratamientos convencionales, con una edad media de 65.6 años. Se realizaron entre 3 y 5 sesiones por paciente, espaciadas por una semana. El método de obtención elegido fue el sistema VIVOSTAT® (MBA Group. Se realizó un control fotográfico en cada sesión. Realizamos un seguimiento visual de las lesiones (pretratamiento- postratamiento, valorándolas según una modificación de la escala de Valbonesi et al a la que llamamos "Escala de Zaragoza", siendo el resultado pobre en 1 paciente, regular en 2, bueno en 5 y excelente en 2. El uso de PRP para úlceras crónicas en pacientes refractarios a otro tipo de tratamientos, tanto conservadores como quirúrgicos, es actualmente una alternativa real para conseguir una mejoría evidente e incluso la curación completa de las lesiones.The aim of this study is to evaluate our clinical experience in the management of chronic ulcers by conservative treatment with autologous fibrin-rich gel further platelet growth factors or PRP. This experience reaffirms the good results obtained in earlier studies relating to Plastic, Reconstructive and Aesthetic Surgery; moreover, the strength of our study is the use of PRP as the only treatment of such injuries, without other adjuvant treatments as usual in other works on this topic. From 2002 to 2007, we treated with PRP 10 patients with a

  20. Diseño decorativo de pavimentos cerámicos adaptado a inyección de tinta mediante tratamiento digital de imagen

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    Defez, B.

    2013-08-01

    Full Text Available The ceramic tile sector is a very competitive industry. The designer’s proficiency to offer new models of the decorated surface, adapted to the production means, plays a very important role in the competitiveness. In the present work, we analyze the evolution of the design process in the ceramic sector, as much as the changes experimented in parallel by the printing equipment. Afterwards, we present a new concept of ceramic design, based on digital image processing. This technique allows the generation of homogeneous and non-repetitive designs for large surfaces, especially thought for inkjet printing. With the programmed algorithms we have compiled a prototype software for the assistance of the ceramic design. This tool allows creating continuous designs for large surfaces saving developing time.El sector productivo de pavimentos y revestimientos cerámicos es una industria muy competitiva. La capacidad de los diseñadores de ofrecer modelos con nuevos diseños de la cara vista, adaptados a los medios de producción, juega un papel muy importante en la competitividad. En el presente trabajo se analiza la evolución del proceso de diseño en el sector cerámico, así como los cambios experimentados de forma paralela por los medios de impresión. A continuación se presenta un nuevo concepto de diseño de baldosa cerámica, basado en procesado de imagen digital. Esta técnica permite la generación de diseños homogéneos y no repetitivos de grandes superficies, especialmente pensados para la decoración mediante inyección de tinta. Con los algoritmos programados se ha creado un programa informático prototipo de ayuda al diseño cerámico. Esta herramienta permite crear diseños continuos para grandes superficies ahorrando tiempo de desarrollo.

  1. Evaluación del tratamiento de consolidación de dolomías mediante nanopartículas de hidróxido de calcio en condiciones de alta humedad relativa

    Directory of Open Access Journals (Sweden)

    Fort, R.

    2011-04-01

    Full Text Available In this article, the results of a treatment applied to dolomitic stones using an isopropyl colloidal solution based on calcium hydroxide nanoparticles with a concentration of 2.0g/l are presented. The consolidation process in the stone has been checked before and after 28 days of exposure to 75% relative humidity. Morphologic and structural studies of the consolidating product confirmed the carbonation process. X ray diffraction, electron microscopy (TEM and ESEM, and electron diffraction carried out on the consolidating product have confirmed the transformation of portlandite phase to calcium carbonate polymorphs, calcite, aragonite and vaterite. Petrophysical tests performed on the stone before and after the application of the product have shown the improvement in the physical and hydrical properties due to the increase in the ultrasound velocity and density of the material, and a decrease in the capillarity coefficient and open porosity without significant changes in colour and brightness. The application of the consolidating product in the proposed experimental conditions is a natural method, compatible with the petrological characteristics of the substrate, without secondary damages on the stone, being an effective method to improve the durability of carbonate stones.

    En este artículo se presentan los resultados del tratamiento aplicado a muestras de piedra dolomía mediante una solución coloidal isopropílica basada en nanopartículas de hidróxido de calcio en una concentración de 2,0g/l. El proceso de consolidación de la piedra ha sido monitoreado antes y después de su aplicación a los 28 días de estar expuesta a una atmósfera del 75% de humedad relativa. Se ha realizado un estudio morfológico y estructural del consolidante confirmándose el proceso de carbonatación. Los resultados de difracción de rayos X, microscopía electrónica (TEM y ESEM y difracción de electrones realizados al producto consolidante han

  2. Influencia de los tratamientos térmicos en el comportamiento frente al desgaste por abrasión de una fundición de grafito esferoidal obtenida mediante adición de boro

    Directory of Open Access Journals (Sweden)

    Varela, A.

    2008-08-01

    Full Text Available By adding boron to the liquid metal, it is possible to obtain spheroidal graphite cast iron without any need for special inoculants. The boron may be in metallic form; alternatively, borax, ferroboron, boron carbonate or borocalcium can be used. These alloys as cast present a pearlite matrix with more or less spheroidal graphite, which is usually edged in ferrite that has markings in the shape of bull’s eye. With normalising, the ferrite edges are eliminated. Thus, a pearlite matrix is achieved. Annealing results in an entirely ferrite matrix; quenching and tempering produce a tempered martensite matrix.This study measures the behaviour under wear of this alloy as cast, normalised, annealed, quenched and tempered . A “pin on disk” test is employed; load and speed conditions, as well as the pin type, are kept constant. Moreover, wear is calculated through weighing, and the variation for the friction coefficient is determined in each case.

    Mediante la adición de boro al metal líquido, bien en forma metálica o en forma de bórax, ferroboro, carburo de boro o boruro cálcico, se pueden obtener fundiciones de grafito esferoidal sin necesidad de inoculantes especiales. Estas fundiciones en estado bruto de colada presentan una matriz perlítica con grafito más o menos esferoidal que suele estar orlado de ferrita formando ojos de buey. Por tratamiento térmico de normalizado, se consigue eliminar la orla ferrítica y tener una matriz enteramente perlítica. Por recocido, se puede obtener una matriz enteramente ferrítica y por temple y revenido una matriz de martensita revenida. En el presente trabajo se mide el comportamiento frente al desgaste abrasivo de la aleación indicada, en estado bruto de colada, normalizado, recocido y bonificado, utilizando el ensayo pin on disk, manteniendo fijas las condiciones de ensayo en cuanto a carga, velocidad y tipo de pin, calculando el desgaste producido por pesada. También, se

  3. Lesiones periapicales: diagnóstico y tratamiento

    OpenAIRE

    A. García-Rubio; A.L. Bujaldón-Daza; A. Rodríguez-Archilla

    2015-01-01

    Las lesiones periapicales resultado de la necrosis de la pulpa dental son las patologías que más frecuentemente ocurren encontradas en el hueso alveolar. El tratamiento consiste en la eliminación de los agentes infecciosos mediante el tratamiento del canal radicular, permitiendo la cicatrización de la lesión.

  4. REVISIÓN DE LAS EXPERIENCIAS EN EL TRATAMIENTO DE AGUAS RESIDUALES DOMÉSTICAS MEDIANTE REACTORES UASB EN COCHABAMBA-BOLIVIA COMPARADAS CON LAS DE LATINOAMÉRICA, INDIA Y EUROPA

    Directory of Open Access Journals (Sweden)

    Vanessa Gandarillas R.

    2017-06-01

    Full Text Available El proceso de tratamiento anaeróbico es cada vez más reconocido como opción viable para la protección del medio ambiente y la conservación de los recursos y representa, combinado con otros métodos adecuados, un sistema de tratamiento de aguas residuales sostenible y apropiado para los países en vías de desarrollo. El tratamiento anaeróbico de aguas residuales se está utilizando con éxito en los países tropicales desde la década de los 80, y con resultados alentadores en las regiones subtropicales y templadas. En este estudio se revisan las principales características del tratamiento de aguas residuales domésticas, con énfasis en el Reactor Anaeróbico de Mantos de Lodos de Flujo Ascendente (RALF o Upflow Anaerobic Sludge Blanket (UASB de su sigla en inglés. Se revisaron las aplicaciones del proceso UASB en Europa, Asia y las Américas. En Latino América y en particular en Bolivia el uso de esta tecnología ha incrementado considerablemente debido a la pequeña demanda de terreno requerida para su implementación y a sus atractivos costos de inversión y operación. La revisión mostró, en base a la experiencia de operación de distintas plantas de tratamiento ubicadas en los valles de Cochabamba, que los reactores anaerobios de mantos de lodos de flujo ascendente apropiadamente diseñados, son adecuados para el tratamiento de aguas residuales domésticas en las regiones de los valles y llanos de Bolivia debido a que presentan condiciones ambientales que hacen que el uso de esta biotecnología anaerobia sea favorable bajo la perspectiva del desarrollo sostenible.

  5. Congenital Intrahepatic Portosystemic Shunts

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Woong Hee; Kim, Young Tong; Jou, Sung Shick; Shin, Hyeong Cheol [Soonchunhyang University, Asan (Korea, Republic of)

    2008-12-15

    Intrahepatic portosystemic shunts are an anomalous connection between the portal vein and hepatic vein/IVC, which may be either congenital or acquired secondary to liver cirrhosis or portal hypertension. Cases of congenital intrahepatic shunts are usually encountered in children and may spontaneously resolve. We report 5 cases of congenital intrahepatic portosystemic shunts in neonates and an adult

  6. 210. Tratamiento de la fibrilación auricular mediante ablación con ultrasonidos concomitante a otra cirugía cardíaca. Resultados a largo plazo en nuestro centro

    Directory of Open Access Journals (Sweden)

    L. Rubio Lobato

    2012-04-01

    Conclusión: La ablación mediante ultrasonidos (US de la FA es un procedimiento sencillo, reproducible y seguro, siendo su efectividad a corto y medio plazo similar a la de otros procedimientos de ablación. En nuestra corta serie, su eficacia a largo plazo disminuye significativamente.

  7. Tratamiento mediante dilatación con balón de un paciente con estenosis subaórtica por membrana: a propósito de un caso

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    Carlos Mariño

    2013-10-01

    Full Text Available La estenosis subaórtica es una lesión cardiaca poco frecuente, en el cual el tracto de salida del ventrículo izquierdo está estrechado por la presencia de un anillo fibroso o fibromuscular. Constituye 8 a 20% de todas las formas de obstrucción al tracto de salida del ventrículo izquierdo. La cirugía ha sido considerada el tratamiento de elección cuando el gradiente pico es mayor de 50 mmHg o en pacientes que, con gradientes menores, presentan progresión de la insuficiencia aórtica o dilatación de los diámetros ventriculares, disfunción ventricular o síntomas. Presentamos el caso de un paciente menor de edad, portador de estenosis subaórtica por membrana, con síntomas de insuficiencia cardiaca y función ventricular izquierda muy comprometida, en la que se realizó el tratamiento percutáneo, alternativo al quirúrgico, con resultado exitoso. Constituye el primer caso reportado en el país de tratamiento percutáneo con balón y con evolución favorable.

  8. Aplicación de tratamiento electroquímico a baja intensidad de corriente para la extracción de cloruros en objetos arqueológicos de hierro de procedencia subacuática. Observación de la evolución de fases mineralógicas mediante XRD-Rietveld

    Directory of Open Access Journals (Sweden)

    Bethencourt, M.

    2004-12-01

    Full Text Available With the purpose of optimising a suitable methodology for the conservation of an archaeological object of iron, a low current intensities electrolytic treatment has been applied, to a piece of cast iron, proving to be effective in the extraction of chloride ions from the structure of akaganeite, principal corrosion product of iron in the marine medium. The monitoring of the electrolytic treatment has been proven by applying the "Rietveld" method to the patterns XRD of samples extracted from the corroded surface before and after the treatment. This method has permitted the unequivocal determination of the akaganeite and its chemical composition. This identification has been corroborated by means of SEM and EDS. After the electrolytic treatment, akaganeite was not present in the sample.

    Con objeto de optimizar una metodología adecuada para la conservación de una pieza de hierro arqueológico de fundición, se ha aplicado un tratamiento electrolítico a bajas intensidades de corriente, demostrando su efectividad en la extracción de iones cloruro de la estructura de akaganeita, principal producto de corrosión del hierro en medio marino. La monitorización del proceso se ha comprobado aplicando el método Rietveld a los patrones XRD de muestras extraídas de la superficie corroída antes y después del tratamiento. Este método ha permitido la determinación inequívoca de la akaganeita y la composición química de este oxihidróxido de hierro no estequiométrico. Dicha identificación se corrobora mediante SEM y EDS. Después del tratamiento electrolítico la akaganeita no está presente en la muestra.

  9. Control biológico de estados edáficos de tefrítidos (Diptera: Tephritidae) mediante tratamientos de suelo con ascomicetos mitospóricos entomopatógenos (Ascomycota: Hypocreales)

    OpenAIRE

    Garrido-Jurado, Inmaculada

    2012-01-01

    Hasta la fecha, los ascomicetos mitospóricos entomopatógenos (AME) se han empleado con éxito en el control de adultos de tefrítidos en pulverización total del sustrato vegetal, o en pulverización cebo, o mediante la técnica de ¿atracción e infección¿. No obstante, recientemente se ha puesto de manifiesto el potencial de estos AME para el control de estados pre-imaginales de tefrítidos mediante su aplicación al suelo, en la base del árbol, donde el inóculo fúngico está protegido frente a los f...

  10. Valoración a largo plazo de los resultados de tratamiento mediante osteosíntesis con miniplacas en sus diferentes usos en cirugía craneomaxilofacial

    OpenAIRE

    Marí Roig, Antonio

    2003-01-01

    Después de la introducción de la osteosíntesis con miniplacas hace más de 25 años, siguen existiendo controversias en su aplicación en determinadas situaciones de la cirugía craneomaxilofacial. En las fracturas mandibulares se utilizan diferentes tipos de placas asociadas o no a bloqueo intermaxilar con un indice de complicaciones muy variable (James y col, 1981; Limchayseng 1988); el tratamiento más adecuado cuando existen dientes en el foco de fractura. La utilización del bloqueo intermaxi...

  11. Tratamiento de efluentes del cultivo de Litopenaeus vannamei mediante procesos de sedimentación, filtración y absorción Treatments of effluents from Litopenaeus vannamei shrimp cultures through sedimentation, filtration and absorption

    Directory of Open Access Journals (Sweden)

    Roberto Ramos

    2010-01-01

    Full Text Available La eficiencia de remoción de materia particulada y nutrientes disueltos de efluentes de estanques de reproductores de Litopenaeus vannamei fue evaluada a escala de laboratorio, empleando tratamientos de sedimentación, filtración por Crassostrea rhizophorae y absorción por Ulva fasciata. En cada tratamiento se empleó un tiempo de residencia hidráulica del efluente de seis horas. En la etapa de sedimentación se utilizaron estanques con 90 L del efluente. Para la etapa de filtración, se emplearon estanques con 20 L del efluente sobrenadante de la etapa de sedimentación. En la absorción se utilizaron estanques con 15 L del efluente sobrenadante de la etapa de filtración. Al final de cada etapa se colectaron muestras de 500 mL para los análisis de calidad de agua. Los resultados indicaron que en la sedimentación, la turbidez, clorofila-a y sólidos suspendidos totales presentaron una remoción de 93,8%, 94,5% y 65,9%, respectivamente. La filtración alcanzó eficiencias de 89,3% y 100% para bacterias totales y clorofila a, respectivamente. En la absorción, fosfato (PO4-3 , amonio (N-NH4- y nitrato (N-NO3 fueron reducidos en 53,6%, 49,6% y 70,2%, respectivamente, en relación a los valores del estanque control. Los tratamientos combinados de sedimentación, filtración y absorción, bacterias totales (95,1%, turbidez (97,1% sólidos suspendidos totales (81,3%, clorofila-a (99,1%, amonio (54,1%, nitrito (58,0%, nitrato (69,2% y fosfato (52,9%, presentaron una alta eficiencia de remoción, en relación a los valores del efluente bruto. Se concluye que la combinación de tratamientos mejora significativamente la calidad de los efluentes del cultivo del camarón Litopenaeus vannamei.

  12. Evaluación de la intervención psicooncológica mediante Counselling en pacientes con cáncer diferenciado de tiroides en tratamiento con radioyodo.

    OpenAIRE

    Javaloyes Bernácer, Nuria

    2017-01-01

    El hecho de recibir un diagnóstico de cáncer y el tratamiento del mismo causan habitualmente una profunda herida emocional a las personas que lo padecen y a su familia. Por esto, el paciente diagnosticado de cáncer debe ser tratado de forma que mantenga la mejor calidad de vida (CV) y bienestar psicológico posibles, cuidando de manera especial todos los factores que originen problemas emocionales (ansiedad y/o depresión) y alteraciones de la vida social, laboral y familiar. Los pacientes ...

  13. ESTUDIO DE LA PROTECCIÓN ANTICORROSIVA SOBRE ACERO DE BAJO CARBONO MEDIANTE TRATAMIENTO DE CONVERSIÓN QUÍMICA BASE CERIO COMO PREPARACIÓN DE SUPERFICIE

    OpenAIRE

    MATA GALLARDO, LUIS JAIME

    2014-01-01

    En este trabajo, se propone un tratamiento de conversión química base cerio sobre acero de bajo carbono para obtener un incremento en las propiedades de protección y ser utilizado como una preparación de superficie para un pintado posterior. El nitrato de cerio fue elegido como precursor y se utilizaron tres métodos para la obtención de películas sobre la superficie de acero al carbono. Las películas son formadas utilizando o no el H2O2, sin embargo, el papel del H2O2 es el de ...

  14. [Shunt and short circuit].

    Science.gov (United States)

    Rangel-Abundis, Alberto

    2006-01-01

    Shunt and short circuit are antonyms. In French, the term shunt has been adopted to denote the alternative pathway of blood flow. However, in French, as well as in Spanish, the word short circuit (court-circuit and cortocircuito) is synonymous with shunt, giving rise to a linguistic and scientific inconsistency. Scientific because shunt and short circuit made reference to a phenomenon that occurs in the field of the physics. Because shunt and short circuit are antonyms, it is necessary to clarify that shunt is an alternative pathway of flow from a net of high resistance to a net of low resistance, maintaining the stream. Short circuit is the interruption of the flow, because a high resistance impeaches the flood. This concept is applied to electrical and cardiovascular physiology, as well as to the metabolic pathways.

  15. VERIFICACIÓN DEL DISEÑO DE TRATAMIENTOS SUPERFICIALES MEDIANTE EL MÉTODO MODOT T 72 Y LA SECCIÓN 409 DEL ESTADO DE MISSOURI Y SU POSIBLE INCORPORACIÓN A LA NORMATIVA ARGENTINA

    Directory of Open Access Journals (Sweden)

    Cecilia J. Soengas Chaparro

    2009-01-01

    Full Text Available El presente artículo tiene por objeto observar la relación entre las especifi caciones citadas en el Departamento de Transporte de Materiales de Construcción del Estado de Missouri, Estados Unidos "Test Method MoDOT T 72 Sweep Test of Bituminous Surface Treatment Simple" y la Sección 409 "Seal Coat" con las especificaciones establecidas en el Pliego de la Dirección Nacional de Vialidad de la República Argentina, considerando además adecuaciones surgidas en el LEMaC, a efectos de lograr mayor representatividad en relación a la obra. Para llevar a cabo la correlación de lo citado, se diseñó un tratamiento superfi cial simple con el método de dosificación propuesto por el Ing. Tagle, conocido como la Regla de 9-5-3 y una capa de sello con arena de trituración. Al tratamiento se lo somete al ensayo de barrido, y teniendo en cuenta los valores citados en la Sección 409 del MoDOT, se desea valorar la eficiencia del método de dosificación optado. Se analizaron los resultados obtenidos y se comparó si el método de dosificación con lo estipulado por la Sección 409 de acuerdo a la granulometría de la capa de sellado y las pérdidas derivadas del ensayo. En las Especifcaciones Nacionales no existe una restricción numérica de dichas pérdidas sino solo la experiencia de obra y los resultados de ensayos cuando el tratamiento ya está colocado como lisura superficial, rugosidad y coeficiente de fricción, además de los parámetros de los materiales separadamente. Se ha logrado con la experimentación analizada, establecer una recomendación para su posible incorporación a los Pliegos citados.

  16. Shunt detection and measurement

    International Nuclear Information System (INIS)

    Grossman, W.

    1986-01-01

    Detection, localization, and quantification of intracardiac shunts are an integral part of the hemodynamic evaluation of patients with congenital heart disease. In most cases, an intracardiac shunt is suspected on the basis of the clinical evaluation of the patient prior to catheterization. However, there are several circumstances in which data obtained at catheterization should alert the cardiologist to look for a shunt that previously had not been suspected

  17. Tratamento de feridas colonizadas/infetadas com utilização de polihexanida Tratamiento de heridas colonizadas/infetadas mediante el uso de polihexanida Treatment of colonized/infected wounds using polyhexanide

    Directory of Open Access Journals (Sweden)

    Eduardo José Ferreira dos Santos

    2011-07-01

    Full Text Available Contexto: Na prática clínica o tratamento de feridas constitui, inevitavelmente, um importante foco de atenção da Enfermagem enquanto disciplina e ciência, bem como, do enfermeiro interessado em cuidar a pessoa com ferida. Com o aparecimento das novas abordagens e novos materiais cresce a necessidade/obrigatoriedade do enfermeiro acompanhar esta evolução. Assim, este artigo surge na sequência da utilização de um produto inovador - a polihexanida. Objetivo: Descrever a evidência científica disponível acerca da eficácia da polihexanida no tratamento de feridas colonizadas/infetadas. Métodos: Foram seguidos os princípios propostos pelo Cochrane Handbook, tendo sido realizada pesquisa manual e eletrónica em várias bases de dados que conduziram a sete artigos que cumpriam critérios previamente definidos. Resultados: Os estudos indicam que a polihexanida é eficaz no tratamento de feridas colonizadas/infetadas, verificando-se redução significativa do tempo de cicatrização, sinais inflamatórios, infeção/colonização e dor, quando esta é utilizada. Conclusão: Estas evidências permitem-nos concluir que a utilização da poliexamida é uma prática segura no tratamento de feridas colonizadas/infetadas.Contexto: En la práctica clínica el tratamiento de heridas constituye inevitablemente un importante foco de atención de Enfermería en cuanto disciplina y ciencia, así como del enfermero interesado en cuidar a la persona herida. Con el aparecimiento de nuevos enfoques y nuevos materiales ha aumentado la necesidad/ obligatoriedad por parte del enfermero en acompañar esta evolución. Así, este artículo surge en la secuencia de la utilización de un producto innovador - la polihexanida. Objectivo: Describir la evidencia científica disponible acerca de la eficacia de la polihexanida en el tratamiento de heridas colonizadas/infetadas. Métodos: Se siguieron los principios propuestos por el Cochrane Handbook, no sin haber

  18. Diseño de un vector no viral basado en nanopartículas lipídicas para el tratamiento de la hepatitis C mediante ARN de interferencia

    OpenAIRE

    Torrecilla Alzola, Josune

    2016-01-01

    199 p. La hepatitis C sigue siendo hoy en día un problema de salud pública a nivel mundial. Se estima que hay 170 millones de personas infectadas por el virus de la hepatitis C (HCV, del inglés hepatitis C virus) en el mundo, con 3-4 millones de nuevas infecciones cada año. Sólo una fracción de las personas infectadas responden al tratamiento estándar consistente en una triple terapia compuesta de interferón-¿ (INT-¿) o interferón-¿ pegilado (PEG-INT-¿), ribavirina e inhibidores de la prot...

  19. Ventriculoperitoneal Shunt Migration

    Directory of Open Access Journals (Sweden)

    Justin P Puller

    2017-01-01

    Full Text Available History of present illness: A 40-year-old female presented to our ED with left upper abdominal pain and flank pain. The pain had begun suddenly 2 hours prior when she was reaching into a freezer to get a bag of frozen vegetables. She described the pain as sharp, constant, severe, and worse with movements and breathing. The pain radiated to the left shoulder. On review of systems, the patient had mild dyspnea and nausea. She denied fever, chills, headache, vision changes, vomiting, or urinary symptoms. Her medical history was notable for obstructive sleep apnea, gastroesophageal reflux disease, arthritis, fibromyalgia, depression, obesity, and idiopathic intracranial hypertension. For the latter, she had a VP (ventriculoperitoneal shunt placed 14 years prior to this visit. She had a history of 2 shunt revisions, the most recent 30 days before this ED visit. Significant findings: An immediate post-op abdominal x-ray performed after the patient’s VP shunt revision 30 days prior to this ED visit reveals the VP shunt tip in the mid abdomen. A CT of the abdomen performed on the day of the ED visit reveals the VP shunt tip interposed between the spleen and the diaphragm. Discussion: VP shunts have been reported to migrate to varied locations in the thorax and abdomen. Incidence of abdominal complications of VP shunt placement ranges from 10%-30%, and can include pseudocyst formation, migration, peritonitis, CSF ascites, infection, and viscus perforation. Incidence of distal shunt migration is reported as 10%, and most previously reported cases occurred in pediatric patients.1 A recent retrospective review cited BMI greater than thirty and previous shunt procedure as risk factors for distal shunt migration.2 The patient in the case presented had a BMI of 59 and 3 previous shunt procedures.

  20. Tratamiento de la fascitis necrosante por E. Coli mediante desbridamiento quirúrgico y terapia Vac®, a propósito de un caso Treatment of necrotizing fasciitis caused by E.Coli with surgical debridement and vacuum assisted therapy (Vac®, case report

    Directory of Open Access Journals (Sweden)

    M. Silva Bueno

    2011-12-01

    Full Text Available La fascitis necrosante es una rara infección de tejidos blandos con una alta tasa de morbi-mortalidad. Presentamos el caso de una paciente de 44 años diagnosticada de fascitis necrosante por E. coli en el contexto clínico de inmunosupresión por trasplante renal. Logramos un tratamiento exitoso mediante la asociación de desbridamiento quirúrgico, antibioticoterapia intravenosa y curas con terapia de presión negativa (VAC®, seguido de injertos autólogos de piel parcial. Remarcamos las ventajas clínicas de la terapia de presión negativa en el manejo y curación de heridas complejas.Necrotizing fasciitis is a rare soft tissue infection which presents a high rate of morbi-mortality. We describe the case of a 44 years old patient diagnosed with necrotizing fasciitis caused by E. coli, in the context of immunosuppression due to renal transplantation. Successful treatment was achieved by combining surgical debridement, intravenous antibiotic treatment and vacuum assisted closure therapy (VAC® completed by autologous split skin grafts. We stress the clinical benefits of subatmospheric pressure therapy in the management and healing of complex wounds.

  1. Tratamiento de la fascitis necrosante por E. Coli mediante desbridamiento quirúrgico y terapia Vac®: a propósito de un caso Treatment of necrotizing fasciitis caused by E.Coli with surgical debridement and vacuum assisted therapy (Vac®: case report

    Directory of Open Access Journals (Sweden)

    M. Silva Bueno

    2011-06-01

    Full Text Available La fascitis necrosante es una rara infección de tejidos blandos con una alta tasa de morbi-mortalidad. Presentamos el caso de una paciente de 44 años diagnosticada de fascitis necrosante por E. coli en el contexto clínico de inmunosupresión por trasplante renal. Logramos un tratamiento exitoso mediante la asociación de desbridamiento quirúrgico, antibioticoterapia intravenosa y curas con terapia de presión negativa (VAC®, seguido de injertos autólogos de piel parcial. Remarcamos las ventajas clínicas de la terapia de presión negativa en el manejo y curación de heridas complejas.Necrotizing fasciitis is a rare soft tissue infection which presents a high rate of morbi-mortality. We describe the case of a 44 years old patient diagnosed with necrotizing fasciitis caused by E. coli, in the context of immunosuppression due to renal transplantation. Successful treatment was achieved by combining surgical debridement, intravenous antibiotic treatment and vacuum assisted closure therapy (VAC® completed by autologous split skin grafts. We stress the clinical benefits of subatmospheric pressure therapy in the management and healing of complex wounds.

  2. Tratamiento Quirúrgico de las Esclerosis Faciales.

    Directory of Open Access Journals (Sweden)

    Ricardo Salazar López

    2006-06-01

    En este estudio se hará una descripción del cuadro clínico y evolución de esta entidad, un análisis de su fisiopatología, una historia de la descripción y tratamiento de la misma, posteriormente se propone el tratamiento quirúrgico mediante colgajos musculares y se presentan varios casos clínicos...

  3. Tratamiento de quiste hepático simple gigante mediante cirugía laparoscópica Treatment of giant simple hepatic cyst by means of laparoscopic surgery

    Directory of Open Access Journals (Sweden)

    Vladimir Írsula Ballaga

    2011-05-01

    Full Text Available Se describe el caso clínico de una fémina de 45 años de edad, con antecedente de hipertensión arterial, ingresada en el Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba por presentar un quiste hepático simple gigante desde hacía 3 años, que fue eliminado mediante cirugía laparoscópica. La paciente evolucionó satisfactoriamente y egresó sin complicaciones, pero con seguimiento por consulta externa.The clinical case of a 45-year-old woman with history of hypertension is described, who was admitted to "Dr. Juan Bruno Zayas Alfonso" General Teaching Hospital of Santiago de Cuba due to a giant simple hepatic cyst for 3 years that was removed by means of laparoscopic surgery. The patient made good progress and was discharged without complications, but she was followed up by outpatient monitoring.

  4. Tratamiento mediante terapia de presión negativa VAC® de herida infectada tras artrodesis raquídea Treatment of infected wound secondary to spinal arthrodesis with negative pressure therapy VAC®

    Directory of Open Access Journals (Sweden)

    V. Yuste Benavente

    2011-12-01

    Full Text Available Las complicaciones cutáneas secundarias a artrodesis raquídea son un problema frecuente que requiere la colaboración de los Servicios de Cirugía Plástica y en cuyo tratamiento la terapia de presión negativa puede resultar útil. En este artículo presentamos el caso de un paciente afectado por metástasis vertebrales de adenocarcinoma gástrico que requirió artrodesis raquídea y desarrolló posteriormente una úlcera por presión dorsal debido al material implantado. El sistema VAC® permitió la limpieza y disminución de tamaño de la lesión, siendo posible la cobertura posterior de la misma con un colgajo miocutáneo de dorsal ancho. En este artículo discutimos la utilidad de la terapia de presión negativa en este tipo de lesiones.Cutaneous complications secondary to spinal fusion are a common problem that requires the collaboration of the Department of Plastic Surgery and in which negative pressure therapy treatment may be useful. In this paper we present the case of a patient with spinal metastases secondary to gastric adenocarcinoma that required spinal fusion and developed a dorsal pressure ulcer secondary to the implanted material. VAC® therapy system allowed cleaning the wound and decreasing the size of the injury, thus making it possible subsequently to cover it with a latissimus dorsi myocutaneous flap. In this paper we discuss the usefulness of negative pressure therapy in this type of injury.

  5. Transjugular intrahepatic portosystemic shunt

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jae Hyung; Han, Joon Koo; Chung, Jin Wook; Han, Man Chung [Seoul National University College of Medicidne, Seoul (Korea, Republic of)

    1992-05-15

    As a new interventional procedure for the control of variceal bleeding, a portosystemic shunt can be established with the installment of metallic stent through the transjugular approach. In order to evaluate the clinical usefulness of the procedure, transjugular intrahepatic portosystemic shunt procedure were performed in 5 patients with variceal bleeding due to liver cirrhosis. The metallic stents were mainly a self expandable Wallstent (Schneider, Switzerland), An 8 to 10 mm shunt was formed by the insertion of the stent and balloon dilatation after puncture of the proximal portal vein from the right or middle hepatic vein. The patency of the shunt was proven by portography after the procedure. The portal pressure measured in 3 patients before and after the procedure improved with decrease from 31 mmHg to 25 mmHg. The procedure failed in 1 patient due to pre-existing portal vein thrombosis. During the follow-up period from 1 month to 4 months, shunts were patent in all 4 patients. However, hepatic encephalopathy occurred in one patient one week following the procedure. Though the follow-up period was not long enough for full evaluation, we found the transjugular intrahepatic portosystemic shunt was a safe and effective procedure for the control of variceal bleeding by lowering the portal pressure. For the appropriate application for this procedure, the optimal size of the shunt and optical degree of the resultant decompression are yet to be determined in the future.

  6. Hydrocephalus and Shunts

    Science.gov (United States)

    ... of a problem. Because of the complexity, a neurosurgeon is the best person to diagnosis and treat ... type of shunt is best for whom. So neurosurgeons usually pick ones that they think are best. ...

  7. Flux shunts for undulators

    International Nuclear Information System (INIS)

    Hoyer, E.; Chin, J.; Hassenzahl, W.V.

    1993-05-01

    Undulators for high-performance applications in synchrotron-radiation sources and periodic magnetic structures for free-electron lasers have stringent requirements on the curvature of the electron's average trajectory. Undulators using the permanent magnet hybrid configuration often have fields in their central region that produce a curved trajectory caused by local, ambient magnetic fields such as those of the earth. The 4.6 m long Advanced Light Source (ALS) undulators use flux shunts to reduce this effect. These flux shunts are magnetic linkages of very high permeability material connecting the two steel beams that support the magnetic structures. The shunts reduce the scalar potential difference between the supporting beams and carry substantial flux that would normally appear in the undulator gap. Magnetic design, mechanical configuration of the flux shunts and magnetic measurements of their effect on the ALS undulators are described

  8. Morbilidad, mortalidad y costes sanitarios evitables mediante una estrategia de tratamiento del tabaquismo en España The effects of implementing a smoking cessation intervention in Spain on morbidity, mortality and health care costs

    Directory of Open Access Journals (Sweden)

    J. González-Enríquez

    2002-08-01

    Full Text Available Objetivo: Se valoran los efectos que tendría una intervención destinada a reducir el uso de tabaco en la población española de fumadores sobre la morbilidad, la mortalidad y los costes asociados al consumo de tabaco. Método: Se ha adaptado el modelo Health and Economic Consequences of Smoking patrocinado por la OMS y desarrollado por The Lewin Group. La intervención propuesta incluye el acceso a asistencia farmacológica de un 35% de los fumadores que intentan dejar de fumar, y obtienen una tasa global de cesación al año del 7,2%. Las enfermedades estudiadas son: cáncer de pulmón, enfermedad coronaria, enfermedad cerebrovascular, EPOC, asma y bajo peso al nacer. Se estiman los casos de enfermedad y muerte atribuibles al consumo de tabaco evitados y la reducción en el coste sanitario debidos a la intervención, proyectados a 20 años. Resultados: Sin intervención, en el año 1 del modelo 2.136.094 fumadores padecen alguna de las condiciones clínicas atribuibles al consumo de tabaco, el coste asistencial es de 4.286 millones de euros y las muertes atribuibles son 26.537. La intervención propuesta evita 2.613, 9.192, 17.415 y 23.837 casos de enfermedad atribuible al consumo de tabaco en los años 2, 5, 10 y 20 del modelo, respectivamente. Los costes asistenciales acumulados evitados son 3,5 millones de euros en el año 2 y 386 millones de euros a los 20 años. Las muertes acumuladas evitadas son 284 en el año 2 y 9.205 a los 20 años de la intervención. La intervención añade un total de 78.173 años de vida al final del período considerado. Conclusiones: La disponibilidad de nuevas intervenciones eficaces en el tratamiento del tabaquismo y el incremento de la accesibilidad a las mismas pueden contribuir de forma relevante a la reducción de la morbilidad, la mortalidad y los costes sanitarios asociados al tabaquismo en España.Objective: We estimated the effect that a smoking cessation intervention in the Spanish population of

  9. Pathophysiology of shunt dysfunction in shunt treated hydrocephalus

    DEFF Research Database (Denmark)

    Blegvad, C.; Skjolding, A D; Broholm, H

    2013-01-01

    We hypothesized that shunt dysfunction in the ventricular catheter and the shunt valve is caused by different cellular responses. We also hypothesized that the cellular responses depend on different pathophysiological mechanisms....

  10. TRATAMIENTO DE AGUAS RESIDUALES MEDIANTE IRRADIACIÓN GAMMA

    OpenAIRE

    Eduardo Campos Medina

    2009-01-01

    Esta investigación tiene por objetivo principal mostrar el efecto que tiene la aplicación de radiación gamma sobre los contaminantes orgánicos disueltos en aguas residuales industriales. En el proceso de investigación se emplearon porciones de agua residual de la empresa tratadora Reciclagua, estas muestras de agua mostraron elevados valores en cuanto a la Demanda Química de Oxígeno (DQO), posteriormente se aplicaron diferentes dosis de radiación gamma, buscando con ello la fragmentación de l...

  11. Tratamientos de efluentes industriales mediante biomasas tropicales activadas

    OpenAIRE

    Domínguez, Osvaldo; Gómez, Ernesto; Mendoza, Edwin; Vásquez, Julio; Franco, Yair; Tejedor De León, Alexis

    2017-01-01

    Este proyecto consiste en utilizar la materia prima en este caso el coco de palma, que será transformado a carbón activo por medio del proceso de incineración. Obtenido este producto utilizaremos una bomba para suministrar el agua industrial que gracias al carbón activo que se obtuvo del coco de palma lograremos la filtración por medio de tres capas de carbón activo, para obtener el mejor rendimiento de nuestro carbón activado en el proceso de filtración con coco de palma.

  12. Aqueous shunts for glaucoma.

    Science.gov (United States)

    Tseng, Victoria L; Coleman, Anne L; Chang, Melinda Y; Caprioli, Joseph

    2017-07-28

    Aqueous shunts are employed to control intraocular pressure (IOP) for people with primary or secondary glaucomas who fail or are not candidates for standard surgery. To assess the effectiveness and safety of aqueous shunts for reducing IOP in glaucoma compared with standard surgery, another type of aqueous shunt, or modification to the aqueous shunt procedure. We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 8), MEDLINE Ovid (1946 to August 2016), Embase.com (1947 to August 2016), PubMed (1948 to August 2016), LILACS (Latin American and Caribbean Health Sciences Literature Database) (1982 to August 2016), ClinicalTrials.gov (www.clinicaltrials.gov); searched 15 August 2016, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 15 August 2016. We did not use any date or language restrictions in the electronic search for trials. We last searched the electronic databases on 15 August 2016. We also searched the reference lists of identified trial reports and the Science Citation Index to find additional trials. We included randomized controlled trials that compared various types of aqueous shunts with standard surgery or to each other in eyes with glaucoma. Two review authors independently screened search results for eligibility, assessed the risk of bias, and extracted data from included trials. We contacted trial investigators when data were unclear or not reported. We graded the certainty of the evidence using the GRADE approach. We followed standard methods as recommended by Cochrane. We included 27 trials with a total of 2099 participants with mixed diagnoses and comparisons of interventions. Seventeen studies reported adequate methods of randomization, and seven reported adequate allocation concealment. Data collection and follow-up times varied.Four trials compared an aqueous shunt (Ahmed or Baerveldt) with trabeculectomy, of which

  13. Ventriculoperitoneal shunt infections in children

    African Journals Online (AJOL)

    1991-02-02

    Feb 2, 1991 ... shunts: epidemiology, clinical manifestations and therapy.] Infecr Vis 1975;. 13: 543-552. 4. Odio C, McCracken GH jun, Nelson JD. CSF shunt infections in pediatrics, a seven-year experience. Am] Dis Child 1984; 138: 1103-1108. 5. Meirovitch J, Kitai-Cohen Y, Keren G, Fiendler G, Rubinstein E. Cerebro-.

  14. Las quemaduras : su tratamiento por injertos de piel

    Directory of Open Access Journals (Sweden)

    Juan Ruiz Mora

    1947-09-01

    Full Text Available Uno de los problemas médicos más discutidos y apasionantes, es el relativo al tratamiento de las quemaduras. Desde los mas remotos tiempos, el hombre en su lucha contra los elementos adversos, uso el calor en distintas formas; los guerreros desde las épocas mas primitivas lo emplearon como medio de destrucción del enemigo, castigo o mutilación de los vencidos, y así tenemos que el problema que vamos a tratar y en el cual se han hecho avances notorios, es tan viejo como la historia misma de la humanidad. Aunque es la intención de este trabajo, llamar la atención de los colegas, hacia el tratamiento de las quemaduras mediante los injertos de piel, es sin embargo indispensable pasar una revista al tratamiento de las quemaduras en general, puesto que dicho tratamiento no se- inicia inmediatamente después de acaecida esta y antes de emprender el tratamiento quirúrgico, es necesario llevar a cabo un tratamiento medico adecuado.

  15. éste durante el tratamiento

    Directory of Open Access Journals (Sweden)

    José Miguel Martínez González

    2005-01-01

    Full Text Available El objetivo de esta investigación fue estudiar si las creencias relacionadas con la vivencia del acompañamiento de un familiar en el tratamiento de un drogodependiente, y las del mismo paciente, varían en función de aspectos como el tiempo de abstinencia, el tiempo dedicado al tratamiento, la presencia de patología dual en el drogodependiente, la gravedad de ajuste psicológico del acompañante, los años de evolución de la drogodependencia y el tiempo transcurrido desde que se conoce el problema. La muestra estuvo compuesta por 130 personas, 65 familiares y 65 drogodependientes en tratamiento en centros ambulatorios. Para el análisis de los datos, obtenidos éstos, mediante distintos diseños cuasi-experimentales de grupos no aleatorios, se aplicó la prueba “t-Student” para un nivel de significación del 0,05. Se analizaron las relaciones bivariadas entre las variables descritas y las diferentes creencias tanto en los pacientes como en los familiares de éstos. Los resultados mostraron que las creencias evaluadas están presentes en la experiencia del adicto y del familiar, cambiando éstas a través de los valores de las variables manipuladas ya mencionadas.

  16. Congenital extrahepatic portosystemic shunts

    Energy Technology Data Exchange (ETDEWEB)

    Murray, Conor P.; Yoo, Shi-Joon; Babyn, Paul S. [Department of Diagnostic Imaging, Hospital for Sick Children, 555 University Avenue, M5G 1X8, Toronto, Ontario (Canada)

    2003-09-01

    A congenital extrahepatic portosystemic shunt (CEPS) is uncommon. A type 1 CEPS exists where there is absence of intrahepatic portal venous supply and a type 2 CEPS where this supply is preserved. The diagnosis of congenital portosystemic shunt is important because it may cause hepatic encephalopathy. To describe the clinical and imaging features of three children with CEPS and to review the cases in the published literature. The diagnostic imaging and medical records for three children with CEPS were retrieved and evaluated. An extensive literature search was performed. Including our cases, there are 61 reported cases of CEPS, 39 type 1 and 22 type 2. Type 1 occurs predominantly in females, while type 2 shows no significant sexual preponderance. The age at diagnosis ranges from 31 weeks of intrauterine life to 76 years. Both types of CEPS have a number of associations, the most common being nodular lesions of the liver (n=25), cardiac anomalies (n=19), portosystemic encephalopathy (n=10), polysplenia (n=9), biliary atresia (n=7), skeletal anomalies (n=5), and renal tract anomalies (n=4). MRI is recommended as an important means of diagnosing and classifying cases of CEPS and examining the associated cardiovascular and hepatic abnormalities. Screening for CEPS in patients born with polysplenia is suggested. (orig.)

  17. Congenital extrahepatic portosystemic shunts

    International Nuclear Information System (INIS)

    Murray, Conor P.; Yoo, Shi-Joon; Babyn, Paul S.

    2003-01-01

    A congenital extrahepatic portosystemic shunt (CEPS) is uncommon. A type 1 CEPS exists where there is absence of intrahepatic portal venous supply and a type 2 CEPS where this supply is preserved. The diagnosis of congenital portosystemic shunt is important because it may cause hepatic encephalopathy. To describe the clinical and imaging features of three children with CEPS and to review the cases in the published literature. The diagnostic imaging and medical records for three children with CEPS were retrieved and evaluated. An extensive literature search was performed. Including our cases, there are 61 reported cases of CEPS, 39 type 1 and 22 type 2. Type 1 occurs predominantly in females, while type 2 shows no significant sexual preponderance. The age at diagnosis ranges from 31 weeks of intrauterine life to 76 years. Both types of CEPS have a number of associations, the most common being nodular lesions of the liver (n=25), cardiac anomalies (n=19), portosystemic encephalopathy (n=10), polysplenia (n=9), biliary atresia (n=7), skeletal anomalies (n=5), and renal tract anomalies (n=4). MRI is recommended as an important means of diagnosing and classifying cases of CEPS and examining the associated cardiovascular and hepatic abnormalities. Screening for CEPS in patients born with polysplenia is suggested. (orig.)

  18. Managing dental caries with atraumatic restorative treatment in children: successful experience in three Latin American countries Control de la caries dental mediante tratamiento restaurador atraumático en niños: experiencia exitosa en tres países de América Latina

    Directory of Open Access Journals (Sweden)

    Saskia Estupiñán-Day

    2013-04-01

    amalgamas en Ecuador, Panamá y Uruguay. MÉTODOS: Se seleccionaron niños de 7 a 9 años de edad, de escuelas rurales y urbanas, que presentaban como mínimo una lesión inicial cavitada de caries del esmalte o una lesión de la dentina en un primer molar permanente, y se distribuyeron aleatoriamente en el grupo sometido a TRA (intervención o en el grupo tratado con amalgamas (control. Se evaluó el fracaso de la restauración a los 12 y 24 meses. Se midió el grado de cooperación y el dolor observados durante los procedimientos. Se calculó el fracaso acumulado e incidental de las restauraciones a los 12 y 24 meses para los dentistas que aplicaron restauraciones de tipo TRA o amalgamas, y únicamente a los 12 meses para el personal auxiliar que llevó a cabo restauraciones de tipo TRA. RESULTADOS: La muestra total incluyó a 1 629 niños. Los grupos de estudio fueron similares en cuanto a país, sexo y ubicación geográfica. La tasa de fracaso acumulado a los 12 meses varió según el grupo: fue de 0,9 a 5,7% para la amalgama aplicada por dentistas; de 2,0 a 10,5% para el TRA aplicado por dentistas; y de 5,7 a 15,8% para el TRA aplicado por personal auxiliar. A los 24 meses, se observaron mayores fracasos acumulados en el grupo de amalgamas aplicadas por dentistas en comparación con el grupo de TRA aplicado por dentistas en Ecuador y Panamá pero no en Uruguay. Fue menos probable que la aplicación de amalgama obtuviera el mejor grado de cooperación, y la aplicación de TRA por personal auxiliar se asoció con la menor intensidad de dolor. El costo de usar el método de TRA en el tratamiento de la caries dental, incluido el retratamiento, fue aproximadamente de la mitad del costo del empleo de amalgama sin retratamiento. CONCLUSIONES: La restauración mediante TRA llevado a cabo por personal auxiliar logrará una supervivencia presumiblemente inferior a la obtenida por la aplicación de amalgama o TRA por dentistas. A pesar del mayor riesgo de fracaso, la tasa es

  19. Subacute bacterial endocarditis and subsequent shunt nephritis from ventriculoatrial shunting 14 years after shunt implantation

    DEFF Research Database (Denmark)

    Burström, Gustav; Andresen, Morten; Bartek, Jiri Jr.

    2014-01-01

    of causing subacute bacterial endocarditis and subsequent shunt nephritis. The patient was successfully treated with antibiotics combined with ventriculoatrial shunt removal and endoscopic third ventriculocisternostomy (VCS). This case illustrates the nowadays rare, but potentially severe complication...... of subacute bacterial endocarditis and shunt nephritis. It also exemplifies the VCS as an alternative to implanting foreign shunt systems for CSF diversion....

  20. Factores asociados a la no adherencia al tratamiento anti tuberculosis

    Directory of Open Access Journals (Sweden)

    Laura Inés Plata-Casas

    2015-12-01

    Full Text Available Objetivo: describir los factores de riesgo asociados a la no adherencia al tratamiento en los pacientes adscritos al programa de tuberculosis en el Municipio de Villavicencio, cohorte 2012. Materiales y Métodos: se ha realizado un estudio descriptivo de corte transversal con enfoque cuantitativo. Se obtuvieron datos de caracterización sociodemográfica sobre factores de riesgo de personas que abandonaron el tratamiento para la enfermedad- cohorte 2012- mediante la aplicación de un instrumento diseñado por el investigador y revisado por expertos. Los datos fueron tabulados y analizados mediante la herramienta Microsoft Excel® 2007 y Epi-info 7.0. Resultados: el 75% de los pacientes pertenecen al género masculino; el promedio de edad es de 30 años, el 63% pertenecen al régimen subsidiado de salud. Las principales causas de abandono fueron: efectos adversos a los medicamentos (58%, inadecuada atención del personal de salud (43%, dificultad de acceso al servicio (32%. Los factores sociales encontrados fueron hacinamiento 67% y desempleo 62%. Conclusiones: algunos factores no modificables como la edad y el género, así como factores modificables como estilos de vida inadecuados y efectos adversos; cuyo control mejoraría el cumplimiento; contribuyen al abandono del tratamiento. Las variables psicológicas y sociales deben ser evaluadas para que se conviertan en predictores de probables abandonos o irregularidades en el tratamiento antituberculoso.

  1. Quadrupole shunt experiments at SPEAR

    International Nuclear Information System (INIS)

    Corbett, W.J.; Hettel, R.O.; Nuhn, H.-D.

    1996-05-01

    As part of a program to align and stabilize the SPEAR storage ring, a switchable shunt resistor was installed on each quadrupole to bypass a small percentage of the magnet current. The impact of a quadrupole shunt is to move the electron beam orbit in proportion to the off-axis beam position at the quadrupole, and to shift the betatron tune. Initially, quadrupole shunts in SPEAR were used to position the electron beam in the center of the quadrupoles. This provided readback offsets for nearby beam position monitors, and helped to steer the photon beams with low-amplitude corrector currents. The shunt-induced tune shift measurements were then processed in MAD to derive a lattice model

  2. Quadrupole shunt experiments at SPEAR

    International Nuclear Information System (INIS)

    Corbett, W.J.; Hettel, R.O.; Nuhn, H.

    1997-01-01

    As part of a program to align and stabilize the SPEAR storage ring, a switchable shunt resistor was installed on each quadrupole to bypass a small percentage of the magnet current. The impact of a quadrupole shunt is to move the electron beam orbit in proportion to the off-axis beam position at the quadrupole and to shift the betatron tune. Initially, quadrupole shunts in SPEAR were used to position the electron beam in the center of the quadrupoles. This provided readback offsets for nearby beam position monitors and helped to steer the photon beams with low-amplitude corrector currents. The shunt-induced tune shift measurements were then processed in MAD to derive a lattice model. copyright 1997 American Institute of Physics

  3. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... a stent is placed to keep the connection open and allow it to bring blood draining from ... veins within the liver. The shunt is kept open by the placement of a small, tubular metal ...

  4. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... bear denotes child-specific content. Related Articles and Media Radiation Dose in X-Ray and CT Exams Contrast Materials Venography Images related to Transjugular Intrahepatic Portosystemic Shunt (TIPS) Sponsored ...

  5. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... story about radiology? Share your patient story here Images × Image Gallery Radiologist and patient consultation. View full size ... X-Ray and CT Exams Contrast Materials Venography Images related to Transjugular Intrahepatic Portosystemic Shunt (TIPS) Sponsored ...

  6. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... Intrahepatic Portosystemic Shunt (TIPS)? What are some common uses of the procedure? How should I prepare? What does the equipment look like? How does the procedure work? How is the procedure performed? What will I ...

  7. Failed Ventriculoperitoneal Shunt: Is Retrograde Ventriculosinus Shunt a Reliable Option?

    Science.gov (United States)

    Oliveira, Matheus Fernandes de; Teixeira, Manoel Jacobsen; Reis, Rodolfo Casimiro; Petitto, Carlo Emanuel; Gomes Pinto, Fernando Campos

    2016-08-01

    Currently, the treatment of hydrocephalus is mainly carried out through a ventriculoperitoneal shunt (VPS) insertion. However, in some cases, there may be surgical revisions and requirement of an alternative distal site for shunting. There are several described distal sites, and secondary options after VPS include ventriculopleural and ventriculoatrial shunt, which have technical difficulties and harmful complications. In this preliminary report we describe our initial experience with retrograde ventriculosinus shunt (RVSS) after failed VPS. In 3 consecutive cases we applied RVSS to treat hydrocephalus in shunt-dependent patients who had previously undergone VPS revision and in which peritoneal space was full of adhesions and fibrosis. RVSS was performed as described by Shafei et al., with some modifications to each case. All 3 patients kept the same clinical profile after RVSS, with no perioperative or postoperative complications. However, revision surgery was performed in the first operative day in 1 out of 3 patients, in which the catheter was not positioned in the superior sagittal sinus. We propose that in cases where VPS is not feasible, RVSS may be a safe and applicable second option. Nevertheless, the long-term follow-up of patients and further learning curve must bring stronger evidence. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Aqueous shunt implantation in glaucoma

    Directory of Open Access Journals (Sweden)

    Jing Wang

    2017-01-01

    Full Text Available Aqueous shunts or glaucoma drainage devices are increasingly utilized in the management of refractory glaucoma. The general design of the most commonly-used shunts is based on the principles of the Molteno implant: ie. a permanent sclerostomy (tube, a predetermined bleb area (plate and diversion of aqueous humour to the equatorial region and away from the limbal subconjunctival space. These three factors make aqueous shunts more resistant to scarring as compared to trabeculectomy. The two most commonly used shunts are the Ahmed Glaucoma Valve, which contains a flow-restrictor, and the non-valved Baervedlt Glaucoma Implant. While the valved implants have a lower tendency to hypotony and related complications, the non-valved implants with larger, more-biocompatible end plate design, achieve lower intraocular pressures with less encapsulation. Non-valved implants require additional suturing techniques to prevent early hypotony and a number of these methods will be described. Although serious shunt-related infection is rare, corneal decompensation and diplopia are small but significant risks.

  9. Ventriculoperitoneal shunt blockage by hydatid cyst

    Directory of Open Access Journals (Sweden)

    Abrar A Wani

    2013-01-01

    Full Text Available Ventriculoperitoneal (VP shunt is one of the commonest procedures done in neurosurgical practice throughout the world. One of the commonest problems after putting the VP shunt is the shunt obstruction, which can be due to varied causes. Shunt obstruction secondary to the parasitic infections is rarely seen. We are presenting a 15-year-old child, a case of operated cerebral hydatid cyst with hydrocephalus. She presented with shunt malfunction after 1 year of surgical excision of the hydatid cyst. Revision of the VP shunt was done and peroperatively, it was found that the shunt tubing was obstructed due to small hydatid cysts. This is the first reported case of VP shunt obstruction by hydatid cyst.

  10. 30 CFR 56.6401 - Shunting.

    Science.gov (United States)

    2010-07-01

    ... HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL MINES Explosives Electric Blasting § 56.6401 Shunting. Except during testing— (a) Electric detonators shall be kept shunted until connected to the blasting line or wired into a blasting round; (b) Wired rounds shall be kept shunted until...

  11. Desarrollo de métodos para la evaluación integrada de propiedades mecánicas y superficiales inducidas en materiales metálicos mediante tratamiento superficial por ondas de choque generadas por láser

    OpenAIRE

    Ruiz de Lara de Luis, Leonardo

    2016-01-01

    El tratamiento superficial por ondas de choque generadas por láser, LSP, es una técnica cuyo principal objetivo es el de la modificación del estado tensional de las primeras micras en profundidad de materiales metálicos. En sus comienzos está técnica fue empleada para inducir tensiones residuales de compresión en superficie, pero mientras se avanzaba en su desarrollo se empezaron a observar otros efectos. Profundizando en ellos se llega a la conclusión de que existe una fuerte relación entre ...

  12. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Transjugular Intrahepatic Portosystemic Shunt ( ...

  13. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... Portosystemic Shunt (TIPS) Sponsored by Please note RadiologyInfo.org is not a medical facility. Please contact your ... links: For the convenience of our users, RadiologyInfo .org provides links to relevant websites. RadiologyInfo.org , ACR ...

  14. Ventriculo-pleural shunt patency study

    International Nuclear Information System (INIS)

    Yeates, K.

    2000-01-01

    Full text: A twenty-four year old male was admitted to hospital complaining of headaches, drowsiness and blurred vision. He suffered from congenital hydrocephalus and had had a ventriculo-peritoneal shunt inserted in infancy. This had undergone many revisions due to persistent peritoneal infections and had recently been replaced with a ventriculo-pleural shunt. The symptoms described suggested shunt blockage and he was referred for a Shunt Patency Study. The current shunt is a HAKIM Programmable Valve Shunt System and the opening pressure was 12cm of CSF (within the normal range). Forty megabecquerels of filtered 99 Tc m O 4 was injected into the pre-chamber of the shunt. Serial images and counts were obtained for twenty-five minutes after the injection. The images showed the tracer flowing from the shunt within the first ten minutes. At twenty minutes almost all of the tracer had drained from the shunt and was present in the right pleural cavity, indicating shunt patency. This study is presented to demonstrate the appearances of a normally functioning, but rarely seen Ventriculo-Pleural CSF Shunt. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  15. Comparación de la técnica de sedimentación contra técnica de centrifugación en el tratamiento del lipoinjerto y la preservación de la morfología del adipocito mediante examinación histológica

    Directory of Open Access Journals (Sweden)

    Jaime Arturo Castro Pallaroso

    2014-12-01

    Full Text Available La cirugía maxilofacial es un área de la medicina que abarca una gran cantidad de aspectos dentro del entorno facial, debiendo realizarse procedimientos tanto estéticos como reconstructivos por diversas causas. Al enfocarnos en tejidos blandos muchas veces se necesita devolver la apariencia normal luego de traumatismos, sin embargo existen en el mercado una gran cantidad de materiales de relleno para dicho efecto. El presente estudio se enfoca en un relleno autólogo que sirve como injerto y es la GRASA del propio paciente, pudiendo dar excelentes resultados dependiendo de varios factores, entre ellos en el que nos enfocamos es el tratamiento que se le da a la grasa luego de la liposucción y previo a su inoculación teniendo en cuenta las dos corrientes más conocidas como son la centrifugación y la decantación. Objetivo: Evaluar la mejor preservación de la morfología del adipocito previo tratamiento de sedimentación y de centrifugación en la preparación del lipoinjerto. Materiales y Métodos: bajo consentimiento informado e historia clínica, se realizó la toma de 30 muestras de tejido graso de 10 ml cada una aproximadamente, de pacientes voluntarios. Dichas muestras fueron separadas en dos grupos iguales de 15 muestras cada una, un grupo se realizó centrifugación y el otro grupo decantación, al finalizar se enviaron muestras al laboratorio para procesamiento de placas histológicas y su respectivo análisis al microscopio para determinar la morfología del tejido graso. Resultados: el análisis histológico demostró que la técnica de sedimentación es superior en relación a la centrifugación, debido a que se presenta mayor cantidad de adipocitos por conteo al igual que núcleos, una disminución notable en el número de adipocitos destruidos y sobre todo la presencia de capilares sanguíneos, misma que fue casi nula en la técnica de centrifugación. Conclusiones: se demuestra que en el tratamiento del tejido graso para ser

  16. Pediatric ventriculoperitoneal shunts and their complications: An analysis

    Directory of Open Access Journals (Sweden)

    Nitin Agarwal

    2017-01-01

    Conclusion: With this retrospective review of complications of VP shunts, age at initial shunt insertion and the interval between the age of initial shunt placement and onset of complications were the most important patient-related predictors of shunt failure. The different predominant etiological factors responsible for early and late shunt failure were infective and mechanical complications, respectively.

  17. Tratamiento de las ictericias

    Directory of Open Access Journals (Sweden)

    Roberto de Zubiría

    1955-05-01

    Full Text Available En el tratamiento de los síndromes ictéricos no existe sistematización de criterios y en más de una ocasión se cometen serios errores terapéuticos. Tal sucede frecuentemente con las hepatitis a virus, por ejemplo las que tratadas con un régimen alimenticio inadecuado, constituído casi siempre por dietas de hambre, se va a complicar más la situación. Otras veces se utilizan sistemáticamente los antibióticos de amplio espectro, los cuales son inútiles e inclusive desaconsejados por la posibilidad de producir fibrosis hepática. Hemos querido hacer un resumen analizando someramente el pro y el contra de las principales medidas terapéuticas.

  18. Influencia de los tratamientos microabrasivos sobre la resistencia adhesiva en dientes con fluorosis

    OpenAIRE

    Paola Mena Silva; Ana del Carmen Armas

    2015-01-01

    La búsqueda de tratamientos mínimamente invasivos y altamente estéticos para pacientes con fluorosis, ha llevado a buscar mecanismos para solucionar esta problemática, mediante la utilización de resinas como la primera opción. Sin embargo el principal problema del tratamiento, se centra en la poca adhesión debido a las características estructurales del esmalte fluorótico, en grados de fluorosis TF 1 al 3, el ácido no actúa correctamente, causando ausencia de grabado principalmente entre las e...

  19. A wireless monitoring system for Hydrocephalus shunts.

    Science.gov (United States)

    Narayanaswamy, A; Nourani, M; Tamil, L; Bianco, S

    2015-08-01

    Patients with Hydrocephalus are usually treated by diverting the excess Cerebrospinal Fluid (CSF) to other parts of the body using shunts. More than 40 percentage of shunts implanted fail within the first two years. Obstruction in the shunts is one of the major causes of failure (45 percent) and the detection of obstruction reduces the complexity of the revision surgery. This paper describes a proposed wireless monitoring system for clog detection and flow measurement in shunts. A prototype was built using multiple pressure sensors along the shunt catheters for sensing the location of clog and flow rate. Regular monitoring of flow rates can be used to adjust the valve in the shunt to prevent over drainage or under drainage of CSF. The accuracy of the flow measurement is more than 90 percent.

  20. Arterioportal shunts on dynamic computed tomography

    International Nuclear Information System (INIS)

    Nakayama, T.; Hiyama, Y.; Ohnishi, K.; Tsuchiya, S.; Kohno, K.; Nakajima, Y.; Okuda, K.

    1983-01-01

    Thirty-two patients, 20 with hepatocelluar carcinoma and 12 with liver cirrhosis, were examined by dynamic computed tomography (CT) using intravenous bolus injection of contrast medium and by celiac angiography. Dynamic CT disclosed arterioportal shunting in four cases of hepatocellular carcinoma and in one of cirrhosis. In three of the former, the arterioportal shunt was adjacent to a mass lesion on CT, suggesting tumor invasion into the portal branch. In one with hepatocellular carcinoma, the shunt was remote from the mass. In the case with cirrhosis, there was no mass. In these last two cases, the shunt might have been caused by prior percutaneous needle puncture. In another case of hepatocellular carcinoma, celiac angiography but not CT demonstrated an arterioportal shunt. Thus, dynamic CT was diagnostic in five of six cases of arteriographically demonstrated arterioportal shunts

  1. The somatic shunt cable model for neurons.

    OpenAIRE

    Durand, D

    1984-01-01

    The derivation of the equations for an electrical model of nerve cells is presented. The model consists of an equivalent cylinder, a lumped somatic impedance, and a variable shunt at the soma. This shunt was introduced to take into account the fast voltage decays observed following the injections of current pulses in some motoneurons and hippocampal granule cells that could not be explained by existing models. The shunt can be interpreted either by penetration damage with the electrode or by ...

  2. Control biológico de enfermedades mediante el tratamiento de semillas de cucurbitáceas con rizobacterias promotoras del crecimiento de las plantas (PGPR./Biological control of diseases by cucurbits seeds treatment with rhizobacteria plant growth promoting (PGPR.

    Directory of Open Access Journals (Sweden)

    Gilda Jiménez Montejo

    2014-01-01

    Full Text Available Resumen:Las regulaciones sobre la producción de alimentos sanos limitan actualmente el uso de fungicidas sintéticos para el tratamiento de semillas y, por otra parte, no se dispone de bactericidas efectivos. Se condujeron experimentos en condiciones controladas para evaluar el efecto de las cepas de rizobacterias antagonistas Bacillus subtilis F16/95, B. subtilis Xph y Pseudomonas putida 14A en el control biológico de la Mancha bacteriana de las cucurbitáceas, la Mancha bacteriana del fruto de melón y la pudrición de la raíz, provocadas por Xanthomonas cucurbitae, Acidovorax avenae subsp. citrulli y Fusarium oxysporum, respectivamente. Se realizó el tratamiento de semillas de pepino (C. sativus, L. var. Poinsett, calabaza (Cucurbita moschata, Duch. var. INIVIT C-88, y melón de Castilla (Cucumis melo, L. var. Hale’s Best. Los tratamientos biológicos mostraron una reducción en la incidencia de las enfermedades e incrementos de longitud del tallo y peso fresco de hojas y raíces, en todas las interacciones planta-patógeno-antagonista. La colonización de raíces alcanzó rangos de 8,9-8,0 y 7,8-7,0 log (ufc cm-1 de raíz a los 4 y 15 días después de la siembra. Estos resultados caracterizaron las cepas aplicadas como rizobacterias promotoras del crecimiento vegetal (PGPR y aconsejan la realización de ensayos de campo./Abstract:Nowadays the regulations about the production of healthy foods limit the use of synthetic fungicides for seeds treatment and, on the other hand, effective bactericides are not available. Experiments under controlled conditions were conducted to evaluate the effect of rhizobacterial antagonistic strains Bacillus subtilis F16/95, B. subtilis Xph and Pseudomonas putida 14A on the biological control of Cucurbits bacterial spot, Watermelon bacterial fruit blotch and Fusarium root rot caused by Xanthomonas cucurbitae, Acidovorax avenae subsp. citrulli and Fusarium oxysporum, respectively. Cucumber (Cucumis sativus

  3. Efecto de un tratamiento intensivo con insulina sobre la reactividad plaquetaria en pacientes con hiperglucemia que ingresan con un síndrome coronario agudo

    OpenAIRE

    Vivas Balcones, Luis David

    2011-01-01

    El objetivo primario de este trabajo ha sido la valoración del efecto que produce el control estricto de la glucemia mediante un tratamiento intensivo y precoz con insulina sobre la reactividad plaquetaria durante la fase hospitalaria en pacientes que ingresan en una unidad de cuidados intensivos cardiológicos con un síndrome coronario agudo e hiperglucemia, respecto a un tratamiento convencional.

  4. Shunt protection for superconducting Maglev magnets

    Energy Technology Data Exchange (ETDEWEB)

    Atherton, D L [Queen' s Univ., Kingston, Ontario (Canada). Dept. of Physics

    1979-09-01

    Closely coupled, short-circuited shunt coils are proposed for quench protection of superconducting Maglev magnets which use high resistance, matrix composite conductors. It is shown that, by suitable design, the shunts can reduce induced ac losses and that the changing currents during magnet energization or vehicle lift off and landing can be tolerated.

  5. Shunt protection for superconducting Maglev magnets

    International Nuclear Information System (INIS)

    Atherton, D.L.

    1979-01-01

    Closely coupled, short-circuited shunt coils are proposed for quench protection of superconducting Maglev magnets which use high resistance, matrix composite conductors. It is shown that, by suitable design, the shunts can reduce induced ac losses and that the changing currents during magnet energization or vehicle lift off and landing can be tolerated. (author)

  6. 30 CFR 57.6401 - Shunting.

    Science.gov (United States)

    2010-07-01

    ... HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Explosives Electric Blasting-Surface and Underground § 57.6401 Shunting. Except during testing— (a) Electric detonators shall be kept shunted until connected to the blasting line or wired into a blasting round; (b) Wired rounds shall be...

  7. MR imaging of syringoperitoneal and syringosubarachnoid shunts

    International Nuclear Information System (INIS)

    Hasso, A.N.; Kucharczyk, W.; Mall, J.C.; Colombo, N.; Newton, T.H.; Norman, D.

    1986-01-01

    The authors utilized MR imaging for the evaluation of syringohydromelic shunt procedures in 16 patients. Four characteristic MR imaging findings were seen: ''tethering'' of the spinal cord posteriorly at the site of laminectomy and placement of the shunt tube distortion of the usual elliptical shape of the spinal cord at the site of the shunt, a ''snake-eyes'' appearance of the cord on transverse images which corresponded to the position of the shunt within or next to a collapsed syringohydromelic cavity, and a generous amount of subachnoid space surrounding the collapsed portion of the cavity. Occasionally the shunt could not be visualized on sagittal images but could be seen on transverse images. In the majority of cases, the MR imaging findings were sufficiently characteristic to warrant accurate diagnosis

  8. Traumatismo renal: Diagnóstico y tratamiento

    Directory of Open Access Journals (Sweden)

    Itsel Vela Caravia

    2003-06-01

    Full Text Available Se investigaron aleatoriamente 57 pacientes con el diagnóstico de traumatismo renal y egresados vivos entre 1993 y 1999. Se valoró como la causa predominante del traumatismo renal a los accidentes del tránsito y la incidencia mayor apareció en los hombres blancos entre 25 y 34 años. Los traumatismos renales cerrados ocurrieron en el 91,2 % y los penetrantes el 8,7 %. Los de grado I representaron el 77,1 %, los del grado II el 12,2 % y los de grado III el 10,5 % del total. En el traumatismo grado I predominó el tratamiento médico conservador; en el grado II un tratamiento conservador quirúrgico y en el grado III predominó el tratamiento no conservador. Se consideró que con un diagnóstico y tratamiento adecuados, mediante una clasificación correcta del traumatismo renal, se puede producir una salvación de la unidad renal afectada57 patients with the diagnosis of kidney traumatism who were discharged alive were investigated at random. Car accidents were asessed as the predominating cause of kidney traumatism. The highest incidence was observed among white men aged 25-34. The closed kidney traumatisms occurred in 91.2 % and the penetrating in 8.7 %. The degree 1 traumatisms accounted for 77.1 %, the degree II for 12.2 % and the degree III for 10.5 % of the total. In degree I traumatism, it was observed a predominance of the conservative medical treatment; in the degree II, a surgical conservative treamtent; and in the degree III, the non-conservative treatment. It was considered that with an adequate diagnosis and treatment and by a correct classification of the renal traumatism, the affected renal unit may be saved

  9. Ventriculoperitoneal shunt complications needing shunt revision in children: A review of 5 years of experience with 48 revisions

    Directory of Open Access Journals (Sweden)

    Rajendra K Ghritlaharey

    2012-01-01

    Full Text Available Background: The aim of this study was to review the management of ventriculoperitoneal (VP shunt complications in children. Patients and Methods: During the last 5 years (January 1, 2006 to December 31, 2010, 236 VP shunt operations were performed in children under 12 years of age; of these, 40 (16.94% developed shunt complications and those who underwent VP shunt revisions were studied. Results: This prospective study included 40 (28 boys and 12 girls children and required 48 shunt revisions. Complications following VP shunts that required shunt revisions were peritoneal catheter/peritoneal end malfunction (18, shunt/shunt tract infections (7, extrusion of peritoneal catheter through anus (5, ventricular catheter malfunction (4, cerebrospinal fluid (CSF leak from abdominal wound (4, shunt system failure (2, ventricular end/shunt displacement (2, CSF pseudocysts peritoneal cavity (2, extrusion of peritoneal catheter from neck, chest, abdominal scar and through umbilicus, one each. Four-fifth of these shunt complications occurred within 6 months of previous surgery. Surgical procedures done during shunt revisions in order of frequency were revision of peritoneal part of shunt (27, 56.25%, revision of entire shunt system (6, 12.5%, extra ventricular drainage and delayed re-shunt (5, 10.41%, shunt removal and delayed re-shunt (5, 10.41%, opposite side shunting (2, 4.16%, cysts excision and revision of peritoneal catheter (2, 4.16% and revision of ventricular catheter (1, 2.08%. The mortalities following VP shunt operations were 44 (18.64% and following shunt revisions were 4 (10%. Conclusions: VP shunt done for hydrocephalus in children is not only prone for complications and need for revision surgery but also associated with considerable mortality.

  10. TRATAMIENTO DE AGUAS RESIDUALES MEDIANTE REACTORES ANAERÓBICOS DE PLACAS VERTICALES PARALELAS EN ACRÍLICO TRATAMENTO DE ÁGUAS RESIDUÁRIAS POR REATORES ANAERÓBIOS DE PLACAS VERTICAIS PARALELAS EM ACRÍLICO WASTEWATER TREATMENT BY ANAEROBIC REACTORS OF VERTICAL PARALLEL PLATES IN ACRYLIC

    Directory of Open Access Journals (Sweden)

    Guillermo Chaux F

    2011-12-01

    Full Text Available Algunos filtros anaeróbicos con lecho de piedra construidos en el departamento del Cauca (Colombia, están presentando problemas de colmatación. Si se reemplaza la piedra por placas verticales paralelas, se elimina el problema de obstrucción. Este documento presenta el desarrollo y resultados de una investigación que evaluó a escala de laboratorio el potencial de los reactores anaeróbicos de placas verticales paralelas en acrílico para remover contaminantes (materia orgánica y sólidos suspendidos. El reactor anaeróbico de placas paralelas en acrílico se desempeñó como tratamiento secundario; se alimentó con agua residual efluente de un Tanque Imhoff con concentraciones medias de 156 ± 14 mg/L de DB05, 438 ± 32 mg/L de DQO y 98 ±22 mg/L de sólidos suspendidos totales. Las remociones de DQO y DB05 en el reactor sobrepasan el 50% y la remoción de sólidos suspendidos sobrepasó el 60% para tiempos de detención de 24 horas. La facilidad en la operación del reactor lo hace viable como tratamiento biológico anaeróbico de aguas residuales previamente decantadasAlguns filtros anaeróbios com recheio de pedras construída no departamento de Cauca (Colombia estão apresentando problemas de obstrução. Se a pedra é substituída por placas verticais paralelas, evita o problema da obstrução. Este artigo apresenta o desenvolvimento e os resultados e no estudo realizado em escala de laboratório que avaliaram o potencial de reatores anaeróbios de placas verticais paralelas em acrílico para remover os contaminantes (sólidos suspensos e matéria orgânica. 0 reator anaeróbio de placas paralelas de acrílico serviu como tratamento secundário; foi alimentado com água residuária do efluente de um tanque Imhoff com concentrações médias de 156 ± 14 mg/L DB05, 438 ± 32 mg/L de DQO e 98 ±22 mg/L de sólidos suspensos totais. A remoção de DQO e DB05 no reator são mais de 50% ea remoção de sólidos em suspensão superior a 60

  11. Análisis del impacto de los valores personales en la elección del Tratamiento Sustitutivo Renal

    Directory of Open Access Journals (Sweden)

    Ana Isabel Aguilera Flórez

    Full Text Available Resumen Una de las actividades que se realizan en el proceso educativo con herramientas de ayuda a la toma de decisión (HATD es ayudarles a explorar sus valores mediante las "tarjetas de valores". El objetivo del estudio fue, conocer los valores de las personas con Enfermedad Renal Crónica en la elección de modalidad de Tratamiento Sustitutivo Renal y analizar si existía relación entre los mensajes de las tarjetas y la modalidad de tratamiento. Estudio retrospectivo. Se incluyeron 281 pacientes que pasaron por el proceso de educación con HATD entre los años 2011-2016. Los datos se obtuvieron de los registros de enfermería de la historia clínica. Se estudiaron variables demográficas, tarjetas de valores y elección de tratamiento. La muestra fue de 281 pacientes. Las 3 tarjetas que obtuvieron un mayor porcentaje de elección fueron, Personal sanitario responsable del tratamiento (14,20%, Ser independiente (13,65%, Impacto para la familia (13,30%; según la modalidad de tratamiento elegida, HD: Impacto para la familia (15,94%, Personal sanitario responsable del tratamiento (15,58%, Ser independiente (13,04%. DP: Ser independiente (18,95%, Personal sanitario responsable del tratamiento (15,26%, Impacto para la familia (14,21%. Tratamiento médico conservador: Ser independiente (25,2%, Autonomía e Impacto para la familia (12,5%. Trasplante de donante vivo: Personal sanitario responsable tratamiento (30%, Ser independiente (30%, Autonomía (10%. Podemos concluir que la mayoría de los mensajes de las tarjetas, parecen estar en concordancia con la modalidad elegida. No hay valores propios de una modalidad de tratamiento sustitutivo renal sino personas con diferentes valores que marcan la toma de decisión.

  12. Research progress in TIPS shunt dysfunction and recanalization

    Directory of Open Access Journals (Sweden)

    WANG Tingting

    2015-11-01

    Full Text Available Transjugular intrahepatic portosystemic shunt (TIPS is widely used in the treatment of cirrhotic portal hypertension and its associated complications. However, postoperative shunt dysfunction has been an important factor restricting the clinical application of TIPS. This article summarizes the use of shunt, the incidence of shunt dysfunction after TIPS, preventive measures and diagnostic methods for shunt dysfunction, and indications and techniques of shunt recanalization, in order to enhance our knowledge of shunt dysfunction and recanalization, which could further improve the efficacy of TIPS for cirrhotic portal hypertension.

  13. Hernia discal lumbar: Tratamiento conservador

    OpenAIRE

    López-Sastre Núñez, Antonio; Candau Pérez, Ernesto

    1999-01-01

    Existe una gran demanda de patología lumbar crónica y aguda que debe de tratarse conjuntamente entre el especialista en Rehabilitación y el Cirujano de columna vertebral. En este trabajo se detallan las posibilidades del tratamiento conservador antes de optar por la cirugía. Se realiza una revisión bibliográfica de los resultados conservadores del tratamiento de la lumbociática de origen discal comparando aquellos estudios publicados con validez estadística. Se detallan las modernas pautas de...

  14. Primary ventriculoperitoneal shunting outcomes: a multicentre clinical audit for shunt infection and its risk factors.

    Science.gov (United States)

    Woo, P Ym; Wong, H T; Pu, J Ks; Wong, W K; Wong, L Yw; Lee, M Wy; Yam, K Y; Lui, W M; Poon, W S

    2016-10-01

    To determine the frequency of primary ventriculoperitoneal shunt infection among patients treated at neurosurgical centres of the Hospital Authority and to identify underlying risk factors. This multicentre historical cohort study included consecutive patients who underwent primary ventriculoperitoneal shunting at a Hospital Authority neurosurgery centre from 1 January 2009 to 31 December 2011. The primary endpoint was shunt infection, defined as: (1) the presence of cerebrospinal fluid or shunt hardware culture that yielded the pathogenic micro-organism with associated compatible symptoms and signs of central nervous system infection or shunt malfunction; or (2) surgical incision site infection requiring shunt reinsertion (even in the absence of positive culture); or (3) intraperitoneal pseudocyst formation (even in the absence of positive culture). Secondary endpoints were shunt malfunction, defined as unsatisfactory cerebrospinal fluid drainage that required shunt reinsertion, and 30-day mortality. A primary ventriculoperitoneal shunt was inserted in 538 patients during the study period. The mean age of patients was 48 years (range, 13-88 years) with a male-to-female ratio of 1:1. Aneurysmal subarachnoid haemorrhage was the most common aetiology (n=169, 31%) followed by intracranial tumour (n=164, 30%), central nervous system infection (n=42, 8%), and traumatic brain injury (n=27, 5%). The mean operating time was 75 (standard deviation, 29) minutes. Shunt reinsertion and infection rates were 16% (n=87) and 7% (n=36), respectively. The most common cause for shunt reinsertion was malfunction followed by shunt infection. Independent predictors for shunt infection were: traumatic brain injury (adjusted odds ratio=6.2; 95% confidence interval, 2.3-16.8), emergency shunting (2.3; 1.0-5.1), and prophylactic vancomycin as the sole antibiotic (3.4; 1.1-11.0). The 30-day all-cause mortality was 6% and none were directly procedure-related. This is the first Hong Kong

  15. Idiopathic intracranial hypertension: lumboperitoneal shunts versus ventriculoperitoneal shunts--case series and literature review.

    LENUS (Irish Health Repository)

    Abubaker, Khalid

    2012-02-01

    OBJECTIVES: Idiopathic intracranial hypertension (IIH) is an uncommon but important cause of headache that can lead to visual loss. This study was undertaken to review our experience in the treatment of IIH by neuronavigation-assisted ventriculoperitoneal (VP) shunts with programmable valves as compared to lumboperitoneal (LP) shunts. METHODS: A retrospective chart review was conducted on 25 patients treated for IIH between 2001 and 2009. Age, sex, clinical presentation, methods of treatment and failure rates were recorded. RESULTS: Seventy-two per cent were treated initially with LP shunts. Failure rate was 11% in this group. Neuronavigation-assisted VP shunts were used to treat 28%. In this group, the failure rate was 14%. CONCLUSION: Our experience indicates that both LP shunts and VP shuts are effective in controlling all the clinical manifestations of IIH in the immediate postoperative period. Failure rates are slightly higher for VP shunts (14%) than LP shunts (11%). However, revision rates are higher with LP shunts (60%) than with VP shunts (30%).

  16. Congenital portosystemic shunts with and without gastrointestinal bleeding - case series

    Energy Technology Data Exchange (ETDEWEB)

    Gong, Ying; Chen, Jun; Chen, Qi; Ji, Min; Pa, Mier; Qiao, Zhongwei [Children' s Hospital of Fudan University, Department of Radiology, Shanghai (China); Zhu, Hui [Fudan University Shanghai Cancer Center, Department of Radiology, Shanghai (China); Zheng, Shan [Children' s Hospital of Fudan University, Department of Surgery, Shanghai (China)

    2015-12-15

    The clinical presentation of congenital portosystemic shunt is variable and gastrointestinal bleeding is an uncommon presentation. To describe the imaging features of congenital portosystemic shunt as it presented in 11 children with (n = 6) and without gastrointestinal bleeding (n = 5). We performed a retrospective study on a clinical and imaging dataset of 11 children diagnosed with congenital portosystemic shunt. A total of 11 children with congenital portosystemic shunt were included in this study, 7 with extrahepatic portosystemic shunts and 4 with intrahepatic portosystemic shunts. Six patients with gastrointestinal bleeding had an extrahepatic portosystemic shunt, and the imaging results showed that the shunts originated from the splenomesenteric junction (n = 5) or splenic vein (n = 1) and connected to the internal iliac vein. Among the five cases of congenital portosystemic shunt without gastrointestinal bleeding, one case was an extrahepatic portosystemic shunt and the other four were intrahepatic portosystemic shunts. Most congenital portosystemic shunt patients with gastrointestinal bleeding had a shunt that drained portal blood into the iliac vein via an inferior mesenteric vein. This type of shunt was uncommon, but the concomitant rate of gastrointestinal bleeding with this type of shunt was high. (orig.)

  17. Resonant Electromagnetic Shunt Damping of Flexible Structures

    DEFF Research Database (Denmark)

    Høgsberg, Jan Becker

    2016-01-01

    Electromagnetic transducers convert mechanical energy to electrical energy and vice versa. Effective passive vibration damping of flexible structures can therefore be introduced by shunting with an accurately calibrated resonant electrical network thatcontains a capacitor to create the desired...

  18. Endoscopic third ventriculostomy versus ventriculoperitoneal shunt ...

    African Journals Online (AJOL)

    Patients' medical records, operative notes, and neural tube database records were used to complete a structured questionnaire. The difference in ... likely after 6 months. Keywords: obstructive hydrocephalus; endoscopic third ventriculostomy; ventriculoperitoneal shunt; children; paediatric surgery; neurosurgery; Ethiopia ...

  19. Nonconventional mesocaval prosthetic shunt interposition in ...

    African Journals Online (AJOL)

    years demonstrates shunt patency and normal development ... However, the child's condition and growth ... The child has satisfactory weight and growth gain. (40kg .... infants and toddlers: replacement with decellularized branched pulmonary.

  20. LABRANZA MECANIZADA DE PASTURAS MEDIANTE TRES IMPLEMENTOS EN UN ULTISOL Y SUS IMPLICACIONES FÍSICAS E HIDROPEDOLÓGICAS

    Directory of Open Access Journals (Sweden)

    Manuel E. Camacho

    2015-01-01

    Full Text Available Mediante un estudio en el campo, se determinó el efecto de la labranza mecanizada con 3 implementos sobre la compactación, las variables físicas e hidropedológicas de un Ultisol dedicado a la ganadería, ubicado en San Mateo, Alajuela. Se seleccionó un lote de aproximadamente 10 000 m2, se dividió en 16 parcelas iguales (650 m2 cada una, y se aleatorizó la mecanización con 3 diferentes implementos correspondientes a los tratamientos, a partir de una parcela y un diseño experimental irrestricto al azar. Como tratamientos se estableció un área sin labranza (T, y labranza mediante un palín mecánico (PM, un arado de cincel (AC o un subsolador (S. Cuarenta días después de la aplicación de los tratamientos se determinó la resistencia a la penetración cada 5 cm hasta los 50 cm de profundidad, y la humedad gravimétrica, densidad aparente y de partículas, infiltración y conductividad hidráulica fueron evaluadas, todas ellas en los primeros 10 cm de profundidad. Se encontró un descenso en la compactación del suelo, expresada como resistencia a la penetración, para los tratamientos de mecanización, y reportó el tratamiento palín mecánico (PM con los valores más bajos. Este mismo tratamiento incrementó la infiltración acumulada (38,70±3,60 mm a los 150 min de manera significativa, al comparar con la obtenida en el tratamiento testigo (0,09±0,02 mm a los 150 min. No se encontró diferencias significativas entre los tratamientos de mecanización para densidad aparente, porosidad y espacio aéreo, pero sí con respecto al tratamiento T. El tratamiento subsolador (S propició los valores más elevados de conductividad hidráulica, sin diferencias estadísticas del resto de tratamientos (p>0,05.

  1. Cell shunt resistance and photovoltaic module performance

    Energy Technology Data Exchange (ETDEWEB)

    McMahon, T.J.; Basso, T.S.; Rummel, S.R. [National Renewable Energy Lab., Golden, CO (United States)

    1996-05-01

    Shunt resistance of cells in photovoltaic modules can affect module power output and could indicate flawed manufacturing processes and reliability problems. The authors describe a two-terminal diagnostic method to directly measure the shunt resistance of individual cells in a series-connected module non-intrusively, without deencapsulation. Peak power efficiency vs. light intensity was measured on a 12-cell, series-connected, single crystalline module having relatively high cell shunt resistances. The module was remeasured with 0.5-, 1-, and 2-ohm resistors attached across each cell to simulate shunt resistances of several emerging technologies. Peak power efficiencies decreased dramatically at lower light levels. Using the PSpice circuit simulator, the authors verified that cell shunt and series resistances can indeed be responsible for the observed peak power efficiency vs. intensity behavior. The authors discuss the effect of basic cell diode parameters, i.e., shunt resistance, series resistance, and recombination losses, on PV module performance as a function of light intensity.

  2. Endoscopic Third Ventriculostomy in Previously Shunted Children

    Directory of Open Access Journals (Sweden)

    Eva Brichtova

    2013-01-01

    Full Text Available Endoscopic third ventriculostomy (ETV is a routine and safe procedure for therapy of obstructive hydrocephalus. The aim of our study is to evaluate ETV success rate in therapy of obstructive hydrocephalus in pediatric patients formerly treated by ventriculoperitoneal (V-P shunt implantation. From 2001 till 2011, ETV was performed in 42 patients with former V-P drainage implantation. In all patients, the obstruction in aqueduct or outflow parts of the fourth ventricle was proved by MRI. During the surgery, V-P shunt was clipped and ETV was performed. In case of favourable clinical state and MRI functional stoma, the V-P shunt has been removed 3 months after ETV. These patients with V-P shunt possible removing were evaluated as successful. In our group of 42 patients we were successful in 29 patients (69%. There were two serious complications (4.7%—one patient died 2.5 years and one patient died 1 year after surgery in consequence of delayed ETV failure. ETV is the method of choice in obstructive hydrocephalus even in patients with former V-P shunt implantation. In case of acute or scheduled V-P shunt surgical revision, MRI is feasible, and if ventricular system obstruction is diagnosed, the hydrocephalus may be solved endoscopically.

  3. Fabricación aditiva mediante sinterizado láser de polvos de acero inoxidable martensítico AISI 420

    OpenAIRE

    Vega Nava, Sergio

    2014-01-01

    Busqueda de los parámetros de fabricación adecuados y los tratamientos térmicos a realizar, con el fin de alcanzar durezas de 50 HRC y una adecuada porosidad, en el acero inoxidable AISI 420 obtenido mediante sinterizado láser.

  4. Idiopathic intracranial hypertension: lumboperitoneal shunts versus ventriculoperitoneal shunts--case series and literature review.

    LENUS (Irish Health Repository)

    Abubaker, Khalid

    2011-02-01

    Idiopathic intracranial hypertension (IIH) is an uncommon but important cause of headache that can lead to visual loss. This study was undertaken to review our experience in the treatment of IIH by neuronavigation-assisted ventriculoperitoneal (VP) shunts with programmable valves as compared to lumboperitoneal (LP) shunts.

  5. GABA Shunt in Durum Wheat

    Directory of Open Access Journals (Sweden)

    Petronia Carillo

    2018-02-01

    Full Text Available Plant responses to salinity are complex, especially when combined with other stresses, and involve many changes in gene expression and metabolic fluxes. Until now, plant stress studies have been mainly dealt only with a single stress approach. However, plants exposed to multiple stresses at the same time, a combinatorial approach reflecting real-world scenarios, show tailored responses completely different from the response to the individual stresses, due to the stress-related plasticity of plant genome and to specific metabolic modifications. In this view, recently it has been found that γ-aminobutyric acid (GABA but not glycine betaine (GB is accumulated in durum wheat plants under salinity only when it is combined with high nitrate and high light. In these conditions, plants show lower reactive oxygen species levels and higher photosynthetic efficiency than plants under salinity at low light. This is certainly relevant because the most of drought or salinity studies performed on cereal seedlings have been done in growth chambers under controlled culture conditions and artificial lighting set at low light. However, it is very difficult to interpret these data. To unravel the reason of GABA accumulation and its possible mode of action, in this review, all possible roles for GABA shunt under stress are considered, and an additional mechanism of action triggered by salinity and high light suggested.

  6. Portal hypertension: A critical appraisal of shunt procedures with emphasis on distal splenorenal shunt in children

    Directory of Open Access Journals (Sweden)

    Nitin Sharma

    2014-01-01

    Full Text Available Background: Extrahepatic portal venous obstruction (EHPVO is the most common cause of pediatric portal hypertension. We analyzed the investigative protocol and results of portosystemic shunts in this group of patients. Materials and Methods: A total of 40 consecutive children aged below 12 years operated with a diagnosis of extra-hepatic portal hypertension formed the study group. Historical data and clinical data were collected. All patients underwent upper gastrointestinal endoscopy, ultrasound Doppler and computed tomographic portogram pre-operatively and post-operatively. Results with respect to shunt patency, hypersplenism and efficacy of different radiological investigations were collected. Results: A total of 40 patients, 28 boys and 12 girls constituted the study group. Lienorenal shunt (LRS was performed in 14 patients; distal splenorenal shunt in 21 patients and side-to-side lienorenal shunt in 4 patients, inferior mesenteric renal shunt was performed in 1 patient. Follow-up ranged from 36 to 70 months. At a minimum follow-up of 3 years, 32 (80% patients were found to have patent shunts. Patent shunts could be visualized in 30/32 patients with computer tomographic portogram (CTP and 28/32 with ultrasound. Varices regressed completely in 26/32 patients and in the rest incomplete regression was seen. Spleen completely regressed in 19/25 patients. Hypersplenism resolved in all patients with patent shunts. Conclusions: Portosystemic shunting in children with EHPVO is a viable option. While long-term cure rates are comparable with sclerotherapy, repeated hospital visits are reduced with one time surgery. Pre-operative and post-operative assessment can be performed with complimentary use of ultrasound, CTP and endoscopy.

  7. Fracturas de tibia, tratamiento con CIMB no fresados

    Directory of Open Access Journals (Sweden)

    Roberto Del Gordo D´Amato

    2013-10-01

    Full Text Available Se realizó un estudio descriptivo tipo serie de casos en el cual se analizan diversos aspectos inherentes al tratamiento quirúrgico de 92 fracturas de tibia diafisiarias cerradas y abiertas tipo I y II de Gustillo, tratadas con Clavos Intramedulares Bloqueados No Fresados (CIMBNF de las 125 atendidas servicio de ortopedia y traumatología de la Clínica El Prado de la Ciudad de Santa Marta D.T.C.H., entre diciembre del 2005 y diciembre del 2007. Se excluyeron de este estudio 33 casos en los cuales por diversas causas se realizó otro tipo de tratamiento fuera ortopédico o quirúrgico mediante colocación de fijadores externos. Utilizamos la clasificación del AO en la cual a este tipo de lesiones corresponde el número 42. Encontramos una alta incidencia en accidentes de transito como factor productor de este tipo de lesión y dentro de ellos la motocicleta como vehículo mas frecuente. Fueron evaluados 86 de los 92 pacientes que corresponde al 93.5% y dentro de ellos se presentaron complicaciones mayores en el 4.6%, cabe mencionar Infecciones post operatorias y deformidades a nivel proximal y distal por diversas causas, las cuales fueron corregidas con procedimientos ulteriores. (Duazary 2008; 1: 4 - 8

  8. SATISFACCIÓN CON EL TRATAMIENTO EN PACIENTES DE ATENCIÓN PRIMARIA CON ARTROSIS

    Directory of Open Access Journals (Sweden)

    Carmen Llanos Val Jiménez

    2017-01-01

    Full Text Available Fundamentos: Al igual que en otros problemas crónicos, en el abor - daje del paciente con artrosis se tiende a un modelo de toma de decisiones compartidas, en el que el punto de vista del paciente debe ser considerado en la elección del tratamiento. El objetivo de este trabajo fue evaluar la sa - tisfacción con el tratamiento en pacientes diagnosticados de osteoartrosis y comprobar si existen diferencias entre diferentes opciones farmacológicas, así como determinar si existe asociación con el estado funcional y las carac - terísticas clínicas y sociodemográficas. Métodos: Se realizó un estudio observacional transversal en una muestra de 487 pacientes seleccionados mediante muestreo consecutivo. La variable principal fue el nivel de satisfacción con el tratamiento (cuestionario ARTS. El estado funcional de los pacientes fue evaluado mediante la escala WO - MAC. Otras variables fueron: características del tratamiento, adherencia te - rapéutica, eventos adversos, y variables clínicas y sociodemográficas. Resultados: En el cuestionario ARTS los pacientes, en un rango entre 28 y 87, obtuvieron una puntuación media de 65,3 (DE: 9,9. La puntuación no fue significativamente diferente en consumidores de 1, 2 o más fármacos. Entre quienes consumían un solo fármaco, no hubo diferencias entre los di - ferentes tipos de fármacos. En el estado funcional se obtuvo una puntuación media de 30,2 puntos (DE: 20,8 y se observó una débil correlación negativa con el nivel de satisfacción (r= - 0,252; p<0,001. Mediante regresión lineal múltiple, se observó mayor puntuación en la escala ARTS (p<0,05 en pa - cientes con menor puntuación en la escala WOMAC, mayor edad y ausencia de eventos adversos. Conclusión : En pacientes con osteoartritis se observa un nivel mode - rado de satisfacción con el tratamiento farmacológico, condicionado por su situación funcional, sus características sociodemográficas y por la presencia de eventos

  9. Tratamiento de rituales compulsivos en un caso de esquizofrenia residual: eficacia de la hipnosis

    Directory of Open Access Journals (Sweden)

    CARLOS SALAMERO

    2005-01-01

    Full Text Available Los autores describen el tratamiento de una conducta compulsiva en un caso de esquizofrenia residual. Tras realizar una descripción general del cuadro clínico y un análisis de las conductas evaluadas, se comentan las distintas etapas de intervención: línea base, control de estímulos, entrenamiento en y tratamiento mediante hipnosis, y seguimiento. Se utilizó un método de inducción mediante la fijación ocular, con sugestiones de relajación y de tranquilidad para la profundización hipnótica, y se dieron instrucciones en forma de sugestiones poshipnóticas para extinguir la conducta. Finalmente, se valoran las implicaciones de la hipnosis en el tratamiento de síntomas obsesivo-compulsivos en cuadros de esquizofrenia a propósito de la extinción de aquella conducta.

  10. Simulation model for port shunting yards

    Science.gov (United States)

    Rusca, A.; Popa, M.; Rosca, E.; Rosca, M.; Dragu, V.; Rusca, F.

    2016-08-01

    Sea ports are important nodes in the supply chain, joining two high capacity transport modes: rail and maritime transport. The huge cargo flows transiting port requires high capacity construction and installation such as berths, large capacity cranes, respectively shunting yards. However, the port shunting yards specificity raises several problems such as: limited access since these are terminus stations for rail network, the in-output of large transit flows of cargo relatively to the scarcity of the departure/arrival of a ship, as well as limited land availability for implementing solutions to serve these flows. It is necessary to identify technological solutions that lead to an answer to these problems. The paper proposed a simulation model developed with ARENA computer simulation software suitable for shunting yards which serve sea ports with access to the rail network. Are investigates the principal aspects of shunting yards and adequate measures to increase their transit capacity. The operation capacity for shunting yards sub-system is assessed taking in consideration the required operating standards and the measure of performance (e.g. waiting time for freight wagons, number of railway line in station, storage area, etc.) of the railway station are computed. The conclusion and results, drawn from simulation, help transports and logistics specialists to test the proposals for improving the port management.

  11. Desarrollo e instrumentación de un sistema exportable de monitorización y control en tiempo real de procesos de tratamiento superficial de aceros con láser

    OpenAIRE

    Álvarez-Feal, José-Carlos

    2016-01-01

    Los tratamientos de temple superficial de metales son ampliamente utilizados en la industria para mejorar las propiedades mecánicas y tribológicas de componentes mecánicos. Estos tratamientos pueden ser realizados mediante láseres de potencia, pero los resultados obtenidos dependen de muchos factores que impiden asegurar la repetibilidad del mismo. El objetivo de la tesis es contribuir a mejorar el resultado final obtenido en estos procesos y garantizar su repetibilidad med...

  12. Balanced calibration of resonant shunt circuits for piezoelectric vibration control

    DEFF Research Database (Denmark)

    Høgsberg, Jan; Krenk, Steen

    2012-01-01

    Shunting of piezoelectric transducers and suitable electric circuits constitutes an effective passive approach to resonant vibration damping of structures. Most common design concepts for resonant resistor-inductor (RL) shunt circuits rely on either maximization of the attainable modal damping...

  13. Coupling slots without shunt impedance drop

    International Nuclear Information System (INIS)

    Balleyguier, P.

    1996-01-01

    It is well known that coupling slots between adjacent cells in a π-mode structure reduce shunt impedance per unit length with respect to single cell cavities. To design optimized coupling slots, one has to answer the following question: for a given coupling factor, what shape, dimension, position and number of slots lead to the lowest shunt impedance drop? A numerical study using the 3D code MAFIA has been carried out. The aim was to design the 352 MHz cavities for the high intensity proton accelerator of the TRISPAL project. The result is an unexpected set of four 'petal' slots. Such slots should lead to a quasi-negligible drop in shunt impedance: about -1% on average, for particle velocity from 0.4 c to 0.8 c. (author)

  14. Distal splenorenal shunt with partial spleen resection

    Directory of Open Access Journals (Sweden)

    Gajin Predrag

    2007-01-01

    Full Text Available Introduction: Hypersplenism is a common complication of portal hypertension. Cytopenia in hypersplenism is predominantly caused by splenomegaly. Distal splenorenal shunt (Warren with partial spleen resection is an original surgical technique that regulates cytopenia by reduction of the enlarged spleen. Objective. The aim of our study was to present the advantages of distal splenorenal shunt (Warren with partial spleen resection comparing morbidity and mortality in a group of patients treated by distal splenorenal shunt with partial spleen resection with a group of patients treated only by a distal splenorenal shunt. Method. From 1995 to 2003, 41 patients with portal hypertension were surgically treated due to hypersplenism and oesophageal varices. The first group consisted of 20 patients (11 male, mean age 42.3 years who were treated by distal splenorenal shunt with partial spleen resection. The second group consisted of 21 patients (13 male, mean age 49.4 years that were treated by distal splenorenal shunt only. All patients underwent endoscopy and assessment of oesophageal varices. The size of the spleen was evaluated by ultrasound, CT or by scintigraphy. Angiography was performed in all patients. The platelet and white blood cell count and haemoglobin level were registered. Postoperatively, we noted blood transfusion, complications and total hospital stay. Follow-up period was 12 months, with first checkup after one month. Results In the first group, only one patient had splenomegaly postoperatively (5%, while in the second group there were 13 patients with splenomegaly (68%. Before surgery, the mean platelet count in the first group was 51.6±18.3x109/l, to 118.6±25.4x109/l postoperatively. The mean platelet count in the second group was 67.6±22.8x109/l, to 87.8±32.1x109/l postoperatively. Concerning postoperative splenomegaly, statistically significant difference was noted between the first and the second group (p<0.05. Comparing the

  15. Biophysical shunt theory for neuropsychopathology: Part I.

    Science.gov (United States)

    Naisberg, Y; Avnon, M; Weizman, A

    1995-11-01

    We present a new model of the origin of schizophrenia based on biophysical ionic shunts in neuronal (electrical) pathways. Microstructural and molecular evidence is presented for the way in which changes in the neuronal membrane ionic channels may facilitate membrane property rearrangement, leading to a change in the density and composition of the ion channel charge which in turn causes a change in ionic flow orientation and distribution. We suggest that, under abnormal conditions, ionic flow shunts are created which redirect the biophysical collateral neuronal (electrical) pathways, resulting in psychiatric signs and symptoms. This model is complementary to the biological basis of schizophrenia.

  16. Genetic and Functional Analysis of Congenital Portosystemic Shunts in Dogs

    NARCIS (Netherlands)

    van den Bossche, L.

    2017-01-01

    The general aim of this thesis was to gain further insight into the pathogenesis of congenital portosystemic shunts (CPSS), elucidate mechanisms involved in the pathophysiology of CPSS, and explore predictors of recovery after surgical ligation of the shunt. For intrahepatic portosystemic shunts

  17. Tratamiento de la enfermedad de Kienbock avanzada mediante la técnica de Graner

    OpenAIRE

    Garcia Mata, S.; Ibarra Zulategui, P.; Hidalgo Ovejero, Angel Manuel; Martínez de Lecea Placer, Francisco; Martínez Grande, M.

    1988-01-01

    The authors made a review about 16 patients with Kienbock disease, in late stage (III-IV of de Decoulx clasification), operated by Graner's procedure, this results was excellent about pain, good strength and poor movility. They beleave is a good procedure in that stage for strengh manual workers.

  18. Hypo fractionated prostate treatment by volumearcotherapy modulated; Tratamiento hipofraccionado de prostata mediante arcoterapia volumetria modulada

    Energy Technology Data Exchange (ETDEWEB)

    Clemente Gutierrez, F.; Perez Vara, C.; Prieto Villacorta, M.

    2013-07-01

    Several studies have been proposed over the years schemes of hypo-fractionated treatment for prostate cancer. Such schemes have been designed in order to increase local control of the disease and reduce complications. They are in addition a clear improvement from the point of view logistical and organizational for treatment centres and the patient. the hypo-fractionated treatments are possible because the ratio a/b for prostate carcinoma is comparable, and even below, the surrounding healthy tissues. This work presents the scheme adopted in our Center for the hypo-fractionated treatment of the cancer of prostate by arco therapy volumetric modulated. (Author)

  19. Hydrodynamic cavitation applied to industrial wastewater; Tratamiento de efluentes industriales mediante cavitacion hidrodinamica

    Energy Technology Data Exchange (ETDEWEB)

    Benito, Y; Arrojo, S

    2006-07-01

    The use environmental technology of the phenomenon known as cavitation has opened in the last new years alternatives for the treatment especially for industrial effluents. CIEMAT has designed and constructed a plant of cavitation hydrodynamics to take to end experiments that it allows us to show the possibilities of this technology as process of advanced oxidation of low cost. The experimentation has been made with water contaminated by substances like toluene and some derivatives, chloride organic compounds, xylenes, ammonia, wastewater from the ended of leather sector, there being achieved important reductions of the DQO (of the order of 60%) in short times. This work shows the results obtained in the experimentation of waters contaminated with toluene and p-nitrophenol. (Author)

  20. Waste Water treatment by membrane bioreactors; Tratamiento de aguas residuales urbanas mediante reactores biologicos de membranas

    Energy Technology Data Exchange (ETDEWEB)

    Malfeito, J. J.; Palacios, E.

    2001-07-01

    Wastewater reuse plants can be simplified to a single step process with a membrane bioreactor developed by PRIDESA. The process consists on a biological reactor integrated with immersed membranes that combines clarification and filtration of an activated sludge process into a simplified single step process. Because of the design of the membranes and plate and frame module, the hydrostatic pressure difference is enough to ensure the design permeate flowrate. That means low energy requirements and reduced fouling, as contaminants are not forced into the membrane pores. A 90-days pilot scale operation for reclamation of urban wastewater was studied and the performance of the system was investigated with a sludge retention time (SRT) of 25 days and membrane flux between 50.90 l/h. with different membranes. Averaged 98% of BODS, a 95% of COD and a 99.49% of SS were removed. (Author) 5 refs.

  1. TRATAMIENTO DE AGUAS DE ESCORRENTÍA MEDIANTE HUMEDALES ARTIFICIALES: ESTADO DEL ARTE

    Directory of Open Access Journals (Sweden)

    Carlos Andrés Peña Guzmán

    2012-01-01

    Full Text Available La concentración de contaminantes en aguas lluvia es un tema que preocupa a las entidades gubernamentales porque deterioran la calidad hídrica de las fuentes receptoras. En varios países, se han iniciado investigaciones y desarrollo de metodologías para tratar este tipo de aguas. Una de estas técnicas es la ejecución de humedales artificiales, y es una de las más aceptadas por su gran eficiencia en la remoción de contaminantes. El presente artículo expondrá el estado del conocimiento, estudiando los métodos de diseño, eficiencias y las nuevas tendencias en la investigación de humedales artificiales que tratan aguas lluvia y/o escorrentía urbana.

  2. TRATAMIENTO DE AGUAS DE ESCORRENTÍA MEDIANTE HUMEDALES ARTIFICIALES: ESTADO DEL ARTE

    OpenAIRE

    Carlos Andrés Peña Guzmán; Jaime Lara Borrero

    2012-01-01

    La concentración de contaminantes en aguas lluvia es un tema que preocupa a las entidades gubernamentales porque deterioran la calidad hídrica de las fuentes receptoras. En varios países, se han iniciado investigaciones y desarrollo de metodologías para tratar este tipo de aguas. Una de estas técnicas es la ejecución de humedales artificiales, y es una de las más aceptadas por su gran eficiencia en la remoción de contaminantes. El presente artículo expondrá el estado del conocimiento, estudia...

  3. Tratamiento de quemaduras mediante plasma rico en plaquetas (PRP): parte I

    OpenAIRE

    G. Rossani; I. Hernández; J.M. Alcolea; R. Castro-Sierra; W. Pérez-Soto; M.A. Trelles

    2014-01-01

    El objetivo del presente trabajo es determinar la eficacia clínica del plasma rico en plaquetas (PRP) en las quemaduras de segundo grado. Estudiamos el tiempo requerido en la reepitelización del tejido dañado, la estancia hospitalaria asociada a la curación de las lesiones y la satisfacción del paciente. Realizamos un estudio prospectivo, observacional y longitudinal, en una muestra de 115 pacientes con quemaduras de segundo grado según la clasificación de Converse-Smith. Las lesiones fueron ...

  4. Tratamiento del polvo de aluminio mediante disolución acuosa

    OpenAIRE

    López, F. A.; Medina, J.; Tayibi, H.; Peña, C.; López-Delgado, A.

    2004-01-01

    Aluminium dust from aluminium remelting industry is a hazardous residue because of its high reactivity in the presence of water. In order to apply the new European Directive about landfill of waste, a study of its hydrolysis was carried out. The influence of temperature, time and pH on the hydrolysis of the aluminium dust was studied. The hydrolysed solids were characterized by XRD and AAS; in the aqueous solutions the pH and the ionic conductivity were determined. The evolved gases were anal...

  5. 234. Tratamiento de la Mediastinitis y Las Dehiscencias Esternales Complejas Mediante Osteosíntesis Costal

    Directory of Open Access Journals (Sweden)

    A. Bermúdez García

    2012-04-01

    Conclusiones: la osteosíntesis en cirugía cardíaca se muestra como una alternativa segura aun en casos de infección local profunda de la herida, tras terapia de aspiración continua (VAC con buenos resultados, y se trata de una técnica sencilla donde lo más importante es la elección del momento óptimo para la intervención de cada paciente.

  6. Clasificación automática mediante la CDU con el procedimiento en cadena

    OpenAIRE

    San Segundo Manuel, Rosa

    2002-01-01

    Actas de las I Jornadas de Tratamiento y Recuperación de Información (JOTRI), Valencia, España, 4-5 julio 2002 Se entiende por clasificación automática el proceso de agrupar según el contenido las referencias de los documentos o bien los propios documentos electróneos. Este proceso se realiza mediante programas capaces de comparar términos empleados utilizados en el documento. E incluso hay otras formas automáticas de clasificación que emplean procedimientos auto...

  7. Autologous patch graft in tube shunt surgery.

    Science.gov (United States)

    Aslanides, I M; Spaeth, G L; Schmidt, C M; Lanzl, I M; Gandham, S B

    1999-10-01

    To evaluate an alternate method of covering the subconjunctival portion of the tube in aqueous shunt surgery. Evidence of tube erosion, graft-related infection, graft melting, or other associated intraocular complications were evaluated. A retrospective study of 16 patients (17 eyes) who underwent tube shunt surgery at Wills Eye Hospital between July 1991 and October 1996 was conducted. An autologous either "free" or "rotating" scleral lamellar graft was created to cover the subconjunctival portion of the tube shunt. All patients were evaluated for at least 6 months, with a mean follow-up of 14.8 months (range 6-62 months). All eyes tolerated the autologous graft well, with no clinical evidence of tube erosion, or graft-related or intraocular complications. Autologous patch graft in tube shunt surgery appears--in selected cases--to be an effective, safe and inexpensive surgical alternative to allogenic graft materials. It also offers ease of availability, and eliminates the risk of transmitting infectious disease.

  8. ARTIFICIAL SHUNTING OF CEREBROSPINAL-FLUID

    NARCIS (Netherlands)

    HOEKSTRA, A

    A compact three-stage shunt valve system (Orbis SigmaTM Valve) which operates as a flow regulator within certain differential pressure values has been clinically evaluated in the treatment of hydrocephalus. Clinical trials were performed in 134 cases, covering 128 patients aged from 1 day to 79

  9. Ventriculoperitoneal shunt infection caused by Bifidobacterium breve.

    Science.gov (United States)

    Suwantarat, Nuntra; Romagnoli, Mark; Wakefield, Teresa; Carroll, Karen C

    2014-08-01

    Bifidobacterium breve is a rare cause of human infections. Previously, bacteremia and meningitis caused by this organism linked to probiotic use have been reported in a neonate. We report the first case of a ventriculoperitoneal shunt infection caused by B. breve in an adult without a history of probiotic use. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Complications of ventriculoperitoneal shunt in hydrocephalic children

    African Journals Online (AJOL)

    These children were treated at the Department of Pediatric Surgery, Dr. Behc¸et Uz Children's Hospital, and at the Department of Neurosurgery, Tepecik Training Hospital. Management of these patients with special emphasis on the literature pertaining to the migration of shunt catheters into the scrotum is reviewed and ...

  11. Acne polimorfo: tratamiento con Implacen

    Directory of Open Access Journals (Sweden)

    Rubén Pérez Armas

    1995-06-01

    Full Text Available Se realiza el estudio de 40 pacientes con acné polimorfo, los que fueron atendidos en la Consulta de Dermatología del Hospital Provincial Clinicoquirúrgico Docente "Celia Sánchez Manduley", en el período comprendido de enero de 1988 a diciembre de 1989. Se revisa la literatura médica sobre los diversos métodos y medicamentos utilizados en la terapéutica de esta dermatosis. Se describe el esquema de tratamiento empleado con implacén en 30 pacientes; los 10 restantes se trataron con placebo; se compara dicho esquema con los tradicionales y se observan mejores resultados con nuestro estudio. Se destaca la ausencia de recaídas, así como el resultado del tratamiento de acuerdo con el sexo.A study was performed in 40 patients presenting with polymorphic acne who were attended in the Dermatology Department of "Celia Sánchez Manduley" Clinicosurgical and Teaching Hospital from January, 1988 to December, 1989. A review of the literature was made seeking for the different methods and drugs used for the treatment of this dermatosis. The treatment schedule with the use of implacen in 30 patients is described. Such therapeutic schedule was compared with traditional ones and better results were observed with the use of implacen. The fact that there were no relapses is highlighted, as well as the result of treatment according to sex.

  12. Tratamiento del paciente con artrosis

    Directory of Open Access Journals (Sweden)

    Francisco Vargas Negrín

    2014-01-01

    Full Text Available El manejo terapéutico del paciente con artrosis tiene como objetivo disminuir la sintomatología dolorosa e inflamatoria, mejorar la capacidad funcional del paciente y la aplicación de intervenciones terapéuticas eficaces y lo más seguras posibles. Un enfoque centrado en el paciente implica su participación activa en el diseño del plan terapéutico y en la toma de decisiones informadas oportunas en todas las etapas de la enfermedad. La educación terapéutica, la actividad física y el ejercicio terapéutico junto con el control de peso, en caso de sobrepeso u obesidad, constituyen el núcleo central del tratamiento. Los autocuidados individuales y por los familiares son fundamentales en el control del día a día del paciente. El uso de terapias físicas, ayudas técnicas (bastón, etc. y de fármacos tipo analgésicos simples, opioides y antiinflamatorios tiene evidencias demostradas en el control del dolor, mejora la funcionalidad y la calidad de vida del paciente y una clara recomendación de uso en el tratamiento de la artrosis. La cirugía conservadora y la de reemplazo articular se indican en los casos en los que no se logran los objetivos terapéuticos en casos concretos.

  13. La percepción de la imagen de marca. Tratamiento por borrosidad.

    OpenAIRE

    Lozano Gutierrez, María del Carmen; Fuentes Martín, Federico

    2003-01-01

    Los sistemas basados en la lógica difusa o borrosa resultan especialmente adecuados en el tratamiento de procesos que están gobernados por reglas intuitivas y que difícilmente pueden expresarse matemáticamente. La gran potencia de esta metodología se debe a la posibilidad de expresar operaciones y controlar las reglas del sistema mediante palabras de uso cotidiano. La lógica borrosa elimina los altos contenidos de la matemática y va directo al nivel en el que el sistema trabaja...

  14. Pathological Predictors of Shunt Stenosis and Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt

    Directory of Open Access Journals (Sweden)

    Fuliang He

    2016-01-01

    Full Text Available Background. Transjugular intrahepatic portosystemic shunt (TIPS is an artificial channel from the portal vein to the hepatic vein or vena cava for controlling portal vein hypertension. The major drawbacks of TIPS are shunt stenosis and hepatic encephalopathy (HE; previous studies showed that post-TIPS shunt stenosis and HE might be correlated with the pathological features of the liver tissues. Therefore, we analyzed the pathological predictors for clinical outcome, to determine the risk factors for shunt stenosis and HE after TIPS. Methods. We recruited 361 patients who suffered from portal hypertension symptoms and were treated with TIPS from January 2009 to December 2012. Results. Multivariate logistic regression analysis showed that the risk of shunt stenosis was increased with more severe inflammation in the liver tissue (OR, 2.864; 95% CI: 1.466–5.592; P=0.002, HE comorbidity (OR, 6.266; 95% CI, 3.141–12.501; P<0.001, or higher MELD score (95% CI, 1.298–1.731; P<0.001. Higher risk of HE was associated with shunt stenosis comorbidity (OR, 6.266; 95% CI, 3.141–12.501; P<0.001, higher stage of the liver fibrosis (OR, 2.431; 95% CI, 1.355–4.359; P=0.003, and higher MELD score (95% CI, 1.711–2.406; P<0.001. Conclusion. The pathological features can predict individual susceptibility to shunt stenosis and HE.

  15. Effect of electromagnetic navigated ventriculoperitoneal shunt placement on failure rates.

    Science.gov (United States)

    Jung, Nayoung; Kim, Dongwon

    2013-03-01

    To evaluate the effect of electromagnetic (EM) navigation system on ventriculoperitoneal (VP) shunt failure rate through comparing the result of standard shunt placement. All patients undergoing VP shunt from October 2007 to September 2010 were included in this retrospective study. The first group received shunt surgery using EM navigation. The second group had catheters inserted using manual method with anatomical landmark. The relationship between proximal catheter position and shunt revision rate was evaluated using postoperative computed tomography by a 3-point scale. 1) Grade I; optimal position free-floating in cerebrospinal fluid, 2) Grade II; touching choroid or ventricular wall, 3) Grade III; tip within parenchyma. A total of 72 patients were participated, 27 with EM navigated shunts and 45 with standard shunts. Grade I was found in 25 patients from group 1 and 32 patients from group 2. Only 2 patients without use of navigation belonged to grade III. Proximal obstruction took place 7% in grade I, 15% in grade II and 100% in grade III. Shunt revision occurred in 11% of group 1 and 31% of group 2. Compared in terms of proximal catheter position, there was growing trend of revision rate according to increase of grade on each group. Although infection rate was similar between both groups, the result had no statistical meaning (p=0.905, chi-square test). The use of EM navigation in routine shunt surgery can eliminate poor shunt placement resulting in a dramatic reduction in failure rates.

  16. Ventriculosubgaleal shunts for posthemorrhagic hydrocephalus in premature infants.

    Science.gov (United States)

    Willis, Brian K; Kumar, Cherukuri Ravi; Wylen, Esther L; Nanda, Anil

    2005-01-01

    The early management of posthemorrhagic hydrocephalus in premature infants is challenging and controversial. These infants need a temporary cerebrospinal fluid (CSF) diversion procedure until they gain adequate weight, and the blood and protein levels in CSF are reasonably low before permanent shunt can be placed. Various options are available with their associated advantages and disadvantages. Ventriculosubgaleal shunts have been recommended as a more physiologic and less invasive means of achieving this goal. We have performed this procedure in 6 premature infants to evaluate their effectiveness and complications. Six consecutive premature infants with posthemorrhagic hydrocephalus underwent placement of ventriculosubgaleal shunts over a 1-year period of time. We reviewed their clinical and imaging progress to assess the ability of the shunt to control hydrocephalus and the complication rates. In all 6 patients, the ventriculosubgaleal shunt controlled the progression of hydrocephalus as assessed by clinical and imaging parameters. A permanent shunt was avoided in 1 patient (16.6%). However, 4 patients developed shunt infections, 1 involving the ventriculosubgaleal shunt itself, and 3 immediately after conversion to ventriculoperitoneal shunt. The total infection rate of the series was 66.6%. All infections were caused by staphylococcus species. There was only a 1% shunt infection rate in our institution for all nonventriculosubgaleal shunts during the same period of time. Placement of ventriculosubgaleal shunts for interim CSF diversion in neonates with posthemorrhagic hydrocephalus is effective as a temporary method of CSF diversion. However, our experience has shown that it is associated with a unacceptably high CSF infection rate. A potential cause for infection is CSF stasis just beneath the extremely thin skin of the premature infants, promoting colonization by skin flora. CSF sampling before conversion to a permanent shunt and replacement of the proximal

  17. Hydrocephalus shunt technology: 20 years of experience from the Cambridge Shunt Evaluation Laboratory.

    Science.gov (United States)

    Chari, Aswin; Czosnyka, Marek; Richards, Hugh K; Pickard, John D; Czosnyka, Zofia H

    2014-03-01

    The Cambridge Shunt Evaluation Laboratory was established 20 years ago. This paper summarizes the findings of that laboratory for the clinician. Twenty-six models of valves have been tested long-term in the shunt laboratory according to the expanded International Organization for Standardization 7197 standard protocol. The majority of the valves had a nonphysiologically low hydrodynamic resistance (from 1.5 to 3 mm Hg/[ml/min]), which may result in overdrainage related to posture and during nocturnal cerebral vasogenic waves. A long distal catheter increases the resistance of these valves by 100%-200%. Drainage through valves without a siphon-preventing mechanism is very sensitive to body posture, which may result in grossly negative intracranial pressure. Siphon-preventing accessories offer a reasonable resistance to negative outlet pressure; however, accessories with membrane devices may be blocked by raised subcutaneous pressure. In adjustable valves, the settings may be changed by external magnetic fields of intensity above 40 mT (exceptions: ProGAV, Polaris, and Certas). Most of the magnetically adjustable valves produce large distortions on MRI studies. The behavior of a valve revealed during testing is of relevance to the surgeon and may not be adequately described in the manufacturer's product information. The results of shunt testing are helpful in many circumstances, such as the initial choice of shunt and the evaluation of the shunt when its dysfunction is suspected.

  18. Nitrogen heat pipe for cryocooler thermal shunt

    International Nuclear Information System (INIS)

    Prenger F.C.; Hill, D.D.; Daney, D.E.

    1996-01-01

    A nitrogen heat pipe was designed, built and tested for the purpose of providing a thermal shunt between the two stages of a Gifford-McMahan (GM) cryocooler during cooldown. The nitrogen heat pipe has an operating temperature range between 63 and 123 K. While the heat pipe is in this temperature range during the system cooldown, it acts as a thermal shunt between the first and second stage of the cryocooler. The heat pipe increases the heat transfer to the first stage of the cryocooler, thereby reducing the cooldown time of the system. When the heat pipe temperature drops below the triple point, the nitrogen working fluid freezes, effectively stopping the heat pipe operation. A small heat leak between cryocooler stages remains because of axial conduction along the heat pipe wall. As long as the heat pipe remains below 63 K, the heat pipe remains inactive. Heat pipe performance limits were measured and the optimum fluid charge was determined

  19. Tratamiento quirúrgico sin circulación extracorpórea de la fibrilación auricular aislada para la prevención secundaria de accidentes cerebrovasculares isquémicos agudos

    Directory of Open Access Journals (Sweden)

    Rafael Hernández-Estefanía

    2006-07-01

    Conclusiones: Nuestra experiencia inicial en el tratamiento de la FA aislada mediante ABVP con argón y sin CEC ofrece buenos resultados. Debe documentarse la persistencia del efecto y su eficacia en la reducción de los fenómenos tromboembólicos.

  20. Tratamiento conservador de las fracturas del cóndilo mandibular en pacientes pediátricos: Serie de casos

    Directory of Open Access Journals (Sweden)

    Ana Verónica D´Andrea

    2017-07-01

    Full Text Available La fractura del cóndilo mandibular es una lesión traumática cuya prevalencia en niños es relativamente baja, lo cual puede deberse tanto a factores anatómicos como ambientales. Las consecuencias incluyen anquilosis de la articulación temporomandibular, asimetrías faciales y trastornos funcionales. El tratamiento conservador es el que cuenta con mayor aceptación, siendo el seguimiento cercano y a largo plazo fundamental. Esta investigación describe el seguimiento de 11 pacientes con antecedentes de fracturas condilares, que asistieron al servicio de Ortodoncia Interceptiva de la Facultad de Odontología de la UCV durante el periodo comprendido entre 2001-2014. Se evaluó la edad del paciente, causa de la fractura, el tipo de fractura, tratamiento recibido y tiempo de duración mediante radiografías panorámicas y tomografías antes y después del tratamiento conservador. Se evaluaron los cambios anatómicos ocurridos. Los tipos de tratamientos variaron desde uso de analgésicos, antiinflamatorios, fisioterapia (ejercicios de apertura y cierre mediante abrebocas y paletas de mordida, aparatos funcionales (Bionator, Klammt, híbridos, y fijación intermaxilar. La prevalencia de fracturas condilares fue de 1,50% siendo las causas más frecuentes caídas de altura y accidentes de tránsito. Las fracturas mas prevalentes fueron 5 casos de fracturas unilaterales y 6 casos de fracturas bilaterales. El tratamiento conservador resultó exitoso en la vasta mayoría de los casos. Como resultado terapéutico se observó remodelado del cóndilo, en ocasiones con leves variantes anatómicas, simetría facial en reposo y apertura. Ningún caso presentó anquilosis de la ATM.

  1. Prophylactic antibiotics in pediatric shunt surgery.

    Science.gov (United States)

    Biyani, N; Grisaru-Soen, G; Steinbok, P; Sgouros, S; Constantini, S

    2006-11-01

    The optimal antibiotic prophylaxis for pediatric shunt-related procedures is not clear. There is much inconsistency among different medical centers. This paper summarizes and analyzes the various prophylactic antibiotic regiments used for shunt-related surgeries at different pediatric neurosurgery centers in the world. A survey questionnaire was distributed through the Pediatric Neurosurgery list-server (an e-mail-based special interest group in pediatric neurosurgery). Forty-five completed questionnaires were received, one per medical center, primarily from pediatric neurosurgeons with the following geographic breakdown: 25 from North America, 13 from Europe, and 7 from Asia and other countries. All centers routinely administered prophylactic antibiotics for shunt-related procedures. The drugs of choice were first-generation cephalosporins (23), second-generation cephalosporins (10), naficillin/oxacillin (4), vancomycin (3), clindamycin (1), amoxicillin (1), and mixed protocols in three centers. The initial drug administration ("first dose") was: in the department before transfer to operating room (5), upon arrival to operating room (11), at induction of anesthesia (13), and at initial skin incision (16). The duration of antibiotic dosage also varied: single dose (13), 24-h administration (26), 48-h administration (2), and longer than 48 h in four centers. Two general tendencies were noted, common to the majority of participating centers. There was a general trend to modify antibiotic treatment protocol in "high-risk" populations. The second common theme noted in more than half of responding centers was the use of long-term antibiotic treatment for externalized devices (such as externalized shunts, external ventricular drains or lumbar drains), usually till the device was in place.

  2. The transjugular intrahepatic portosystemic shunt (TIPS)

    International Nuclear Information System (INIS)

    Owen, A.R.; Stanley, A.J.; Vijayananthan, A.; Moss, J.G.

    2009-01-01

    The creation of an intrahepatic portosystemic shunt via a transjugular approach (TIPS) is an interventional radiological procedure used to treat the complications of portal hypertension. TIPS insertion is principally indicated to prevent or arrest variceal bleeding when medical or endoscopic treatments fail, and in the management refractory ascites. This review discusses the development and execution of the technique, with focus on its clinical efficacy. Patient selection, imaging surveillance, revision techniques, and complications are also discussed.

  3. Train shunting at a workshop area

    DEFF Research Database (Denmark)

    Jacobsen, Per Munk; Pisinger, David

    2011-01-01

    We consider the problem of planning the shunting of train units at a railway workshop area. Before and after the maintenance check, a train unit is parked at a depository track. The problem is to schedule the trains to workshops and depot tracks in order to complete the repairs as soon as possibl....... It turns out, that both GLS and SA find within a few minutes solutions that are a few percent from the best MIP solution found....

  4. The transjugular intrahepatic portosystemic shunt (TIPS)

    Energy Technology Data Exchange (ETDEWEB)

    Owen, A.R. [Department of Radiology, Austin Health, Heidelberg, Melbourne (Australia)], E-mail: andrewowen@doctors.org.uk; Stanley, A.J. [Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow (United Kingdom); Vijayananthan, A. [Department of Biomedical Imaging, University of Malaya, Kuala Lumpur (Malaysia); Moss, J.G. [Department of Radiology, Gartnavel General Hospital, Glasgow (United Kingdom)

    2009-07-15

    The creation of an intrahepatic portosystemic shunt via a transjugular approach (TIPS) is an interventional radiological procedure used to treat the complications of portal hypertension. TIPS insertion is principally indicated to prevent or arrest variceal bleeding when medical or endoscopic treatments fail, and in the management refractory ascites. This review discusses the development and execution of the technique, with focus on its clinical efficacy. Patient selection, imaging surveillance, revision techniques, and complications are also discussed.

  5. "DETECCIÓN DE TRASTORNO DE DEFICIT DE ATENCIÓN MEDIANTE LA ESCALA DE CONNERS EN NIÑOS 6 A 9 AÑOS DE EDAD"

    OpenAIRE

    Cancino Estrada, Yurixhi

    2012-01-01

    Antecedentes: el TDAH es la enfermedad psiquiátrica crónica más frecuente en la edad pediátrica. Su prevalencia es del 3 al 5%. No existe una encuesta única para sospechar TDAH, una de ellas es la escala de Conners, al detectar oportunamente a estos niños e iniciar tratamiento, se disminuye fracaso escolar y rechazo social. Objetivo: detectar TDAH mediante la escala de Conners en niños de 6 a 9 años de edad. Material y métodos: estudio descriptivo mediante aplicación de l...

  6. Fracturas de clavícula. Tratamiento quirúrgico con clavos intramedulares flexibles

    Directory of Open Access Journals (Sweden)

    Roberto Joaquín Del Gordo D'amato

    2014-05-01

    Full Text Available Se realizó un estudio de tipo descriptivo en una serie de casos en el cual se presentan los resultados de 12 fracturas de clavícula tratadas en forma quirúrgica mediante clavos intramedulares flexibles. Todos los pacientes fueron tratados por los autores en la Clínica El Prado del D.T.C.H. de la Ciudad de Santa Marta mediante reducción cerrada bajo control radioscópico. Presentando resultados excelentes y buenos en todos los casos. Así mismo, se evidenció consolidación clínica a las cuatro semanas con reintegro a la vida laboral alrededor de las seis semanas. Todos los pacientes mostraron alto grado de satisfacción con el resultado obtenido. Se concluye que el tratamiento empleado es una alternativa terapéutica a tener en cuenta en aquellas fracturas desplazadas, sean estas del tercio externo, medio o interno que permite consolidación sin las complicaciones que con alguna frecuencia se presentan con el tratamiento conservador. (Duazary 2006; 2:115-120

  7. Cranial dural arteriovenous shunts. Part 4. Clinical presentation of the shunts with leptomeningeal venous drainage.

    Science.gov (United States)

    Baltsavias, Gerasimos; Spiessberger, Alex; Hothorn, Torsten; Valavanis, Anton

    2015-04-01

    Cranial dural arteriovenous fistulae have been classified into high- and low-risk lesions mainly based on the pattern of venous drainage. Those with leptomeningeal venous drainage carry a higher risk of an aggressive clinical presentation. Recently, it has been proposed that the clinical presentation should be considered as an additional independent factor determining the clinical course of these lesions. However, dural shunts with leptomeningeal venous drainage include a very wide spectrum of inhomogeneous lesions. In the current study, we correlated the clinical presentation of 107 consecutive patients harboring cranial dural arteriovenous shunts with leptomeningeal venous drainage, with their distinct anatomic and angiographic features categorized into eight groups based on the "DES" (Directness and Exclusivity of leptomeningeal venous drainage and features of venous Strain) concept. We found that among these groups, there are significant angioarchitectural differences, which are reflected by considerable differences in clinical presentation. Leptomeningeal venous drainage of dural sinus shunts that is neither direct nor exclusive and without venous strain manifested only benign symptoms (aggressive presentation 0%). On the other end of the spectrum, the bridging vein shunts with direct and exclusive leptomeningeal venous drainage and venous strain are expected to present aggressive symptoms almost always and most likely with bleeding (aggressive presentation 91.5%). Important aspects of the above correlations are discussed. Therefore, the consideration of leptomeningeal venous drainage alone, for prediction of the clinical presentation of these shunts appears insufficient. Angiographic analysis based on the above concept, offers the possibility to distinguish the higher- from the lower-risk types of leptomeningeal venous drainage. In this context, consideration of the clinical presentation as an additional independent factor for the prediction of their clinical

  8. Transjugular Intrahepatic Portosystemic Shunt Dysfunction: Concordance of Clinical Findings, Doppler Ultrasound Examination, and Shunt Venography.

    Science.gov (United States)

    Owen, Joshua M; Gaba, Ron Charles

    2016-01-01

    The objective of this study was to evaluate the concordance between clinical symptoms, Doppler ultrasound (US), and shunt venography for the detection of stent-graft transjugular intrahepatic portosystemic shunt (TIPS) dysfunction. Forty-one patients (M:F 30:11, median age 55 years) who underwent contemporaneous clinical exam, Doppler US, and TIPS venography between 2003 and 2014 were retrospectively studied. Clinical symptoms (recurrent ascites or variceal bleeding) were dichotomously classified as present/absent, and US and TIPS venograms were categorized in a binary fashion as normal/abnormal. US abnormalities included high/low (>190 or 50 cm/s), absent flow, and return of antegrade intra-hepatic portal flow. Venographic abnormalities included shunt stenosis/occlusion and/or pressure gradient elevation. Clinical and imaging concordance rates were calculated. Fifty-two corresponding US examinations and venograms were assessed. The median time between studies was 3 days. Forty of 52 (77%) patients were symptomatic, 33/52 (64%) US examinations were abnormal, and 20/52 (38%) TIPS venograms were abnormal. Concordance between clinical symptoms and TIPS venography was 48% (25/52), while the agreement between US and shunt venography was 65% (34/52). Clinical symptoms and the US concurred in 60% (31/52) of the patients. The sensitivity of clinical symptoms and US for the detection of venographically abnormal shunts was 80% (16/20) and 85% (17/20), respectively. Both clinical symptoms and the US had low specificity (25%, 8/32 and 50%, 16/32) for venographically abnormal shunts. Clinical findings and the US had low concordance rates with TIPS venography, with acceptable sensitivity but poor specificity. These findings suggest the need for improved noninvasive imaging methods for stent-graft TIPS surveillance.

  9. Transjugular Intrahepatic Portosystemic Shunt Dysfunction: Concordance of Clinical Findings, Doppler Ultrasound Examination, and Shunt Venography

    Directory of Open Access Journals (Sweden)

    Joshua M Owen

    2016-01-01

    Full Text Available Objectives: The objective of this study was to evaluate the concordance between clinical symptoms, Doppler ultrasound (US, and shunt venography for the detection of stent-graft transjugular intrahepatic portosystemic shunt (TIPS dysfunction. Materials and Methods: Forty-one patients (M:F 30:11, median age 55 years who underwent contemporaneous clinical exam, Doppler US, and TIPS venography between 2003 and 2014 were retrospectively studied. Clinical symptoms (recurrent ascites or variceal bleeding were dichotomously classified as present/absent, and US and TIPS venograms were categorized in a binary fashion as normal/abnormal. US abnormalities included high/low (>190 or 50 cm/s, absent flow, and return of antegrade intra-hepatic portal flow. Venographic abnormalities included shunt stenosis/occlusion and/or pressure gradient elevation. Clinical and imaging concordance rates were calculated. Results: Fifty-two corresponding US examinations and venograms were assessed. The median time between studies was 3 days. Forty of 52 (77% patients were symptomatic, 33/52 (64% US examinations were abnormal, and 20/52 (38% TIPS venograms were abnormal. Concordance between clinical symptoms and TIPS venography was 48% (25/52, while the agreement between US and shunt venography was 65% (34/52. Clinical symptoms and the US concurred in 60% (31/52 of the patients. The sensitivity of clinical symptoms and US for the detection of venographically abnormal shunts was 80% (16/20 and 85% (17/20, respectively. Both clinical symptoms and the US had low specificity (25%, 8/32 and 50%, 16/32 for venographically abnormal shunts. Conclusion: Clinical findings and the US had low concordance rates with TIPS venography, with acceptable sensitivity but poor specificity. These findings suggest the need for improved noninvasive imaging methods for stent-graft TIPS surveillance.

  10. Impedance Changes Indicate Proximal Ventriculoperitoneal Shunt Obstruction In Vitro.

    Science.gov (United States)

    Basati, Sukhraaj; Tangen, Kevin; Hsu, Ying; Lin, Hanna; Frim, David; Linninger, Andreas

    2015-12-01

    Extracranial cerebrospinal fluid (CSF) shunt obstruction is one of the most important problems in hydrocephalus patient management. Despite ongoing research into better shunt design, robust and reliable detection of shunt malfunction remains elusive. The authors present a novel method of correlating degree of tissue ingrowth into ventricular CSF drainage catheters with internal electrical impedance. The impedance based sensor is able to continuously monitor shunt patency using intraluminal electrodes. Prototype obstruction sensors were fabricated for in-vitro analysis of cellular ingrowth into a shunt under static and dynamic flow conditions. Primary astrocyte cell lines and C6 glioma cells were allowed to proliferate up to 7 days within a shunt catheter and the impedance waveform was observed. During cell ingrowth a significant change in the peak-to-peak voltage signal as well as the root-mean-square voltage level was observed, allowing the impedance sensor to potentially anticipate shunt malfunction long before it affects fluid drainage. Finite element modeling was employed to demonstrate that the electrical signal used to monitor tissue ingrowth is contained inside the catheter lumen and does not endanger tissue surrounding the shunt. These results may herald the development of "next generation" shunt technology that allows prediction of malfunction before it affects patient outcome.

  11. Treatment of refractory chylothorax with externalized pleuroperitoneal shunts in children.

    Science.gov (United States)

    Wolff, A B; Silen, M L; Kokoska, E R; Rodgers, B M

    1999-09-01

    Traditional therapy for refractory chylothorax in the pediatric population has included pleurodesis and thoracic duct ligation. These procedures are associated with high morbidity and questionable success rates. We retrospectively reviewed our experience with 15 patients who underwent treatment for chylous effusions using pleuroperitoneal shunts with exteriorized pump chambers. Mean patient age at time of shunt placement was 2.1 (0.1 to 11.5) years and the most common indication (7 of 15) was refractory chylothorax following surgical correction of congenital heart disease. Mean chylothorax duration before shunt placement was 76 (5 to 810) days and shunts were in place for an average of 104 (12 to 365) days. A total of 19 chylous effusions (pleural or pericardial) were treated with shunts. Nine of 11 right-sided chylothoraces, 5 of 6 left-sided chylothoraces, and 2 of 2 chylopericardia resolved with shunt therapy (84% total). Pleuroperitoneal shunting failed to clear the effusion in 3 children. There were six episodes of shunt malfunction that were repaired and two episodes of infection. Inguinal or umbilical hernia developed in 4 patients. Externalized pleuroperitoneal shunting is a safe, effective, and minimally invasive treatment for children with refractory chylous effusions.

  12. Superconducting fault current-limiter with variable shunt impedance

    Science.gov (United States)

    Llambes, Juan Carlos H; Xiong, Xuming

    2013-11-19

    A superconducting fault current-limiter is provided, including a superconducting element configured to resistively or inductively limit a fault current, and one or more variable-impedance shunts electrically coupled in parallel with the superconducting element. The variable-impedance shunt(s) is configured to present a first impedance during a superconducting state of the superconducting element and a second impedance during a normal resistive state of the superconducting element. The superconducting element transitions from the superconducting state to the normal resistive state responsive to the fault current, and responsive thereto, the variable-impedance shunt(s) transitions from the first to the second impedance. The second impedance of the variable-impedance shunt(s) is a lower impedance than the first impedance, which facilitates current flow through the variable-impedance shunt(s) during a recovery transition of the superconducting element from the normal resistive state to the superconducting state, and thus, facilitates recovery of the superconducting element under load.

  13. FISURAS LABIO PALATINAS. TRATAMIENTO MULTIDISCIPLINARIO

    Directory of Open Access Journals (Sweden)

    Dr. Luis Monasterio A.

    2016-01-01

    Full Text Available La fisura labio palatina es la segunda malformación congénita más frecuente. En su génesis hay factores genéticos (25% y ambientales siendo en general multifactorial. La incidencia en Chile es de aproximadamente 1 en 550 recién nacidos vivos. Las fisuras pueden afectar el labio a uno o ambos lados, el paladar o ambos. La evaluación genética es fundamental para descartar casos sindrómicos, siendo estos frecuentes en las fisuras asiladas de paladar (sindrome velocardiofacial, stickler. El tratamiento de esta enfermedad debe ser multidisciplinario e iniciarse en el periodo de recién nacido para garantizar los mejores resultados. El equipo debiera estar integrado por enfermera especialista, otorrinolaringólogo, odontólogos de diferentes especialidades, genetista, fonoaudióloga y cirujano plástico. Las cirugías primarias incluyen la plastia del labio(3-6 meses, plastia de velo del paladar (6 meses y el cierre de paladar óseo junto a plastia de velo (12 meses.

  14. Over-drainage and persistent shunt-dependency in patients with idiopathic intracranial hypertension treated with shunts and bariatric surgery.

    Science.gov (United States)

    Roth, Jonathan; Constantini, Shlomi; Kesler, Anat

    2015-01-01

    Idiopathic intracranial hypertension (IIH) may lead to visual impairment. Shunt surgery is indicated for refractory IIH-related symptoms that persist despite medical treatment, or those presenting with significant visual decline. Obesity is a risk factor for IIH; a reduction in weight has been shown to improve papilledema. Bariatric surgery (BS) has been suggested for treating IIH associated with morbid obesity. In this study, we describe a high rate of over-drainage (OD) seen in patients following shunts and BS. The study cohort includes 13 patients with IIH that underwent shunt surgery for treatment of the IIH-related symptoms. Six patients underwent BS in addition to the shunt surgery (but not concomitantly). Seven patients had only shunt surgeries with no BS. Data were collected retrospectively. BS effectively led to weight reduction (body mass index decreasing from 43 ± 4 to 28 ± 5). Patients undergoing BS had 1-6 (2.5 ± 1.9) shunt revisions for OD following BS, as opposed to 0-3 (1.4 ± 1.1) revisions prior to BS over similar time spans (statistically insignificant difference), and 0-6 (1.6 ± 2.5) revisions among the non-BS patients over a longer time span (statistically insignificant difference). Two patients in the BS group underwent shunt externalization and closure; however, they proved to be shunt-dependent. Patients with IIH that undergo shunt surgery and BS (not concomitantly) may suffer from OD symptoms, necessitating multiple shunt revisions, and valve upgrades. Despite BS being a valid primary treatment for some patients with IIH, among shunted patients, BS may not lead to resolution of IIH-related symptoms and patients may remain shunt-dependent.

  15. Influencia sobre los tratamientos térmicos del contenido de aluminio de aceros no aleados

    Directory of Open Access Journals (Sweden)

    Carreras, L.

    1999-08-01

    Full Text Available The main purpose of this article is to determine the optimal level of aluminum content in plain steels to have the optimal mechanical properties by means of surface heat treatments. Various plain steels with different aluminium content have been studied. The importance of treatment temperature is analyzed. The influence of other factors, like nitrogen content or the homogenous distribution of particles, is evaluated. It is concluded that the aluminum composition of plain steels that are subjected to heat treatments should not exceed 0.02 %.

    El objetivo de este trabajo es determinar el intervalo óptimo de contenidos de aluminio en aceros no aleados para los que se consiguen las propiedades mecánicas óptimas mediante tratamientos térmicos de superficie. Se estudian diferentes coladas de acero en las que varía el contenido de aluminio y las temperaturas de tratamiento. Se evalúa la importancia de otros factores tales como el contenido de nitrógeno y la homogeneidad en la distribución de partículas endurecedoras. Se llega a la conclusión de que los aceros no aleados destinados a tratamientos térmicos no deben tener un contenido de aluminio superior al 0,02 %.

  16. Análisis de contaminantes en aguas residuales industriales mediante espectrofotometría de absorción molecular y atómica

    OpenAIRE

    Torres Andrés, Adrián

    2017-01-01

    Las aguas residuales suponen un grave problema incrementado con el desarrollo industrial. Las plantas de tratamiento de aguas residuales son muy importantes para preservar el medioambiente y eliminar compuestos contaminantes. Es interesante desarrollar métodos analíticos sencillos y robustos para determinar contaminantes como metales, amonio o cianuro y conocer la calidad del agua. Este trabajo recoge determinaciones de este tipo de compuestos en aguas residuales industriales mediante espectr...

  17. Rate of shunt revision as a function of age in patients with shunted hydrocephalus due to myelomeningocele.

    Science.gov (United States)

    Dupepe, Esther B; Hopson, Betsy; Johnston, James M; Rozzelle, Curtis J; Jerry Oakes, W; Blount, Jeffrey P; Rocque, Brandon G

    2016-11-01

    OBJECTIVE It is generally accepted that cerebrospinal fluid shunts fail most frequently in the first years of life. The purpose of this study was to describe the risk of shunt failure for a given patient age in a well-defined cohort with shunted hydrocephalus due to myelomeningocele (MMC). METHODS The authors analyzed data from their institutional spina bifida research database including all patients with MMC and shunted hydrocephalus. For the entire population, the number of shunt revisions in each year of life was determined. Then the number of patients at risk for shunt revision during each year of life was calculated, thus enabling them to calculate the rate of shunt revision per patient in each year of life. In this way, the timing of all shunt revision operations for the entire clinic population and the likelihood of having a shunt revision during each year of life were calculated. RESULTS A total of 655 patients were enrolled in the spina bifida research database, 519 of whom had a diagnosis of MMC and whose mean age was 17.48 ± 11.7 years (median 16 years, range 0-63 years). Four hundred seventeen patients had had a CSF shunt for the treatment of hydrocephalus and thus are included in this analysis. There were 94 shunt revisions in the 1st year of life, which represents a rate of 0.23 revisions per patient in that year. The rate of shunt revision per patient-year initially decreased as age increased, except for an increase in revision frequency in the early teen years. Shunt revisions continued to occur as late as 43 years of age. CONCLUSIONS These data substantiate the idea that shunt revision surgeries in patients with MMC are most common in the 1st year of life and decrease thereafter, except for an increase in the early teen years. A persistent risk of shunt failure was observed well into adult life. These findings underscore the importance of routine follow-up of all MMC patients with shunted hydrocephalus and will aid in counseling patients and

  18. Subgaleo-peritoneal shunt: An effective and safer alternative to lumboperitoneal shunt in the management of persistent or recurrent iatrogenic cranial pseudomeningoceles.

    Science.gov (United States)

    Kiran, Narayanam Anantha Sai; Thakar, Sumit; Mohan, Dilip; Aryan, Saritha; Rao, Arun Sadashiva; Hegde, Alangar S

    2013-01-01

    Subgaleo-peritoneal (SP) shunting for pseudomeningoceles (PMCs) is an effective and safer alternative as compared to the lumboperitoneal (LP) shunt. SP shunting was done in six patients (14-60 years) with persistent or recurrent PMCs using the cranial (ventricular part) and the distal parts of a Chhabra shunt connected by a rigid connector without any intervening chamber or valve. Two patients had undergone a prior LP shunt that had failed. One patient was unsuitable for a LP shunt placement. The PMC subsided completely in all the patients following the SP shunt. In one patient, the shunt got displaced and required repositioning. None of the patients developed symptoms of over-drainage or any other complication. All patients were asymptomatic at a mean follow-up of 15 months. These results suggest that SP shunting is a safe, simple, and effective alternative to the traditional LP shunt in the management of persistent or recurrent cranial PMCs.

  19. Tratamiento de dolor lumbar crónico mediante radiofrecuencia pulsada y aplicación de esteroides em forma epidural: estudio comparativo Tratamento da dor lombar crônica por meio da radiofrequência pulsada e a aplicação de esteroides na forma epidural: estudo comparativo Treatment of chronic low back pain by means of pulsed radiofrequency and application of steroids in epidural form: comparative study

    Directory of Open Access Journals (Sweden)

    Matín Tejeda-Barreras

    2010-03-01

    Full Text Available OBJETIVOS: valorar el resultado clínico de mejoría de dolor y de escala funcional lumbar de radiofrecuencia pulsada, en comparación con aplicación de esteroides epidurales, en el tratamiento de pacientes con dolor lumbar crónico. TIPO DE INVESTIGACIÓN: un ensayo clínico ciego y simple. MÉTODOS: el estudio se realizó dese mayo de 2008 a julio de 2009. Fueron 40 pacientes, de los medios institucional y privado, de la ciudad de Hermosillo, Sonora, en el México, con dolor lumbar crónico. Se aplicó el cuestionario de Roland-Morris y la escala visual análoga de dolor, previa a tratamiento, y posterior al mismo. No se registraron pérdidas de pacientes en el seguimiento. Se analizaron los resultados de las diferentes variables (edad, sexo, ocupación, evolución, trabajo de carga, incapacidad, hallazgos de imagenología, estableciendo una comparación con la prueba de χ2. RESULTADOS: fueron muy similares en ambos grupos de tratamiento (χ2=2.8283, p=0.093, con dos casos complicados por punción en el grupo de esteroides epidurales, sin casos complicados por el procedimiento de radiofrecuencia pulsada. Los valores de χ2 no muestran diferencias estadísticamente significativas, con valores de p de 0.09 a 0.9. CONCLUSIÓN: la aplicación de radiofrecuencia pulsada es tan eficaz como la aplicación de esteroides epidurales para el manejo del dolor lumbar crónico.OBJETIVOS: avaliar o resultado clínico de melhoria da dor e da escala funcional lombar de radiofrequência pulsada, comparada com a aplicação de esteroides epidurais, no tratamento de pacientes com dor lombar crônico. TIPO DE INVESTIGAÇÃO: um ensaio clínico cego e simples. MÉTODOS: o estudo foi realizado desde maio de 2008 a julho de 2009. Foram utilizados 40 pacientes, dos meios institucional e privado, da cidade de Hermosillo, Sonora, no México, com dor lombar crônico. Foi aplicado o questionário de Roland-Morris e a escala visual análoga de dor, com tratamento pr

  20. Determinación de la necesidad de tratamiento de ortodoncia en población de Tepic Nayarit, México

    Directory of Open Access Journals (Sweden)

    Alan Paul Ayala–Sarmiento

    2014-07-01

    Full Text Available De acuerdo a la Organización Mundial de la Salud, las maloclusiones ocupan el cuarto lugar dentro de las enfermedades más frecuentes en la cavidad bucal. Se han  utilizado diferentes índices para medir la necesidad de tratamiento. Uno de los más empleados es el Index of Orthodontic Treatment Need (IOTN, se caracteriza por medir dos componentes, el estético (AC y el de salud dental (DHC. Objetivo: determinar el nivel de necesidad de tratamiento ortodóntico en una muestra de modelos de estudio de personas sin tratamiento previo de la ciudad de Tepic, Nayarit. Materiales y métodos: se utilizaron 130 modelos de estudio. Fueron medidos los dos componentes: AC y DHC. La necesidad de tratamiento se determinó mediante la comparación de modelos de estudios y el SCAN para el componente estético, y la calibración para el componente de salud dental. Resultados: se demostró que de acuerdo al DHC el 24 % de la población  presenta gran necesidad de tratamiento (DHC grados 4 y 5, el 25 % porciento una moderada necesidad de tratamiento (DHC grado 3, mientras que de acuerdo al AC el 19% requiere pocotratamiento (scan 5–7 y en el mismo porcentaje (19% requiere realmente tratamiento (scan 8–10. Conclusión: para determinar la necesidad de tratamiento de un paciente, se debe considerar el componente de salud dental, independientemente del componente estético, ya que este último queda a expensas de la percepción del ortodoncista.  

  1. Internal carotid artery rupture caused by carotid shunt insertion.

    Science.gov (United States)

    Illuminati, Giulio; Caliò, Francesco G; Pizzardi, Giulia; Vietri, Francesco

    2015-01-01

    Shunting is a well-accepted method of maintaining cerebral perfusion during carotid endarterectomy (CEA). Nonetheless, shunt insertion may lead to complications including arterial dissection, embolization, and thrombosis. We present a complication of shunt insertion consisting of arterial wall rupture, not reported previously. A 78-year-old woman underwent CEA combined with coronary artery bypass grafting (CABG). At the time of shunt insertion an arterial rupture at the distal tip of the shunt was detected and was repaired via a small saphenous vein patch. Eversion CEA and subsequent CABG completed the procedure whose postoperative course was uneventful. Shunting during combined CEA-CABG may be advisable to assure cerebral protection from possible hypoperfusion due to potential hemodynamic instability of patients with severe coronary artery disease. Awareness and prompt management of possible shunt-related complications, including the newly reported one, may contribute to limiting their harmful effect. Arterial wall rupture is a possible, previously not reported, shunt-related complication to be aware of when performing CEA. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Evaluation of Blalock-Taussig shunts using magnetic resonance imaging

    International Nuclear Information System (INIS)

    Okajima, Yoshitomo; Tashima, Kazuyuki; Terai, Masaru; Niwa, Koichirou.

    1988-01-01

    Four patients aged 3 to 18 months (mean 13 months) with a total of five Blalock-Taussig shunts (BT shunts; two were original BT shunts and three were modified BT shunts using GOLASKI grafts) underwent evaluation by ECG-gated magnetic resonance imaging. There were two cases with pulmonary atresia with intact ventricular septum, one with double outlet right ventricle with pulmonary stenosis and one with tetralogy of Fallot with pulmonary atresia who underwent bilateral BT shunts. At the time of study, an auscultory shunt murmur was audible in all patients. The magnetic resonance images were obtained with a Picker International Vista MR with a superconducting magnet operating at 0.5 Tesla. A spin echo sequence (echo time 40 msec) was used. All patients were placed within a 30 cm head coil radio antenna and sedated with chloral hydrate or diazepam. Four of 5 shunts were imaged on both coronal sections and sagittal sections during enddiastole. And there was no signal within the grafts. When the velocity of blood flow is beyond the cutoff velocity, the signal intensity of flowing blood is near background level. So we judged these grafts were patient. Our results showed that MRI was a very useful noninvasive method for evaluation of BT shunts. (author)

  3. Evaluation of Blalock-Taussig shunts using magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Okajima, Yoshitomo; Tashima, Kazuyuki; Terai, Masaru; Niwa, Koichirou.

    1988-10-01

    Four patients aged 3 to 18 months (mean 13 months) with a total of five Blalock-Taussig shunts (BT shunts; two were original BT shunts and three were modified BT shunts using GOLASKI grafts) underwent evaluation by ECG-gated magnetic resonance imaging. There were two cases with pulmonary atresia with intact ventricular septum, one with double outlet right ventricle with pulmonary stenosis and one with tetralogy of Fallot with pulmonary atresia who underwent bilateral BT shunts. At the time of study, an auscultory shunt murmur was audible in all patients. The magnetic resonance images were obtained with a Picker International Vista MR with a superconducting magnet operating at 0.5 Tesla. A spin echo sequence (echo time 40 msec) was used. All patients were placed within a 30 cm head coil radio antenna and sedated with chloral hydrate or diazepam. Four of 5 shunts were imaged on both coronal sections and sagittal sections during enddiastole. And there was no signal within the grafts. When the velocity of blood flow is beyond the cutoff velocity, the signal intensity of flowing blood is near background level. So we judged these grafts were patient. Our results showed that MRI was a very useful noninvasive method for evaluation of BT shunts.

  4. Splenophrenic portosystemic shunt in dogs with and without portal ...

    African Journals Online (AJOL)

    The possible existence of the same pattern of porto-caval connection in dogs having a single congenital portosystemic shunt (CPSS) and in dogs having multiple acquired portosystemic shunt (MAPSS) secondary to portal hypertension (PH) was evaluated. Retrospective evaluation of all CT examinations of patients having ...

  5. Spontaneous knot; a rare cause of ventriculoperitoneal shunt blockage.

    LENUS (Irish Health Repository)

    Mohammed, Wail

    2011-02-01

    A 14-year old X linked congenital hydrocephalus presented with unexplained headaches and vomiting. He had external ventricular drain and intracranial pressure monitoring (ICP). Subsequently, he underwent exploration and removal of previously inserted ventriculoperitoneal (VP) shunts. On retrieval of peritoneal catheters a double knot was noted between his two distal catheters. This case illustrates a rare cause of ventriculoperitoneal shunt malfunction.

  6. Spontaneous knot; a rare cause of ventriculoperitoneal shunt blockage.

    LENUS (Irish Health Repository)

    Mohammed, Wail

    2012-02-01

    A 14-year old X linked congenital hydrocephalus presented with unexplained headaches and vomiting. He had external ventricular drain and intracranial pressure monitoring (ICP). Subsequently, he underwent exploration and removal of previously inserted ventriculoperitoneal (VP) shunts. On retrieval of peritoneal catheters a double knot was noted between his two distal catheters. This case illustrates a rare cause of ventriculoperitoneal shunt malfunction.

  7. Clopidogrel in infants with systemic-to-pulmonary-artery shunts

    DEFF Research Database (Denmark)

    Wessel, David L; Berger, Felix; Li, Jennifer S

    2013-01-01

    BACKGROUND: Infants with cyanotic congenital heart disease palliated with placement of a systemic-to-pulmonary-artery shunt are at risk for shunt thrombosis and death. We investigated whether the addition of clopidogrel to conventional therapy reduces mortality from any cause and morbidity relate......-related morbidity. (Funded by Sanofi-Aventis and Bristol-Myers Squibb; ClinicalTrials.gov number, NCT00396877.)....

  8. Migration of the peritoneal catheter of a ventriculoperitoneal shunt ...

    African Journals Online (AJOL)

    Ventricular shunt is a well-established modality in the management of hydrocephalus. However, it can be associated with numerous complications and disastrous consequences. The reported incidence of intra-abdominal complications in infants and children after ventriculoperitoneal (VP) shunt procedures is about 24% ...

  9. Shunt hybrid active power filter for harmonic mitigation: A practical ...

    Indian Academy of Sciences (India)

    The increasing importance of Power Quality problems has been responsible for several improvements in Active Power Filter (APF) typologies in the last decade. The increased cost and switching losses make a pure shunt APF economically impractical for high power applications. In higher power levels shunt Hybrid Active ...

  10. Leakage Inductance Calculation for Planar Transformers with a Magnetic Shunt

    DEFF Research Database (Denmark)

    Zhang, Jun; Ouyang, Ziwei; Duffy, Maeve C.

    2014-01-01

    with a magnetic shunt by means of the stored magnetic energy in the primary and secondary sides of the transformer using the magnetomotive force (MMF) variation method, as well as the stored energy in the shunt based on the reluctance model. The detailed calculation method is described. Both the FEA simulation...

  11. An unusual case of intrahepatic portosystemic venous shunt

    African Journals Online (AJOL)

    vena cava (IVC) (most common). Intrahepatic portosystemic venous shunts are rare vascular anomalies that may be detected in asymptomatic patients, given the recent advances in radiological imaging techniques. Accurate shunt evaluation and classification can be performed with ultrasound and multi-detector computed.

  12. Calibration of piezoelectric RL shunts with explicit residual mode correction

    DEFF Research Database (Denmark)

    Høgsberg, Jan Becker; Krenk, Steen

    2017-01-01

    Piezoelectric RL (resistive-inductive) shunts are passive resonant devices used for damping of dominant vibration modes of a flexible structure and their efficiency relies on the precise calibration of the shunt components. In the present paper improved calibration accuracy is attained by an exte......Piezoelectric RL (resistive-inductive) shunts are passive resonant devices used for damping of dominant vibration modes of a flexible structure and their efficiency relies on the precise calibration of the shunt components. In the present paper improved calibration accuracy is attained...... by an extension of the local piezoelectric transducer displacement by two additional terms, representing the flexibility and inertia contributions from the residual vibration modes not directly addressed by the shunt damping. This results in an augmented dynamic model for the targeted resonant vibration mode...

  13. Shunt attachment and method for interfacing current collection systems

    Science.gov (United States)

    Denney, Paul E.; Iyer, Natraj C.; Hannan, III, William F.

    1992-01-01

    A composite brush to shunt attachment wherein a volatile component of a composite but mostly metallic brush, used for current collection purposes, does not upon welding or brazing, adversely affect the formation of the interfacial bond with a conductive shunt which carries the current from the zone of the brush. The brush to shunt attachment for a brush material of copper-graphite composite and a shunt of copper, or substituting silver for copper as an alternative, is made through a hot isostatic pressing (HIP). The HIP process includes applying high pressure and temperature simultaneously at the brush to shunt interface, after it has been isolated or canned in a metal casing in which the air adjacent to the interface has been evacuated and the interfacial area has been sealed before the application of pressure and temperature.

  14. Vibration damping with negative capacitance shunts: theory and experiment

    International Nuclear Information System (INIS)

    De Marneffe, B; Preumont, A

    2008-01-01

    This paper analyzes in detail the enhancement of piezoelectric stack transducers by means of the well known 'negative' capacitive shunting. The stability is thoroughly studied: starting from the electrical admittance curve of the transducer, a method is introduced that quantifies the stability margins of the shunted structure. Two different implementations (series vs parallel) are investigated, and the lack of robustness of the parallel one is demonstrated. Next, this technique is experimentally applied on a truss structure. Its performances are compared with those of passive shunt circuits and with those of an active control law, the so-called Integral Force Feedback or IFF. As expected, the damping introduced by the negative capacitance shunt is larger than the damping obtained with the passive shunts; it remains, however, one order of magnitude smaller than that obtained with the IFF

  15. Percutaneous peritoneovenous shunt positioning: technique and preliminary results

    International Nuclear Information System (INIS)

    Orsi, Franco; Grasso, Rosario Francesco; Bonomo, Guido; Marinucci, Irene; Monti, Cinzia; Bellomi, Massimo

    2002-01-01

    Nine peritoneovenous shunts were positioned by percutaneous technique in seven patients with advanced malignancy causing severe refractory ascites, and in two patients with hepatic cirrhosis (one with hepatocarcinoma). In all patients the shunts were percutaneously placed through the subclavian vein in the angiographic suite under digital fluoroscopic guide. No complications directly related to the procedure occurred. The shunt was successfully positioned in all patients in 60 min average time. No patient showed symptoms related to pulmonary overload or to disseminated intravascular coagulation. All patients had a significant improvement of the objective symptoms related to ascites such as respiratory symptoms, dyspepsia, and functional impairment to evacuation describing an improvement of their quality of life. Maximum shunt patency was 273 days. Percutaneous placement of peritoneovenous shunt is a safe, fast, and inexpensive procedure, extremely useful in resolution of refractory ascites, reducing symptoms, and allowing effective palliation, with a great improvement in quality of life. (orig.)

  16. Percutaneous peritoneovenous shunt positioning: technique and preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Orsi, Franco; Grasso, Rosario Francesco; Bonomo, Guido; Marinucci, Irene [Division of Radiology, European Institute of Oncology, Milan (Italy); Monti, Cinzia [Institute of Radiology, University of Milan (Italy); Bellomi, Massimo [Division of Radiology, European Institute of Oncology, Milan (Italy); Institute of Radiology, University of Milan (Italy)

    2002-05-01

    Nine peritoneovenous shunts were positioned by percutaneous technique in seven patients with advanced malignancy causing severe refractory ascites, and in two patients with hepatic cirrhosis (one with hepatocarcinoma). In all patients the shunts were percutaneously placed through the subclavian vein in the angiographic suite under digital fluoroscopic guide. No complications directly related to the procedure occurred. The shunt was successfully positioned in all patients in 60 min average time. No patient showed symptoms related to pulmonary overload or to disseminated intravascular coagulation. All patients had a significant improvement of the objective symptoms related to ascites such as respiratory symptoms, dyspepsia, and functional impairment to evacuation describing an improvement of their quality of life. Maximum shunt patency was 273 days. Percutaneous placement of peritoneovenous shunt is a safe, fast, and inexpensive procedure, extremely useful in resolution of refractory ascites, reducing symptoms, and allowing effective palliation, with a great improvement in quality of life. (orig.)

  17. Láser de dióxido de carbono fraccionado asociado a corticoide tópico para el tratamiento del prurito en las secuelas cicatriciales del paciente quemado

    Directory of Open Access Journals (Sweden)

    Sara A. González-Porto

    Full Text Available El prurito en los pacientes quemados supone una secuela frecuente que puede ser incapacitante y difícilmente controlable mediante tratamiento médico. Presentamos el caso de un paciente con prurito grave resistente a tratamiento médico y los resultados tras el tratamiento con láser ablativo y liberación de corticoide local asistida por láser. Se trata de un paciente con quemaduras graves en el 70% de superficie corporal, con prurito refractario a tratamiento médico y lesiones por rascado que precisaron de sedorrelajación e intubación orotraqueal, y en el que realizamos una sola sesión de tratamiento con láser CO² fraccionado tras la que se aplicó cura oclusiva con triamcinolona acetónido disuelta en suero (20 mg/ml. La evaluación del resultado se realizó mediante valoración del prurito (escala Burn Itch Questionnaire y del resultado clínico y estético de la cicatriz (escalas Vancouver Scar Scale y Patient and Observer Scar Assessment Scale. Logramos un buen control del prurito y de las lesiones por rascado sin complicaciones asociadas. La liberación de fármacos asistida por láser fue la base del nuestro tratamiento, en el que el láser ablativo crea canales de comunicación transepidérmicos que favorecen la entrada del corticoide a la dermis y el efecto inmediato del mismo. Esta modalidad de tratamiento y este nuevo concepto clínico se presentan como una alternativa terapéutica importante en el tratamiento del prurito refractario en el paciente quemado.

  18. Parylene MEMS patency sensor for assessment of hydrocephalus shunt obstruction.

    Science.gov (United States)

    Kim, Brian J; Jin, Willa; Baldwin, Alexander; Yu, Lawrence; Christian, Eisha; Krieger, Mark D; McComb, J Gordon; Meng, Ellis

    2016-10-01

    Neurosurgical ventricular shunts inserted to treat hydrocephalus experience a cumulative failure rate of 80 % over 12 years; obstruction is responsible for most failures with a majority occurring at the proximal catheter. Current diagnosis of shunt malfunction is imprecise and involves neuroimaging studies and shunt tapping, an invasive measurement of intracranial pressure and shunt patency. These patients often present emergently and a delay in care has dire consequences. A microelectromechanical systems (MEMS) patency sensor was developed to enable direct and quantitative tracking of shunt patency in order to detect proximal shunt occlusion prior to the development of clinical symptoms thereby avoiding delays in treatment. The sensor was fabricated on a flexible polymer substrate to eventually allow integration into a shunt. In this study, the sensor was packaged for use with external ventricular drainage systems for clinical validation. Insights into the transduction mechanism of the sensor were obtained. The impact of electrode size, clinically relevant temperatures and flows, and hydrogen peroxide (H2O2) plasma sterilization on sensor function were evaluated. Sensor performance in the presence of static and dynamic obstruction was demonstrated using 3 different models of obstruction. Electrode size was found to have a minimal effect on sensor performance and increased temperature and flow resulted in a slight decrease in the baseline impedance due to an increase in ionic mobility. However, sensor response did not vary within clinically relevant temperature and flow ranges. H2O2 plasma sterilization also had no effect on sensor performance. This low power and simple format sensor was developed with the intention of future integration into shunts for wireless monitoring of shunt state and more importantly, a more accurate and timely diagnosis of shunt failure.

  19. Tube shunt complications and their prevention.

    Science.gov (United States)

    Sarkisian, Steven R

    2009-03-01

    Glaucoma drainage devices (GDDs) have been generally accepted as a treatment of refractory glaucoma. GDDs have their own unique set of complications that are important to evaluate to prevent them. Tube shunts are typically used in eyes with refractory glaucoma. There is increased interest in studying the efficacy of GDDs. Most of the attention has been focused on comparing trabeculectomy with the Baerveldt implant (Advanced Medical Optics, Inc., Santa Anna, California, USA). The other leading implant is the Ahmed Glaucoma Valve. There are several retrospective studies comparing these two devices and a prospective study is ongoing. There is great interest in the complication rate of tube shunts and these have been published both retrospectively and prospectively. Complications such as hypotony, diplopia, strabismus, proptosis, tube erosion, failure, corneal decompensation, endophthalmitis, and visual loss are all important and some have recently been reviewed in the literature. Moreover, the use of glaucoma drainage implants in the pediatric population has been evaluated. Glaucoma drainage implants have been a powerful tool in our surgical fight to prevent blindness; however, they are not without complications or controversy.

  20. Tratamento da escoliose em crianças com paralisia cerebral utilizando a prótese vertical expansível de titânio para costela (VEPTR Tratamiento de la escoliosis en niños con parálisis cerebral mediante la prótesis vertical expansible de titanio para las costillas (VEPTR Treatment of scoliosis in children with cerebral palsy using the vertical expandable prosthetic titanium rib (VEPTR

    Directory of Open Access Journals (Sweden)

    Kiyomori de Quental Tyba

    2011-01-01

    Full Text Available OBJETIVO: Avaliar o uso da prótese vertical expansível de titânio (VEPTR como opção de tratamento inicial da escoliose em crianças de baixa idade portadoras de paralisia cerebral. MÉTODOS: Foram avaliados 10 pacientes portadores de paralisia cerebral (PC tratados com VEPTR pelo grupo de escoliose da AACD de São Paulo. Caracterizavam-se por imaturidade esquelética e escoliose progressiva; sem deformidade grave no plano sagital. Realizamos avaliação da curva pelo método de Cobb no pré e pós-operatório e após dois anos de seguimento. RESULTADOS: A correção obtida com o uso do VEPTR no pós-operatório imediato foi em média de 41,4% nas radiografias iniciais sem tração (p = 0,005 e 9,1% (p = 0,055 nas radiografias com tração. Após quatro meses de pós-operatório mantiveram-se ganhos de 27,2% com relação ao início. Houve correção da obliquidade pélvica de 10,2º no pré-operatório para 5,4º em média (p = 0,007. As complicações ocorreram em seis pacientes (60% e em apenas um paciente foi necessária a retirada do VEPTR. CONCLUSÃO: O VEPTR é um método que obteve correção significativa no tratamento provisório das escolioses na PC, apesar de frequentes complicações de baixa morbidade.OBJETIVO: Evaluar el uso de la prótesis vertical expansible de titanio (VEPTR como opción de tratamiento inicial para la escoliosis en niños pequeños con parálisis cerebral. MÉTODOS: 10 pacientes con parálisis cerebral (PC fueron evaluados y tratados con VEPTR por el grupo de escoliosis de la AACD en Sao Paulo. Caracterizados por escoliosis progresiva inmadurez esquelética, sin deformidad grave en el plano sagital. Se evaluó la curva por el método de Cobb en el preoperatorio, posoperatorio, y después de dos años de seguimiento. RESULTADOS: LA CORRECCIón, obtenida con el uso de VEPTR en el posoperatorio inmediato, fue en promedio 41,4% en relación a las radiografías iniciales sin tracción (p = 0,005 y 9,1% (p = 0

  1. Estudio de aleaciones amorfas Hf1-x Cux mediante correlaciones angulares perturbadas

    OpenAIRE

    Damonte, Laura Cristina

    1988-01-01

    Con la intención de contribuir a un mejor entendimiento de la estructura atómica local en aleaciones del tipo MT-MT, en este trabajo de tesis se realiza un estudio, mediante la aplicación de la técnica TDPAC, sobre aleaciones amorfas Hf1-x Cux (x=0.33, 0.44, 0.50, 0.59) y sus contrapartes cristalinas. Muy pocos trabajos han sido publicados sobre este sistema. El objetivo general de este trabajo es analizar el orden local en estas aleaciones, su evolución con tratamientos térmicos (r...

  2. RECUENTO DE COLIFORMES Y Escherichia coli EN CANALES BOVINAS SOMETIDAS A TRATAMIENTOS FÍSICOS Y QUÍMICOS

    Directory of Open Access Journals (Sweden)

    EDUARDO JAVID CORPAS-IGUARÁN

    Full Text Available Se evaluó el recuento de coliformes totales y Escherichia coli en canales bovinas sometidas a diferentes tratamientos que incluyeron combinaciones de los métodos de lavado, desinfección y vaporización, utilizando el diseño completamente aleatorizado de un factor con 3 repeticiones. El muestreo se realizó mediante frotis de superficie en tres áreas diferentes de la muestra (espalda, pecho y anca, que fueron posteriormente analizadas mediante el método de recuento en placa. Al aplicar secuencialmente los métodos de remoción microbiana se apreció la disminución progresiva en el recuento de coliformes totales y E. coli, y en la variabilidad de los datos, principalmente en los tratamientos C, D y E. La prueba de contrastes múltiples de Friedman mostró la inexistencia de diferencias estadísticas entre los recuentos de los tratamientos C y E en la muestra 2, indicando la ineficacia de la vaporización como coadyuvante de la acidificación para disminuir el recuento de los microorganismos de estudio. Las pruebas de comparación en muestras independientes mostraron resultados idénticos a la prueba de Friedman, excepto para el recuento de E. coli entre los tratamientos D y E, sugiriendo que la vaporización tiene efecto significativo para potenciar la disminución del recuento del microorganismo en las canales.

  3. Nuevas terapias en el tratamiento del VIH

    OpenAIRE

    Garrido Estévez, Julieta

    2017-01-01

    Desde hace décadas, los avances en el tratamiento del VIH han conseguido controlar la infección y disminuir su progresión hacia SIDA. La eliminación del VIH, virus capaz de evadir e incapacitar al sistema inmune, que es el que nos protege de otras infecciones, es en la actualidad uno de los retos más importantes en la investigación científica, pretendiendo con ello las ansiadas prevención y curación de la enfermedad. Objetivo: Definir la situación actual del tratamiento de la infección por...

  4. Tratamiento ortodóncicoquirúrgico de un paciente con síndrome de cara larga

    OpenAIRE

    Meneses López, Abraham

    2014-01-01

    El aumento de la altura facial anteroinferior es también reconocida con otros términos como:Síndrome de cara larga, rotación horaria extrema, fascie adenoidea, exceso maxilar vertical,entre otros. Cuando la severidad de la deformación vertical es tan grande que no se puede obteneruna corrección adecuada mediante la modificación de crecimiento o camuflaje, la combinaciónde Ortodoncia y Cirugía provee la única opción de tratamiento viable. Se presenta el caso de unapaciente adulta con Síndrome ...

  5. Vivencias psicosociales reveladas por niños que reciben tratamiento con quimioterapia por cáncer

    OpenAIRE

    BLANCA CECILIA VANEGAS DE AHOGADO; MARÍA ELVIRA BELTRÁN HERRERA; VIVIANA CIFUENTES GIL; YULIETH ALEJANDRA DUARTE; JIMMY JULIÁN MONTOYA; JOHANNA MARCELA RIVERA ZABALA; MARÍA MERCEDES LAFAURIE VILLAMIL

    2009-01-01

    Se realizó un estudio cualitativo con el propósito de descubrir las vivencias psicosociales de niños y niñas de 9 a 12 años que recibían tratamiento con quimioterapia por cáncer. La recolección de la información se hizo mediante encuentros lúdicos con el apoyo de algunas preguntas básicas que facilitaron las revelaciones narrativas. Tres aspectos se destacan en los hallazgos del estudio: vivencias desfavorables, vivencias relacionadas con la autoestima y vivencias favorables; las dos primeras...

  6. Evaluación de diagramas de flujo de sistemas de tratamiento de deyecciones ganaderas que incluyan codigestión anaerobia

    OpenAIRE

    Pineda Castro, Carme

    2011-01-01

    El objetivo del presente trabajo ha sido la confección de una herramienta informática que permita evaluar, mediante balances de materia y energía, las diferentes combinaciones de procesos de tratamiento de deyecciones ganaderas conducentes a la producción de energía, mediante digestión o codigestión anaerobia, o a la obtención de productos que permitan una mejora en la gestión de los nutrientes, mediante la aplicación de sistemas de separación, concentración o eliminación biológica de nitróge...

  7. La Vía Posterior en el Tratamiento de las Lesiones del Recto

    Directory of Open Access Journals (Sweden)

    Carlos Rey León

    1990-12-01

    Full Text Available

    En este trabajo presentamos la experiencia con 22 pacientes tratados en el Instituto Nacional de Cancerología, desde 1969 a 1987. Incluye 11 hombres e igual número de mujeres, cuyas edades oscilaron entre 23 y 80 años. Las indicaciones para la cirugía fueron: adenoma velloso en 13 pacientes, adenocarcinoma del recto en 3; fístula rectovaginal en 1; fístula rectovesical en 1; fístula post-resección anterior del recto en 1; estenosis rectal en 1; cirugía de rescate por recidiva tumoral en el recto en l y en 1 más, para diagnóstico y tratamiento, por lesión rectal sospechosa de malignidad no diagnosticada por las biopsias previas.

    En todos los pacientes se practicó el acceso posterior al recto, en 20 de ellos mediante la técnica trans-sacra de Kraske y en 2 con el procedimiento transesfinteriano de Mason.

    Seis pacientes presentaron complicaciones después del tratamiento quirúrgico. De los 4 pacientes con fístulas, 3 fueron tratados mediante colostomía. Uno de ellos con un prolapso rectal trans-sacro corregido quirúrgicamente sin complicaciones posteriores.

    Dos pacientes con infección de la herida quirúrgica fueron tratados localmente. No hubo problemas de incontinencia ni de estenosis. Ningún paciente murió como complicación del procedimiento.

    El 33% de los adenomas vellosos tratados mediante esta vía de acceso recidivó, lo que requirió una o más escisiones y esta recidiva se encontró en los tumores mayores de 5 cm de diámetro.

    Las resecciones posteriores no son el tratamiento de elección en el cáncer rectal avanzado, pero sí es un procedimiento seguro y efectivo para varias condiciones benignas y malignas seleccionadas.

    La resección trans-sacra de Kraske y la transesfinteriana de York-Mason son dos procedimientos que facilitan el acceso al recto, mantienen la función del esfínter y permiten extirpar lesiones ano-rectales, evitando la laparotomía...

  8. Ventriculoperitoneal shunt infection in Haji Adam Malik Hospital, Medan

    Science.gov (United States)

    Dharmajaya, R.

    2018-03-01

    Installation of ventriculoperitoneal shunts (VP) represented a substantial progress in the neurosurgical management of hydrocephalus in children. However, infection is the most commonpostoperative complication of aventriculoperitoneal shunt. It is important because it is related to substantial morbidity and mortality, and exerts a negative impact on the quality of life of patients. We retrospectively analyzed all 20 cases of shunt infection from 2013 to 2016. The types of infections found were exposed shunts15 cases (75%), and 5 cases of ventriculitis (25%). Length of infection time which calculated from the beginning of surgery was 350.20 days or 11 months. The most common pathogen types are S. epidermidis followed by P. aeruginosa, E. coli, and A. baumanii. There were many risk factors for shunt infection, but the interesting fact was the level of pre-operative albumin. There was a significant difference between low albumin levels (<3.0) and normal albumin (≥3.0) levels against the risk of exposure shunt, p = 0.015. It means there is asignificant difference between low pre-operative albumin and normal level for the risk of theexposed shunt.

  9. A plasma polymerization technique to overcome cerebrospinal fluid shunt infections

    Energy Technology Data Exchange (ETDEWEB)

    Coekeliler, D [Plasma Aided Bioengineering and Biotechnology Research Laboratory, Engineering Faculty, Hacettepe University, 06532, Ankara (Turkey); Caner, H [Department of Neurosurgery, School of Medicine, Baskent University, 06610, Ankara (Turkey); Zemek, J [Institute of Physics, Academy of Sciences of the Czech Republic, Cukrovarnicka 10, 162 53, Prague, Czech Republic (Czech Republic); Choukourov, A [Department of Macromolecular Physics, Charles University, V Holesovickach 2, 18000 Prague (Czech Republic); Biederman, H [Department of Macromolecular Physics, Charles University, V Holesovickach 2, 18000 Prague (Czech Republic); Mutlu, M [Plasma Aided Bioengineering and Biotechnology Research Laboratory, Engineering Faculty, Hacettepe University, 06532, Ankara (Turkey)

    2007-03-01

    Prosthetic devices, mainly shunts, are frequently used for temporary or permanent drainage of cerebrospinal fluid. The pathogenesis of shunt infection is a very important problem in modern medicine and generally this is characterized by staphylococcal adhesion to the cerebrospinal fluid shunt surfaces. In this paper, the prevention of the attachment of test microorganism Staphylococcus epidermidis on the cerebrospinal fluid shunt surfaces by 2-hydroxyethylmethacrylate (HEMA) precursor modification in the plasma polymerization system, is reported. Different plasma polymerization conditions (RF discharge power 10-20-30 W, exposure time 5-10-15 min) were employed during the surface modification. The surface chemistry and topology of unmodified and modified shunts was characterized by x-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM) and atomic force microscopy (AFM). Also, static contact angle measurements were performed to state the change of surface hydrophilicity. All samples were tested in vitro with Staphylococcus epidermidis. A plasma-polymerized HEMA film (PP HEMA) was found to be an alternative simple method to decrease the microorganism attachment and create bacterial anti-fouling surfaces. The attachment of the model microorganism Staphylococcus epidermidis on the shunt surface modified by PP HEMA at 20 W and 15 min was reduced 62.3% if compared to the unmodified control surface of the shunt.

  10. Research on spark discharge of floating roof tank shunt

    International Nuclear Information System (INIS)

    Bi, Xiaolei; Liu, Quanzhen; Liu, Baoquan; Gao, Xin; Hu, Haiyan; Liu, Juan

    2013-01-01

    In order to quantitatively analyze the spark discharge risk of floating roof tank shunts, the breakdown voltage of shunt has been calculated by Townsend theory, the shunt spark discharge experiment is carried out by using 1.2/50 μs impulse voltage wave, and the relationship between breakdown voltage of shunt spark discharge and air gap is analyzed. It has been indicated by theoretical analysis and experimental study that the small gap is more easily cause spark discharge than the big gap when the contact between shunt and tank shell is poor. When air gap distance is equal to 0.1 cm, average breakdown voltage is 5280 V. When the air gap distance is less than 0.3 cm, experiment data agree well with Townsend theory. Therefore, in the condition of small gap, Townsend theory can be used to calculated breakdown voltage of shunt. Finally, based on the above conclusions, improvements for avoiding the spark discharge risk of shunt of floating roof tanks have been proposed.

  11. Aberrant hepatic lipid storage and metabolism in canine portosystemic shunts.

    Directory of Open Access Journals (Sweden)

    Lindsay Van den Bossche

    Full Text Available Non-alcoholic fatty liver disease (NAFLD is a poorly understood multifactorial pandemic disorder. One of the hallmarks of NAFLD, hepatic steatosis, is a common feature in canine congenital portosystemic shunts. The aim of this study was to gain detailed insight into the pathogenesis of steatosis in this large animal model. Hepatic lipid accumulation, gene-expression analysis and HPLC-MS of neutral lipids and phospholipids in extrahepatic (EHPSS and intrahepatic portosystemic shunts (IHPSS was compared to healthy control dogs. Liver organoids of diseased dogs and healthy control dogs were incubated with palmitic- and oleic-acid, and lipid accumulation was quantified using LD540. In histological slides of shunt livers, a 12-fold increase of lipid content was detected compared to the control dogs (EHPSS P<0.01; IHPSS P = 0.042. Involvement of lipid-related genes to steatosis in portosystemic shunting was corroborated using gene-expression profiling. Lipid analysis demonstrated different triglyceride composition and a shift towards short chain and omega-3 fatty acids in shunt versus healthy dogs, with no difference in lipid species composition between shunt types. All organoids showed a similar increase in triacylglycerols after free fatty acids enrichment. This study demonstrates that steatosis is probably secondary to canine portosystemic shunts. Unravelling the pathogenesis of this hepatic steatosis might contribute to a better understanding of steatosis in NAFLD.

  12. Aberrant hepatic lipid storage and metabolism in canine portosystemic shunts.

    Science.gov (United States)

    Van den Bossche, Lindsay; Schoonenberg, Vivien A C; Burgener, Iwan A; Penning, Louis C; Schrall, Ingrid M; Kruitwagen, Hedwig S; van Wolferen, Monique E; Grinwis, Guy C M; Kummeling, Anne; Rothuizen, Jan; van Velzen, Jeroen F; Stathonikos, Nikolas; Molenaar, Martijn R; Helms, Bernd J; Brouwers, Jos F H M; Spee, Bart; van Steenbeek, Frank G

    2017-01-01

    Non-alcoholic fatty liver disease (NAFLD) is a poorly understood multifactorial pandemic disorder. One of the hallmarks of NAFLD, hepatic steatosis, is a common feature in canine congenital portosystemic shunts. The aim of this study was to gain detailed insight into the pathogenesis of steatosis in this large animal model. Hepatic lipid accumulation, gene-expression analysis and HPLC-MS of neutral lipids and phospholipids in extrahepatic (EHPSS) and intrahepatic portosystemic shunts (IHPSS) was compared to healthy control dogs. Liver organoids of diseased dogs and healthy control dogs were incubated with palmitic- and oleic-acid, and lipid accumulation was quantified using LD540. In histological slides of shunt livers, a 12-fold increase of lipid content was detected compared to the control dogs (EHPSS Plipid-related genes to steatosis in portosystemic shunting was corroborated using gene-expression profiling. Lipid analysis demonstrated different triglyceride composition and a shift towards short chain and omega-3 fatty acids in shunt versus healthy dogs, with no difference in lipid species composition between shunt types. All organoids showed a similar increase in triacylglycerols after free fatty acids enrichment. This study demonstrates that steatosis is probably secondary to canine portosystemic shunts. Unravelling the pathogenesis of this hepatic steatosis might contribute to a better understanding of steatosis in NAFLD.

  13. Portosystemic shunts for extrahepatic portal hypertension in children.

    Science.gov (United States)

    Tocornal, J; Cruz, F

    1981-07-01

    Twenty-three children with prehepatic portal hypertension and hemorrhage due to ruptured esophagogastric varices had portosystemic shunts. Their ages ranged from two years and seven months to 15 years. Eleven were less than eight years of age. Twenty patients had portal vein cavernomatosis and three patients had double portal veins. In 21 patients, a mesocaval type of shunt was done. A splenorenal shunt was performed in two. There was no surgical mortality. Two shunts occluded, both in rather young infants--two years and seven months and three years of age. In all the others, there was no further bleeding, and the shunts remained patent, as shown by abdominal angiograms. Neuropsychiatric disorders, probably due to hepatic encephalopathy, occurred in only one patient. On the basis of this favorable experience, we believe that an elective portosystemic shunt should, in general, be performed upon children with prehepatic portal hypertension after one major variceal hemorrhage. We favor a mesocaval type of shunt in these children because of the larger diameter of the vessels involved in the anastomosis and because it preserves the spleen, maintaining defense against subsequent infection.

  14. Grado de adherencia a tratamientos en personas con riesgo cardiovascular

    Directory of Open Access Journals (Sweden)

    Stella Ignacia Ortega Oviedo

    2014-01-01

    Full Text Available Objetivo: Determinar el grado de adherencia al tratamiento farmacológico y no farmacológico en personas con factores de riesgo cardiovascular inscritos en el programa de promoción de la salud y prevención de la enfermedad cardiovascular en una Institución Prestadora de Salud de Montería, Colombia. Metodología: Estudio descriptivo, transversal, cuantitativo, con 204 pacientes de un programa de promoción de la salud y prevención de la enfermedad cardiovascular. La información se obtuvo aplicando la cuarta versión del Instrumento para evaluar los factores que influyen en la adherencia a tratamientos farmacológicos y no farmacológicos en pacientes con factores de riesgo de enfermedad cardiovascular, diseñado por Bonilla y Gutiérrez (3. Los resultados se analizaron mediante técnicas de estadística descriptiva y medidas de tendencia central y de posición. Resultados: El grado de adherencia terapéutica en los participantes mostró un 67% en situación de ventaja para adherencia; un 29% en riesgo a no adherirse y un 4% en situación de no adherencia. Los tres grupos de situación de adherencia identificados varían estadísticamente con relación a las cuatro dimensiones estudiadas, siendo la Dimensión II relacionada con el proveedor la que aportó mayor diferencia. Conclusiones: Estos hallazgos permiten destacar la importancia de la relación paciente-proveedor en el grado de adherencia de los pacientes, haciendo necesario que la institución y el equipo de salud y enfermería enfaticen las acciones de autocuidado con apoyo, acompañamiento permanente y orientación acorde a sus necesidades, a sus expectativas y a las características individuales de las personas atendidas.

  15. Tratamiento acortado estrictamente supervisado para tuberculosis pulmonar

    Directory of Open Access Journals (Sweden)

    Alvarez-Gordillo Guadalupe del Carmen

    1998-01-01

    Full Text Available Objetivo. Evaluar la posibilidad de aplicar el tratamiento acortado estrictamente supervisado (TAES en el Programa de Control de la Tuberculosis en Chiapas, México. Material y métodos. Se evaluó la eficacia y la eficiencia del tratamiento en una cohorte de pacientes con tuberculosis pulmonar confirmada por baciloscopía, que ingresaron a tratamiento con esquemas de autoadministración semisupervisión y estricta supervisión, de enero a junio de 1996. Resultados. La eficacia fue de 90.9. 97.7 y 100% para los esquemas de tratamiento autoadministrado, semisupervisado y TAES, respectivamente, mientras que la eficiencia fue de 68.1. 77.6 y 88.5% en el mismo orden. Conclusiones. Para la salud pública el TAES demostró ser la actividad más importante en el control de la tuberculosis, al elevar las tasas de curación y disminuir, por lo tanto, las fuentes de transmisión de la enfermedad.

  16. Muzzle shunt augmentation of conventional railguns

    International Nuclear Information System (INIS)

    Parker, J.V.

    1991-01-01

    This paper reports on augmentation which is a technique for reducing the armature current and hence the armature power dissipation in a plasma armature railgun. In spite of the advantages, no large augmented railguns have been built, primarily due to the mechanical and electrical complexity introduced by the extra conductors required. it is possible to achieve some of the benefits of augmentation in a conventional railgun by diverting a fraction φ of the input current through a shunt path at the muzzle of the railgun. In particular, the relation between force and armature current is the same as that obtained in an n-turn, series-connected augmented railgun with n = 1/(1 - φ). The price of this simplification is a reduction in electrical efficiency and some additional complexity in the external electrical system

  17. Prevention and treatment of complications after transjugular intrahepatic portosystemic shunt

    Directory of Open Access Journals (Sweden)

    XUE Hui

    2016-02-01

    Full Text Available The application of transjugular intrahepatic portosystemic shunt (TIPS in the treatment of cirrhotic portal hypertension has been widely accepted both at home and abroad. This article focuses on the fatal complications of TIPS (including intraperitoneal bleeding and acute pulmonary embolism, shunt failure, and recurrent portosystemic hepatic encephalopathy, and elaborates on the reasons for such conditions and related preventive measures, in order to improve the accuracy and safety of intraoperative puncture, reduce common complications such as shunt failure and hepatic encephalopathy, and improve the clinical effect of TIPS in the treatment of cirrhotic portal hypertension.

  18. Spinal cord arteriovenous shunts: from imaging to management

    International Nuclear Information System (INIS)

    Rodesch, G.; Lasjaunias, P.

    2003-01-01

    Spinal cord arteriovenous shunts (SCAVSs) are either fistulas or niduses that can be separated in four different groups according to their localization and relationship to the dura. Paraspinal AVSs are located outside the spine and are responsible for neurological symptoms because of cord compression by ertatic veins, venous congestion or arterial steal. Epidural shunts are located in the epidural space and drain in epidural veins with secondary intradural congestion. Dural shunts are embedded in the dura, produce a cord venous myelopathy after draining through veins that either pierce the dura far from a nerve root or accompany a nerve root. Intradural shunts affect the cord, the roots or the filum. Additionally, they can be classified according to their potential relationships with genetics, vascular biological features and angiogenesis into genetic hereditary lesions (hereditary hemorrhagic telangiectasia), genetic non-hereditary lesions (multiple lesions with metameric links) and single lesions (AVMs or micro AVFs). MRI and MRA are able to visualise SCAVS early after the onset of clinical symptoms. The type of shunt and its localization may remain difficult to be precise. Angiography remains the gold standard for analysis of the anatomical, morphological and architectural features necessary for therapeutic decisions in both paediatric and adult populations. In our series, embolisation is chosen in first intention whatever the type of shunt responsible for the clinical symptoms and glue is preferably used. In paraspinal, dural or epidural arteriovenous shunts, the goal of treatment should be complete closure of the shunt. A complete cure by embolization is rather easily achieved in paraspinal lesions. Failure of endovascular therapy in dural or epidural shunts must bring the patient to surgery. The prognosis of most intradural shunts seems better than previously thought, even after haemorrhage. In intradural spinal cord arteriovenous shunts, embolisation

  19. Tratamiento conservador en pacientes con retinoblastoma bilateral

    Directory of Open Access Journals (Sweden)

    Juan C. Suárez

    2008-11-01

    Full Text Available OBJETIVO: comparar el tratamiento convencional del retinoblastoma bilateral, usado hasta hace algunos años, consistente en radioterapia o enucleación bilateral, con el tratamiento conservador actual que incluye termoterapia transpupilar (TTT o TTT/quimioterapia al menos en un ojo, en niños con diagnóstico de retinoblastoma bilateral. DISEÑO: estudio retrospectivo descriptivo. MUESTRA: 20 pacientes con diagnóstico de retinoblastoma bilateral que consultaron al Hospital Universitario San Vicente de Paúl, de Medellín, Colombia, entre 1997 y 2007. MÉTODO: se hizo enucleación del ojo con el tumor de mayor tamaño. En el otro ojo se hizo tratamiento con TTT, con el láser diodo (810 nm, spot amplio, solo o combinado con otras terapias. RESULTADOS: se dividió a los pacientes en dos grupos: 16 pacientes (32 ojos en el grupo 1 tratados conservadoramente y 4 pacientes (8 ojos en el grupo 2 con tratamiento convencional. El rango de edad fue de 1-72 meses en el grupo 1 y de 1-12 meses en el grupo 2. El tiempo de seguimiento fue de 7-67 meses para el grupo 1 y de 13-73 meses para el grupo 2. En el grupo 1 se hizo enucleación de 16 ojos (50%, radioterapia externa de uno (3,1%, quimioterapia más termoterapia de 5 (15,6% y quimioterapia más termoterapia más crioterapia de 10 (31,3%. En todos los pacientes se logró preservar al menos un ojo. En el grupo 2, se enuclearon 7 ojos (87,5% y se hizo radioterapia externa más enucleación en un paciente (12.5%. Además, todos los pacientes recibieron quimioterapia. CONCLUSIÓN: la terapia conservadora actual consistente en tratamiento local (termoterapia, crioterapia o braquiterapia y quimiorreducción permite preservar al menos un ojo y en algunos casos de los dos, muchas veces con buena agudeza visual, en niños con retinoblastoma bilateral; se evitan así la enucleación bilateral y la radioterapia externa usada en el tratamiento convencional con todos sus efectos secundarios. La enucleación contin

  20. Estudio de la digestión anaerobia en dos fases para el tratamiento de las aguas residuales de despulpe del beneficiado húmedo del café

    OpenAIRE

    Guardia Puebla, Yans

    2013-01-01

    Debido al aumento de los estándares de calidad exigidos internacionalmente, así como por una mayor presión sobre la industria mediante legislaciones ambientales más rigurosas, el sector cafetalero está obligado a buscar, a través de la investigación, un sistema adecuado de tratamiento para las aguas residuales generadas en el beneficiado húmedo del café. En este trabajo se evaluó el funcionamiento de la digestión anaerobia para el tratamiento de las aguas residuales de despulpe. Para ello, se...

  1. Calidad de la dieta "antes y durante" un tratamiento de pérdida de peso basado en dieta mediterránea, terapia conductual y educación nutricional

    OpenAIRE

    Eva María Morales-Falo; Carmen Sánchez-Moreno; Alberto Esteban; Juan José Alburquerque; Marta Garaulet

    2013-01-01

    Introducción: El método de pérdida de peso (dieta mediterránea, terapia de comportamiento y educación nutricional) ha mostrado ser efectivo en el tratamiento de la obesidad. Objetivo: El objetivo del presente trabajo es evaluar y comparar la calidad de las dietas ingeridas antes y durante el tratamiento mediante el Índice de Alimentación Saludable (IAS) y su relación con diferentes variables. Materiales y métodos: La muestra fue de 392 pacientes (330 mujeres, 62 hombres), edad 39,3 ± 11,5 año...

  2. Eficacia de la inducción miofascial para el tratamiento de la espasticidad en pacientes con parálisis cerebral espástica: ensayo clínico aleatorizado

    OpenAIRE

    Ayesa Justicia, Aiantze

    2014-01-01

    ¿El tratamiento mediante la inducción miofascial disminuye la espasticidad en los pacientes con Parálisis Cerebral Espástica (PCE) mientras son intervenidos con un tratamiento convencional? Objetivos: Comprobar si la inducción miofascial disminuye la espasticidad en pacientes con parálisis cerebral espástica (PCE) y así mismo prevenir las complicaciones musculoesqueléticas y aumentar el rango de movilidad articular. Metodología: Ensayo controlado clínico aleatorizado que recoge un total...

  3. Influencia de los tratamientos microabrasivos sobre la resistencia adhesiva en dientes con fluorosis

    Directory of Open Access Journals (Sweden)

    Paola Mena Silva

    2015-12-01

    Full Text Available La búsqueda de tratamientos mínimamente invasivos y altamente estéticos para pacientes con fluorosis, ha llevado a buscar mecanismos para solucionar esta problemática, mediante la utilización de resinas como la primera opción. Sin embargo el principal problema del tratamiento, se centra en la poca adhesión debido a las características estructurales del esmalte fluorótico, en grados de fluorosis TF 1 al 3, el ácido no actúa correctamente, causando ausencia de grabado principalmente entre las estrías de Retzius, en las rugosidades y espacios adamantinos ocupados por detritus de materia orgánica y cúmulos de placa dentobacteriana, siendo necesario efectuar técnicas microabrasivas y desproteinizantes como paso previo a los procesos adhesivos. Así, el presente estudio pretendió determinar la resistencia adhesiva en dientes con fluorosis grados TF 2 y 3, empleando tres diferentes técnicas de abrasión adamantina, se seleccionaron 48 dientes divididos en 3 grupos de 16 muestras cada uno, 8 con grado TF2 y 8 con grado TF3. Las superficies del esmalte fueron preparadas mediante la técnica “microabrasión modificada”, la “técnica de microabrasión” y “Opalustre”, todos los grupos recibieron desproteinización con hipoclorito de sodio al 5% por un minuto. Posterior a lo cual fueron realizados los procesos adhesivos mediante sistema adhesivo y resina compuesta, sometiéndose posteriormente a pruebas de cizallamiento. Los resultados analizados mediante testes de ANOVA y T de Student no determinaron una diferencia estadísticamente significativa entre los grupos, la facilidad en los protocolos de aplicación debe ser considerada en la elección de la técnica, sin embargo resulta importante su ejecución en dientes afectados por fluorosis.

  4. Scoliosis and Syringomyelia With Chiari Malformation After Lumbar Shunting

    Directory of Open Access Journals (Sweden)

    Hsin-Hung Chen

    2010-07-01

    Full Text Available Unsteady gait was noted in a 2-year-old boy with a lumboperitoneal (LP shunt that had been inserted 1 year earlier for increased head circumference caused by communicating hydrocephalus. Scoliosis was also noted during postoperative follow-up. Magnetic resonance imaging revealed new hindbrain tonsillar herniation and an extensive syrinx from C3 to L1. The malfunctioning LP shunt was removed and posterior fossa decompression with ventriculoperitoneal shunt insertion was performed. The unsteady gait recovered completely and scoliosis improved. Magnetic resonance imaging demonstrated resolution of the syrinx and tonsillar herniation. Acquired Chiari I malformation after LP shunt is well documented; usually, patients have no symptoms. This is the first report to have all the cause and effect mechanisms among syringomyelia, scoliosis and Chiari I malformation in 1 patient. We review the literature and discuss the possible mechanisms.

  5. Optimization methods for the Train Unit Shunting Problem

    DEFF Research Database (Denmark)

    Haahr, Jørgen Thorlund; Lusby, Richard Martin; Wagenaar, Joris Camiel

    2017-01-01

    We consider the Train Unit Shunting Problem, an important planning problem for passenger railway operators. This problem entails assigning train units from shunting yards to scheduled train services in such a way that the resulting operations are without conflicts. The problem arises at every...... shunting yard in the railway network and involves matching train units to arriving and departing train services as well as assigning the selected matchings to appropriate shunting yard tracks. We present an extensive comparison benchmark of multiple solution approaches for this problem, some of which...... are novel. In particular, we develop a constraint programming formulation, a column generation approach, and a randomized greedy heuristic. We compare and benchmark these approaches with two existing methods, a mixed integer linear program and a two-stage heuristic. The benchmark contains multiple real...

  6. Epidural haematoma: pathophysiological significance of extravasation and arteriovenous shunting

    International Nuclear Information System (INIS)

    Habash, A.H.; Sortland, O.; Zwetnow, N.N.

    1982-01-01

    35 patients with epidural bleeding operated on at Rikshospitalet, Oslo, during the period 1965 - 1980 had preoperative angiography with visualization of the external carotid artery. Twenty-one patients had extravasation of contrast medium from meningeal arteries. Seventeen of the 21 had also shunting of contrast medium from meningeal arteries to meningeal or diploic veins, while 20 of the 21 also had bled from a ruptured meningeal artery at operation. It was further found that of 20 patients who deteriorated after trauma 18 had an epidural arteriovenous shunt or extravasation. Conversely, of 15 patients who improved after trauma 12 had no evidence of a shunt. The strong correlation between the clinical course and the occurrence of extravasation supports previous experimental and clinical data, indicating the epidural arteriovenous shunt to be a major factor in the pathophysiology and the outcome of epidural bleeding. (author)

  7. Eficacia del extracto fluido de Vimang® en el tratamiento de pacientes con alveolitis

    Directory of Open Access Journals (Sweden)

    Yolanda Del Toro Gámez

    2014-09-01

    Full Text Available Se realizó un ensayo clínico de fase III en 118 pacientes con alveolitis, atendidos en la consulta estomatológica del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, para evaluar la eficacia del extracto fluido de Vimang® en el tratamiento de ellos. La muestra se dividió en 2 grupos (experimental y control, distribuidos aleatoriamente; los integrantes del primero, tratados con el mencionado extracto; y los del segundo, con Alvogyl. Los resultados del estudio fueron validados mediante el estadígrafo de Ji al cuadrado. Se concluye que el extracto fluido de Vimang® fue eficaz para eliminar la alveolitis en menor tiempo y sin reacciones adversas, por lo cual se recomendó generalizar su uso

  8. Clinical outcomes of temporary shunting for infants with cerebral pseudomeningocele.

    Science.gov (United States)

    Mattei, Tobias A; Sambhara, Deepak; Bond, Brandon J; Lin, Julian

    2014-02-01

    Although in the case of subdural collections temporary shunting has been suggested as a viable alternative for definitive drainage of the accumulated fluid until restoration of the normal CSF dynamics, there is no agreement on the best management strategy for pseudomeningocele. The authors performed a retrospective chart review in order to evaluate the clinical outcomes of infants temporarily shunted for pseudomeningocele without encephalocele at our institution (The University of Illinois at Peoria/Illinois Neurological Institute) in the period from 2004 to 2012. The epidemiological characteristics, clinical management, and final outcomes of such subpopulation were compared with a control group which received temporary shunting for subdural hematomas (SDH) during the same period. Four patients (100% male) ranging in age from 8.9 to 27.1 months (mean = 13.88) with pseudomeningocele and 17 patients (64.7% male) ranging in age from 1.9 to 11.8 months (mean = 4.15) with SDH were identified. Although the initial management included sequential percutaneous subdural tapping in 82% of the patients, all children ultimately failed such strategy, requiring either subdural-peritoneal (81% of the cases) or subgaleal-peritoneal (19% of the cases) shunting. The mean implant duration was 201 days for the pseudomeningocele group and 384 days for the SDH one. Mean post-shunt hospitalization was 2 days for patients with pseudomeningocele and 4 days for patients with SDH. There was no statistical difference in terms of complications, length of hospitalization post-shunting, or clinical outcomes between the patients with pseudomeningocele and those with SDH. Temporary shunting of infants with pseudo-meningocele constitutes a viable therapeutic alternative with favorable clinical outcomes and a low risk of shunt dependency similar to those of children with SDH.

  9. Cross-species functionality of pararetroviral elements driving ribosome shunting.

    Directory of Open Access Journals (Sweden)

    Mikhail M Pooggin

    Full Text Available BACKGROUND: Cauliflower mosaic virus (CaMV and Rice tungro bacilliform virus (RTBV belong to distinct genera of pararetroviruses infecting dicot and monocot plants, respectively. In both viruses, polycistronic translation of pregenomic (pg RNA is initiated by shunting ribosomes that bypass a large region of the pgRNA leader with several short (sORFs and a stable stem-loop structure. The shunt requires translation of a 5'-proximal sORF terminating near the stem. In CaMV, mutations knocking out this sORF nearly abolish shunting and virus viability. METHODOLOGY/PRINCIPAL FINDINGS: Here we show that two distant regions of the CaMV leader that form a minimal shunt configuration comprising the sORF, a bottom part of the stem, and a shunt landing sequence can be replaced by heterologous sequences that form a structurally similar configuration in RTBV without any dramatic effect on shunt-mediated translation and CaMV infectivity. The CaMV-RTBV chimeric leader sequence was largely stable over five viral passages in turnip plants: a few alterations that did eventually occur in the virus progenies are indicative of fine tuning of the chimeric sequence during adaptation to a new host. CONCLUSIONS/SIGNIFICANCE: Our findings demonstrate cross-species functionality of pararetroviral cis-elements driving ribosome shunting and evolutionary conservation of the shunt mechanism. We are grateful to Matthias Müller and Sandra Pauli for technical assistance. This work was initiated at Friedrich Miescher Institute (Basel, Switzerland. We thank Prof. Thomas Boller for hosting the group at the Institute of Botany.

  10. Treatment of Hydrocephalus Associated with Neurosarcoidosis by Multiple Shunt Placement

    OpenAIRE

    Kim, Sung Hoon; Lee, Sang Weon; Sung, Soon Ki; Son, Dong Wuk

    2012-01-01

    A 31-year-old man was admitted to our hospital due to hydrocephalus with neurosarcoidosis. Ventriculo-peritoneal shunting was performed in the right lateral ventricle with intravenous methylprednisolone. Subsequently, after 4 months, additional ventriculo-peritoneal shunting in the left lateral ventricle was performed due to the enlarged left lateral ventricle and slit-like right lateral ventricle. After 6 months, he was re-admitted due to upward gaze palsy, and magnetic resonance image showe...

  11. Transluminal angioplasty of a stenotic surgical splenorenal shunt

    International Nuclear Information System (INIS)

    Beers, B. van; Roche, A.; Cauquil, P.

    1988-01-01

    A stenosis of a side-to-side splenorenal shunt was treated by percutaneous angioplasty two years after the performance of the shunt. After dilatation, there was a fall of the splenorenal pressure gradient from 28 to 17 cm H 2 O and good transanastomotic flow was re-estabilshed. As in other arterial and venous territories, angioplasty may be an interesting alternative to surgery. (orig.)

  12. Arranque y operación a escala real de un sistema de tratamiento de lodos activos para aguas residuales de matadero

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    Sandra Liliana Pabón

    2009-05-01

    Full Text Available La investigación se desarrolló en la planta de tratamiento de aguas residuales de la empresa Frigorífico Frigofrontera Ltda., la cual está constituida por un sistema de tratamiento primario que incluye cribado, desarenado, trampa de grasas y sedimenta- ción, un reactor de lodo activo con recirculación para el tratamiento secundario y un filtro descendente como tratamiento ter- ciario. El caudal tratado en promedio es de 1,38 L/s; el reactor de lodo activo tiene un volumen de 144 m3, un tiempo de reten- ción celular de 2 días. Los niveles de oxígeno en el reactor son garantizados mediante la inyección de aire con equipos de alta eficiencia. Las concentraciones de los parámetros básicos del agua residual son: 5242,13 mg/L de DBO5; 9039,75 mg/L de DQO y 2972,69 mg/L de SS. El arranque de la planta de tratamiento se realizó durante el mes de febrero de 2006 y a partir de esa fecha ha operado continuamente, obteniéndose una eficiencia de remoción en carga de DBO5 de 89,73 %, 89,03 de DQO y 94,09 de SS. Los lodos generados por el proceso son tratados mediante cribado donde se separan los sólidos del a- gua residual. El líquido es retornado a los sedimentadotes y el sólido es compostado.

  13. Assessment Lumboperitoneal or Ventriculoperitoneal Shunt Patency by Radionuclide Technique: A Review Experience Cases

    International Nuclear Information System (INIS)

    Chiewvit, Sunanta; Nuntaaree, Sarun; Kanchaanapiboon, Potjanee; Chiewvit, Pipat

    2014-01-01

    Hydrocephalus-related symptoms that worsen after shunt placement may indicate a malfunctioning or obstructed shunt. The assessment of shunt patency and site of obstruction is important for planning of treatment. The radionuclide cerebrospinal fluid (CSF) shunt study provides a simple, effective, and low-radiation-dose method of assessing CSF shunt patency. The radionuclide CSF shuntography is a useful tool in the management of patients presenting with shunt-related problems not elucidated by conventional radiological examination. This article described the imaging technique of ventriculoperitoneal (VP) shunt and lumbar puncture (LP) shunt. The normal finding, abnormal finding of completed obstruction and partial obstruction is present by our cases experience. The radiopharmaceutical (Tc-99m diethylenetriaminepentaacetic acid) was injected via the reservoir for VP shunt and via lumbar puncture needle in subarachnoid space for LP shunt, then serial image in the head and abdominal area. The normal function of VP and LP shunt usually rapid spillage of the radioactivity in the abdominal cavity diffusely. The patent proximal tube VP shunt demonstrates ventricular reflux. The early image of patent LP shunt reveals no activity in the ventricular system contrast to distal LP shunt reveals early reflux of activity in the ventricular system. The completed distal VP and LP shunt obstruction show absence of tracer in the peritoneal area or markedly delayed appearance of abdominal activity. The partial distal VP and LP shunt obstruction recognized by slow transit or accumulation of tracer at the distal end or focal tracer in the peritoneal cavity near the tip of distal shunt. The images of the normal and abnormal CSF shunt as describe before are present in the full paper. Radionuclide CSF shuntography is a reliable and simple procedure for assessment shunt patency

  14. Resident-performed Ex-PRESS shunt implantation versus trabeculectomy.

    Science.gov (United States)

    Seider, Michael I; Rofagha, Soraya; Lin, Shan C; Stamper, Robert L

    2012-09-01

    To compare outcomes between resident-performed trabeculectomy and Ex-PRESS shunt implantation. A consecutive cohort of 36 Ex-PRESS shunt implantations and 57 trabeculectomies (1 eye/patient) performed by resident surgeons in their third year of ophthalmic training at the University of California, San Francisco and at the San Francisco Veterans Administration Hospital, under the supervision of a single glaucoma fellowship-trained surgeon were included in this study. Eyes with PRESS shunt groups at all follow-up points. On average, the Ex-PRESS shunt group required significantly less ocular antihypertensive medication to control IOP at 3 months postoperative (P=0.01), but no difference was found at 6 months or 1 year (all, P≥0.28). A larger proportion of Ex-PRESS shunt patients had good IOP control without medication at 3 (P=0.057) and 6 months (P=0.076) postoperatively. No difference was found in the rates of sight-threatening complications between groups (all, P≥0.22). In the hands of ophthalmology residents in their third year of training, the trabeculectomy and Ex-PRESS shunt implantation procedures perform comparably in terms of postoperative IOP control, reduction in patient dependence on ocular antihypertensive medications, and risk of complication in our population.

  15. PREACONDICIONAMIENTO DE Pinus engelmannii Carr. MEDIANTE DÉFICIT DE RIEGO EN VIVERO

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    Israel J. Ávila-Flores

    2014-01-01

    Full Text Available Con el objetivo de mejorar el preacondicionamiento de plántulas de Pinus engelmannii Carr. en vivero, se evaluaron tres frecuencias de riego: 48, 96 y 192 h. Las plántulas de ocho meses de edad se evaluaron durante 40 días. El ensayo se desarrolló en condiciones de invernadero en el vivero del Campo Experimental Valle del Guadiana del INIFAP. Los datos se analizaron mediante prueba de permutaciones. Los resultados muestran que el riego cada 48 h causó los mejores efectos en altura (7.70 cm, diámetro (4.38 mm, biomasa total (6.59 g e índice de calidad de Dickson (0.55. Por otro lado, el estrés hídrico originado por el tratamiento con riego cada 192 h (-1.22 MPa limitó el crecimiento de las plántulas; sin embargo, el índice de lignificación (26.63 fue significativa - mente mejor ( P = 0.0001 con esta frecuencia de riego. A pesar de haberse encontrado diferencias im - portantes ( P = 0.0001 en el potencial hídrico y en las variables morfológicas, no se encontró evidencia suficiente que permita definir un tratamiento absolutamente superior para mejorar el preacondiciona - miento de las plántulas en vivero. Por lo tanto, es recomendable evaluar dichos tratamientos durante mayor tiempo, además de evaluarlos en campo.

  16. Adaptación transcultural de la escala de incertidumbre de M. Mishel, en personas con insuficiencia renal crónica en tratamiento con hemodiálisis

    OpenAIRE

    Torres-Ortega, Clara-María

    2013-01-01

    [ES]Disponer de la escala de Incertidumbre de Mishel, en el contexto español, puede aportar a las enfermeras las claves para el conocimiento del enfermo renal en tratamiento con hemodiálisis. El objetivo de este estudio ha sido realizar una adaptación transcultural de la escala de Incertidumbre de Mishel en pacientes de hemodiálisis de Jaén. Se realizó una adaptación de la escala mediante traducción- retrotraducción y se calculó la validez de contenido mediante consenso de expertos. Par...

  17. Mercurius solubilis en el tratamiento de pacientes con estomatitis aftosa recurrente

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    María Isabel Aguilar Vallejo

    2015-01-01

    Full Text Available Se realizó ensayo clinicoterapéutico controlado, de fase II B, de 112 pacientes con estomatitis aftosa recurrente, atendidos en la Clínica Estomatológica "José Luis Tassende" de Santiago de Cuba, desde enero hasta diciembre de 2013, para evaluar la eficacia del Mercurius solubilis en el tratamiento de estos. La muestra fue distribuida de forma aleatoria, mediante orden de llegada, en 2 grupos (uno de estudio y uno control, con 56 integrantes cada uno. Los primeros fueron tratados con Mercurius solubilis y los segundos con los remedios homeopáticos habituales. Para la validación estadística de la información obtenida se emplearon el porcentaje, el test de Ji al cuadrado, con 95 % de confiabilidad, y la probabilidad exacta de Fisher. Entre los grupos estudiados no existieron diferencias significativas en relación con la remisión de la intensidad del dolor, la recuperación de la integridad epitelial y la curación al tercer, quinto y séptimo días de tratamiento. Se demostró que esta terapia alternativa fue tan eficaz como el bórax

  18. Miltefosina versus antimoniato de meglumina en el tratamiento de la leishmaniasis mucosa

    Directory of Open Access Journals (Sweden)

    María F García Bustos

    2014-10-01

    Full Text Available El tratamiento convencional para la leishmaniasis tegumentaria es el antimoniato de meglumina, el cual presenta falla terapéutica creciente, producción de efectos adversos graves, y necesidad de administración parenteral, justificando la búsqueda de alternativas terapéuticas. Presentamos aquí los resultados preliminares de un ensayo clínico de fase II en pacientes con leishmaniasis mucosa, en el que se comparó la eficacia de miltefosina por vía oral con respecto a la del compuesto antimonial. La evaluación de la respuesta a los tratamientos se realizó mediante un seguimiento con videofibroscopia nasofaríngea, utilizándose un score de gravedad de lesiones mucosas para aplicar en cada momento del seguimiento de los pacientes. No se encontraron hasta ahora diferencias significativas entre el número de pacientes curados con miltefosina o con la quimioterapia convencional. Los resultados favorables de este trabajo sugieren que miltefosina podría constituir una alternativa terapéutica efectiva y segura en la región.

  19. Tratamiento contable de las stock options según la normativa contable internacional

    Directory of Open Access Journals (Sweden)

    Elena Merino Madrid

    2010-01-01

    Full Text Available La retribución que hacen las empresas a sus directivos y empleados mediante la entrega de opciones sobre acciones (stock options se ha convertido en una práctica habitual en muchos países del mundo. Hasta fechas recientes no existía un consenso sobre el tratamiento contable que se debía dar a este tipo de transacciones; sin embargo, en la actualidad parece que tal consenso se ha alcanzado al exigir tanto el International Accounting Standards Board (iasb como el Financial Accounting Standards Board (fasb, en la International Financial Reporting Standard, ifrs 2 (niif 2, Norma Internacional de Información Financiera y Statement of Financial Accounting Standards (sfas 123 (R respectivamente, que se reconozca la remuneración basada en la entrega de opciones sobre acciones como un gasto en los estados financieros. El objetivo de este trabajo es analizar el tratamiento contable aplicable de acuerdo con la normativa contable internacional o de información financiera (nic/niif.

  20. Criocirugía en el tratamiento de pacientes con hiperplasia papilomatosa del paladar

    Directory of Open Access Journals (Sweden)

    Gladys Aída Estrada Pereira

    2015-10-01

    Full Text Available Se efectuó un estudio descriptivo y transversal de 40 pacientes con prótesis removibles, tratados en la consulta estomatológica del Policlínico de Especialidades del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" de Santiago de Cuba, desde marzo de 2013 hasta igual periodo de 2015, a fin de evaluar los resultados de la criocirugía en el tratamiento de afectados por hiperplasia papilomatosa del paladar. Por su gran poder refrigerante se utilizó nitrógeno líquido en la remoción de esta enfermedad. Las propiedades anestésica, antimicrobiana, antiinfecciosa, cicatrizante e inmunológica de esta modalidad crioquirúrgica garantizaron la curación rápida de los tejidos bucales lesionados, que fueron reparados y reepitelizados entre los 7 y 14 días de aplicada la técnica. La valoración de la crioterapia se estableció mediante la medición del tiempo de congelación y descongelación (20-30 segundos y 91-120, respectivamente, la cual resultó beneficiosa por ser inocua, sencilla, atraumática y eficaz en el tratamiento de esta afección

  1. Diagnostico y tratamiento de la myasthenia gravis estudio de una poblacion hospitalaria

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    Roberto D. Rey

    1990-09-01

    Full Text Available Durante la observacion de 50 pacientes con Myasthenia gravis entre los anos 1974 y 1987 se encontro un predominio del sexo femenino en la proporcion de 2,5 a 1 y mayor frecuencia de presentacion en Ias 3ª y 5ª décadas de la vida. Luego de la evaluacion clínica, el diagnóstico fué confirmado mediante: (1 prueba dei edrofonio, (2 estímulo nervioso repetitivo, (3 dosaje de anticuerpos antirreceptor colinérgico y (4 transferencia pasiva del suero al raton con ulterior niedicion de la amplitud de mepp's. La positividad diagnostica vario entre el 90 y el 100%, segun el tipo de prueba empleada. El estúdio radiológico del timo fué hecho con neumomediastinografía. obteniendose excelente correlación con la descripcion histológica de la glândula, y con tomografia computada, que demostro menor eficiência diagnostica. El tratamiento fué implementado en base a anticolinesterásicos, timectomía y corticoterapia inmunosupresora, evidenciandose con esta última mejores resultados. Nueve pacientes desarrollaron peoria transitória del cuadro muscular al iniciarse el tratamiento esteroideo, 6 de ellos exhibieron posteriormente evolucion desfavorable. Esta observacion aparenta tener valor pronóstico en la evolucion de la MG.

  2. Etiología, prevención y tratamiento de la delincuencia sexual

    Directory of Open Access Journals (Sweden)

    Ana Martínez-Catena

    2016-01-01

    Full Text Available En este trabajo se analiza el conocimiento actual sobre etiología, prevención y tratamiento de la delincuencia sexual. Diferentes experiencias infantiles traumáticas, como graves carencias afectivas, desatención familiar, crianza inapropiada y victimización sexual pueden contribuir al inicio de conductas de abuso o agresión sexual en algunos varones. Posteriormente, tales comportamientos delictivos pueden consolidarse en asociación con otros factores de riesgo personales, incluyendo graves déficits en empatía y firmes distorsiones cognitivas y justificaciones del delito. Dada esta diversidad de factores de riesgo, se considera aquí imprescindible que la agresión sexual se prevenga ya desde la infancia y la adolescencia, mediante intervenciones educativas en los contextos de la familia, la escuela y la justicia de menores. Aun así, cuando se producen delitos sexuales graves, sus autores van a ser probablemente detenidos y encarcelados. De ahí la necesidad también de aplicar tratamientos en las prisiones, que favorezcan la mejora terapéutica de los participantes y, a la postre, reduzcan su riesgo de reincidencia.

  3. Programmable shunts and headphones: Are they safe together?

    Science.gov (United States)

    Spader, Heather S; Ratanaprasatporn, Linda; Morrison, John F; Grossberg, Jonathan A; Cosgrove, G Rees

    2015-10-01

    Programmable shunts have a valuable role in the treatment of patients with hydrocephalus, but because a magnet is used to change valve settings, interactions with external magnets may reprogram these shunts. Previous studies have demonstrated the ability of magnetic toys and iPads to erroneously reprogram shunts. Headphones are even more ubiquitous, and they contain an electromagnet for sound projection that sits on the head very close to the shunt valve. This study is the first to look at the magnetic field emissions of headphones and their effect on reprogrammable shunt valves to ascertain whether headphones are safe for patients with these shunts to wear. In this in vitro study of the magnetic properties of headphones and their interactions with 3 different programmable shunts, the authors evaluated Apple earbuds, Beats by Dr. Dre, and Bose QuietComfort Acoustic Noise Cancelling headphones. Each headphone was tested for electromagnetic field emissions using a direct current gaussmeter. The following valves were evaluated: Codman Hakim programmable valve, Medtronic Strata II valve, and Aesculap proGAV. Each valve was tested at distances of 0 to 50 mm (in 5-mm increments) from each headphone. The exposure time at each distance was 1 minute, and 3 trials were performed to confirm results at each valve setting and distance. All 3 headphones generated magnetic fields greater than the respective shunt manufacturer's recommended strength of exposure, but these fields did not persist beyond 5 mm. By 2 cm, the fields levels were below 20 G, well below the Medtronic recommendation of 90 G and the Codman recommendation of 80 G. Because the mechanism for the proGAV is different, there is no recommended gauss level. There was no change in gauss-level emissions by the headphones with changes in frequency and amplitude. Both the Strata and Codman-Hakim valves were reprogrammed by direct contact (distance 0 mm) with the Bose headphones. When a rotation component was added, all

  4. Abordaje quirúrgico combinado como alternativa mínimamente invasiva en el tratamiento de la Gangrena de Fournier

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    Juan C. Larsson

    Full Text Available Introducción y Objetivo: La Gangrena de Fournier es una fascitis necrotizante del perineo y genitales externos que presenta una morbi-mortalidad elevada debido a su diagnóstico tardío y a las comorbilidades comúnmente asociadas en estos pacientes. Terapias adyuvantes como la presión negativa y los sustitutos dérmicos, han mostrado eficacia en el tratamiento de pacientes con defectos complejos de tejidos blandos y forman parte de nuestro protocolo de tratamiento actual. El objetivo de este estudio es describir la utilidad de nuestro abordaje quirúrgico combinado en la Gangrena de Fournier. Material y método. Presentamos un trabajo retrospectivo en el que describimos 3 pacientes varones tratados por defectos complejos de tejidos blandos secundarios a Gangrena de Fournier mediante nuestro protocolo de tratamiento quirúrgico que comprende: una primera etapa de control de la herida mediante desbridamientos agresivos y terapia de presión negativa, seguido de una etapa de contemporización que combina la utilización de matriz dérmica y terapia de presión negativa, y por último una etapa de reconstrucción para dar cobertura final al defecto. Resultados. Los 3 pacientes presentaron compromiso extenso de la región perineal y de las regiones adyacentes incluyendo genitales externos y miembros inferiores. Todos fueron tratados con éxito mediante el abordaje que describimos, sin secuelas funcionales y manteniendo el contorno a la región. Conclusiones. El abordaje utilizado en nuestros 3 casos representó una alternativa terapéutica eficaz. La combinación de terapia de presión negativa y matriz dérmica nos permitió un manejo simplificado de la herida y una reconstrucción con mayor seguridad y mínima morbilidad mediante cierre primario de las heridas y avance de colgajos locales.

  5. Enfermería infantil y dislexia. Hacia un tratamiento definitivo. Revisión sistemática

    Directory of Open Access Journals (Sweden)

    Campos Palomo, Álvaro David

    2013-04-01

    Full Text Available La dislexia es una dificultad en la lectura que impide su correcta comprensión. Se trata de un desorden que pone mucha resistencia a las intervenciones del logopeda. El abordaje de este tipo de pacientes por parte del terapeuta del lenguaje, en ningún caso pasa por el tratamiento farmacológico del mismo, motivo por el cual, se plantea en el presente trabajo encontrar estudios, trabajos e investigaciones que avalen el uso de medicamentos en la mejoría de la dislexia, o dicho de otra manera, averiguar si existe algún fármaco para uso exclusivo en este trastorno o que lo mejore sustancialmente. Mediante una exhaustiva revisión sistemática en la Biblioteca Virtual del Sistema Sanitario Público de Andalucía, se llega a la conclusión de que no existe ningún fármaco que solucione el trastorno y que solo existen tratamientos coadyuvantes a la terapia logopédica, tratamientos que, todo enfermero infantil, debería conocer a modo de reciclaje en esta dificultad.

  6. SISTEMA DE ELECTROCOAGULACIÓN COMO TRATAMIENTO DE AGUAS RESIDUALES GALVÁNICAS

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    Nelly Bibiana Morales Posada

    2010-01-01

    Full Text Available El presente artículo muestra la segunda fase del proyecto "Implementación y evaluación de un sistema piloto de electrocoagulación como tratamiento de aguas residuales con fines de reuso. Estudio de caso: aguas residuales industriales de origen galvánico". Para su desarrollo, se valoró y optimizó un prototipo existente en la Universidad, a partir de ensayos realizados en aguas residuales con contenido de metales, implementando un porcentaje mayor al 47% para la remoción de metales pesados como Cr+6, Pb y Zn de tales aguas, mediante proceso de electrocoagulación. Para el estudio, se utilizaron 10L de agua residual correspondientes al vertimiento de la empresa Compañía Eléctrica Ltda. Los análisis se hicieron, mediante la confrontación de parámetros de Cu, Cr, Cr+6, Ni, Pb y Zn, antes y después del tratamiento de electrocoagulación. Se obtuvo una reducción en Cr del 51.65%, donde el valor arrojado está por debajo de los estándares establecidos en materia de vertimientos (Res. No 1074 28 Oct. 1997, Ni del 18.09%, Pb del 50%, Zn del 47.37%, los cuales a pesar de la remoción producida, tienen valores superiores a lo estipulado en esta normativa. El Cu tuvo un aumento del 519.48%, debido a la placa empleada para el tratamiento. Los valores promedio obtenidos durante los ensayos fueron: pH: 3.18, conductividad: 21.83 mS/m y temperatura: 48.5 ºC. A pesar de que los valores de las variables y los parámetros no se encuentran dentro de los rangos generalmente expuestos por la literatura consultada para sistemas de electrocoagulación con aguas residuales, se obtuvo una reducción relevante en cuanto a la presencia de los metales estudiados.

  7. Tratamiento quirúrgico de las colecciones agudas y crónicas del pericardio

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    Orestes Noel Mederos Curbelo

    Full Text Available Introducción: las colecciones agudas o crónicas del pericardio con frecuencia producen una compresión del corazón que en los casos crónicos conlleva invalidez y, en los agudos, peligro de muerte por taponamiento cardíaco. Objetivo: caracterizar a los pacientes intervenidos quirúrgicamente en el Hospital Universitario "Comandante Manuel Fajardo" entre 1995 y 2012 a causa de colecciones pericárdicas. Métodos: se realizó un estudio descriptivo transversal con los pacientes atendidos quirúrgicamente en dicha institución por colecciones del pericardio. Constituyeron el universo 24 pacientes: 22 con colecciones agudas y 2 con colecciones crónicas. Resultados: la causa más frecuente de los derrames agudos fue la pericarditis aguda idiopática (25 %. Las colecciones crónicas fueron por pericarditis fibrosa de causa idiopática en el 100 % de los enfermos. La intervención realizada fue la resección del pericardio y el drenaje de las colecciones agudas mediante toracotomía izquierda o por vía preperitoneal subxifoidea. En las colecciones de origen maligno se realizó la resección pericárdica con fines paliativos y, en los derrames por lesión traumática del corazón, la sutura de este órgano fue el tratamiento quirúrgico empleado en todos los casos. En las pericarditis constrictivas, la pericardiectomía radical fue el tratamiento empleado en el 100 % de los casos. Conclusiones: el tratamiento quirúrgico en las colecciones agudas y crónicas del pericardio permite drenar el contenido por una ventana pericárdica obtenida por toracoscopia o por vía preperitoneal subxifoidea, mientras que la toracotomía izquierda es útil en las emergencias. En los derrames crónicos con fibrosis y síntomas de insuficiencia cardíaca, la pericardiectomía radical mediante esternotomía media ofrece los mejores resultados.

  8. Outcomes of systemic to pulmonary artery shunts in patients weighing less than 3 kg: analysis of shunt type, size, and surgical approach.

    Science.gov (United States)

    Myers, John W; Ghanayem, Nancy S; Cao, Yumei; Simpson, Pippa; Trapp, Katie; Mitchell, Michael E; Tweddell, James S; Woods, Ronald K

    2014-02-01

    To evaluate outcomes of systemic to pulmonary artery shunts (SPS) in patients weighing less than 3 kg with regard to shunt type, shunt size, and surgical approach. Patients weighing less than 3 kg who underwent modified Blalock-Taussig or central shunts with polytetrafluoroethylene grafts at our institution from January 1, 2000, to May 31, 2011, were reviewed. Patients who had undergone other major concomitant procedures were excluded from the analysis. Primary outcomes included mortality (discharge mortality and mortality before next planned palliative procedure or definitive repair), cardiac arrest and/or extracorporeal membrane oxygenation (ECMO), and shunt reintervention. In this cohort of 80 patients, discharge survival was 96% (77/80). Postoperative cardiac arrest or ECMO occurred in 6/80 (7.5%), and shunt reintervention was required in 14/80 (17%). On univariate analysis, shunt reintervention was more common in patients with 3-mm shunts (11/30, 37%) compared with 3.5-mm (2/36, 6%) or 4-mm shunts (1/14, 7%) (P approach and cardiac arrest/ECMO or mortality. Multiple logistic regression demonstrated that a shunt size of 3 mm (P = .019) and extracardiac anomaly (P = .047) were associated with shunt reintervention, whereas no variable was associated with cardiac arrest/ECMO or mortality. In this high-risk group of neonates weighing less than 3 kg at the time of SPS, survival to discharge and the next planned surgical procedure was high. Outcomes were good with the 3.5- and 4-mm shunts; however, shunt reintervention was common with 3-mm shunts. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  9. A Modified Shunt System for the Management of Pyogenic Hydrocephalus

    Directory of Open Access Journals (Sweden)

    Abdul Naveed Khan

    2017-01-01

    Full Text Available BACKGROUND: To describe the structure and efficacy of a modified cerebrospinal fluid (CSF shunt system with Bhatti CSF access chamber and ventriculoperitoneal shunt, for the management of hydrocephalus associated with pyogenic ventriculitis. METHODS: This was an observational study performed at the National Medical Center and Ziauddin Medical University, Karachi, Pakistan. Chemically bonded Bhatti CSF access chamber and ventriculoperitoneal shunt was inserted into 443 patients with hydrocephalus and pyogenic ventriculitis to allow injection of antibiotics into the lateral ventricles. RESULTS: In all patients, symptoms and signs of hydrocephalus were relieved immediately after shunt insertion and infection brought under control within two weeks of intraventricular injection of antibiotics (vancomycin or linezolid, via the CSF access chamber. In two patients peritoneal catheter was blocked by a precipitate of vancomycin. Reduction in the dose of intraventricular vancomycin from 50mg to 20mg and increased dilution (additional 2ml of 0.9% N/S solution prevented recurrence of this complication. All patients recovered from ventriculitis within two weeks of initiating this treatment. Follow-up was from 3 months to 2 years to monitor continued relief of hydrocephalus and absence of recurrence of ventriculitis. CONCLUSION: Bhatti CSF access chamber and the ventriculoperitoneal shunt is the only system available at present that fulfills the management of hydrocephalus associated with pyogenic ventriculitis. It provides continuous internal drainage of CSF combined with access to the ventricles for injection of antibiotics.

  10. Determining the optimal portal blood volume in a shunt before surgery in extrahepatic portal hypertension

    Directory of Open Access Journals (Sweden)

    Yurchuk Vladimir A

    2016-04-01

    Full Text Available The aim of the study: To determine the necessary shunt diameter and assess the optimal portal blood volume in a shunt in children with extrahepatic portal hypertension before the portosystemic shunt surgery. Changes in the liver hemodynamics were studied in 81 children aged from 4 to 7 years with extrahepatic portal hypertension. We established that it is necessary to calculate the shunt diameter and the blood volume in a shunt in patients with extrahepatic portal hypertension before the portosystemic shunt surgery. It allows us to preserve the hepatic portal blood flow and effectively decrease the pressure in the portal system. Portosystemic shunt surgery in patients with extrahepatic portal hypertension performed in accordance with the individualized shunt volume significantly decreases portal pressure, preserves stable hepatic hemodynamics and prevents gastro-esophageal hemorrhage.

  11. Post V-P shunt surgical site EDH an uncommon complication: case report

    Directory of Open Access Journals (Sweden)

    Garg Manish

    2017-06-01

    Full Text Available ventriculoparitoneal shunt is well established modality of treatment for hydrocephalous. Complication of v-p shunt are also mentioned in literature like shunt infection shunt migration etc [8]. Here we are describing a rare complication of vp shunt which barely mentioned in literature. A 22 yr male admitted with complain of headache & vomiting patient was diagnosed to have tubercular meningities with hydrocephalous. Patient planned for ventriculoparietoneal shunt surgery and vp shunt was done. On 3rd post-surgery day patient develop weakness in Left side of body. Urgent ncct head done which showed EDH at surgical site. Immediate craniotomy and evacuation of hematoma was done patient improved and discharged. Thus we are discussing the importance of meticulous surgery for v-p shunt, post op ct scan and treatment.

  12. Patrones de consumo de heroína en una cárcel de la frontera norte de México: barreras de acceso a tratamiento

    Directory of Open Access Journals (Sweden)

    Cravioto Patricia

    2003-01-01

    Full Text Available OBJETIVO: Describir la prevalencia del consumo de heroína, los patrones de inicio, el alto consumo y la dependencia a esta sustancia e identificar barreras que impidan a los adictos acudir a tratamiento. MATERIAL Y MÉTODOS: El estudio se realizó en la cárcel de Ciudad Juárez, Chihuahua, México, entre abril y junio de 2000; los participantes se obtuvieron a través de un muestreo aleatorio simple, partiendo del censo del penal. Se identificaron las barreras al tratamiento, estimadas mediante un modelo de regresión logística. RESULTADOS: La prevalencia de consumo de heroína en los últimos seis meses fue de 26.4%; de 25.3% para usuarios fuertes; 95% fueron dependientes. El promedio de la edad de inicio del consumo fue a los 21 años. El modelo multivariado mostró que baja escolaridad, abstinencia, sobredosis, enfermedades crónicas y tiempo de exposición son barreras que impiden solicitar tratamiento. CONCLUSIONES: Las implicaciones de los resultados se discuten en función de aplicarlos para implantar programas de tratamiento en las cárceles.

  13. TRATAMIENTO DE AGUAS RESIDUALES EN LA URBANIZACIÓN CIUDAD POLITÉCNICA, CANTÓN BOLÍVAR, PROVINCIA DE MANABÍ

    Directory of Open Access Journals (Sweden)

    Ángel Mariano Montesdeoca Zambrano

    2013-06-01

    Full Text Available La urbanización Ciudad Politécnica está en fase de implementación, por lo que es necesario definir el suministro de los servicios básicos tales como agua potable, energía eléctrica, alcantarillado de aguas lluvia, de aguas servidas, etc. El presente estudio tuvo cómo objetivo diseñar una planta de tratamiento de las aguas residuales que se generarán, a futuro, en Ciudad Politécnica, que cumpla con las normas vigentes en el Ecuador. Se realizó una revisión de las leyes y normas vigentes para efluentes de plantas de tratamiento de aguas residuales, planificación urbanística, disponibilidad de terreno para la ubicación de la planta de tratamiento; determinándose que el proceso de lodos activados mediante reactores secuenciales por tandas, es el mejor sistema para el tratamiento de aguas residuales de comunidades pequeñas que, gran parte del día, están fuera de su domicilio y por lo tanto, generan bajo volumen e intermitente flujo de aguas residuales. La línea base permitió realizar los cálculos de ingeniería y finalmente, el diseño hidráulicosanitario y ambiental de la planta.

  14. Factores predictivos de la no adherencia al tratamiento de la tuberculosis en municipios del Área Metropolitana de Buenos Aires, Argentina

    Directory of Open Access Journals (Sweden)

    Silvina Arrossi

    2012-01-01

    Full Text Available El objetivo de este estudio fue identificar las características sociodemográficas de los pacientes y las características del tratamiento que influyen en la no-adherencia al tratamiento antituberculoso. Se realizó un estudio de corte transversal, en el Área Metropolitana de Buenos Aires. Se encuestaron 38 pacientes que no adhirieron al tratamiento y 85 pacientes que adhirieron al tratamiento, diagnosticados durante el año 2007, residentes y atendidos en hospitales de municipios seleccionados. El análisis de los factores se llevó a cabo mediante regresión logística. Los resultados indican que los pacientes con viviendas sin agua, tuvieron 3 veces más probabilidad de no adherencia (OR=2,8; IC95% 1,1-6,9. Asimismo, los pacientes que realizaban los controles en un hospital tuvieron 3 veces más riesgo de no adherir que los que los realizaban en centros de atención primaria (OR=3,2; IC95% 1,1-8,9. Estos resultados permiten delinear un perfil de paciente en riesgo de no-adherencia, caracterizado por estar en condiciones de pobreza, y con dificultades de acceso a la atención de su salud.

  15. Costo efectividad del tratamiento de denervación renal vs. mejor tratamiento médico estándar disponible en el control de la hipertensión resistente en Colombia

    Directory of Open Access Journals (Sweden)

    Juan E. Valencia

    2014-06-01

    Full Text Available Objetivo: Mediante la adaptación a Colombia del modelo realizado por BresMed y previo análisis de transferibilidad, se realizó un análisis de costo-efectividad del tratamiento de denervación renal vs. mejor tratamiento estándar en el control de la hipertensión resistente y los eventos cardiovasculares relacionados. Métodos: Se construyó un modelo de Markov con 32 estados de salud y siete resultados finales: accidente cerebrovascular, infarto del miocardio, enfermedad coronaria, falla cardiaca, enfermedad renal crónica terminal, mortalidad cardiovascular y muerte. Se consideró un horizonte de toda la vida, la perspectiva desde el pagador y una tasa de descuento del 3%. Para el cálculo de las probabilidades de sufrir eventos se utilizaron las ecuaciones de riesgo de Framingham y las efectividades se tomaron del estudio clínico SYMPLICITY HTN-2. Los costos se extrajeron del entorno local y las tasas de mortalidad del Observatorio global de salud de la Organización Mundial de la Salud. Los resultados incluyeron los costos de cada alternativa de tratamiento, así como los años de vida ajustados a calidad ganados. Se realizaron análisis determinístico y probabilístico. Resultados: El tratamiento de denervación renal produjo 12,48 años de vida ajustados a calidad ganados a un costo de US $46.509 vs. 11,68 años de vida ajustados a calidad ganados del mejor tratamiento estándar a un costo de US $41.199, con un costo incremental por años de vida ajustados a calidad ganados de US $6.612. Tanto el análisis de sensibilidad univariado como el probabilístico, mostraron la robustez de los resultados. Conclusiones: El tratamiento de denervación renal, con un costo incremental por años de vida ajustados a calidad ganados de $6.612, muy por debajo de 1 PIB per cápita de Colombia, mostró ser altamente costo-efectivo.

  16. Tratamientos psicologicos en la hipertension arterial

    Directory of Open Access Journals (Sweden)

    Lilia Mabel Labiano

    2002-01-01

    Full Text Available En vista que las evidencias obtenidas acerca del beneticio percibido por los sujetos hipertensos leves con los tratamientos farmacológicos resultan conflictivas, se ha considerado importante para estos pacientes, la aplicación de intervenciones psicológicas y comportamentales. Se presentan en este trabajo, distintos tipos de tratamientos psicológicos que en los últimos años han demostrado su efectividad en la reducción de la presión arterial esencial. Se consideraron importantes para individuos hipertensos leves, la implementación de procedimientos tales como: la relajación, el entrenamiento autógeno, la retroalimentación biológica, la meditación, el Hatha -Yoga, la reestructuración cognitiva y el entrenamiento en habilidades sociales, porque contribuyeron a la reducción, no solo de los niveles hipertensivos sino también de los efectos adversos de la medicación farmacológica que afectan la calidad de vida. Es necesario evidentemente que el individuo generalice las estrategias aprendidas en el contexto clínico-experimental, a los diferentes contextos vitales. La técnica empleada, las características del terapeuta y el tipo de personalidad del paciente son componentes principales en la determinación del éxito del tratamiento. La práctica diaria sostenida fuera del contexto clínico, es un elemento de crucial importancia para el mantenimiento de la mejoría lograda.

  17. Shunted-Josephson-junction model. II. The nonautonomous case

    DEFF Research Database (Denmark)

    Belykh, V. N.; Pedersen, Niels Falsig; Sørensen, O. H.

    1977-01-01

    The shunted-Josephson-junction model with a monochromatic ac current drive is discussed employing the qualitative methods of the theory of nonlinear oscillations. As in the preceding paper dealing with the autonomous junction, the model includes a phase-dependent conductance and a shunt capacitance....... The mathematical discussion makes use of the phase-space representation of the solutions to the differential equation. The behavior of the trajectories in phase space is described for different characteristic regions in parameter space and the associated features of the junction IV curve to be expected are pointed...... out. The main objective is to provide a qualitative understanding of the junction behavior, to clarify which kinds of properties may be derived from the shunted-junction model, and to specify the relative arrangement of the important domains in the parameter-space decomposition....

  18. Secondary pediatric encephalocele after ventriculosubgaleal shunting for posthemorrhagic hydrocephalus.

    Science.gov (United States)

    Seeburg, Daniel; Ahn, Edward; Huisman, Thierry

    2014-08-01

    Intraventricular hemorrhage and posthemorrhagic hydrocephalus continue to be common complications in very low-birth-weight premature infants, often requiring ventricular shunting for cerebrospinal fluid diversion. We report on two infants with posthemorrhagic hydrocephalus that developed a secondary encephalocele after ventriculosubgaleal shunting. Encephaloceles can act as a source of seizure activity and can result in various additional complications including meningitis, abscess formation, and infarction of herniated brain parenchyma. With continued improvements in neonatal intensive care, the survival of infants with significant medical comorbidities-including those that develop posthemorrhagic hydrocephalus requiring ventricular shunting-continues to increase. It is thus important for the radiologist and treating physician to be aware of this rare, potential complication. Georg Thieme Verlag KG Stuttgart · New York.

  19. Forty years of shunt surgery at Rigshospitalet, Denmark

    DEFF Research Database (Denmark)

    Mansson, Philip Kofoed; Johansson, Sofia; Ziebell, Morten

    2017-01-01

    Objective The objective of this study is to review our experience of shunt surgery by investigating 40years of development in terms of rates of revision and infection, shunt survival and risk factors. Design and participants Medical records and operative reports were reviewed retrospectively...... for all patients who underwent primary shunt surgery at our department in the years 2010 to 2012. All results were compared with a previous study from our department. A mixed population consisting of 434 patients was included. Adults (≥15years) accounted for 89.9% of all patients and the mean follow.......1-54.9). Within 4weeks postoperatively, 3.2% had an infection and overall infection rate was 5.5%. Short duration of surgery and the use of antibiotic prophylaxis were associated with a lower risk of infection. The most frequent causes of revision were valve defects (18.4%) and proximal defects or obstructions...

  20. Shunt impedance of spiral loaded resonant rf cavities

    International Nuclear Information System (INIS)

    Peebles, P.Z. Jr.; Parvarandeh, M.

    1975-01-01

    Based upon a treatment of the spiral loaded resonant radio frequency cavity as a shorted quarter-wave transmission line, a model for shunt impedance is developed. The model is applicable to loosely wound spirals in large diameter containers. Theoretical shunt impedance is given for spirals wound from tubing of circular or rectangular cross section. The former produces higher shunt impedance. Measurements made at Oak Ridge National Laboratory on 17 copper cavities are described which support the theoretical results. Theoretical results are also compared to data from twenty-three additional cavities measured at Los Alamos Scientific Laboratory. It is shown that the theoretical function forms a useful means of interpreting the quality of constructed cavities. (author)

  1. Treatment of hydrocephalus associated with neurosarcoidosis by multiple shunt placement.

    Science.gov (United States)

    Kim, Sung Hoon; Lee, Sang Weon; Sung, Soon Ki; Son, Dong Wuk

    2012-09-01

    A 31-year-old man was admitted to our hospital due to hydrocephalus with neurosarcoidosis. Ventriculo-peritoneal shunting was performed in the right lateral ventricle with intravenous methylprednisolone. Subsequently, after 4 months, additional ventriculo-peritoneal shunting in the left lateral ventricle was performed due to the enlarged left lateral ventricle and slit-like right lateral ventricle. After 6 months, he was re-admitted due to upward gaze palsy, and magnetic resonance image showed an isolated fourth ventricle with both the inlet and outlet of fourth ventricle obstructed by recurrent neurosarcoidosis. Owing to the difficulty of using an endoscope, we performed neuronavigator-guided ventriculo-peritoneal shunting via the left lateral transcerebellar approach for the treatment of the isolated fourth ventricle with intravenous methyl prednisolone. The patient was discharged with improved neurological status.

  2. Tratamiento quirúrgico de la hernia discal lumbosacra en el hospital "Ernesto Guevara de la Serna"

    Directory of Open Access Journals (Sweden)

    Henry López Jimenez

    2015-11-01

    Full Text Available Fundamento: la hernia discal lumbosacra tiene una alta prevalencia en el mundo y en Cuba. El resultado del tratamiento quirúrgico tiene gran impacto individual, familiar, laboral, social y económico.Objetivo: describir los resultados del tratamiento quirúrgico de la hernia discal en pacientes operados en el Hospital General Docente “Dr. Ernesto Guevara de la Serna”, en el período de tiempo comprendido entre enero de 2005 y mayo de 2015.Métodos: se realizó una investigación observacional descriptiva, retrospectiva, en el referido hospital de la provincia de Las Tunas y durante el período de tiempo declarado antes. Se utilizaron fuentes de recolección de datos secundarias, como expedientes clínicos e informes operatorios. Se confeccionaron registros para la recolección de datos continuos. Se creó una base de datos para el procesamiento de la información que se analizó mediante la estadística descriptiva, utilizando el valor porcentual para reportar los resultados.Resultados: la hernia discal fue más frecuente en el sexo masculino y en el grupo de edad de 40 - 49 años. El nivel discal más afectado fue L4-L5, la raíz de S1 fue la más comprimida y predominó la hernia posterolateral. Primaron los resultados satisfactorios en el tratamiento quirúrgico y las complicaciones más frecuentemente encontradas fueron la discitis y fibrosis postquirúrgica.Conclusiones: se logró describir los principales resultados del tratamiento quirúrgico de la hernia discal en pacientes operados en el Hospital General Docente “Dr. Ernesto Guevara de la Serna”, durante los últimos diez años.

  3. Tratamiento cognitivo-conductual en la menopausia

    OpenAIRE

    Gutiérrez Gómez-Calcerrada, Sonia

    2012-01-01

    Dada la carencia de alternativas terapéuticas a la terapia hormonal sustitutiva que aborden la sintomatología menopáusica y los diferentes aspectos que influyen en esta etapa, y la incapacidad de los tratamientos hormonales para la remisión de la sintomatología psicológica en la etapa climatérica, se plantea como objetivo de la presente investigación: establecer un programa de intervención cognitivo-conductual eficaz para mujeres climatéricas con sintomatología menopáusica.

  4. Tratamiento de aguas contaminadas con cianuro

    OpenAIRE

    Aguilar Roca, Fernando; Aguilar Roca, Fernando; Aguilar Roca, Fernando

    2011-01-01

    El presente trabajo “Tratamiento de aguas contaminadas con cianuro" se divide en tres partes: química del contaminante, procesos de descontaminación estudiados y un procedimiento basado en una investigación reciente. Principales propiedades físico-químicas del ion cianuro y de sus principales compuestos, cianuros simples o complejos, en medio acuoso. Métodos y procesos que existen para la descontaminación de efluentes cianurados, tanto los que se dan de forma natural (degradación natu...

  5. Treatment of Portosystemic Shunt Myelopathy with a Stent Graft Deployed through a Transjugular Intrahepatic Route

    International Nuclear Information System (INIS)

    Jain, Deepak; Arora, Ankur; Deka, Pranjal; Mukund, Amar; Bhatnagar, Shorav; Jindal, Deepti; Kumar, Niteen; Pamecha, Viniyendra

    2013-01-01

    A case of surgically created splenorenal shunt complicated with shunt myelopathy was successfully managed by placement of a stent graft within the splenic vein to close the portosystemic shunt and alleviate myelopathy. To our knowledge, this is the first report of a case of shunt myelopathy in a patient with noncirrhotic portal fibrosis without cirrhosis treated by a novel technique wherein a transjugular intrahepatic route was adopted to deploy the stent graft

  6. Adherencia al tratamiento farmacológico en pacientes en hemodiálisis

    Directory of Open Access Journals (Sweden)

    Estíbaliz Ruiz García

    Full Text Available Introducción: La mala adherencia a largo plazo es reconocida como uno de los principales problemas clínicos en la gestión de las enfermedades crónicas, y en concreto de la enfermedad renal crónica avanzada. Objetivo: Conocer la producción científica sobre el grado de adherencia al tratamiento farmacológico en pacientes en hemodiálisis. Metodología: Se ha realizado una revisión sistemática no metaanalítica mediante una búsqueda en las bases de datos de Scielo, PubMed y Google Académico. Se incluyeron artículos escritos en inglés y español. Se analizaron los artículos que trataban la adherencia al tratamiento en pacientes en hemodiálisis. Resultados: Se han revisado 19 artículos, 6 revisiones y 13 estudios observacionales, publicados entre el 2007 y 2015. Se estudiaron variables sociodemográficas: edad, género, nivel socioeconómico y estudios, estado civil, raza y situación laboral; variables clínicas y psicosociales y, factores relacionados con la medicación. Se encontró que entre 15-72% de los pacientes en hemodiálisis presentan falta de adherencia al tratamiento farmacológico. La depresión se encuentra asociada a la falta de adherencia. La edad se asocia a mayor adherencia. Conclusiones: Los pacientes en hemodiálisis presentan con frecuencia falta de adherencia al tratamiento farmacológico, aunque con una gran variabilidad,debido a las diferencias en la definición y medición de la falta de adherencia. La depresión parece ser el predictor más influyente en la falta de adhesión. Los factores demográficos y clínicos no están consistentemente asociados con la falta de adherencia, a excepción de la edad, siendo los pacientes de mayor edad los que presentan mayor adherencia.

  7. LEVANTAMIENTO BATIMÉTRICO DE LA PLANTA DE TRATAMIENTO DE AGUAS RESIDUALES DE NEVES PAULISTA

    Directory of Open Access Journals (Sweden)

    Iván Andrés Sánchez Ortiz

    2014-01-01

    Full Text Available Las lagunas de estabilización son uno de los sistemas naturales para tratamiento de aguas residuales más adecuados para reducir los impactos ambientales por vertimiento de efluentes en países en vías de desarrollo. La presente investigación tuvo como objetivo diagnosticar la acumulación de lodos y evaluar el desempeño de la planta de tratamiento de aguas residuales de la ciudad Neves Paulista (São Paulo, Brasil. Mediante un estudio batimétrico de las lagunas de estabilización anaerobia y facultativa se determinaron los perfiles y volúmenes de acumulación de lodos; se midieron diversos parámetros de la calidad del agua afluente y efluente, así como el caudal entrante durante 24 horas consecutivas. La batimetría indicó que los lodos acumulados redujeron los volúmenes útiles de las lagunas anaerobia y facultativa en 26,4% y 23,7% respectivamente y que su heterogénea distribución en las unidades de tratamiento afectó su desempeño hidráulico. La eficiencia media de remoción de la DBO fue del 76,6%, inferior a la mínima establecida por la legislación ambiental brasilera. El número más probable de coliformes fecales en el efluente fue de 6,34x10 5 /100mL, que superó en gran medida los valores máximos permitidos para vertimientos en cuerpos receptores. La planta requiere de la implementación de un sistema de pre-tratamiento, de la remoción de los lodos acumulados en las zonas más críticas y la implementación de un sistema de postratamiento que garantice remoción adicional de DBO y coliformes para ajustarse a la normatividad ambiental.

  8. Optimización de los tratamientos para la depresión y la ansiedad

    Directory of Open Access Journals (Sweden)

    Varas R

    2010-12-01

    Full Text Available Mostrar los resultados de la implicación activa del farmacéutico comunitario en la dispensación de medicamentos de los grupos terapéuticos N05B y N06A, mejorando el proceso de uso de los mismos y protegiendo de posibles RNM mediante la identificación/resolución de PRM. MÉTODO • Adaptación del procedimiento de actuación para realizar la entrevista en el mostrador. • Cuestionario con datos sanitarios. • Registro de datos durante siete meses en el módulo de AF del Bot PLUS. RESULTADOS Se registraron 790 actuaciones, dispensándose 1.177 fármacos. La demanda fue realizada mayoritariamente por mujeres con edades comprendidas entre 30 y 69 años. Los fármacos más dispensados pertenecieron al grupo N05 (alprazolam y lorazepam y fueron para tratamientos de continuación en el 73% de los casos. Tres cuartas partes de los pacientes que iniciaban tratamiento decían no saber cuál era su indicación Los tratamientos de continuación eran percibidos como efectivos y/o seguros por el 93% de los pacientes. Se detectaron 105 PRM y 65 RNM (60% falta de seguridad y 35,5% falta de efectividad. La principal actuación realizada fue dispensar con IPM (82%. Las intervenciones fueron facilitar información sobre los medicamentos (32%, ofrecer educación sanitaria (23%, derivar a SFT (16% y derivar al médico (26%, aceptando (93% y observando mejoría (37%. CONCLUSIONES El farmacéutico juega un papel fundamental en la optimización del tratamiento terapéutico de estos pacientes y en la detección e identificación de los PRM, previniendo y/o evitando los RNM asociados a la necesidad, falta de efectividad y falta de seguridad de los mismos, que real o potencialmente pudieran aparecer.

  9. Shunted Piezoelectric Vibration Damping Analysis Including Centrifugal Loading Effects

    Science.gov (United States)

    Min, James B.; Duffy, Kirsten P.; Provenza, Andrew J.

    2011-01-01

    Excessive vibration of turbomachinery blades causes high cycle fatigue problems which require damping treatments to mitigate vibration levels. One method is the use of piezoelectric materials as passive or active dampers. Based on the technical challenges and requirements learned from previous turbomachinery rotor blades research, an effort has been made to investigate the effectiveness of a shunted piezoelectric for the turbomachinery rotor blades vibration control, specifically for a condition with centrifugal rotation. While ample research has been performed on the use of a piezoelectric material with electric circuits to attempt to control the structural vibration damping, very little study has been done regarding rotational effects. The present study attempts to fill this void. Specifically, the objectives of this study are: (a) to create and analyze finite element models for harmonic forced response vibration analysis coupled with shunted piezoelectric circuits for engine blade operational conditions, (b) to validate the experimental test approaches with numerical results and vice versa, and (c) to establish a numerical modeling capability for vibration control using shunted piezoelectric circuits under rotation. Study has focused on a resonant damping control using shunted piezoelectric patches on plate specimens. Tests and analyses were performed for both non-spinning and spinning conditions. The finite element (FE) shunted piezoelectric circuit damping simulations were performed using the ANSYS Multiphysics code for the resistive and inductive circuit piezoelectric simulations of both conditions. The FE results showed a good correlation with experimental test results. Tests and analyses of shunted piezoelectric damping control, demonstrating with plate specimens, show a great potential to reduce blade vibrations under centrifugal loading.

  10. Percutaneous gastrostomy tube placement in patients with ventriculoperitoneal shunts

    Energy Technology Data Exchange (ETDEWEB)

    Sane, S.S.; Towbin, A.; Bergey, E.A.; Kaye, R.D.; Fitz, C.R.; Albright, L.; Towbin, R.B. [Department of Radiology, Children`s Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, PA 15213 (United States)

    1998-07-01

    Objective. The purpose of this study is to determine the risk of CNS and/or peritoneal infection in children with ventriculoperitoneal shunts in whom a percutaneous gastrostomy tube is placed. Materials and methods. We placed 205 gastrostomy or gastrojejunostomy tubes from January of 1991 to December 1996. Twenty-three patients (10 boys, 13 girls) had ventriculoperitoneal shunts at the time of placement. All shunts were placed at least 1 month prior to placement of the gastrostomy tube. The patients ranged in age from 8 months to 16 years with a mean age of 6 years, 9 months. Patient weight ranged from 2 kg to 60 kg. All 23 children required long-term nutritional support due to severe neurologic impairment. No prophylactic antibiotics were given prior to the procedure. Of the patients, 21/23 had a 14-F Sacks-Vine gastrostomy tube with a fixed terminal retention device inserted, using percutaneous fluoroscopic antegrade technique. Two of the 23 patients had a Ross 14-F Flexi-flo gastrostomy tube which required a retrograde technique due to a small caliber esophagus in these children. Results. All 23 children had technically successful placements of percutaneous gastrostomy (7) or gastrojejunostomy (16) tubes. Of the children, 21/23 (91 %) had no complications from the procedure. Two of 23 (9 %) patients demonstrated signs of peritonitis after placement of their gastrostomy tubes and subsequently had shunt infections. In both, children CSF culture grew gram-positive cocci. The antegrade technique was used in both children who developed peritonitis. Conclusion. Our study indicates children with ventriculoperitoneal shunts who undergo percutaneous gastrostomy are at greater risk for infection and subsequent shunt malfunction. Therefore, we recommend prophylactic antibiotic therapy to cover for skin and oral flora. (orig.) With 1 fig., 7 refs.

  11. Measurement of shunt amount using radionuclide angiocardiography: accuracy according to level of shunt and associated lesion

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yang Min [Sejong General Hospital, Bucheon (Korea, Republic of)

    2006-08-15

    Determination of pulmonary to systemic blood flow ratio (QP/QS) is important for the management of patients with left-to-right shunt. This study was performed to assess the agreement of Qp/Qs ratio using the radionuclide method and oxymetry, to investigate the factors influencing the agreement, and to know how interchangeable the results of each technique. We compared the Qp/Qs measured by single-pass radionuclide angiocardiography and oxymetry during catheterization in 207 patients who underwent both studies. In radionuclide method, Qp/Qs was calculated from the pulmonary time-activity curves using a gamma variate fit. The correlation and Bland-Altman analysis were performed according to the levels of shunt and associated lesions. The mean Qp/Qs was 1.83 {+-} 0.50 by radionuclide, and 1.74 {+-} 0.51 by oxymetry. The overall correlation coefficient was 0.86 ({rho} 0.001), and Bland-Altman range of agreement encompassing 4SD was 1.05. For atrial septal defect, ventricular septal defect, patent ductus arteriosus, tricuspid and mitral insufficiency, the correlation coefficient was 0.78, 0.90, 0.84, 0.63 and 0.44 and Bland-Altman range was 1.52, 0.74, 0.96, 1.57 and 1.50, respectively. There is good agreement but wide variance between the Qp/Qs ratios by radionuclide method and oxymetry. Associated atrioventricular valvar insufficiency decreases the correlation coefficient and widens the variance. Wide overall variance suggests that Qp/Qs measurements by two techniques should not be used interchangeably.

  12. Measurement of shunt amount using radionuclide angiocardiography: accuracy according to level of shunt and associated lesion

    International Nuclear Information System (INIS)

    Kim, Yang Min

    2006-01-01

    Determination of pulmonary to systemic blood flow ratio (QP/QS) is important for the management of patients with left-to-right shunt. This study was performed to assess the agreement of Qp/Qs ratio using the radionuclide method and oxymetry, to investigate the factors influencing the agreement, and to know how interchangeable the results of each technique. We compared the Qp/Qs measured by single-pass radionuclide angiocardiography and oxymetry during catheterization in 207 patients who underwent both studies. In radionuclide method, Qp/Qs was calculated from the pulmonary time-activity curves using a gamma variate fit. The correlation and Bland-Altman analysis were performed according to the levels of shunt and associated lesions. The mean Qp/Qs was 1.83 ± 0.50 by radionuclide, and 1.74 ± 0.51 by oxymetry. The overall correlation coefficient was 0.86 (ρ 0.001), and Bland-Altman range of agreement encompassing 4SD was 1.05. For atrial septal defect, ventricular septal defect, patent ductus arteriosus, tricuspid and mitral insufficiency, the correlation coefficient was 0.78, 0.90, 0.84, 0.63 and 0.44 and Bland-Altman range was 1.52, 0.74, 0.96, 1.57 and 1.50, respectively. There is good agreement but wide variance between the Qp/Qs ratios by radionuclide method and oxymetry. Associated atrioventricular valvar insufficiency decreases the correlation coefficient and widens the variance. Wide overall variance suggests that Qp/Qs measurements by two techniques should not be used interchangeably

  13. Isolation and characterization of Salmonella typhimurium glyoxylate shunt mutants.

    OpenAIRE

    Wilson, R B; Maloy, S R

    1987-01-01

    Growth of Salmonella typhimurium on acetate as a sole carbon source requires expression of the glyoxylate shunt; however, the genes for the glyoxylate shunt enzymes have not been previously identified in S. typhimurium. In this study, we isolated transposon insertions in the genes for the two unique enzymes of this pathway, aceA (isocitrate lyase) and aceB (malate synthase). The aceA and aceB genes were located at 89.5 min on the S. typhimurium genetic map. Genetic linkage to nearby loci indi...

  14. Controversy about Management of Hydrocephalus - Shunt vs. Endoscopic Third Ventriculostomy.

    Science.gov (United States)

    Kumar, Vikas; Bodeliwala, Shaam; Singh, Daljit

    2017-08-01

    The best management of hydrocephalus is still controversial in the twenty-first century. Shunt treatment for hydrocephalus is the most common procedure performed in neurosurgical practice and is associated with the highest complications rate. But during the last 2 decades, the treatment of hydrocephalus has improved with better shunt devices available today, increased facilities for investigations and newer approaches like endoscopic third ventriculostomy. The recent advances in development of better endoscopes have provided the patient and treating doctor with an option for an alternative surgery for treatment of hydrocephalus.

  15. Cryptococcal cerebrospinal fluid shunt infection treated with fluconazole

    Directory of Open Access Journals (Sweden)

    Daniel Eymard

    1993-01-01

    Full Text Available A 37-year-old woman with a cadaveric renal allotransplantation required intra-cranial shunting devices after a presumptive episode of tuberculous meningitis. Six months later, she developed a culture-proven cryptococcal meningitis. Without having her ventriculo-auricular shunt removed, she was successfully treated with a short course of amphotericin B (335 mg and flucytosine (nine days followed by prolonged therapy with oral fluconazole (400 mg daily for 72 days. Three years post treatment she had no evidence of relapse, and normal renal graft function.

  16. Liquid radioactive wastes from hospitals by polymeric membrane; Tratamiento de residuos liquidos radiactivos hospitalarios mediante membranas polimericas

    Energy Technology Data Exchange (ETDEWEB)

    Arnal, J M; Sancho, M; Verdu, G [Universidad Politecnica de Valencia (Spain); Campayo, J M [LAINSA (Spain)

    1998-12-01

    Streams containing I``125 produced from RIA process, classified as radioactive waste of low activity, are generated by all different treatments applied in IN VITRO techniques. Consequently, an accumulation of solutions containing I``125 is produced in the order of 50-100 L/month approximately. The storage at sanitary centres and the accumulation caused by it creates a serious problem in the hospital. According to the specific activity and the installation spill authorization, one can choose between three ways of handling: direct discharge, temporal storage until the radioactive waste come to decay and then discharged, waste management by the authorised company (ENRESA). If the third way of discharge is applied the treatment of waste using membranes should be considered. Using membranes, important reduction coefficients in volume in the order of 10:1 are obtained. The aim of this work is the declassification of the I``125 solutions as a liquid radioactive waste using membrane techniques. Both, a radioactive concentrated waste and non-contaminated waste are obtained. (Author)

  17. Risk analysis in radiosurgery treatments using risk matrices; Analisis de riesgos en tratamientos de radiocirugia mediante matrices de riesgo

    Energy Technology Data Exchange (ETDEWEB)

    Delgado, J. M.; Sanchez Cayela, C.; Ramirez, M. L.; Perez, A.

    2011-07-01

    The aim of this study is the risk analysis process stereotactic single-dose radiotherapy and evaluation of those initiating events that lead to increased risk and a possible solution in the design of barriers.

  18. Tratamiento y reutilización de efluentes de la industria textil mediante técnicas de membranas

    OpenAIRE

    Buscio Olivera, Valentina

    2015-01-01

    Textile industry consumes large amount of water in their processes, mainly in dyeing and finishing operations. In general, during the dyeing process, up to 30% of dyes used can be discharged into wastewater. For this reason, the wastewater generated by this industry is characterized by high colouration. Different treatments such as biological or physico-chemical processes have been used to treat this kind of wastewater. Nonetheless, these treatments do not degrade dyes and, in general, a p...

  19. Industrial waste water treatment by advanced oxidation processes; Tratamiento de aguas residuales industriales mediante procesos de oxidacion avanzada

    Energy Technology Data Exchange (ETDEWEB)

    Gasso, S.; Baldasano, J.M.

    1996-06-01

    Advanced Oxidation Technologies have been defined as processes which involve the generation of highly reactive oxy radicals. These systems show promise for the destruction of non biodegradable and hazardous organic substances in industrial wastewater. Two types of advanced oxidation processes are considered in this paper: (1) systems that use high energy oxidants (O{sub 3}, H{sub 2}O{sub 2}, UV, etc) at ambient temperature to initiate the oxidation reaction, and (2) processes that use molecular oxygen and high temperature and pressure to initiate the reaction (wet oxidation at subcritical and supercritical conditions). The fundamental aspects of these oxidation technologies are discussed, the application framework is defined and the technology development is indicated. (Author) 33 refs.

  20. Tratamiento de la artropatía crónica hemofílica mediante inyecciones intraarticulares de cortisona

    OpenAIRE

    Fernández Palazzi, F.; Dib, O.; Del Vecchio, R.

    1997-01-01

    Se evaluaron las historias clínicas de 34 pacientes hemofílicos con artropatía crónica severa (25 grado III y 9 grado IV), todos ellos con deformidades axiales, atrofia muscular y limitación del movimiento articular (31 rodillas, 2 tobillos y 2 hombros), a quienes se les inyectó intraarticularmcnte entre 1 y 9 dosis de cortisona de liberación prolongada con intervalos de 3 semanas. Se les realizó una evaluación subjetiva y objetiva en base a los siguientes parámetros: bueno: no do...

  1. Cerebral venous thrombosis: treatment with local fibrinolysis plus alteplase; Trombosis venosa cerebral. Tratamiento mediante fibrinolisis local con alteplasa

    Energy Technology Data Exchange (ETDEWEB)

    Asis Bravo, F. de; Delgado, F.; Cano, A.; Bautista, D.

    2002-07-01

    Cerebral venous thrombosis is a rare entity with widely variable clinical signs: thus, a high degree of suspicion is required for diagnosis. It affects the dural sinuses and may or may not invade cerebral veins. The diagnosis has usually been based on an angiographic study although, at the present time, new noninvasive imaging techniques, such as computed tomography, magnetic resonance and magnetic resonance angiography are being employed in a growing number of cases. Treatment should involve symptomatic and etiologic therapy. Although anti coagulation would appear to be a reasonable option in these patients, it remains controversial. As in other processes such as pulmonary embolism and coronary thrombosis, the introduction of novel and increasingly safe fibrinolytic drugs, together with technical innovations in the field of interventional neuroradiology, is changing the perspectives for the management of these patients. We present the case of a 43-year-old woman with right sinus thrombosis who was treated with local thrombolysis plus alteplase (tissue plasminogen activator). The authors describe the technique employed and review the literature. (Author) 16 refs.

  2. New and improved ways to treat hydrocephalus: Pursuit of a smart shunt.

    Science.gov (United States)

    Lutz, Barry R; Venkataraman, Pranav; Browd, Samuel R

    2013-01-01

    The most common treatment for hydrocephalus is placement of a cerebrospinal fluid shunt to supplement or replace lost drainage capacity. Shunts are life-saving devices but are notorious for high failure rates, difficulty of diagnosing failure, and limited control options. Shunt designs have changed little since their introduction in 1950s, and the few changes introduced have had little to no impact on these long-standing problems. For decades, the community has envisioned a "smart shunt" that could provide advanced control, diagnostics, and communication based on implanted sensors, feedback control, and telemetry. The most emphasized contribution of smart shunts is the potential for advanced control algorithms, such as weaning from shunt dependency and personalized control. With sensor-based control comes the opportunity to provide data to the physician on patient condition and shunt function, perhaps even by a smart phone. An often ignored but highly valuable contribution would be designs that correct the high failure rates of existing shunts. Despite the long history and increasing development activity in the past decade, patients are yet to see a commercialized smart shunt. Most smart shunt development focuses on concepts or on isolated technical features, but successful smart shunt designs will be a balance between technical feasibility, economic viability, and acceptable regulatory risk. Here, we present the status of this effort and a framework for understanding the challenges and opportunities that will guide introduction of smart shunts into patient care.

  3. Successful Embolization of a Spontaneous Mesocaval Shunt Using the Amplatzer Vascular Plug II

    International Nuclear Information System (INIS)

    Boixadera, Helena; Tomasello, Alejandro; Quiroga, Sergi; Cordoba, Joan; Perez, Mercedes; Segarra, Antoni

    2010-01-01

    A 48-year-old man with alcoholic liver cirrhosis and hepatic encephalopathy was found to have a large, spontaneous mesocaval shunt. The shunt was successfully occluded with the use of an Amplatzer Vascular Plug. To our knowledge, this is the first report of the use of this device to embolize a mesocaval shunt involving the superior mesenteric vein.

  4. Posthemorrhagic Hydrocephalus in Newborns: Clinical Characteristics and Role of Ventriculoperitoneal Shunts

    Directory of Open Access Journals (Sweden)

    Inn-Chi Lee

    2009-02-01

    Conclusion: Patients who were shunt-dependent had worse neurodevelopmental outcomes and greater mortality than those without shunts. The results appeared to depend on how far the hydrocephalus had progressed and on the degree of IVH, but the necessity of VP shunts requires reevaluation before they are implanted.

  5. Shoulder tip pain: an under-reported complication of ventriculoperitoneal shunt.

    LENUS (Irish Health Repository)

    Lim, C

    2012-02-03

    Ventriculoperitoneal (VP) shunt insertion is the commonest form of treatment for hydrocephalus. Shoulder tip pain after VP shunt insertion is unusual and has only recently been reported. We present a case of excruciating shoulder tip pain due to diaphragmatic irritation after VP shunt insertion.

  6. Treatment of Occluded Distal Splenorenal Shunts with Endovascular Stents: A Report of Two Cases

    International Nuclear Information System (INIS)

    Lopez-Medina, Antonio; Peiro, Javier; Gonzalez de Garay, Miguel; Antonana, Miguel A.; Sustacha, Jon; Grande, Domingo

    2001-01-01

    Surgical treatment of an occluded or stenotic portosystemic shunt is difficult and carries a high risk of mortality. We report two cases of early thrombosis of distal splenorenal shunt (DSRS) successfully treated by transcatheter recanalization and stent placement. At 18-month follow-up, the patients remained asymptomatic and control venograms showed continued patency of the shunt with no evidence of stenosis or collaterals

  7. Aneurisma de la aorta abdominal: Tratamiento endovascular con una endoprótesis fenestrada Abdominal aortic aneurysm: Endovascular treatment with fenestrated endoprothesis

    Directory of Open Access Journals (Sweden)

    Román Rostagno

    2008-12-01

    Full Text Available El tratamiento endovascular de los aneurismas de aorta abdominal es una alternativa a la cirugía abierta para pacientes de alto riesgo. Consiste en la exclusión del saco aneurismático mediante la interposición de una endoprótesis colocada por vía femoral. El tratamiento endovascular no puede ser utilizado en todos los pacientes. Una limitación frecuente la constituye el nacimiento de una arteria visceral desde el saco aneurismático. Para contrarrestar esta limitación recientemente se han desarrollado endoprótesis fenestradas que presentan orificios que se corresponden con el nacimiento de las arterias involucradas en el aneurisma evitando su oclusión, permitiendo de esta manera el tratamiento endovascular. En esta comunicación se presenta un caso de tratamiento endovascular de un aneurisma de aorta abdominal mediante la colocación de una endoprótesis fenestrada en un paciente cuya arteria renal izquierda nacía directamente del saco aneurismático.Endovascular treatment of the abdominal aortic aneurysm is consider an alternative to open surgery for high risk patients. Its goal is to exclude the aneurysm from the circulation by using an endoprothesis introduced from a femoral approach. Patients must be strictly selected to avoid possible complications. The most frequent limitation is related to anatomic contraindications such as visceral arteries involved in the aneurysm. Fenestrated endograft have been recently developed to allow endovascular treatment when anatomic features contraindicate classic endovascular procedures. Fenestrated endograft have holes that match with the origin of the visceral arteries maintaining its potency. In this paper we report the endovascular treatment of an abdominal aortic aneurysm by using a fenestrated endoprothesis in a patient whose left renal artery is originated from the aneurysm.

  8. Uso del aralen en el tratamiento de la teniasis

    Directory of Open Access Journals (Sweden)

    Carlos Arteaga Camargo

    1951-08-01

    Full Text Available En el presente trabajo se hace referencia al tratamiento de siete casos de Taeniasis (todos de Taenia saginata, por medio del "Aralen". Dicho tratamiento es de administración fácil, no produjo manifestaciones tóxicas y dio éxito en todos los casos tratados.

  9. Y PROCEDIMIENTOS QUIRÚRGICOS DE TRATAMIENTO

    Directory of Open Access Journals (Sweden)

    FBE Guevara

    2005-01-01

    Full Text Available La hemiplejía laríngea idiopática es la causa más común de insuficiencia de las vías respiratorias altas en equinos. La enfermedad está clasificada como una axonopatía distal que afecta el nervio laríngeo recurrente y que produce atrofia neurogénica de la musculatura intrínseca de la laringe. La enfermedad se manifiesta por la paresa o parálisis de los músculos abductores laríngeos (cricoaritenoides dorsal, lo que termina en la obstrucción de la vía aérea y en el colapso dinámico del cartílago aritenoideo afectado, durante el ejercicio. Su diagnóstico es realizado por medio de un examen endoscópico, en reposo o durante el ejercicio. Las técnicas quirúrgicas de tratamiento para caballos con grados III o IV de hemiplejía laríngea son principalmente la laringoplastia prostética, la aritenoidectomía, la ventriculectomía/cordectomía y los procedimientos de reinervación del músculo cricoaritenoideo dorsal. De las anteriores técnicas, la laringoplastia continúa siendo el tratamiento quirúrgico de primera elección.

  10. Hacia un tratamiento computacional del Aktionsart

    Directory of Open Access Journals (Sweden)

    Juan Aparicio

    2013-12-01

    Full Text Available En el área del Procesamiento del Lenguaje Natural (PLN, a la hora de crear aplicaciones inteligentes, el tratamiento semántico es fundamental. Sin embargo, la investigación que actualmente se está llevando a cabo en PLN está todavía lejos de conseguir niveles profundos de compresión del lenguaje. El objetivo principal de nuestra investigación es la representación del Aktionsart (la manera como se construye el evento expresado por un verbo en su desarrollo temporal. Una de las dificultades básicas que presenta el tratamiento semántico del lenguaje es el establecimiento de clases, debido principalmente a la naturaleza gradual del significado y la alta incidencia del contexto en la interpretación de las diferentes unidades. En este artículo nos centraremos en la presentación de las clases aspectuales léxicas de nuestra propuesta. El total de clases definidas se clasifica en dos grupos, las clases simples: estados, procesos y puntos, cuya combinación da lugar a las clases complejas: culminaciones, realizaciones y graduales. Esta presentación se llevará a cabo tanto desde el punto de vista teórico, como de su implementación computacional.

  11. Sensado de variables mediante terminal Android

    OpenAIRE

    Altaba Rosas, Mar

    2017-01-01

    El presente documento describe los procesos de diseño y desarrollo de un sistema que, a través de una aplicación móvil, sirve como dispositivo para el registro de la actividad cardíaca del paciente, mediante la obtención del electrocardiograma (ECG), y que permite detectar irregularidades para posteriormente, en caso que fuera necesario, poder enviar los datos adquiridos al profesional sanitario pertinente para que éste los analice. El sistema tiene dos componentes diferenciados, por un lado,...

  12. Reconciliando modularidad y eficiencia mediante atajos

    OpenAIRE

    Marco Gómez, Jordi; Franch Gutiérrez, Javier

    1997-01-01

    Se presenta en este artículo una propuesta para el desarrollo de programas eficientes en el marco de la programación con tipos abstractos de datos (TAD), con el objetivo de respetar la estructura modular de los programas propia de este ámbito. La propuesta se centra en el concepto de atajo como camino eficiente de acceso a los datos, alternativo al acceso mediante las operaciones propias del TAD, y se desarrolla sobre un TAD concreto, el almacén de elementos. La definición de los atajos es al...

  13. Tratamiento Endodóntico no Instrumentado en dientes deciduos

    Directory of Open Access Journals (Sweden)

    Perona-G

    2014-01-01

    Full Text Available Teniendo en cuenta la complejidad del tratamiento pulpar en una pieza decidua y diversos factores que determinan el éxito clínico como son la anatomía de una pieza decidua, el proceso de reabsorción ya sea de origen fisiológico o por una infección odontogénica, la conducta del paciente, la técnica empleada y la pericia del operador; es de suma importancia que en la práctica odontopediátrica se tenga en cuenta ciertos procedimientos que aseguren la presencia del diente en boca hasta su exfoliación fisiológica, es de esta manera que la Técnica de Endodoncia no Instrumentadas en dientes deciduos es un tema muy importante a tener presente en cuanto a terapia pulpar se refiere. Las pulpectomías no instrumentadas (NIET; termino mal empleado para este procedimiento, ya que la técnica no consiste en realizar una pulpectomía propiamente dicha; en su lugar emplean diversas pastas que tienen por objetivo la desinfección de los conductos radiculares mediante el empleo de sustancias bacteriostáticas y bactericidas y de esta manera permitirán la reparación del los tejidos dañados. El propósito de este artículo fue hacer una revisión de la literatura de todo lo concerniente a Terapia Endodóntica no Instrumentada en dentición decidua. En conclusión se puede decir que dadas las características de la dentición temporal, la cual impide una completa manipulación de los conductos radiculares, el éxito de la pulpectomía depende de la reducción o eliminación de las bacterias no solo dentro del conducto sino también en lugares donde la preparación química y mecánica sea difícil de acceder, en la técnica NIET se utiliza una mezcla de antibióticos para esterilizar el conducto radicular en vez de usar la técnica de instrumentación, las pastas obturadoras asumen un papel fundamental para que la reparación de los elementos dentarios se desenvuelva de acuerdo a los patrones biológicos normales.

  14. Filtración ribereña: una tecnología eficiente y económica para el tratamiento de agua potable.

    OpenAIRE

    Jaramillo Uribe, Marcela

    2012-01-01

    La tecnología de filtración ribereña (FRB) consiste en extraer agua de corrientes superficiales mediante el bombeo de pozos ubicados en el acuífero aluvial adyacente al río. En el trayecto se presentan procesos físicos, químicos y biológicos que mejoran la calidad del agua superficial, sustituyendo o reduciendo los tratamientos convencionales de agua para consumo humano. A pesar de su extensivo uso en Europa y su reciente utilización en Estados Unidos, no existe ninguna publicación científica...

  15. Realidad virtual en el tratamiento del paciente con ictus post-isquémico. Revisión bibliográfica y narrativa.

    OpenAIRE

    Vela Martínez, Daniela Elizabeth

    2017-01-01

    En España cada año hay 85000 nuevos casos de ictus isquémico. Entre sus secuelas está el déficit motor que afecta tanto a extremidades superiores como inferiores y su tratamiento fundamental es la rehabilitación. En la última década se han incorporado al proceso de rehabilitación nuevas tecnologías como es la realidad virtual. En este trabajo, mediante una revisión bibliográfica narrativa se pretende conocer lo publicado sobre la utilización de la realidad virtual junto al tratamient...

  16. Impacto económico del tratamiento y gestión de los residuos sólidos producidos por el Hospital Militar Central – Lima

    OpenAIRE

    Nava Torres, César Augusto; Nava Torres, César Augusto; Loayza Berrocal, Luis Alberto; Nava Torres, César Augusto

    2012-01-01

    El manejo de los residuos sólidos hospitalarios en nuestro país es uno de los aspectos de la gestión hospitalaria que ha ido tomando importancia e interés en los últimos años. Mediante la presente investigación se pretende evaluar el actual Tratamiento y Gestión de los residuos sólidos en el Hospital Militar Central (HMC) de la ciudad de Lima, analizando los servicios de salud donde los pacientes se hospitalizan y se genere la mayor cantidad de desechos, a fin de determinar las ganancias...

  17. Propuesta de dispositivos de tratamiento de base comunitaria para las toxicomanías en barrios urbano-marginales de la ciudad de Quito

    OpenAIRE

    Villacís Rengifo, María Lorena

    2016-01-01

    Nuestro trabajo investigativo pretende trazar abordajes terapéuticos para el tratamiento de las toxicomanías en contextos de alta vulnerabilidad y exclusión social. Por lo tanto, trabaja sobre dos fenómenos sociales complejos y a la vez relacionales: la marginalidad y las toxicomanías. Los analiza mediante el diálogo entre dos campos del saber: la sociología y el psicoanálisis. En el primer capítulo: Marginalidad y Toxicomanías, analizamos la marginalidad desde los planteamient...

  18. Efectividad del tratamiento con neurofeedback en trastornos del estado del ánimo, ansiedad y fibromialgia: una revisión de literatura

    OpenAIRE

    Barrera Ferro, Laura; Gómez Olivella, Estefanía; Prieto Lizarazo, Luisa Fernanda

    2013-01-01

    El neurofeedback es una técnica no invasiva en la que se pretende corregir, mediante condicionamiento operante, ondas cerebrales que se encuentren alteradas en el electroencefalograma. Desde 1967, se han conducido numerosas investigaciones relacionadas con los efectos de la técnica en el tratamiento de alteraciones psicológicas. Sin embargo, a la fecha no existen revisiones sistemáticas que reúnan los temas que serán aquí tratados. El aporte de este trabajo es la revisión de 56...

  19. Diagnóstico y tratamiento de las infecciones en vías urinarias: un enfoque multidisciplinario para casos no complicados

    OpenAIRE

    Calderón-Jaimes, Ernesto; Casanova-Román, Gerardo; Galindo-Fraga, Arturo; Gutiérrez-Escoto, Pablo; Landa-Juárez, Sergio; Moreno-Espinosa, Sarbelio; Rodríguez-Covarrubias, Francisco; Simón-Pereira, Luis; Valdez-Vázquez, Rafael

    2013-01-01

    Las infecciones en vías urinarias afectan tanto a niños como a adultos. En niños son un problema de salud frecuente. En mujeres embarazadas merecen especial atención por los riesgos perinatales. La ausencia de nuevas moléculas antimicrobianas y el incremento en la resistencia bacteriana, favorecida por el uso indiscriminado de antibióticos, obliga a normar conductas para el abordaje y tratamiento inicial de las infecciones en vías urinarias. Este artículo fue desarrollado mediante un panel de...

  20. High-Flow Arterio-Hepatic Venous Shunt in Hepatocellular Carcinoma: Use of Multi-Electrode Radiofrequency for Shunt Obliteration

    Energy Technology Data Exchange (ETDEWEB)

    Pua, Uei, E-mail: druei@yahoo.com [Tan Tock Seng Hospital, Department of Diagnostic Radiology (Singapore)

    2015-10-15

    Intra-tumoral arterio-hepatic venous shunting (AHVS) poses an impediment to transarterial chemoembolization of liver tumors. Not only does it present a potential hazard for systemic shunting and embolization, but also the altered flow dynamics may also result in poor delivery of drug/embolics to the target tumor bed. Current available techniques to overcome AVHS include arterial embolization (particles, coils, glue, etc.) or temporary venous occlusion using balloons. We hereby illustrate the use of radiofrequency ablation to obliterate a complex AHVS consisting of a varix-like venous aneurysm.

  1. Un método para el tratamiento de las pilas y baterías domésticas usadas de tamaño medio. III Parte. Propuesta de un método para su tratamiento

    Directory of Open Access Journals (Sweden)

    de Juan, D.

    1996-06-01

    Full Text Available A method for the primary treatment of spent batteries and domestic cells is proposed. Basic processes for the secondary treatment, metals recovering and detoxifying wastes are developed. Iron is directly recovered in the primary treatment as a ferrous scrap. Zinc is recovered from ammoniacal solution obtained in primary treatment by means of a hydrothermal process. For recovering cadmium, copper and nickel, a cementation with zinc dusts is proposed along with the application of the COCADEX process. Detoxifying the fraction bioxide obtained and the mercury recovered are made by heat treatment at 300- 400°C. The heat treatment wastes and the non ferrous fraction can be treated in a Waelz furnace, for the simultaneous recovery of zinc and cadmium contained in the waste as a Waelz oxide.

    Se propone un método para llevar a cabo el tratamiento primario de las pilas y baterías domésticas usadas. Se desarrollan los procesos necesarios para realizar el tratamiento secundario, recuperar los metales contenidos y separar los componentes tóxicos de los residuos. En el tratamiento primario se recupera el hierro directamente como una chatarra férrea. El cinc se recupera de la disolución amoniacal procedente del tratamiento primario mediante un proceso hidrotermal. Para la recuperación del cadmio, cobre y níquel se propone su cementación con polvo de cinc y posterior aplicación del proceso COCADEX. La eliminación de los productos tóxicos de la fracción bióxido resultante, así como la recuperación del mercurio se realizan mediante calcinación a 300-400 °C. El residuo de calcinación y la fracción no férrea se pueden tratar conjuntamente en un horno Waelz para recuperar simultáneamente el cinc y el cadmio residual como óxido Waelz.

  2. Risk factors for shunt malfunction in pediatric hydrocephalus: a multicenter prospective cohort study.

    Science.gov (United States)

    Riva-Cambrin, Jay; Kestle, John R W; Holubkov, Richard; Butler, Jerry; Kulkarni, Abhaya V; Drake, James; Whitehead, William E; Wellons, John C; Shannon, Chevis N; Tamber, Mandeep S; Limbrick, David D; Rozzelle, Curtis; Browd, Samuel R; Simon, Tamara D

    2016-04-01

    OBJECT The rate of CSF shunt failure remains unacceptably high. The Hydrocephalus Clinical Research Network (HCRN) conducted a comprehensive prospective observational study of hydrocephalus management, the aim of which was to isolate specific risk factors for shunt failure. METHODS The study followed all first-time shunt insertions in children younger than 19 years at 6 HCRN centers. The HCRN Investigator Committee selected, a priori, 21 variables to be examined, including clinical, radiographic, and shunt design variables. Shunt failure was defined as shunt revision, subsequent endoscopic third ventriculostomy, or shunt infection. Important a priori-defined risk factors as well as those significant in univariate analyses were then tested for independence using multivariate Cox proportional hazard modeling. RESULTS A total of 1036 children underwent initial CSF shunt placement between April 2008 and December 2011. Of these, 344 patients experienced shunt failure, including 265 malfunctions and 79 infections. The mean and median length of follow-up for the entire cohort was 400 days and 264 days, respectively. The Cox model found that age younger than 6 months at first shunt placement (HR 1.6 [95% CI 1.1-2.1]), a cardiac comorbidity (HR 1.4 [95% CI 1.0-2.1]), and endoscopic placement (HR 1.9 [95% CI 1.2-2.9]) were independently associated with reduced shunt survival. The following had no independent associations with shunt survival: etiology, payer, center, valve design, valve programmability, the use of ultrasound or stereotactic guidance, and surgeon experience and volume. CONCLUSIONS This is the largest prospective study reported on children with CSF shunts for hydrocephalus. It confirms that a young age and the use of the endoscope are risk factors for first shunt failure and that valve type has no impact. A new risk factor-an existing cardiac comorbidity-was also associated with shunt failure.

  3. Assessment of surgical portosystemic shunts and associated complications: The diagnostic and therapeutic role of radiologists

    Energy Technology Data Exchange (ETDEWEB)

    Taslakian, Bedros, E-mail: btaslakian@gmail.com [Department of Radiology, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Faraj, Walid, E-mail: wf07@aub.edu.lb [Department of General Surgery, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Khalife, Mohammad, E-mail: mk12@aub.edu.lb [Department of General Surgery, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Al-Kutoubi, Aghiad, E-mail: mk00@aub.edu.lb [Department of Radiology, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); El-Merhi, Fadi, E-mail: fe19@aub.edu.lb [Department of Radiology, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Saade, Charbel, E-mail: cs39@aub.edu.lb [Department of Radiology, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Hallal, Ali, E-mail: ah05@aub.edu.lb [Department of General Surgery, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Haydar, Ali, E-mail: ah24@aub.edu.lb [Department of Radiology, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon)

    2015-08-15

    Highlights: • Portal hypertension is the pathological increase in portal venous pressure. • Surgical portosystemic shunting is an accepted methods to decrease portal venous pressure. • Surgical portosystemic shunts are divided into selective and nonselective. • Shunt thrombosis is a serious complication, resulting in shunt dysfunction. • Imaging is essential in the assessment of the shunt function and anatomy. - Abstract: Surgical portosystemic shunting, the formation of a vascular connection between the portal and systemic venous circulation, has been used as a treatment to reduce portal venous pressure. Although the use of portosystemic shunt surgery in the management of portal hypertension has declined during the past decade in favour of alternative therapies, and subsequently surgeons and radiologists became less familiar with the procedure, it remains a well-established treatment. Knowledge of different types of surgical portosystemic shunts, their pathophysiology and complications will help radiologists improve communication with surgeons and enhance their understanding of the diagnostic and therapeutic role of radiology in the assessment and management of these shunts. Optimal assessment of the shunt is essential to determine its patency and allow timely intervention. Both non-invasive and invasive imaging modalities complement each other in the evaluation of surgical portosystemic shunts. Interventional radiology plays an important role in the management of complications, such as shunt thrombosis and stenosis. This article describes the various types of surgical portosystemic shunts, explains the anatomy and pathophysiology of these shunts, illustrates the pearls and pitfalls of different imaging modalities in the assessment of these shunts and demonstrates the role of radiologists in the interventional management of complications.

  4. Assessment of surgical portosystemic shunts and associated complications: The diagnostic and therapeutic role of radiologists

    International Nuclear Information System (INIS)

    Taslakian, Bedros; Faraj, Walid; Khalife, Mohammad; Al-Kutoubi, Aghiad; El-Merhi, Fadi; Saade, Charbel; Hallal, Ali; Haydar, Ali

    2015-01-01

    Highlights: • Portal hypertension is the pathological increase in portal venous pressure. • Surgical portosystemic shunting is an accepted methods to decrease portal venous pressure. • Surgical portosystemic shunts are divided into selective and nonselective. • Shunt thrombosis is a serious complication, resulting in shunt dysfunction. • Imaging is essential in the assessment of the shunt function and anatomy. - Abstract: Surgical portosystemic shunting, the formation of a vascular connection between the portal and systemic venous circulation, has been used as a treatment to reduce portal venous pressure. Although the use of portosystemic shunt surgery in the management of portal hypertension has declined during the past decade in favour of alternative therapies, and subsequently surgeons and radiologists became less familiar with the procedure, it remains a well-established treatment. Knowledge of different types of surgical portosystemic shunts, their pathophysiology and complications will help radiologists improve communication with surgeons and enhance their understanding of the diagnostic and therapeutic role of radiology in the assessment and management of these shunts. Optimal assessment of the shunt is essential to determine its patency and allow timely intervention. Both non-invasive and invasive imaging modalities complement each other in the evaluation of surgical portosystemic shunts. Interventional radiology plays an important role in the management of complications, such as shunt thrombosis and stenosis. This article describes the various types of surgical portosystemic shunts, explains the anatomy and pathophysiology of these shunts, illustrates the pearls and pitfalls of different imaging modalities in the assessment of these shunts and demonstrates the role of radiologists in the interventional management of complications

  5. Shunt hybrid active power filter for harmonic mitigation: A practical ...

    Indian Academy of Sciences (India)

    shunt HAPF, APF is connected in series with PPF and the whole system is connected in parallel to the load. ... LC filter, it will force a fundamental reactive current to flow into it. ..... Since SHAPF is operating as a boost rectifier, d.c. voltage.

  6. Leakage Inductance Calculation for Planar Transformers with a Magnetic Shunt

    DEFF Research Database (Denmark)

    Jun, Zhang; Ouyang, Ziwei; Duffy, M. C.

    2013-01-01

    The magnetic shunt is generally inserted in a planar transformer to increase the leakage inductance which can be utilized as the series inductor in resonant circuits such as the LLC resonant converter. This paper presents a calculation methodology for the leakage inductance of the transformer...

  7. A plasma polymerization technique to overcome cerebrospinal fluid shunt infections

    Czech Academy of Sciences Publication Activity Database

    Çökeliler, D.; Caner, H.; Zemek, Josef; Choukourov, A.; Biederman, H.; Mutlu, M.

    2007-01-01

    Roč. 2, č. 1 (2007), s. 39-47 ISSN 1748-6041 Grant - others:TUBITAK(TR) MISAG-COST 527 Institutional research plan: CEZ:AV0Z10100521 Keywords : shunt infections * cerebrospinal * PP HEMA * biomaterials Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 0.787, year: 2007

  8. Systemic Arterial-to-Pulmonary Artery Shunt Utilization

    African Journals Online (AJOL)

    multiruka1

    In certain circumstances, such as cyanotic neonates with tetralogy of Fallot (4) or cyanotic patients with. Tetralogy of Fallot and hypoplastic pulmonary arteries. (5), better outcomes are obtained if definitive surgery. (total correction or palliation) is preceded by creation of a systemic arterial-to-pulmonary artery shunt (SAPAS).

  9. Shunt hybrid active power filter for harmonic mitigation: A practical ...

    Indian Academy of Sciences (India)

    2016-08-26

    Aug 26, 2016 ... The increasing importance of Power Quality problems has been responsible for several improvements in Active Power Filter (APF) typologies in the last decade. The increased cost and switching losses make a pure shunt APF economically impractical for high power applications. In higher power levels ...

  10. k-Shortest routing of trains on shunting yards

    NARCIS (Netherlands)

    Riezebos, Jan; van Wezel, Wout

    2009-01-01

    We consider the problem of designing algorithmic support for k-best routing decisions in train shunting scheduling. A study at the Netherlands Railways revealed that planners like to interact with the solution process of finding suitable routes. Two types of interaction were required: the

  11. Aberrant hepatic lipid storage and metabolism in canine portosystemic shunts

    NARCIS (Netherlands)

    Van Den Bossche, Lindsay; Schoonenberg, Vivien A.C.; Burgener, Iwan A.; Penning, Louis C.; Schrall, Ingrid M.; Kruitwagen, Hedwig S.; Van Wolferen, Monique E.; Grinwis, Guy C.M.; Kummeling, Anne; Rothuizen, Jan; Van Velzen, Jeroen F.; Stathonikos, Nikolas; Molenaar, Martijn R.; Helms, Bernd J.; Brouwers, Jos F.H.M.; Spee, Bart; Van Steenbeek, Frank G.

    2017-01-01

    Non-alcoholic fatty liver disease (NAFLD) is a poorly understood multifactorial pandemic disorder. One of the hallmarks of NAFLD, hepatic steatosis, is a common feature in canine congenital portosystemic shunts. The aim of this study was to gain detailed insight into the pathogenesis of steatosis in

  12. Anatomical Evidence for Intracardiac Blood Shunting in Marine Turtles

    African Journals Online (AJOL)

    ... suggests that right to left intra-cardiac blood shunts may be a feature of diving in sea turtles; the sphincter providing a mechanism for the control of blood flow through the heart. The comparative anatomy of the pulmonary arteries of selected terrestrial reptiles suggests that a similar mechanism exists in non-diving species.

  13. Reversible Venting Stitch for Fenestrating Valve-less Glaucoma Shunts.

    Science.gov (United States)

    Akil, Handan; Vu, Priscilla Q; Nguyen, Anhtuan H; Nugent, Alexander; Chopra, Vikas; Francis, Brian A; Tan, James C

    2017-12-01

    The purpose of this is to describe a venting stitch modification for valveless glaucoma aqueous shunts and characterize early postoperative intraocular pressure (IOP) and glaucoma medication use following the modification. Retrospective chart review of 61 sequential patients undergoing Baerveldt glaucoma implant (BGI)-350 implantation at the Doheny Eye Institute. Twenty-four patients received a glaucoma shunt with venting stitch modification (modified BGI) and 37 patients received an unmodified shunt (BGI-only). IOP, number of glaucoma medications, and number of hypotony cases (intraocular pressure ≤5 mm Hg) were compared between the groups. T-tests were used for statistical analysis. At postoperative-day 1, mean IOP was significantly lower compared with preoperatively in the modified BGI group (14 mm Hg; reduced by 51%; P<0.0001) but not the BGI-only group (27 mm Hg; P=0.06). IOP difference between groups persisted till immediately before tube opening (P=0.005) and fewer IOP-lowering medications needed in the modified BGI group (P<0.0001). One case (4.2%) of postoperative hypotony was encountered with BGI modification, which resolved after the stitch was removed in clinic. The venting stitch valveless shunt modification allows for effective, reliable, and safe control of early postoperative IOP.

  14. Small-Diameter PTFE Portosystemic Shunts: Portocaval vs Mesocaval

    Directory of Open Access Journals (Sweden)

    Robert Shields

    1998-01-01

    Full Text Available Fifty-seven patients with failed sclerotherapy received a mesocaval interposition shunt with an externally supported, ringed polytetrafluoroethylene prosthesis of either 10 or 12 mm diameter. Thirty-one patients had Child-Pugh gradeA disease and 26 grade B; all had a liver volume of 1000– 2500 ml. Follow-up ranged from 16 months to 6 years 3 months. Three patients (5 per cent died in the postoperative period. There were two postoperative recurrences of variceal haemorrhage and one recurrent bleed in the second year after surgery. The cumulative shunt patency rate was 95 per cent and the incidence of encephalopathy 9 per cent; the latter was successfully managed by protein restriction and/or lactulose therapy. The actuarial survival rate for the whole group at 6 years was 78 per cent, for those with Child-Pugh grade A 88 per cent and for grade B 67 per cent. Small-lumen mesocaval interposition shunting achieves portal decompression, preserves hepatopetal flow, has a low incidence of shunt thrombosis, prevents recurrent variceal bleeding and is not associated with significant postoperative encephalopathy.

  15. Shunt impedance measurement of the APS BBC injector

    International Nuclear Information System (INIS)

    Sun, Y.E.; Lewellen, J.W.

    2006-01-01

    The injector test stand (ITS) at Advanced Photon Source (APS) presently incorporates a ballistic bunch compression (BBC) gun, and it is used as a beam source for a number of experiments, including THz generation, beam position monitor testing for the Linac Coherent Light Source (LCLS), novel cathode testing, and radiation therapy source development. The BBC gun uses three independently powered and phased rf cavities, one cathode cell, and two full cells to provide beam energies from 2 to 10 MeV with variable energy spread, energy chirp, and, to an extent, bunch duration. The shunt impedance of an rf accelerator determines how effectively the accelerator can convert supplied rf power to accelerating gradient. The calculation of the shunt impedance can be complicated if the beam energy changes substantially during its transit through a cavity, such as in a cathode cell. We present the results of direct measurements of the shunt impedance of the APS BBC gun on an individual cavity basis, including the cathode cell, and report on achieved gradients. We also present a comparison of the measured shunt impedance with theoretical values calculated from the rf models of the cavities.

  16. Temporary vascular shunting in vascular trauma: A 10-year review ...

    African Journals Online (AJOL)

    of a physiologically unstable patient requiring a damage control procedure, and in the ... ensure that the tubing would not fall out, but not so tight that the lumen of the .... Time to removal of the shunt represents a balance between removing the ...

  17. Congenital extrahepatic portosystemic shunt associated with heterotaxy and polysplenia

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley [Lucile Packard Children' s Hospital, Department of Radiology, Stanford University School of Medicine, Stanford, CA (United States); Feinstein, Jeffrey A. [Stanford University School of Medicine, Division of Pediatric Cardiology, Department of Pediatrics, Lucile Packard Children' s Hospital, Stanford (United States); Cohen, Ronald A.; Patel, Hitendra [Children' s Hospital and Research Center, Department of Diagnostic Radiology, Oakland, CA (United States); Feingold, Brian; Kreutzer, Jacqueline [Children' s Hospital of Pittsburgh, Department of Pediatrics, Division of Pediatric Cardiology, Pittsburgh, PA (United States); Chan, Fandics P. [Stanford University School of Medicine, Cardiovascular Imaging Section, Department of Radiology, Lucile Packard Children' s Hospital, Stanford, CA (United States)

    2010-07-15

    Heterotaxy with polysplenia is associated with many cardiovascular anomalies including the occasional occurrence of congenital extrahepatic portosystemic shunts (CEPS). Missing this anomaly can lead to inappropriate and ineffective therapy. To emphasize the importance and associated anatomy of CEPS in conjunction with heterotaxy with polysplenia. Review of three young children who presented with cyanosis and pulmonary hypertension without a cardiac etiology. They were known (1) or discovered (2) to have heterotaxy with polysplenia. There was absence of the intrahepatic inferior vena cava (IVC) with azygos or hemiazygos continuation in all three cases. In spite of normal liver function, they were discovered to have large portosystemic shunts, splenorenal in location, along with diffuse peripheral pulmonary arterial dilatation suggestive of CEPS (Abernethy malformation) with hepatopulmonary or, more accurately, portopulmonary syndrome. All CEPS were ipsilateral to the spleens. Patency of the portal veins in these cases allowed for percutaneous shunt closure with resolution of cyanosis. CEPS is associated with heterotaxy with polysplenia and can be symptomatic because of pulmonary arteriovenous (AV) shunting. Portal and hepatic vein patency are critical for determining feasibility of CEPS closure. (orig.)

  18. Effects of an interatrial shunt on rest and exercise hemodynamics

    DEFF Research Database (Denmark)

    Kaye, David; Shah, Sanjiv J; Borlaug, Barry A

    2014-01-01

    BACKGROUND: A treatment based on an interatrial shunt device has been proposed for counteracting elevated pulmonary capillary wedge pressure (PCWP) in patients with heart failure and mildly reduced or preserved ejection fraction (HFpEF). We tested the theoretical hemodynamic effects of this appro...

  19. Creating interatrial shunts in heart failure and pulmonary hypertension

    DEFF Research Database (Denmark)

    Wolsk, Emil; Gustafsson, Finn

    2016-01-01

    Patients with elevated filling pressures are at increased risk of adverse cardiovascular (CV) outcomes. Structural interventions to lower elevated either left or right atrial filling pressures are gaining attention. Studies in heart failure show that lowering left atrial pressure may reduce CV...... interatrial device shunt therapy a part of our armamentarium in patients with heart failure or pulmonary hypertension and increased filling pressure....

  20. Embolization of nonvariceal portosystemic collaterals in transjugular intrahepatic portosystemic shunts

    International Nuclear Information System (INIS)

    Bilbao, Jose Ignacio; Arias, Mercedes; Longo, Jesus Maria; Alejandre, Pedro Luis; Betes, Maria Teresa; Elizalde, Arlette Maria

    1997-01-01

    Percutaneous embolization of large portosystemic collaterals was performed in three patients following placement of a transjugular intrahepatic portosystemic shunt in order to improve hepatopetal portal flow. Improved hepatic portal perfusion was achieved in these cases, thereby theoretically reducing the risk of chronic hepatic encephalopathy

  1. Global robust stability for shunting inhibitory CNNs with delays.

    Science.gov (United States)

    Wang, Lingna; Lin, Yiping

    2004-08-01

    In this paper, the problem of global robust stability for shunting inhibitory cellular neural networks (SICNNs) is studied. A sufficient condition guaranteeing the network's global robust stability is established. The result can easily be used to verify globally robust stable networks. An example is given to illustrate that the conditions of our results are feasible.

  2. A new method for the measurement of intrahepatic shunts

    International Nuclear Information System (INIS)

    Hoefs, J.C.; Reynolds, T.B.; Pare, P.; Sakimura, I.

    1984-01-01

    After transhepatic portal pressure determination, 96 patients were assessed for the presence of intrahepatic shunts by injection of microspheres (25 +/- 5 micron diameter) into the portal vein using RISA-131I as an indicator of dilution. Multiple portal vein injections in each patient allowed blood sampling from the hepatic vein (site 1) and from two inferior vena cava sampling sites (site 2, at the junction of the hepatic vein orifice with the inferior vena cava, and site 3, 2 to 3 cm closer to or within the right atrium). Intrahepatic shunting was calculated from each site: hepatic vein in 57 patients and inferior vena cava, site 2 in 43 patients and site 3 in 77 patients. At least one valid IHS calculation was available in 92 of the patients. Intrahepatic shunting calculated from sequential portal vein injections with sampling from the hepatic vein was highly correlated (r . 0.98, p less than 0.0001, slope . 1.0), with a mean difference of 1.9% +/- 1.9%. There was no significant difference by t test comparison of the mean IHS calculated from sites 1, 2, and 3. Occasional marked discrepancies were noted between IHS calculated from site 1 or site 2 compared with site 3, and the site 3 calculation was always greater. A shunt index in all patients included shunts calculated from the hepatic vein in 57 patients plus shunt calculation from the inferior vena cava in the remaining patients (site 2 in 26 patients and site 3 in nine). The 82 patients with portal hypertension or chronic liver disease had a higher portal pressure, 13.8 +/- 4.6 mm Hg, and a significantly greater shunt index, 13.7% +/- 24.5% compared with controls. The frequency distribution of IHS in patients with chronic liver disease demonstrated less than 2% IHS in 49% of patients and less than 5% IHS in 63%. The validity of our methods and the implications of the infrequent demonstration of a large IHS are discussed

  3. New and improved ways to treat hydrocephalus: Pursuit of a smart shunt

    Science.gov (United States)

    Lutz, Barry R.; Venkataraman, Pranav; Browd, Samuel R.

    2013-01-01

    The most common treatment for hydrocephalus is placement of a cerebrospinal fluid shunt to supplement or replace lost drainage capacity. Shunts are life-saving devices but are notorious for high failure rates, difficulty of diagnosing failure, and limited control options. Shunt designs have changed little since their introduction in 1950s, and the few changes introduced have had little to no impact on these long-standing problems. For decades, the community has envisioned a “smart shunt” that could provide advanced control, diagnostics, and communication based on implanted sensors, feedback control, and telemetry. The most emphasized contribution of smart shunts is the potential for advanced control algorithms, such as weaning from shunt dependency and personalized control. With sensor-based control comes the opportunity to provide data to the physician on patient condition and shunt function, perhaps even by a smart phone. An often ignored but highly valuable contribution would be designs that correct the high failure rates of existing shunts. Despite the long history and increasing development activity in the past decade, patients are yet to see a commercialized smart shunt. Most smart shunt development focuses on concepts or on isolated technical features, but successful smart shunt designs will be a balance between technical feasibility, economic viability, and acceptable regulatory risk. Here, we present the status of this effort and a framework for understanding the challenges and opportunities that will guide introduction of smart shunts into patient care. PMID:23653889

  4. Uterine perforation by a cystoperitoneal shunt, an unusual cause of recurrent vaginal discharge.

    Science.gov (United States)

    Poilblanc, Mathieu; Sentilhes, Loïc; Mercier, Philippe; Lefèbvre, Céline; Descamps, Philippe

    2012-01-01

    We describe the first reported case of uterine perforation by a cystoperitoneal shunt. The mechanism of this unusual complication is unclear. A 17-year-old patient had a cystoperitoneal shunt for a porencephalic cyst. She presented with recurrent watery vaginal discharge. A pelvic ultrasound examination showed that the uterus had been perforated by the distal tip of the shunt. The cystoperitoneal shunt was converted to a ventriculo-atrial shunt, and the vaginal discharge subsequently resolved. The appearance of light and clear vaginal discharge in a patient with a cystoperitoneal shunt raises the possibility of uterine perforation. This can be confirmed by ultrasound and analysis of the discharge. Removal of the shunt leads to spontaneous closure of the uterine defect.

  5. Bacterial contamination of surgeons' gloves during shunt insertion; a pilot study

    DEFF Research Database (Denmark)

    Sørensen, Preben; Ejlertsen, Tove; Aaen, Dorte

    2008-01-01

    Bacterial infection is a major cause of shunt dysfunction. It is well-known that the majority of pathogenic micro-organisms are low-virulent bacteria normally found on intact skin. Probably shunts become contaminated during surgery either by contact to the patient skin, or contact from contaminated...... gloves or instruments. This study was performed to find out to what extent gloves become contaminated during shunt surgery. Gloves used during shunt implantation were examined in 10 operations. Shunt implantation was done using recommended precautions to avoid infection, including prophylactic...... nurse and assistant were contaminated with micro-organisms less than 15 min after surgery has been commenced and before the shunts were handled. This study offers a feasible, simple and logical explanation of how shunts may become contaminated and infected. A simple measure would be to change the outer...

  6. Experimental Comparison of Piezoelectric and Magnetostrictive Shunt Dampers

    Science.gov (United States)

    Asnani, Vivake M.; Deng, Zhangxian; Scheidler, Justin J.; Dapino, Marcelo J.

    2016-01-01

    A novel mechanism called the vibration ring is being developed to enable energy conversion elements to be incorporated into the driveline of a helicopter or other rotating machines. Unwanted vibration is transduced into electrical energy, which provides a damping effect on the driveline. The generated electrical energy may also be used to power other devices (e.g., health monitoring sensors). PZT (piezoceramic) and PMN-30%PT (single crystal) stacks, as well as a Tb_0.3 Dy_0.7 Fe_1.92 (Terfenol-D) rod with a bias magnet array and a pickup coil, were tested as alternative energy conversion elements to use within the vibration ring. They were tuned for broadband damping using shunt resistors, and dynamic compression testing was conducted in a high-speed load frame. Energy conversion was experimentally optimized at 750Hz by tuning the applied bias stress and resistance values. Dynamic testing was conducted up to 1000Hz to determine the effective compressive modulus, shunt loss factor, internal loss factor, and total loss factor. Some of the trends of modulus and internal loss factor versus frequency were unexplained. The single crystal device exhibited the greatest shunt loss factor whereas the Terfenol-D device had the highest internal and total loss factors. Simulations revealed that internal losses in the Terfenol-D device were elevated by eddy current effects, and an improved magnetic circuit could enhance its shunt damping capabilities. Alternatively, the Terfenol-D device may be simplified to utilize only the eddy current dissipation mechanism (no pickup coil or shunt) to create broadband damping.

  7. Experimental comparison of piezoelectric and magnetostrictive shunt dampers

    Science.gov (United States)

    Asnani, Vivake M.; Deng, Zhangxian; Scheidler, Justin J.; Dapino, Marcelo J.

    2016-04-01

    A novel mechanism called the vibration ring is being developed to enable energy conversion elements to be incorporated into the driveline of a helicopter or other rotating machines. Unwanted vibration is transduced into electrical energy, which provides a damping effect on the driveline. The generated electrical energy may also be used to power other devices (e.g., health monitoring sensors). PZT (`piezoceramic') and PMN-30%PT (`single crystal') stacks, as well as a Tb0.3Dy0.7Fe1.92 (`Terfenol-D') rod with a bias magnet array and a pickup coil, were tested as alternative energy conversion elements to use within the vibration ring. They were tuned for broadband damping using shunt resistors, and dynamic compression testing was conducted in a high-speed load frame. Energy conversion was experimentally optimized at 750Hz by tuning the applied bias stress and resistance values. Dynamic testing was conducted up to 1000Hz to determine the effective compressive modulus, shunt loss factor, internal loss factor, and total loss factor. Some of the trends of modulus and internal loss factor versus frequency were unexplained. The single crystal device exhibited the greatest shunt loss factor whereas the Terfenol-D device had the highest internal and total loss factors. Simulations revealed that internal losses in the Terfenol-D device were elevated by eddy current effects, and an improved magnetic circuit could enhance its shunt damping capabilities. Alternatively, the Terfenol-D device may be simplified to utilize only the eddy current dissipation mechanism (no pickup coil or shunt) to create broadband damping.

  8. Fuzzy Inference System Approach for Locating Series, Shunt, and Simultaneous Series-Shunt Faults in Double Circuit Transmission Lines.

    Science.gov (United States)

    Swetapadma, Aleena; Yadav, Anamika

    2015-01-01

    Many schemes are reported for shunt fault location estimation, but fault location estimation of series or open conductor faults has not been dealt with so far. The existing numerical relays only detect the open conductor (series) fault and give the indication of the faulty phase(s), but they are unable to locate the series fault. The repair crew needs to patrol the complete line to find the location of series fault. In this paper fuzzy based fault detection/classification and location schemes in time domain are proposed for both series faults, shunt faults, and simultaneous series and shunt faults. The fault simulation studies and fault location algorithm have been developed using Matlab/Simulink. Synchronized phasors of voltage and current signals of both the ends of the line have been used as input to the proposed fuzzy based fault location scheme. Percentage of error in location of series fault is within 1% and shunt fault is 5% for all the tested fault cases. Validation of percentage of error in location estimation is done using Chi square test with both 1% and 5% level of significance.

  9. Rabdomiolisis asociada al tratamiento con valaciclovir

    Directory of Open Access Journals (Sweden)

    Héctor Enríquez Gómez

    2012-03-01

    Full Text Available La rabdomiolisis es un efecto secundario asociado a un buen número de fármacos, entre ellos los antivirales. Describimos un caso de rabdomiolisis secundaria a valaciclovir, efecto no descrito anteriormente en laliteratura, en un contexto clínico muy especial. Se trata de un varón queingresa por un golpe de calor secundario a la realización de ejercicio físicoextremo. Durante su ingreso se comienza tratamiento con valaciclovir porun herpes nasolabial, observándose en los días siguientes una marcadaelevación de las cifras de CPK que desaparece con la suspensión del mismo. Proponemos, por tanto, que ante la administración de valaciclovir ensituaciones que puedan comportar daño mitocondrial habría que realizarmonitorización estrecha de los niveles de CPK

  10. An experimental in-vivo canine model for adult shunt infection

    Directory of Open Access Journals (Sweden)

    Procop Gary

    2008-10-01

    Full Text Available Abstract Background Detailed human studies of the mechanisms and development of shunt infection in real time are not possible, and we have developed a canine hydrocephalus model to overcome this. The intention of this pilot study was to show that the canine hydrocephalus model could be shunted using conventional "human" shunts, and that a shunt infection could be established so that further studies could then be planned. Methods Hydrocephalus was induced in seven dogs (Canis familiaris by fourth ventricle obstruction. Four weeks later they were shunted using a Hakim Precision valve. Four of the dogs received shunts whose ventricular catheter had been inoculated with Staphylococcus epidermidis, and three were uninoculated controls. Four weeks after shunting the dogs were sacrificed and necropsy was performed. Removed shunts and tissue samples were examined microbiologically and isolates were subjected to detailed identification and genomic comparison. Results All the dogs remained well after shunting. Examination of removed shunt components revealed S. epidermidis in the brain and throughout the shunt system in the four inoculated animals, but in two of these Staphylococcus intermedius was also found. S. intermedius was also isolated from all three "negative" controls. There were slight differences between S. intermedius strains suggesting endogenous infection rather than cross- infection from a point source. Conclusion Shunt infection was established in the canine model, and had the experiment been extended beyond four weeks the typical microbiological, pathological and clinical features might have appeared. The occurrence of unplanned shunt infections in control animals due to canine normal skin flora reflects human clinical experience and underlines the usual source of bacteria causing shunt infection.

  11. Predicting ventriculoperitoneal shunt infection in children with hydrocephalus using artificial neural network.

    Science.gov (United States)

    Habibi, Zohreh; Ertiaei, Abolhasan; Nikdad, Mohammad Sadegh; Mirmohseni, Atefeh Sadat; Afarideh, Mohsen; Heidari, Vahid; Saberi, Hooshang; Rezaei, Abdolreza Sheikh; Nejat, Farideh

    2016-11-01

    The relationships between shunt infection and predictive factors have not been previously investigated using Artificial Neural Network (ANN) model. The aim of this study was to develop an ANN model to predict shunt infection in a group of children with shunted hydrocephalus. Among more than 800 ventriculoperitoneal shunt procedures which had been performed between April 2000 and April 2011, 68 patients with shunt infection and 80 controls that fulfilled a set of meticulous inclusion/exclusion criteria were consecutively enrolled. Univariate analysis was performed for a long list of risk factors, and those with p value < 0.2 were used to create ANN and logistic regression (LR) models. Five variables including birth weight, age at the first shunting, shunt revision, prematurity, and myelomeningocele were significantly associated with shunt infection via univariate analysis, and two other variables (intraventricular hemorrhage and coincided infections) had a p value of less than 0.2. Using these seven input variables, ANN and LR models predicted shunt infection with an accuracy of 83.1 % (AUC; 91.98 %, 95 % CI) and 55.7 % (AUC; 76.5, 95 % CI), respectively. The contribution of the factors in the predictive performance of ANN in descending order was history of shunt revision, low birth weight (under 2000 g), history of prematurity, the age at the first shunt procedure, history of intraventricular hemorrhage, history of myelomeningocele, and coinfection. The findings show that artificial neural networks can predict shunt infection with a high level of accuracy in children with shunted hydrocephalus. Also, the contribution of different risk factors in the prediction of shunt infection can be determined using the trained network.

  12. Tratamiento de la obesidad con productos naturales

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    Lina Neri Espinosa Pire

    2016-12-01

    Full Text Available Los crecientes índices de obesidad alrededor del mundo, provocados principalmente por los excesos en la ingesta y la vida sedentaria, constituye uno de los grandes problemas de salud pública en nuestras sociedades. Entre otras formas como dietas y tratamientos que surgen cada día para combatir la obesidad, el uso de plantas medicinales conocido como fitoterapia, ha despertado gran interés. Existen ciertas plantas que poseen propiedades adelgazantes, sin embargo, lo mejor es ponerse en manos de especialistas en este campo, para recibir una correcta asesoría de acuerdo a las necesidades personales. Las plantas medicinales y los productos que de ellas se obtienen, constituyen remedios eficaces para combatir la obesidad, pues no tienen efectos adversos. No obstante el tratamiento debe combinarse con un cambio de hábitos alimentarios y actividad física y no conviene utilizarlos irresponsablemente, pues no todos tienen los mismos beneficios y efectos. La eficacia de la aplicación de plantas con la finalidad de bajar de peso ha sido comprobada en numerosos ensayos clínicos que se han realizado con determinadas especies vegetales. Las plantas medicinales se han utilizado tradicionalmente en forma de infusión, sin embargo esta forma de administración no permite controlar efectivamente las dosis administradas, por lo que es preferible hacerlo en preparados como cápsulas o comprimidos. Cada planta deberá administrarse de una manera específica y es importante que los preparados se tomen siempre en el mismo horario para potenciar su efectividad.

  13. A comparison of micropore membrane inlet mass spectrometry-derived pulmonary shunt measurement with Riley shunt in a porcine model.

    Science.gov (United States)

    Duenges, Bastian; Vogt, Andreas; Bodenstein, Marc; Wang, Hemei; Böhme, Stefan; Röhrig, Bernd; Baumgardner, James E; Markstaller, Klaus

    2009-12-01

    The multiple inert gas elimination technique was developed to measure shunt and the ratio of alveolar ventilation to simultaneous alveolar capillary blood flow in any part of the lung (V(A)'/Q') distributions. Micropore membrane inlet mass spectrometry (MMIMS), instead of gas chromatography, has been introduced for inert gas measurement and shunt determination in a rabbit lung model. However, agreement with a frequently used and accepted method for quantifying deficits in arterial oxygenation has not been established. We compared MMIMS-derived shunt (M-S) as a fraction of total cardiac output (CO) with Riley shunt (R-S) derived from the R-S formula in a porcine lung injury model. To allow a broad variance of atelectasis and therefore shunt fraction, 8 sham animals did not receive lavage, and 8 animals were treated by lung lavages with 30 mL/kg warmed lactated Ringer's solution as follows: 2 animals were lavaged once, 5 animals twice, and 1 animal 3 times. Variables were recorded at baseline and twice after induction of lung injury (T1 and T2). Retention data of sulfur hexafluoride, krypton, desflurane, enflurane, diethyl ether, and acetone were analyzed by MMIMS, and M-S was derived using a known algorithm for the multiple inert gas elimination technique. Standard formulas were used for the calculation of R-S. Forty-four pairs of M-S and R-S were recorded. M-S ranged from 0.1% to 35.4% and R-S from 3.7% to 62.1%. M-S showed a correlation with R-S described by linear regression: M-S = -4.26 + 0.59 x R-S (r(2) = 0.83). M-S was on average lower than R-S (mean = -15.0% CO, sd = 6.5% CO, and median = -15.1), with lower and upper limits of agreement of -28.0% and -2.0%, respectively. The lower and upper limits of the 95% confidence intervals were -17.0 and -13.1 (P < 0.001, Student's t-test). Shunt derived from MMIMS inert gas retention data correlated well with R-S during breathing of oxygen. Shunt as derived by MMIMS was generally less than R-S.

  14. INFLUENCIA DEL TRATAMIENTO CON AMINAS EN LOS PARAMETROS HEMODINAMICOS y METABOLICOS EN EL SHOCK SEPTICO EXPERIMENTAL

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    Felisa Alonso Garcia,

    2003-01-01

    Full Text Available OBJETIVO: Estudiar las variaciones hemodinámicas y metabólicas de las primeras fases del Shock Séptico Experimental (SSE, inducidas por el tratamiento con distinta asociación de aminas. METODO: Investigación experimental en 22 perros. Se les indujo SSE mediante la administración de endotoxina de E. Coli (Serotipo 0111 B.M. Difco Laboratories. Michigan. USA. En función del tiempo se establecieron 5 fases: Basal ó "t=0" (considerado tiempo 0, SSE ó "t=30" (a los 30 minutos del inicio de la infusión del estímulo séptico, "t = 60", "t = 90" y "t = 120" a los 60, 90 y 120 minutos respectivamente de la administración de la endotoxina. En relación al tratamiento administrado, se distinguieron 3 grupos: Grupo A (n=7: tratamiento de soporte; Grupo B (n=8: Dopamina a 10 mcg/kg/min y Dobutamina a 5 mcg/kg/min (DPDB en la fase "t=60", DPDB más Noradrenalina (NA a 0,5 mcg/kg/min (NA0,5 en la fase "t=90"; DPDB más NA a 1 mcg/kg/min (NA1 en la fase "t=120"; Grupo C (n=7: Dopexamina a 12 mcg/kg/min (DX en la fase "t=60", DX más NA0,5 en la fase "t=90" y DX más NA1 en la fase "t=120". La comparación estadística se realizó mediante: "t" de Student-Fisher, Análisis de la Varianza, Chi Cuadrado y cálculo de la potencia estadística en caso necesario. RESULTADOS: Grupo B respecto al A: DP-DB NA0.5 aumentó la Frecuencia cardiaca (FC; DPDB-NA1 además incrementó la Presión diastólica (TAD. Grupo C respecto al A: DX- NA0,5 aumentó la FC; DX- NA1, incrementó la FC y TAD. CONCLUSIONES: La FC, TAS y TAD, se modificaron significativamente con las diversas asociaciones de aminas, mientras que no se evidenciaron variaciones intergrupo de la glucemia y plaquetas. Los cambios significativos en las últimas fases de la investigación experimental, de la glucemia y de las plaquetas, fueron secundarios a la progresión del shock séptico experimental y no a la diferente terapia recibida en cada grupo (ya que se comportaron de forma independiente al

  15. Microestructura y propiedades de capas de tribaloy T-800 depositadas mediante plaqueado láser

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    Navas, C.

    2004-04-01

    Full Text Available The present work is based on obtaining Co based coatings (Tribaloy T-800 on plates of 18/8 stainless steel (AISI 304 by laser cladding technique. After the treatment, samples were characterized by optical and scanning electron microscopy with EDS analysis. The elemental composition of the coating was determined with a glow discharge lamp spectrometer (GDL. The study of the interface revealed a good adherence between the substrate and coating without substantial defects. For the laser cladded coatings, the microstructure was dendritic with a high degree of refinement and chemical homogeneity close to the original powder. The grain coarsening was observed in the overlapping zones due to the second heat treatment. Microhardness of the coatings reached 750 HV, a considerably higher value than the substrate hardness (200 HV. Also, the coating corrosion resistance in saline solutions had a great improvement.

    El presente trabajo se centra en la obtención de capas de aleación base Cobalto (Tribaloy T-800 sobre un sustrato de acero inoxidable 18/8 (AISI 304 mediante la técnica de plaqueado láser. Tras los tratamientos, se caracterizaron las probetas mediante microscopía óptica y electrónica de barrido con microanálisis (EDS. La composición elemental del recubrimiento se determinó en un espectrómetro de emisión óptica con fuente de excitación (GDL. El estudio de la interfase reveló una perfecta adherencia entre el recubrimiento y el material base, sin defectos apreciables. La microestructura de las capas depositadas es dendrítica con un alto grado de refinamiento y una homogeneidad química a lo largo del cordón y con valores muy próximos a los del polvo de partida. En las zonas de solape entre cordones, se observó un crecimiento del grano debido al segundo tratamiento térmico recibido. La microdureza de las capas alcanza los 750 HV, valor considerablemente superior al del sustrato (200 HV. Asimismo, se obtuvo una mejora

  16. Tratamiento con eritropoyetina humana recombinante Human recombinant erythropoietin therapy

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    Hugo Donato

    2006-02-01

    Full Text Available La eritropoyetina recombinante (rHuEPO se ha transformado en la citoquina más utilizada terapéuticamente en el mundo. Luego del éxito obtenido en pacientes con insuficiencia renal terminal, se pudo establecer la utilidad de la terapia con rHuEPO para mejorar otras anemias, incluso en pacientes pediátricos y neonatos. El tratamiento o la prevención de la anemia del prematuro mediante el uso de rHuEPO llevó a una significativa reducción en cantidad de transfusiones y en exposición a dadores. Aún debe establecerse una clara definición sobre cuáles niños prematuros deben recibir tratamiento rutinariamente. Otras indicaciones en período neonatal incluyen anemias hiporregenerativas y hemolíticas. La eficacia de la rHuEPO en niños mayores, con excepción de la insuficiencia renal crónica, no ha sido tan exhaustivamente evaluada como en adultos. Mientras que durante los últimos años se han realizado gran cantidad de estudios en adultos con anemia asociada al cáncer o a infección por HIV, permitiendo establecer conclusiones claras sobre su eficacia, sólo escasa cantidad de estudios con pequeño número de pacientes han sido realizados en niños. Hasta la fecha, los resultados sugieren que la terapia con rHuEPO en niños es tan útil como en adultos, pero la realización de estudios aleatorizados prospectivos incluyendo gran número de pacientes es esencial para alcanzar conclusiones definitivas. Los resultados de estudios dirigidos a evaluar la eficacia de la rHuEpo para mantener una dosis adecuada de ribavirina en pacientes en tratamiento por hepatitis C son alentadores. La utilización potencial de los efectos no hemopoyéticos de la rHuEPO en neonatos es un terreno novedoso y apasionante. El rol de la Epo como citoprotector para sistema nervioso central y mucosa intestinal está bajo investigación exhaustiva.Recombinant human erythropoietin (rHuEpo has become the most widely used cytokine in the world. Following the success of

  17. Resultados del tratamiento a pacientes con tríada terrible del codo

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    Héctor Gabriel Díaz Carrillo

    2015-04-01

    Full Text Available La luxación del codo, asociada a la fractura del proceso coronoideo y a la fractura de la cabeza radial, es denominada “tríada terrible del codo”, debido a la complejidad al abordar el tratamiento correcto y lo desalentador de los resultados que se obtienen con el mismo. Se realizó un estudio prospectivo, donde se recogen los resultados postoperatorios, obtenidos en cuatro pacientes con inestabilidad traumática aguda del codo, tratados entre enero de 2012 y mayo de 2013, que acudieron inicialmente al cuerpo de guardia del Hospital General Docente “Dr. Ernesto Guevara de La Serna” y tuvieron un seguimiento medio de ocho meses. El proceder consistió en reparación de la coronoides, del ligamento lateral externo, reparación de la cúpula radial, cupulectomía y colocación de pin endomedular; la técnica operatoria a emplear se definió por los estudios radiográficos realizados y los hallazgos en el transcurso del proceder. Los pacientes, tres hombres y una mujer, tuvieron cinco codos lesionados y un promedio de edad de 34 años. Como resultado del tratamiento la flexión fue normal entre 130-135° en 4 codos y limitada en uno a 110°, la extensión se encontró limitada de 8 a 21° en todos los pacientes, la pronosupinación se mantuvo limitada en todos los casos entre 5 y 22°. La intervención quirúrgica mediante fijación y reparación de los estabilizadores del codo proporcionó a corto plazo una funcionabilidad del codo cercana a la normalidad, los pacientes evolucionaron positivamente. Las complicaciones fueron: reluxación, infección local y aflojamiento de la osteosíntesis

  18. Rol de la Ortodoncia y la Ortopedia en el tratamiento de pacientes con traumatismos a nivel dentoalveolar. Reporte de casos

    Directory of Open Access Journals (Sweden)

    Grassi-A

    2014-01-01

    Full Text Available Se presentan 2 casos clínicos de pacientes con traumatismos dentarios que avalan la importancia de un abordaje multidisciplinario a fin de optimizar su resolución. Se resalta el rol del ortodoncista y el ortopedista dento-máxilo-facial en la prevención, atención adecuada de las diferentes situaciones que pueden presentarse en el transcurso de un traumatismo, y rehabilitación en las diferentes etapas de la dentición, optimizando resultados mediante una fluida interrelación con otros profesionales. Se enfatiza la importancia de que, en la etapa diagnóstica y de planificación de los tratamientos, el profesional sea capaz de detectar secuelas de posibles traumatismos, que de pasar inadvertidos pueden complicar la resolución del caso

  19. Caracterización nutricional del cactus nopal (Opuntia ficus-indica bajo diferentes tratamientos de fertilización

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Rodríguez-M.

    2011-02-01

    Full Text Available Nuestro planeta se enfrenta actualmente a grandes cambios en su ambiente natural, no sólo como consecuencia de su evolución, sino también del acelerado proceso de degradación antrópica. Dentro de este contexto se origina la necesidad de buscar soluciones que mitiguen el bajo nivel de vida del campesino, dadas las precarias condiciones de muchos de los actuales ecosistemas, que no permiten implementar los modelos tradicionales de explotación desmesurada de los recursos. El cactus nopal  (Opuntia ficus-indica ofrece ventajas en la producción animal, presentándose como una alternativa agroecológica, fácil de implementar en zonas semiáridas bajo condiciones adversas y con un mínimo de insumosagropecuarios. El  objetivo de este estudio fue evaluar el desempeño nutricional del cactus nopal bajo cuatro tipos de fertilización, mediante el análisis proximal de alimentos, implementado en el laboratorio de nutrición animal de la Universidad Pedagógica y Tecnológica de Colombia, UPTC sede Tunja, en los especímenes de cactus nopal existentes en el jardín botánico de la misma. Se utilizaron cuatro tipos de tratamientos para la fertilización: 1.Químico, 2.Orgánico, 3. Químico + Orgánico y 4.Testigo, aplicados en intervalos de veinte (20 días, por tres veces, aplicando también agua en un riego semanal; tiempo al cabo del cual se realizó la valoraciónnutricional, en donde el Tratamiento 2 (Orgánico fue el de mejor desempeño, seguido por el Tratamiento 3, luego el tratamiento 1 y, por último, el tratamiento 4 (testigo.

  20. What is the risk of infecting a cerebrospinal fluid-diverting shunt with percutaneous tapping?

    Science.gov (United States)

    Spiegelman, Lindsey; Asija, Richa; Da Silva, Stephanie L; Krieger, Mark D; McComb, J Gordon

    2014-10-01

    Most CSF-diverting shunt systems have an access port that can be percutaneously tapped. Tapping the shunt can yield valuable information as to its function and whether an infection is present. The fear of causing a shunt infection by tapping may limit the physician's willingness to do so. The authors of this study investigate the risk of infecting a shunt secondary to percutaneous tapping. Following institutional review board approval, CSF specimens obtained from tapping an indwelling CSF-diverting shunt during the 2011 and 2012 calendar years were identified and matched with clinical information. A culture-positive CSF sample was defined as an infection. If results were equivocal, such as a broth-only-positive culture, a repeat CSF specimen was examined. The CSF was obtained by tapping the shunt access port with a 25-gauge butterfly needle after prepping the unshaven skin with chlorhexidine. During the study period, 266 children underwent 542 shunt taps. With 541 taps, no clinical evidence of a subsequent shunt infection was found. One child's CSF went from sterile to infected 11 days later; however, this patient had redness along the shunt tract at the time of the initial sterile tap. The risk of infection from tapping a shunt is remote if the procedure is done correctly.

  1. Factores que influyen en la adherencia al tratamiento del paciente en diálisis peritoneal

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    Jenny Forero Villalobos

    Full Text Available Resumen Introducción: Actualmente, los profesionales de enfermería al implementar los cuidados para el paciente con enfermedad renal crónica mediante diálisis peritoneal, encuentran como principal dificultad la poca adherencia del mismo en las áreas correspondientes al dominio en la técnica, control de factores nutricionales, control hídrico y manejo farmacológico entre otros; los cuales conllevan un impacto negativo en la permanencia en la terapia así como en la supervivencia. Objetivo: Explorar los factores que influyen en la adherencia de los pacientes adultos a la terapia dialítica peritoneal y las consecuencias de la falta de ésta reportadas en la literatura. Material y Método: La búsqueda electrónica se realizó utilizando las bases de datos PUBMED, meta buscadores como google académico, Epistemonikos, Scielo, entre otros. Se consideraron estudios primarios realizados en pacientes adultos de 18 a 80 años, entre los años 2008-2015, en idioma inglés y español. Resultado: Los pacientes en DP presentan problemas de falta de adherencia en mayor proporción en los parámetros nutricionales, restricción de fluidos seguida del manejo correcto de la técnica y pautas farmacológicas indicadas por el profesional de la salud. Conclusión: La adherencia al tratamiento del paciente en diálisis peritoneal debe ser explorada por enfermería por su diversa complejidad mediante estudios fenomenológicos.

  2. Soporte social percibido en cuidadores familiares de personas en tratamiento contra el cáncer

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    Henry Mauricio Puerto Pedraza

    2017-01-01

    Full Text Available Introducción: El cáncer se reconoce como un problema universal que afecta a las personas de cualquier edad, género, cultura y situación económica, además impone fuertes cargas financieras y sociales para la persona enferma al igual que su familia. El objetivo fue determinar el Soporte social percibido en enfermedad crónica en los cuidadores familiares de personas en tratamiento contra el cáncer. Materiales y Métodos: Estudio descriptivo de corte transversal, se entrevistaron 75 cuidadores familiares de personas en tratamiento contra el cáncer a los cuales se les aplicó el instrumento "Soporte social percibido en enfermedad crónica". El análisis se realizó mediante estadística descriptiva y estratificación de la escala Soporte social percibido. Resultados: Los cuidadores familiares son en mayoría mujeres de estratos socioeconómicos 1 y 2, de escolaridad primaria incompleta el (37,3%, en relación al estado civil se informó estar casados o en unión libre (66,7%, de ocupación hogar (50,7%, con una mediana de 18 horas de cuidado. Los cuidadores familiares presentan una percepción media del soporte social percibido de (36%. Las subescalas del instrumento reportan puntajes medios en la interacción personal (42,7%, guía (40%, retroalimentación (41,3% ayuda tangible (28%, interacción social (45,3%. Discusión: Se hace necesario abordar el soporte social desde una perspectiva holística donde las interrelaciones de salud física, emocional, funcionamiento familiar y social respondan a las necesidades de los cuidadores familiares. Conclusiones: El soporte social es conocido por ser la fuerza más grande y poderosa que facilita el éxito cuando una persona y su cuidador se ven amenazadas por el cáncer. Cómo citar este artículo: Puerto HM. Soporte social percibido en cuidadores familiares de personas en tratamiento contra el cáncer. Rev Cuid. 2017; 8(1:1407-22. http://dx.doi.org/10.15649/cuidarte.v8i1.345

  3. Fitoterapia como coadyuvante en el tratamiento de la obesidad

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    López-Regueiro S

    2013-03-01

    Full Text Available La obesidad es uno de los problemas de salud más importantes a nivel mundial debido a su relación con numerosas patologías como la diabetes mellitus tipo 2, la hipertensión y el aumento importante en el riesgo cardiovascular. La base del tratamiento es la dieta y el ejercicio físico, pero en muchos casos no es sufi ciente y es necesario combinarlo con tratamiento farmacológico. Recientemente se ha retirado sibutramina del mercado por lo que sólo se dispone de orlistat, que no está exento de contraindicaciones y efectos secundarios. Ante esta situación, se ha vuelto a retomar el tratamiento fi toterápico, aunque, en muchas ocasiones, con numerosas dudas. Esta revisión pretende aportar la información necesaria sobre las principales plantas utilizadas en este tratamiento.

  4. Fitoterapia como coadyuvante en el tratamiento de la obesidad

    Directory of Open Access Journals (Sweden)

    López-Regueiro S

    2012-12-01

    Full Text Available La obesidad es uno de los problemas de salud más importantes a nivel mundial debido a su relación con numerosas patologías como la diabetes mellitus tipo 2, la hipertensión y el aumento importante en el riesgo cardiovascular. La base del tratamiento es la dieta y el ejercicio físico, pero en muchos casos no es suficiente y es necesario combinarlo con tratamiento farmacológico. Recientemente se ha retirado sibutramina del mercado por lo que sólo se dispone de orlistat, que no está exento de contraindicaciones y efectos secundarios. Ante esta situación, se ha vuelto a retomar el tratamiento fitoterápico, aunque, en muchas ocasiones, con numerosas dudas. Esta revisión pretende aportar la información necesaria sobre las principales plantas utilizadas en este tratamiento.

  5. Amebiasis: Epidemiología y Tratamiento

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    Alberto Albornoz Plata

    1986-08-01

    Full Text Available

    Introducción

    El concepto que se tenía hace varios años de “Enfermedades Tropicales” (se pensaba en un tipo de medicina exótica, como se llamaban en Europa, la malaria y amebiasis ha cambiado totalmente en la actualidad y específicamente para la amebiasis en el sentido de considerarla como enfermedad universal a la que puede ser susceptible cualquier ser humano que viva en cualquier sitio del mundo. Actualmente esta parasitosis cobra especial interés por los estudios inmunológicos, enzimáticos, epidemiológicos, metabólicos y terapéuticos que se desarrollan en centros muy especializados y se supone, con fundamento lógico, que no estará lejos el día en que se disponga de una vacuna eficaz contra esta enfermedad que ataca a muchas gentes, es causa de ausentismo al trabajo, incapacita por períodos largos a muchos pacientes por la complicación hepática y muchas veces es causa de mortalidad en los llamados casos de amebiasis invasora-fulminante.

    En este escrito solo se explicará lo referen te al aspecto epidemiológico y preventivo y, además, se hará énfasis para combatir ideas diagnósticas equivocadas con la entidad colon irritable.

    Al final se explicará el tratamiento actual de la amebiasis.

    Prevalencia y Susceptibilidad
    La amebiasis se considera como una enfermedad mundial, pero la mayor frecuencia es en aquellos lugares en donde las condiciones higiénicas ambientales son defectuosas, en especial lo referente al correcto suministro de agua potable, al buen tratamiento de las excretas y al control sanitario de los alimentos; por este motivo, en los países sub-desarrollados, o mejor subprivilegiados, y en las clases socio-económicas débiles, es donde más se encunetra esta enfermedad.

    Se ha calculado que en el mundo, el 20%de la población alberga la Endamoeba histolytica (l pero la gran mayoría no se consideran enfermos ya que son simplemente

  6. TRATAMIENTO DE AGUA RESIDUAL MUNICIPAL POR UN SISTEMA FISICOQUÍMICO Y OXIDACIÓN QUÍMICA EN FLUJO CONTINUO

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    Lina A. Bernal-Martínez

    2011-01-01

    Full Text Available El objetivo de este trabajo fue la remoción de contaminantes de un efluente de aguas residuales municipales, mediante tratamientos fisicoquímicos de coagulación-floculación, sedimentación, filtración, oxidación química y desinfección en un tren de tratamiento en flujo continúo a 1.65 mL/s. Para el proceso de coagulación-floculación se utilizó una dosis de 1mL/L de Al2(SO43 0.01 M, los filtros fueron empacados de arena sílice natural y carbón activado proveniente de concha de coco, en el proceso de oxidación química se aplicó una concentración de 3 mg/L de ozono con un tiempo de contacto de 10 a 15 min, la desinfección se realizó mediante radiación ultravioleta a una longitud de onda de 253-260 nm. La remoción obtenida fue del 98% de color, 94% de turbiedad, 93% de DQO, 93% de DBO5, el 84 de SAAMS, el 63% de NH3, el 98% de coliformes totales y fecales.

  7. An Adaptive Speed Control Approach for DC Shunt Motors

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    Ruben Tapia-Olvera

    2016-11-01

    Full Text Available A B-spline neural networks-based adaptive control technique for angular speed reference trajectory tracking tasks with highly efficient performance for direct current shunt motors is proposed. A methodology for adaptive control and its proper training procedure are introduced. This algorithm sets the control signal without using a detailed mathematical model nor exact values of the parameters of the nonlinear dynamic system. The proposed robust adaptive tracking control scheme only requires measurements of the velocity output signal. Thus, real-time measurements or estimations of acceleration, current and disturbance signals are avoided. Experimental results confirm the efficient and robust performance of the proposed control approach for highly demanding motor operation conditions exposed to variable-speed reference trajectories and completely unknown load torque. Hence, laboratory experimental tests on a direct current shunt motor prove the viability of the proposed adaptive output feedback trajectory tracking control approach.

  8. US and angiographic examination of brachial dialysis shunts

    International Nuclear Information System (INIS)

    Langer, R.; Langer, M.F.J.; Zwicker, C.; Wakat, J.P.; Treisch, J.

    1988-01-01

    In an experimental study, 13 bypass grafts and eight patches were evaluated. With PTFE-Vitagraft, IMPRA, and Microvel Haemashield grafts total reflection occurred, so that these grafts are not suitable for ultrasound (US) examination. In a prospective clinical trial 40 patients were examined with intraarterial digital subtraction angiography (DSA) and US of the hemodialysis shunts; for DSA, a contrast material with 150 mg/mL of iodine was used. The image quality was excellent in all cases, and no sensation of pain was reported, only a mild sensation of warmth during the injection. The evaluation of image quality for the sonographic investigation showed the following results: shunt artery, 74% excellent, 17% good, and 9% nondiagnostic; anastomosis, 70% excellent, 26% good, and 4% nondiagnostic; draining vein, 91% excellent and 9% good. US is a suitable screening procedure, and DSA can be performed preoperatively without major discomfort and with excellent image quality

  9. Management of intracranial dural arteriovenous shunts in adults

    International Nuclear Information System (INIS)

    Sarma, Dipanka; Brugge, Karel ter

    2003-01-01

    Dural arteriovenous shunts are abnormal arteriovenous communications within the dura. They are thought to be an acquired condition in adults and can present with a variety of clinical features, ranging from benign bruits to intracranial hemorrhage and neurological deficits. The presentation and natural history of these shunts is largely determined by the pattern of venous drainage. Knowledge of natural history and careful study of the angioarchitexture by angiography is therefore mandatory for correct management of these lesions. In this review, principles of management in adults and the various factors that influence treatment decisions are discussed, with a focus on endovascular therapy. Retrograde leptomeningeal or cortical venous drainage has a strong correlation with adverse clinical events and the requirement for aggressive management in this situation is highlighted. Indications for endovascular treatment, therapeutic goals, approaches and techniques are reviewed. The role of surgical treatment is also briefly discussed

  10. Endoscopic third ventriculostomy has no higher costs than ventriculoperitoneal shunt

    Directory of Open Access Journals (Sweden)

    Benicio Oton de Lima

    2014-07-01

    Full Text Available Objective: To evaluate the cost of endoscopic third ventriculostomy (ETV compared to ventriculoperitoneal shunt (VPS in the treatment of hydrocephalus in children. Method: We studied 103 children with hydrocephalus, 52 of which were treated with ETV and 51 with VPS in a prospective cohort. Treatment costs were compared within the first year after surgery, including subsequent surgery or hospitalization. Results: Twenty (38.4% of the 52 children treated with VPS needed another procedure due to shunt failure, compared to 11 (21.5% of 51 children in the ETV group. The average costs per patient in the group treated with ETV was USD$ 2,177,66±517.73 compared to USD$ 2,890.68±2,835.02 for the VPS group. Conclusions: In this series there was no significant difference in costs between the ETV and VPS groups.

  11. GABA shunt in the callus cells derived from soybean cotyledon

    Energy Technology Data Exchange (ETDEWEB)

    Tokunaga, M; Nakano, Y; Kitaoka, S [Osaka Prefectural Univ., Sakai (Japan). Coll. of Agriculture

    1975-01-01

    In the growing callus cells from soybean cotyledon, the activities of glutamate decarboxylase and GABA transaminase were increased in the early phase of the callus growth on the Miller agar medium. Succinate dehydrogenase activity was also changed in a similar manner. From these and the additional evidences that GABA transaminase was probably localized in the mitochondria, it has been made clear that the GABA shunt (GABA by-pass pathway) is operative and contributes to the respiratory metabolism in growing callus cells. Feeding young callus cells with GABA-U-/sup 14/C for 24 hr actually resulted in finding 53% of the taken up radioactivity in released carbon dioxide. Considerable parts of the taken up radioactivity were found in amino acids and proteins which should have been formed via the GABA shunt also.

  12. Anatomy and Classification of Gastrorenal and Gastrocaval Shunts

    Science.gov (United States)

    Sabri, Saher S.; Saad, Wael E. A.

    2011-01-01

    The gastric varices communicate with gastrorenal and gastrocaval shunts and are classified according to the pattern of venous inflow into three types, which differ in the number and location of the inflow veins. The gastric varices are also classified according to their venous drainage into four different types, reflecting the size and number of collateral veins communicating with the gastric varices and the gastrorenal/gastrocaval shunt. Lastly, the gastric varices are classified according to their appearance on balloon-occluded retrograde venography into five grades representing the degree of opacification of the gastric varices and the collateral veins. Understanding these anatomic classifications is crucial in planning endovascular obliteration of gastric varices. PMID:22942547

  13. Analysis and control of a shunt active power filter

    Energy Technology Data Exchange (ETDEWEB)

    Ottersten, R.; Petersson, Andreas [Chalmers Univ. of Technology, Goeteborg (Sweden). Dept. of Electric Power Engineering

    1999-09-01

    This report deals with active power filtering of low-frequency current harmonics. The active filter consists of a forced-commutated voltage source inverter with a digital control system. The aim of this master thesis is to investigate the performance of a shunt active power filter, and the parameters influence on the system performance. Three different harmonic identification methods are presented and compared. The shunt active power filter is very well suited for harmonic current reduction, provided that the phase shift due to the digital implementation of the control system is compensated. The performance of the active power filter depends on the switching frequency. When using individual harmonic detection methods the amount of compensation can be fully controlled for each current harmonic.

  14. Fobia social: Naturaleza, evaluación y tratamiento (2015)

    OpenAIRE

    Bados López, Arturo

    2015-01-01

    Se abordan diversos aspectos de la fobia social: naturaleza, edad de comienzo y curso, frecuencia, problemas asociados, génesis y mantenimiento, métodos e instrumentos de evaluación, y eficacia y utilidad clínica del tratamiento psicológico y farmacológico. Además, se ofrecen guías para aplicar los tratamientos psicológicos más eficaces.

  15. Cervicoartrosis: efectividad de un tratamiento fisioterápico convencional

    OpenAIRE

    Pérez Navarro, Mario; García Madrid, José Luis; Pérez Albert, José María; Martínez Fuentes, Juan

    2005-01-01

    El objetivo de este estudio consiste en valorar la efectividad de un tratamiento de fisioterapia convencional para la cervicoartrosis (microondas, tracción cervical, movilización activa, masaje e higiene postural). Para su realización, se han seleccionado 32 pacientes (26 mujeres y 6 hombres) diagnosticados de cervicoartrosis. Se han valorado factores como el dolor y el balance articular. Tras analizar los resultados, concluimos que el tratamiento planteado es efectivo en la patol...

  16. Tratamiento de un caso de pedofilia desde la terapia de aceptación y compromiso (ACT

    Directory of Open Access Journals (Sweden)

    Rafael Jiménez Díaz

    2016-09-01

    Full Text Available En este artículo se expone un caso clínico de pedofilia en el que la conducta (masturbación con cierto contenido mental tenía consecuencias tanto positivas como negativas para el cliente. Debido a este conflicto, cuando el cliente experimentaba deseos pedófilos, intentaba controlarlos o evitarlos, empeorando paradójicamente el problema debido a las consecuencias negativas adicionales que el acto de control llevaba consigo, como mostrará el análisis funcional. Como tratamiento se aplicó la terapia de aceptación y compromiso (ACT con el objetivo de que el cliente saliera del círculo vicioso de lucha y rendición respecto a la conducta pedófila mediante la aceptación de sus eventos privados, ya que esta aceptación está al servicio de acciones valiosas. Por último, se propone que la ACT muestra potencial en el tratamiento de este tipo de problemas, ya que, en el caso tratado, produce una disminución del sufrimiento subjetivo experimentado por el cliente y la realización de conductas encaminadas a sus propios valores personales.

  17. Estilo de afrontamiento y resultados del tratamiento de exposición en sujetos con fobia a volar

    Directory of Open Access Journals (Sweden)

    Jordi Miró

    2003-01-01

    Full Text Available El objetivo de este trabajo cuasi-experimental es doble. Por una parte, se trata de estudiar si el estilo de afrontamiento de los pacientes (buscadores y evitadores de información; monitoring y blunting está relacionado con los efectos de la terapia de exposición; por otra, examinar si este estilo está relacionado con sesgos de atención. Aplicamos el CAFFT (Computer Assisted Fear of Flying Treatment, esto es, un programa de exposición asistido por ordenador, a una muestra de 17 personas con miedo a volar en avión. Para la evaluación del estilo de afrontamiento empleamos la versión española de la Miller Behavioural Style Scale, mientras que los sesgos de atención fueron valorados mediante el test Stroop . Los resultados muestran que el tratamiento fue efectivo, y si bien no detectan relación con el estilo de afrontamiento, se observa que el estilo de búsqueda de información (por ejemplo, monitoring está asociado con mayores trastornos antes del tratamiento, aunque éstos desaparecen tras el mismo. Nuestros datos también muestran una relación estadísticamente significativa entre sesgo de atención y estilo de afrontamiento.

  18. Influencia del tratamiento HIP en la distribución de los carburos en prótesis Co-Cr-Mo

    Directory of Open Access Journals (Sweden)

    Amigó, V.

    2004-04-01

    Full Text Available The development of porous coatings by microspheres sintering is made on cobalt alloys at high temperatures. These temperatures modify the base alloy microstructure, and some partial fusions can appear if temperatures are about eutectic temperature. High temperature is conditioned by diffusion in these alloy, needed to form adequate bonds between beads and substrate Solution annealing and hot isostatic pressing process (HIP modify the casting microstructure and reduce the porosity. These treatments involve high temperatures like 1200°C, dissolving carbides and modifying its morphology and distribution. The influence of HIP treatment in the evolution of distribution and morphology of carbides is studied.

    El desarrollo de recubrimientos porosos por sinterizado de microesferas en prótesis de cobalto precisa de una sinterización a temperaturas elevadas, a las que se producen cambios microestructurales notables e incluso fusiones parciales al superar la temperatura de transformación eutéctica de estas aleaciones Co-Cr-Mo. Las temperaturas tan elevadas de tratamiento de sinterización vienen condicionadas por la difusividad en estas aleaciones y la necesidad de crear los cuellos necesarios entre las bolas y éstas con el material base, de manera que permitan unas características mecánicas adecuadas a la aplicación de las prótesis. Estos cambios microestructurales, desde la microestructura de colada de la aleación, pueden ser controlados mediante los tratamientos complementarios de solubilización. Además, es frecuente someter al material de colada, para reducir la porosidad residual y modificar la distribución de los poros, a prensado isostático en caliente, HIP, a temperaturas alrededor de los 1200°C. Este nuevo tratamiento permite una redisolución de parte de los carburos con una modificación importante del lugar de precipitación de los mismos durante el enfriamiento lento que los lleva hacia borde de grano, con un notable

  19. Shunted-Josephson-junction model. I. The autonomous case

    DEFF Research Database (Denmark)

    Belykh, V. N.; Pedersen, Niels Falsig; Sørensen, O. H.

    1977-01-01

    The shunted-Josephson-junction model: the parallel combination of a capacitance, a phase-dependent conductance, and an ideal junction element biased by a constant current, is discussed for arbitrary values of the junction parameters. The main objective is to provide a qualitative understanding...... current-voltage curves are presented. The case with a time-dependent monochromatic bias current is treated in a similar fashion in the companion paper....

  20. Integrating rolling stock scheduling with train unit shunting

    DEFF Research Database (Denmark)

    Haahr, Jørgen Thorlund; Lusby, Richard Martin

    2017-01-01

    In this paper, we consider integrating two important railway optimization problems, in particular the Rolling Stock Scheduling Problem and the Train Unit Shunting Problem. We present two similar branch-and-cut based approaches to solve this integrated problem and, in addition, provide a comparison......, sequential approach ends in infeasibility. Furthermore, for the considered instances, solutions are typically found within a few minutes, indicating the applicability of the methodology to short-term planning....

  1. Pre-Liver Transplant: Tips Versus Distal Splenorenal Shunt

    Directory of Open Access Journals (Sweden)

    Thomas W. Faust

    1997-01-01

    Full Text Available Recurrent variceal bleeding in liver transplant candidates with end-stage liver disease can complicate or even prohibit a subsequent transplant procedure (OLT. Endoscopic sclero-therapy and medical therapy are considered as first-line management with surgical shunts reserved for refractory situations. Surgical shunts can be associated with a high mortality in this population and may complicate subsequent OLT. The transjugular intrahepatic portosystemic shunt (TIPS has been recommended in these patients as a bridge to OLT. This is a new modality that has not been compared with previously established therapies such as the distal splenorenal shunt (DSRS. In this study we report our experience with 35 liver transplant recipients who had a previous TIPS (18 patients or DSRS (17 patients for variceal bleeding. The TIPS group had a significantly larger proportion of critically ill and Child-Pugh C patients. Mean operating time was more prolonged in the DSRS group (P=0.014 but transfusion requirements were similar. Intraoperative portal vein blood flow measurements averaged 2132±725 ml/min in the TIPS group compared with 1120±351ml/min in the DSRS group (P<0.001. Arterial flows were similar. Mean ICU and hospital stays were similar. There were 3 hospital mortalities in the DSRS group and none in the TIPS group (P=0.1. We conclude that TIPS is a valuable tool in the management of recurrent variceal bleeding prior to liver transplantation. Intra0Perative hemodynamic measurements suggest a theoretical advantage with TIPS. In a group of patients with advanced liver disease we report an outcome that is similar to patients treated with DSRS prior to liver transplantation. The role of TIPS in the treatment of nontransplant candidates remains to be clarified.

  2. Determination of blood flow through arteriovenous fistulae and shunts

    International Nuclear Information System (INIS)

    Lantz, B.M.T.; Holcroft, J.W.; Foerster, J.M.; Link, D.P.; Reid, M.H.

    1979-01-01

    A videodensitometric method for estimating relative flow was employed in a patient with a bovine arteriovenous fistula. Analogous arteriovenous communications of different sizes were created in two dogs for comparison. Local and general hemodynamic parameters were measured. The videodensitometric method proved to be highly accurate compared to electromagnetic flow readings and is the method of choice in estimating shunt flow in connection with routine angiography. (Auth.)

  3. Almost periodic solution of shunting inhibitory CNNs with delays

    Science.gov (United States)

    Chen, Anping; Cao, Jinde

    2002-06-01

    Using the Banach fixed point theorem, we obtain a sufficient condition for the existence of almost periodic solution of shunting inhibitory cellular neural networks {dx ij}/{dt}=-a ijx ij- limit∑C kl∈N r(i,j) C ijklf x kl(t-τ) x ij+L ij(t), the global attractivity of SICNNs is also obtained. An example is given to illustrate that the condition of our results are feasible.

  4. Maculopatía tóxica por cloroquina y rehabilitación visual mediante microperímetro MP1

    Directory of Open Access Journals (Sweden)

    Mayrelis Quintero Busutil

    Full Text Available La cloroquina es un fármaco que puede producir disfunciones visuales, baja visión e incluso ceguera según la dosis. Una dosis acumulativa menor a 100 g de cloroquina, o una duración de tratamiento de menos de un año raramente se asocia con lesión retiniana. El riesgo de toxicidad aumenta cuando la dosis acumulativa excede los 300 g (250mg/día durante 3 años. Este medicamento es utilizado en el tratamiento de enfermedades autoinmunes. Se presenta una paciente de 44 años de edad, con antecedentes de artritis reumatoide hace 14 años para lo cual se indicó tratamiento con cloroquina (1 tableta 250 mg/diaria desde el diagnóstico inicial, y presenta un diagnóstico de maculopatía por cloroquina hace 5 años, a consulta por presentar baja visión y solicitando una posibilidad de rehabilitación visual. Se realizó examen oftalmológico, estudios complementarios y se rehabilitó mediante el microperímetro MP1. Se concluye que la maculopatía por cloroquina es una de las causas de discapacidad visual y que la rehabilitación visual con microperimetría proporciona mejoría en varios parámetros visuales, mejorando la calidad visual del paciente.

  5. A case of repeated intracerebral hemorrhages secondary to ventriculoperitoneal shunt

    Directory of Open Access Journals (Sweden)

    Jinbing Zhao

    2015-03-01

    Full Text Available Ventriculoperitoneal shunt is a routinely performed treatment in neurosurgical department. Intracerebral hemorrhage, as a complication after shunt catheterization, is really rare but with high mortality. In this study, we reported a case of a 74-year-old man who suffered from repeated intracerebral hemorrhage after ventriculoperitoneal shunt. The first hemorrhage happened 63 h after the 1st surgery, and most hematomas were located in the ipsilateral occipital lobe and intraventricles, along the ventricular catheter. Fresh blood clot casts blocked the external ventricular draining catheter, which was inserted into the right front horn during the 3rd surgery, indicating new intraventricular bleeding happened. A large hematoma in ipsilateral frontal lobe was detected on the 3rd day after the removal of external ventricular draining catheter. Different hemorrhagic locations and time points were encountered on the same case. We discussed the possible causes of repeated hemorrhage for this case, and the pre-operative preparation including risk evaluation in future clinical work.

  6. Retinal complications after aqueous shunt surgical procedures for glaucoma.

    Science.gov (United States)

    Law, S K; Kalenak, J W; Connor, T B; Pulido, J S; Han, D P; Mieler, W F

    1996-12-01

    To assess retinal complications and to identify risk factors for retinal complications following aqueous shunt procedures. Records of 38 consecutive aqueous shunt procedures that were performed on 36 patients at the Eye Institute of the Medical College of Wisconsin, Milwaukee, from June 1993 to March 1995 (minimum follow-up, 6 months) were reviewed. The mean +/- SD follow-up was 11.4 +/- 5.2 months (median, 10.5 months). Twelve patients (32%) had the following retinal complications: 4 serous choroidal effusions (10%) that required drainage, 3 suprachoroidal hemorrhages (8%), 2 vitreous hemorrhages (5%), 1 rhegmatogenous retinal detachment (3%), 1 endophthalmitis (3%), and 1 scleral buckling extrusion (3%). Surgical procedures for retinal complications were required in 8 (67%) of these 12 patients. Visual acuity decreased 2 lines or more in 9 (75%) of these 12 patients. The median onset of a postoperative retinal complication was 12.5 days, with 10 patients (83%) experiencing complications within 35 days. Serous choroidal effusions developed in 10 other patients (26%), and these effusions resolved spontaneously. Visual acuity decreased 2 lines or more in 2 (20%) of these additional 10 patients. Patients who experienced serious retinal complications were significantly older, had a higher rate of hypertension, and postoperative ocular hypotony. Serious retinal complications were distributed evenly among patients with Krupin valves with discs and Molteno and Baerveldt devices. Experience with the Ahmed glaucoma valve implant was limited. Aqueous shunt procedures may be associated with significant retinal complications and subsequent visual loss.

  7. Modificación de la personalidad mediante una terapia cognitivo-conductual de afrontamiento al estrés

    Directory of Open Access Journals (Sweden)

    Julia Linares-Ortiz

    2014-01-01

    Full Text Available El objetivo de este estudio ha sido comprobar la posibilidad de modulación de variables de personalidad (tales como algunos de los Cinco Grandes Factores, o la personalidad resistente a través de la aplicación de un programa de afrontamiento del estrés. Para ello, han participado 26 personas del ámbito universitario con alto estrés percibido, distribuidas en dos grupos (grupo de tratamiento y grupo de control. Los instrumentos de evaluación seleccionados se clasificaron en dos grupos: variables psicológicas y emocionales y variables de personalidad. Los resultados encontrados mediantes un ANOVA de medidas repetidas mostraron que existía interacción momento x grupo en las variables optimismo, extraversión y responsabilidad, correspondientes al Modelo de los Cinco Grandes Factores, mostrando un incremento de las puntuaciones en estas variables en el grupo terapia y no encontrándose dicha interacción en el grupo control. Las puntuaciones en los componentes de neuroticismo, amabilidad, apertura a la experiencia y personalidad resistente no se modificaron en ninguno de los dos grupos. Este estudio apoya la idea de que modificando determinados parámetros emocionales relacionados con el estrés mediante terapia cognitivo-conductual se pueden ver modulados algunos factores de personalidad.

  8. Valoración de las aguas residuales mediante procedimientos analíticos y biológicos

    Directory of Open Access Journals (Sweden)

    M. Carballo

    2002-06-01

    Full Text Available Ciertos procedimientos, basados en aproximaciones analíticas y biológicas, están demostrando ser útiles en la valoración del riesgo de las aguas residuales urbanas procedentes de las Plantas de Tratamiento. Estos efluentes, considerados “mezclas complejas”, compuestos por sustancias de muy diferente naturaleza, origen y características toxicológicas y medio ambientales, requieren una valoración realista. Con el fin de colaborar al conocimiento de una parte de la realidad de nuestro país, presentamos un estudio sobre once depuradoras urbanas en las que se ha realizado un perfil de compuestos orgánicos y una valoración toxicológica mediante tests de toxicidad agudos, crónicos, de estrogenicidad, mutagenicidad y teratogenia. Los resultados muestran que 7 efluentes presentan toxicidad aguda, 3 toxicidad crónica y 4 estrogenicidad. Destacamos el hecho de que los 4 efluentes que presentan estrogenicidad, poseen al menos 3 de las sustancias estrogénicas detectadas mediante el perfil cromatográfico. Este tipo de consideraciones nos hace reflexionar sobre la necesidad de incorporar este tipo de metodologías para disponer de un conocimiento más realista de estas situaciones.

  9. Transmicrocatheter local injection of ethanol to treat hepatocellular carcinoma with high flow arteriovenous shunts

    International Nuclear Information System (INIS)

    Guan Shouhai; Shan Hong; Jiang Zaibo; Huang Mingsheng; Zhu Kangshun; Li Zhengran; Meng Xiaochun

    2002-01-01

    Objective: To evaluate the feasibility and clinical effect of embolization therapy in treating the high flow hepatic arteriovenous shunts in hepatocellular carcinoma (HCC) by locally injected ethanol through microcatheter. Methods: Forty-one branches of arteriovenous shunts were treated by local ethanol infusion through microcatheter in 29 patients suffered with HCC. Angiography was performed to observe the embolization effect and influence to non-targeted vessels. Result: Forty-one branches of arteriovenous shunts in 29 patients were injected with ethanol locally. Each single shunt was infused 1-6 times. The dose of ethanol was 2-3 ml per time, and the total dose of ethanol was 2-12 ml. All shunting tracts were embolized, and all non-target vessels were protected fluently. Iodine-oil deposition was well in continued TACE. Their syndromes were improved or disappeared. Conclusion: Transmicrocatheter injection of ethanol could safely and effectively treat the hepatic arteriovenous shunts and make advantages to TACE in HCC

  10. Valved or valveless ventriculoperitoneal shunting in the treatment of post-haemorrhagic hydrocephalus

    DEFF Research Database (Denmark)

    Andreasen, Trine Hjorslev; Holst, Anders Vedel; Lilja, Alexander

    2016-01-01

    BACKGROUND: Implant infection and obstruction are major complications for ventriculoperitoneal shunts in patients with post-haemorrhagic hydrocephalus. In an effort to (1) reduce the incidence of these complications, (2) reduce the rate of shunt failure and (3) shorten the duration of neurosurgical...... hospitalisation, we have implemented valveless ventriculoperitoneal shunts at our department for adult patients with post-haemorrhagic hydrocephalus and haemorrhagic cerebrospinal fluid at the time of shunt insertion. METHODS: All adult patients (>18 years old) treated for post-haemorrhagic hydrocephalus.......3 %, p = 0.02), but a higher rate of overdrainage (10.3 % vs 2.6 %, p = 0.04). CONCLUSION: The use of a valveless shunting for patients with post-haemorrhagic hydrocephalus results in shorter duration of neurosurgical hospitalisation and lower rate of shunt infection, although these advantages should...

  11. Laparoscopic assisted ventriculoperitoneal shunt revisions as an option for pediatric patients with previous intraabdominal complications

    Directory of Open Access Journals (Sweden)

    Fernanda O. de Carvalho

    2014-04-01

    Full Text Available Multiple shunt failure is a challenge in pediatric neurosurgery practice and one of the most feared complications of hydrocephalus. Objective: To demonstrate that laparoscopic procedures for distal ventriculoperitoneal shunt failure may be an effective option for patients who underwent multiple revisions due to repetitive manipulation of the peritoneal cavity, abdominal pseudocyst, peritonitis or other situations leading to a “non reliable” peritoneum. Method: From March 2012 to February 2013, the authors reviewed retrospectively the charts of six patients born and followed up at our institution, which presented with previous intra-peritoneal complications and underwent ventriculoperitoneal shunt revision assisted by video laparoscopy. Results: After a mean follow-up period of nine months, all patients are well and no further shunt failure was identified so far. Conclusion: Laparoscopy assisted shunt revision in children may be, in selected cases, an effective option for patients with multiple peritoneal complications due to ventriculo-peritoneal shunting.

  12. Galactosemia: Diagnóstico precoz mediante estudio enzimático

    Directory of Open Access Journals (Sweden)

    Úrsula Carrillo Estrada

    2003-09-01

    Full Text Available Se presentan los resultados obtenidos del estudio realizado a un paciente masculino de 45 días de nacido, cuyo motivo de ingreso fue pérdida de peso, decaimiento, retraso psicomotor y crisis de hipoglucemia. Los síntomas comenzaron en el período neonatal y coincidieron con la introducción de la lactancia materna. En estudios realizados se constató en la orina la presencia de lactosa y galactosa. Se confirma el diagnóstico por estudio enzimático. La evolución clínica ha sido satisfactoria. El tratamiento dietético que excluía a los alimentos que contienen galactosa y lactosa fue de mucha importancia. Es el primer caso diagnosticado en Cuba mediante estudio enzimático.This paper presents the results of a study performed on a 45-day old male patient who was admitted to the hospital for weight loss, tiredness, psychomotor retardation and hypoglicemic crisis. The symptoms had begun in the neonatal period and had coincided with the introduction of breast feeding. The studies detected lactose and galactose in urine. The enzymatic study confirmed the diagnosis. The clinical recovery was satisfactory. The dietary treatment that excluded foods containing galactose and lactose was important and successful. He is the first case diagnosed on enzymatic study in Cuba.

  13. Medida de similaridad entre imágenes de marcas de ganado mediante distribuciones de forma

    Directory of Open Access Journals (Sweden)

    Germán Sánchez Torres

    2014-12-01

    Full Text Available Este documento reporta los resultados de una investigación orientada hacia el diseño de un método de tratamiento de imágenes digitales para la automatización de los procesos de registro y control de marcas de ganado requeridas por las regulaciones del sector ganadero en Colombia. El método permite automatizar los procesos de búsqueda y de comparación necesarios para garantizar la unicidad de las marcas dentro de un sistema asistido por computadora. Se inicia con la generación de un histograma estimado de la geometría de la marca, lo que permite comparar y detectar similitudes entre las figuras previamente almacenadas, mediante una métrica de similitud basada en la distancia de Minkowski. Los resultados obtenidos indican que el método es adecuado para realizar un proceso de discriminación de dichas imágenes, reducir las ambigüedades y garantizar la unicidad de los registros. Los resultados obtenidos y un análisis de su aplicación son reportados.

  14. Vigilancia del riesgo de ocurrencia de incendios forestales mediante estaciones meteorológicas de superficie

    Directory of Open Access Journals (Sweden)

    I. M. Domínguez-Hurtado

    2008-01-01

    Full Text Available Para la estimación del riesgo de ocurrencia de incendios forestales se emplean diferentes variantes a nivel mundial, en este trabajo se propone un sistema de vigilancia para la detección del riesgo de ocurrencia de incendios forestales a partir de la información procedente de estaciones meteorológicas de superficie, debido básicamente a la carencia de salidas operativas diarias que evaluarán las condiciones de riesgo de fuegos a nivel nacional. Se emplearon los índices de Nesterov modificado y Monte Alegre, los cuales se estimaron a partir de los datos procedentes de las 68 estaciones meteorológicas de Cuba. A partir de dicha información se obtiene la salida mapificada diaria de cada uno de ellos, mediante la utilización de la técnica de interpolación bicubic spline. Se obtuvo un sistema operativo totalmente automatizado para la evaluación de las condiciones de riesgo de ocurrencia de incendios para Cuba, el cual brinda la posibilidad de completar y perfeccionar el sistema de vigilancia de fuegos, basado en la reducción de la escala temporal y el tratamiento de la información.

  15. Tratamiento quirúrgico con clavo intramedular elástico estable en fracturas diafisiarias del antebrazo en niños.

    Directory of Open Access Journals (Sweden)

    Francisco Vera Rosas

    2009-07-01

    Full Text Available Objetivo: Evaluar los resultados del tratamiento quirúrgico de las fracturas diafisiarias del radio y/o cubito mediante la colocación intramedular de clavos Kirschner moldeados en pacientes pediátricos. Material y métodos: Estudio descriptivo observacional de pacientes tratados con clavo intramedular en fracturas diafisiarias de antebrazo en el Hospital Nacional Cayetano Heredia - Lima. Se usaron clavos Kirschner moldeado de acuerdo a especificaciones del clavo ESIN y se evaluaron la técnica operatoria, tiempo de consolidación, complicaciones y funcionalidad. Resultados: Se incluyeron 12 pacientes, 10 de sexo masculino, con edad promedio de 13.7 años (11 a 15 años, se encontró evidencia de consolidación a las seis semanas y el tiempo operatorio promedio fue de 75 minutos. Un paciente presentó parestesias del nervio cubital que remitió a los 4 meses, la perdida sanguínea fue mínima con un abordaje minimamente invasivo. Todas las fracturas consolidaron. Conclusión: El uso de clavo Kirschner moldeado es una alternativa de tratamiento en este tipo de fracturas debido a su bajo costo, y resultados comparables con el ESIN que es el tratamiento de elección. (Rev Med Hered 2009;20:151-155.

  16. Tratamiento de la enfermedad de Hansen en Colombia: medicalización y control de la enfermedad a lo largo del siglo XX

    Directory of Open Access Journals (Sweden)

    Natalia Botero-Jaramillo

    2017-09-01

    Full Text Available Objetivo: investigar el tratamiento de la enfermedad de Hansen durante el siglo XX en Colombia, para analizar el proceso de medicalización, la biopolítica, el significado de la curación y su impacto en el control de la enfermedad y en los enfermos. Metodología: estudio histórico, descriptivo y analítico sobre los tratamientos para la enfermedad de Hansen a lo largo del siglo XX, por medio de metodologías cualitativas como entrevistas con relatos de vida y entrevistas temáticas, y se trabajó con fuentes documentales primarias y secundarias en archivos nacionales y locales. Resultados y discusión: La enfermedad de Hansen, causada por el microorganismo Mycobacterium leprae, fue controlada mediante el aislamiento y reclusión de los enfermos de lepra en hospitales y lazaretos. El desarrollo de algunos tratamientos y el descubrimiento de la terapia antibiótica, las sulfas, que representó una cura efectiva desde la medicina y su poder político y social, participaron en la transformación de las políticas de manejo de la enfermedad y de la comprensión de la misma, en los Lazaretos de Contratación y Agua de Dios.

  17. Tratamiento acupuntural de la bursitis subdeltoidea calcificada en la atención primaria de salud Acupuncture treatment of calcified subdeltoid bursitis in health primary care

    Directory of Open Access Journals (Sweden)

    Orlando Manuel Pérez Rivera

    2009-09-01

    Full Text Available Se presenta el caso de un paciente del sexo masculino, de 43 años de edad, con historia de dolor en el hombro derecho desde hace aproximadamente 3 meses, a raíz de una contusión superficial, el cual recibió tratamiento conservador con reposo y medicamentos, pero no resolvió la sintomatología. Ahora, con diagnóstico de bursitis subdeltoidea calcificada, recibe tratamiento acupuntural en el Departamento de Medicina Natural y Tradicional de la sala de rehabilitación de su área de salud. Se presenta esta variante de tratamiento mediante sus estudios radiológicos.This is the case of a male patient aged 43 with a pain history in right shoulder of approximately 3 months ago caused by a superficial contusion receiving conservative treatment with rest and drugs, without symptoms resolution. For the tine being time diagnosed with calcified subdeltoid bursitis and acupuncture treatment in Natural and Traditional Medicine Service of rehabilitation ward of his health area. This treatment variant is presented by its radiologic studies.

  18. Design strategy for the combined system of shunt passive and series active filters

    OpenAIRE

    Fujita, Hideki; Akagi, Hirofumi

    1991-01-01

    A design strategy for the combined power filter for a three-phase twelve-pulse thyristor rectifier is proposed. The shunt passive filter, which can minimize the output voltage of the series active filter, is designed and tested in a prototype model. A specially designed shunt passive filter makes it possible to reduce the required rating of the series active filter to 60% compared with a conventional shunt passive filter

  19. Phenotypic and chemotypic characterization of GABA-shunt mutants in Arabidopsis thaliana

    OpenAIRE

    Mekonnen, Dereje Worku

    2013-01-01

    Gamma-Aminobutyric acid (GABA) is a four carbon non protein amino acid, and the pathway that involves its production and degradation is called the GABA shunt. The GABA shunt is a short enzymatic pathway that involves three enzymes: glutamate decarboxylase (GAD), GABA transaminase (GABA-T) and succinic semi aldehyde dehydrogenase (SSADH). GABA shunt is conserved almost in all organisms studied so far. The pathway starts in the cytosol and finishes in mitochondria in higher organisms like plant...

  20. Haematology and coagulation profiles in cats with congenital portosystemic shunts.

    Science.gov (United States)

    Tzounos, Caitlin E; Tivers, Michael S; Adamantos, Sophie E; English, Kate; Rees, Alan L; Lipscomb, Vicky J

    2017-12-01

    Objectives The objectives of this study were, first, to report the haematological parameters and coagulation times for cats with a congenital portosystemic shunt (CPSS) and the influence of surgical shunt attenuation on these parameters; and, second, to identify any association between prolongation in coagulation profiles and incidence of perioperative haemorrhage. Methods This was a retrospective clinical study using client-owned cats with a CPSS. Signalment, shunt type (extra- or intrahepatic), degree of shunt attenuation (complete or partial), haematological parameters, prothrombin time (PT) and activated partial thromboplastin time (aPTT) test results, and occurrence of any perioperative clinical bleeding complications were recorded for cats undergoing surgical treatment of a CPSS at the Royal Veterinary College, UK, between 1994 and 2011. Results Forty-two cats were included. Thirty-six (85.7%) had an extrahepatic CPSS and six (14.3%) had an intrahepatic CPSS. Preoperatively, mean cell volume (MCV) and mean cell haemoglobin (MCH) were below the reference interval (RI) in 32 (76.2%) and 31 (73.8%) cats, respectively. Red blood cell count and mean cell haemoglobin concentration (MCHC) were above the RI in 10 (23.8%) and eight (19.1%) cats, respectively. Postoperatively, there were significant increases in haematocrit ( P = 0.044), MCV ( P = 0.008) and MCH ( P = 0.002). Despite the significant increase in MCV postoperatively, the median MCV postoperatively was below the RI, indicating persistence of microcytosis. Preoperatively, PT was above the upper RI in 14 cats (87.5%), and aPTT was above the upper RI in 11 cats (68.8%). No cat demonstrated a perioperative clinical bleeding complication. Conclusions and relevance Cats with a CPSS are likely to present with a microcytosis, but rarely present with anaemia, leukocytosis or thrombocytopenia. Surgical attenuation of the CPSS results in a significant increase in the HCT and MCV. Coagulation profiles in cats with a

  1. Intrahepatic porto-hepatic venous shunts in Rendu-Osler-Weber disease: imaging demonstration

    International Nuclear Information System (INIS)

    Matsumoto, Shunro; Mori, Hiromu; Yamada, Yasunari; Hayashida, Tomoko; Hori, Yuzo; Kiyosue, Hiro

    2004-01-01

    This study describes the imaging features of the intrahepatic portohepatic venous (PHV) shunt, which is a potential cause of portosystemic encephalopathy in Rendu-Osler-Weber disease. Six patients with Rendu-Osler-Weber disease (two men, four women; age range 42-73 years) were retrospectively studied. There were two from one family and three from another family. Of these patients, one was diagnosed with definitive portosystemic encephalopathy because of a psychiatric disorder. We retrospectively reviewed the radiological examinations, including abdominal angiography (n=6), three-phase dynamic helical computed tomography (CT; n=3), and conventional enhanced CT (n=1). In one patient, CT during angiography and CT angioportography were also performed. Evaluation was placed on the imaging features of intrahepatic PHV shunts. On angiography, intrahepatic PHV shunts showing multiple and small shunts <5 mm in diameter in an apparent network were detected in all patents. In two patients, a large shunt with a size of either 7 or 10 mm was associated. These intrahepatic PHV shunts were predominantly distributed in the peripheral parenchyma. Intrahepatic PHV shunts would be characterized by small and multiple shunts in an apparent network on the periphery with or without a large shunt. (orig.)

  2. Radiologic follow-up of the transjugular intrahepatic stent-shunt (TIPSS)

    International Nuclear Information System (INIS)

    Hansmann, H.J.; Noeldge, G.; Leutloff, U.; Radeleff, B.; Richter, G.M.

    2001-01-01

    The transjugular intrahepatic stent-shunt (TIPSS) is a well accepted minimal invasive therapy for complications of portal hypertension: recurrent variceal bleeding, refractory ascites and liver failure due to the Budd-Chiari syndrome. The high frequency of shunt stenoses and occlusions makes regular follow up examinations essential. Despite modern non invasive imaging methods direct portography still is the gold standard for shunt surveillance in TIPSS. Ultrasound is helpful to detect shunt dysfunction, but nevertheless its failure rate is considerable despite the use of contrast enhancers such as Levovist because of anatomic and physical limitations, particularly when TIPSS-tracts deep in the liver are present. Reintervention rates approach 90-100% after 24 months, with 100% in child's A patients with comparatively good liver function. However, a strict shunt surveillance program with early portography and reintervention when necessary guarantees high clinical success rates associated with very low rebleeding rates below 10%. Overall the secondary success rate is 80%. Secondary failures are mainly caused by lack of patient compliance during follow-up. In a subgroup of patients no shunt maturation is observed, requiring multiple shunt revisions. In cases of recurrent shunt occlusions an association with bile leaks is presumed. In selected cases patients with chronically recurrent shunt stenosis or occlusions may benefit from placement of TIPSS stent grafts. (orig.) [de

  3. Study on the Automatic Detection Method and System of Multifunctional Hydrocephalus Shunt

    Science.gov (United States)

    Sun, Xuan; Wang, Guangzhen; Dong, Quancheng; Li, Yuzhong

    2017-07-01

    Aiming to the difficulty of micro pressure detection and the difficulty of micro flow control in the testing process of hydrocephalus shunt, the principle of the shunt performance detection was analyzed.In this study, the author analyzed the principle of several items of shunt performance detection,and used advanced micro pressure sensor and micro flow peristaltic pump to overcome the micro pressure detection and micro flow control technology.At the same time,This study also puted many common experimental projects integrated, and successfully developed the automatic detection system for a shunt performance detection function, to achieve a test with high precision, high efficiency and automation.

  4. Embolization of portal-systemic shunts in cirrhotic patients with chronic recurrent hepatic encephalopathy

    International Nuclear Information System (INIS)

    Sakurabayashi, Shin; Sezai, Shuichi; Yamamoto, Yoshihiro; Hirano, Masanori; Oka, Hiroshi

    1997-01-01

    Purpose. To evaluate the efficacy of embolization of portal-systemic shunts in cirrhotic patients with chronic recurrent hepatic encephalopathy (CRHE). Methods. Seven cirrhotic patients with CRHE refractory to medical treatment (3 men and 4 women, mean age 66 years) were studied. Five patients had splenorenal shunts, 1 had a gastrorenal shunt, and 1 had an intrahepatic portal vein-hepatic vein shunt. Shunt embolization was performed using stainless steel coils, with a percutaneous transhepatic portal vein approach in 4 patients and a transrenal vein approach in 3 patients. Results. After embolization, the shunt disappeared in 4 patients on either ultrasound pulsed Doppler monitoring or portography. Complications observed in the 7 patients were fever, transient pleural effusion, ascites, and mild esophageal varices. For 3-6 months after embolization, the 4 patients whose shunts disappeared showed minimal or no reappearance of a shunt, and had no recurrence of encephalopathy. The serum ammonia levels decreased and electroencephalograms also improved. One of the 4 patients, who developed mild esophageal varices, required no treatment. Treatment was effective in 3 of the 4 patients (75%) who underwent embolization via a transhepatic portal vein. Conclusion. Transvascular embolization of shunts improved the outcome in 4 of 7 patients. The most effective embolization was achieved via the percutaneous transhepatic portal vein approach

  5. ALTERNATIVAS BIOMOLECULARES EN EL TRATAMIENTO DE LA OBESIDAD

    Directory of Open Access Journals (Sweden)

    Fernando Lizcano

    2010-09-01

    Full Text Available

    Resumen

    La obesidad se ha convertido en un problema de salud pública que cobija tanto a países desarrollados como a aquellos en vía de desarrollo. En la mayoría de los casos las políticas de salud no han tenido el efecto deseado para reducir la prevalencia de esta patología y muchos de los fármacos útiles para contrarrestar la obesidad no han podido continuar en el mercado debido a serios efectos secundarios. Algunas alternativas terapéuticas más agresivas como la cirugías reductivas han demostrado una utilidad restringida. Incluso, recientes observaciones han puesto de manifiesto las consecuencias a largo plazo de este tipo de intervenciones.

    En la búsqueda de nuevas estrategias para el tratamiento de la obesidad se ha investigado, tanto en la propia célula grasa como en los genes que podrían ser modificados y cuya función está enfocada en regular el gasto calórico y la termogénesis adaptativa. Algunos de estos genes son modificados por factores de transcripción que pueden determinar la característica fenotípica de la célula grasa. Recientemente se ha observado que en la persona adulta es posible evidenciar vestigios de célula grasa parda que puede gastar energía en forma de calor y esta modificación podría ser una alternativa terapéutica en la obesidad. Nuestro grupo de investigación ha observado que mediante la modificación de la función de la proteína del retinoblastoma (pRb se pueden aumentar los genes que estimulan la pérdida calórica en el adipocito.

    Palabras clave: Grasa Parda, Obesidad, transcripción, EID1, transdiferenciación

    BIOMOLECULAR OPTIONS IN TREATING OBESITY

    Abstract

    Obesity is a public health issue for both developed and third world countries. Although many efforts have been made to reverse the trend of this prevalent pathology, no results have been obtained with public health policies in most cases. Furthermore, many medicines approved for

  6. POLVO DE LA SEMILLA Cassia fistula COMO COAGULANTE NATURAL EN EL TRATAMIENTO DE AGUA CRUDA

    Directory of Open Access Journals (Sweden)

    LUIS GUZMÁN C

    Full Text Available Los extractos naturales de plantas se han usado para la purificación de agua por muchos siglos. La mayoría de estos se derivan de semillas, hojas, cortezas o savia, raíces y frutos de árboles y plantas. En este trabajo se estudió la utilización del polvo de la semilla de la Cassia fístula como coagulante natural, estableciendo su dosis óptima mediante la prueba de jarras y determinando los parámetros de color, turbidez, alcalinidad total y dureza total, utilizando agua del Canal del Dique. La dosis óptima del coagulante encontrada está entre 15-25 mg/L, obteniendo valores finales de turbidez y color de 6 NTU y 25 UC respectivamente. Los valores de pH y alcalinidad total no presentaron mayores variaciones. Los valores de los parámetros turbidez y color al igual que el pH, alcalinidad total y dureza total se encuentran cerca de los estándares establecidos por la norma colombiana que garantizan la calidad del agua para consumo humano; demostrando la potencialidad de uso de este coagulante natural como coagulante primario en tratamiento de aguas crudas.

  7. TRATAMIENTO DE LODOS DE FONDO DE LAGUNAS FACULTATIVAS CON ESTABILIZACIÓN EN CONDICIONES DE LABORATORIO

    Directory of Open Access Journals (Sweden)

    Jhon Jairo Feria Diaz

    Full Text Available En este artículo se muestran los resultados obtenidos en el proceso de estabilización química de lodos de lagunas de estabilización, mediante la adición de cal hidratada común. Se adicionaron en condiciones controladas de laboratorio, dosis de cal al 5 %, 7 %, 9 %, 10 %, 11 %, 12 % y 15 % a una muestra de lodos de fondo de la laguna primaria del sistema de tratamiento de aguas residuales de la ciudad de Montería, Colombia. Se analizaron la peligrosidad del lodo (corrosividad, inflamabilidad y reactividad y las concentraciones de sulfuros, metales pesados (As, Ba, Cd, Cr, Hg, Ag, Pb, Se, coliformes, salmonella, bacterias mesófilas, áscaris y otros helmintos, antes y después de aplicar una dosis optima al 10%. Con esta dosis se logró controlar la reactividad por sulfuros y cianuros, pero no se redujeron las concentraciones de coliformes y de bacterias mesófilas. Algunos metales pesados (Cd, Cr, Hg, Ag, Pb aumentaron luego de la aplicación de la dosis de cal hidratada, aunque las concentraciones halladas no constituyen peligro ambiental, de acuerdo a la normatividad ambiental vigente.

  8. La biotecnología en el tratamiento de úlcera vascular: estudio de caso

    Directory of Open Access Journals (Sweden)

    Alana Tamar Oliveira de Sousa

    2013-07-01

    Full Text Available El objetivo de este estudio de caso fue describir la asistencia prestada a una paciente portadora de úlcera venosa mediante la utlización de asociaciones de solución de limpieza a base de cloruro de sodio y del aceite esencial de las hojas de Cymbopogon citratus Stapf, gel a base de Aloe vera, colágeno y una cobertura de película de hemicelulosa. Se realizó acompañamiento a la paciente durante las curaciones, la evolución de la lesión y la aplicación del tratamiento establecido, a partir de las escalas de valoración se pudieron obtener los datos necesarios para conocer los resultados de la terapéutica utilizada. La asociación de los productos y el seguimiento de las orientaciones sobre los cuidados de la enfermedad de la paciente, evidenciaron resultados positivos en cuanto a la cicatrización, la reducción del dolor y olor. El uso de productos adecuados a las condiciones de la úlcera y las escalas utilizadas para evaluaciones sistemáticas de la herida, mostraron avances en los procesos de cicatrización.

  9. Predictors of Shunt Dysfunction and Overall Survival in Patients with Variceal Bleeding Treated with Transjugular Portosystemic Shunt Creation Using the Fluency Stent Graft.

    Science.gov (United States)

    Wan, Yue-Meng; Li, Yu-Hua; Xu, Ying; Wu, Hua-Mei; Li, Ying-Chun; Wu, Xi-Nan; Yang, Jin-Hui

    2018-01-16

    Transjugular intrahepatic portosystemic shunt (TIPS) is an established method for portal hypertension. This study was to investigate the long-term safety, technical success, and patency of TIPS, and to determine the risk factors and clinical impacts of shunt dysfunction. A total of 154 consecutive patients undergoing embolotherapy of gastric coronary vein and/or short gastric vein and TIPS creation were prospectively studied. Follow-up data included technical success, patency and revision of TIPS, and overall survival of patients. During the study, the primary and secondary technical success rates were 98.7% and 100%, respectively. Sixty-three patients developed shunt dysfunction, 30 with shunt stenosis and 33 with shunt occlusion. The cumulative 60-month primary, primary assisted, and secondary patency rates were 19.6%, 43.0%, and 93.4%, respectively. The cumulative 60-month overall survival rates were similar between the TIPS dysfunction group and the TIPS non-dysfunction group (68.6% vs. 58.6%, P = .096). Baseline portal vein thrombosis (P value of 8.5 had 77.8% sensitivity and 64.8% specificity. The long-term safety, technical success, and patency of TIPS were good; baseline portal vein thrombosis, use of bare stents, and PPG were significantly associated with shunt dysfunction; shunt dysfunction has little impact on patients' long-term survival because of high secondary patency rates. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  10. La fisioterapia en el proceso de readaptación físico – deportiva mediante el uso de gimnasio en el paciente postoperado de reconstrucción de ligamento cruzado anterior. Caso clínico

    Directory of Open Access Journals (Sweden)

    Raúl Ernesto Cortés González

    2017-01-01

    Full Text Available La ruptura del ligamento cruzado anterior (LCA tiene gran incidencia en deportistas, el procedimiento quirúrgico es vital para la restauración de su funcionamiento, pero sin tratamiento fisioterapéutico posquirúrgico, la cirugía no cumple con las expectativas deseadas. En este artículo, se analiza el caso clínico de un paciente femenino de 28 años, futbolista recreativa, intervenida quirúrgicamente por reconstrucción de LCA izquierdo con autoinjerto de semitendinoso, que recibió tratamiento fisioterapéutico durante 7 meses, mediante un macro ciclo de entrenamiento periodizado por fases de recuperación biológica en un gimnasio, con el uso de pesas y entrenamiento funcional deportivo. Al término del tratamiento, el miembro sano mostró 135° en flexión de rodilla, 48 centímetros en circunferencia de muslo, 28 repeticiones en leg curl y 30 repeticiones en leg extension; mientras que el miembro afectado mostró 130° en flexión de rodilla, 46.5 centímetros en circunferencia de muslo, 26 repeticiones en leg curl y 28 repeticiones en leg. El tratamiento puede tomarse como guía para manejar reconstrucciones de LCA y otras lesiones de rodilla.

  11. Experience and outcome of ventricular-atrial shunt: a multi centre study

    International Nuclear Information System (INIS)

    Akhtar, N.; Khan, A.A.; Yousaf, M.

    2015-01-01

    Ventriculoperitoneal (VP) shunt has been widely utilized in the treatment of hydrocephalus as a safe option but there is recent literature evidence that ventricularatrial (VA) shunt is not as notorious for its complications as proclaimed, to analyse and report our success with this procedure we conducted our study. Methods: A total of 64 patients undergoing VA shunting were included in this case series study conducted at RMC and Allied hospital Rawalpindi. The data was collected over a period of 4 years from, 1st June 2010 to 1st June 2015. Result: Our study included 64 patients who underwent a VA shunt for hydrocephalus. Their age ranged from 25 to 75 years. Most of the patients were females (60%). The following complications were observed with 2 (3.12%) patients having blockage of the shunt at the neck, 3 (4.68%) suffered from glomerulonephritis, 2 (3.1%) had post-operative neck hematoma, 4 (6.25 %) had wound infection, short lower end of the tube was found in 3 (4.68%), migrated lower end (into the subclavian) was seen in 1 (1.56%). Mortality was 1(1.56%). These results were comparable to other studies. Conclusion: Neurosurgeons have been doing a VA shunt as a second procedure, after a VP shunt when the need due to a complication was encountered. We however share our experience regarding ventriculo-atrial shunting, as first choice procedure, because of its low incidence of shunt blockage unlike VP shunt, which has high rate of shunt blockage and therefore warrants repeated surgeries. (author)

  12. Investigating PID Shunting in Polycrystalline Silicon Modules via Multiscale, Multitechnique Characterization

    Energy Technology Data Exchange (ETDEWEB)

    Harvey, Steven P [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Moseley, John [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Norman, Andrew [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Hacke, Peter L [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Johnston, Steven [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Al-Jassim, Mowafak M [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Stokes, Adam [Colorado School of Mines; Gorman, Brian [Colorado School of Mines

    2018-02-27

    We investigated the potential-induced degradation (PID) shunting mechanism in multicrystalline-silicon photovoltaic modules by using a multiscale, multitechnique characterization approach. Both field-stressed modules and laboratory-stressed mini modules were studied. We used photoluminescence, electroluminescence, and dark lock-in thermography imaging to identify degraded areas at the module scale. Small samples were then removed from degraded areas, laser marked, and imaged by scanning electron microscopy. We used simultaneous electron-beam induced current imaging and focused ion beam milling to mark around PID shunts for chemical analysis by time-of-flight secondary-ion mass spectrometry or to isolate individual shunt defects for transmission electron microscopy and atom-probe tomography analysis. By spanning a range of 10 orders of magnitude in size, this approach enabled us to investigate the root-cause mechanisms for PID shunting. We observed a direct correlation between recombination active shunts and sodium content. The sodium content in shunted areas peaks at the SiNX/Si interface and is consistently observed at a concentration of 0.1% to 2% in shunted areas. Analysis of samples subjected to PID recovery, either activated by electron beam or thermal effects only, reveals that recovery of isolated shunts correlates with diffusion of sodium out of the structural defects to the silicon surface. We observed the role of oxygen and chlorine in PID shunting and found that those species - although sometimes present in structural defects where PID shunting was observed - do not play a consistent role in PID shunting.

  13. Endoscopic Third Ventriculostomy Instead of Shunt Revision in Children Younger Than 3 Years of Age.

    Science.gov (United States)

    Zhao, Rui; Shi, Wei; Yang, Haowei; Li, Hao

    2016-04-01

    Endoscopic third ventriculostomy (ETV) is a valuable option in the treatment of shunt failure, but no clinical data exist for young children. The aim of this study was to elucidate the role of ETV in patients younger than 3 years of age with shunt malfunction. A cohort of 37 patients younger than 3 years of age with shunt malfunction underwent ETV instead of shunt revision. Patients' preoperative condition and medical history were studied to determine the impact of a number of variables on outcome. The Fisher exact test was used to assess differences among groups. Median age at ETV was 21.6 months (8-36 months). Diagnosis was obstructive hydrocephalus in 24 patients and communicating hydrocephalus in 13. Median age at initial shunt placement was 3.2 months (10 days to 30 months). The etiology of shunt malfunction was obstruction (n = 27) or infection (n = 10). Overall ETV failure rate was 40.5% (15/37). Patients whose age at initial shunt placement was <6 months and/or who had a preterm birth history had higher relative rates of ETV failure. Other variables, including type of hydrocephalus, interval between initial shunt placement and ETV, history of intraventricular bleeding and/or infection, and etiology of shunt malfunction, did not significantly affect the final outcome. Patients younger than 3 years with obstructive or communicating hydrocephalus may benefit from ETV in the event of shunt malfunction and have about a 60% probability of becoming shunt free. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. El tratamiento a largo plazo del trastorno bipolar

    Directory of Open Access Journals (Sweden)

    Leonardo Tondo

    2015-07-01

    Full Text Available Las indicaciones medicamentosas para el tratamiento del trastorno bipolar (TB requieren de una ponderación de la necesidad de tratamiento del episodio en curso y su evolución a largo plazo. Los objetivos principales radicarán en estabilizar el ánimo, evitar un episodio de polaridad opuesta y prevenir posibles recaídas. Dentro del abanico de tratamientos disponibles se encuentran los estabilizadores del humor, los antipsicóticos, los antidepresivos, y las terapias no farmacológicas. En el presente trabajo se realiza un recorrido sobre las ventajas y desventajas de estos tratamientos. La evidencia empírica indica que el litio resulta el estabilizador del humor más utilizado siendo considerado como gold standard para la prueba de nuevos tratamientos. Los antipsicóticos suelen ser los fármacos de elección para episodios maníacos con o sin este tipo de síntomas y prefiriéndose a los atípicos por presentar menores efectos secundarios. El uso de antidepresivos debe ser cauteloso por el riesgo de polarización a estados maníacos. Finalmente, dentro de las terapias no farmacológicas, la terapia cognitivo conductual y la psicoeducación son consideradas las intervenciones más eficaces.

  15. Analysis of surface modification of carbon nanotubes under different oxidation treatments Análisis de la modificación superficial de los nanotubos de carbono sometidos a distintos tratamientos de oxidación

    Directory of Open Access Journals (Sweden)

    J. A. Sánchez-Márquez

    2013-03-01

    Full Text Available Carbon nanotubes oxidation has attracted the interest of researchers, because in addition to eliminating impurities, it increases the dispersion of aggregates creating new interac­tions between materials. In this work, carbon nanotubes (CNT were treated using two dif­ferent oxidation methods to determine the effects of each treatment on the surface area of the material. The following methods were used: the traditional chemical treatment (using strong acids and a treatment supported by microwaves. Results showed that both treat­ments reduced the surface area (traditional CNT   La oxidación de los nanotubos de carbono, ha generado gran interés porque además de eliminar impurezas, aumenta el grado de dispersión de los agregados y logra nuevas in­teracciones entre los materiales. En este trabajo, nanotubos de carbono (NTC fueron tra­tados con diferentes métodos de oxidación para conocer la modificación superficial que cada tratamiento efectúa en la estructura del material. Los métodos contrastados fueron el tratamiento químico tradicional (mediante ácidos fuertes y el tratamiento asistido por microondas. Los resultados mostraron que ambos tratamientos disminuyen el área super­ficial (NTC tradicional

  16. Modelización de costes en los procesos de tratamiento de aguas residuales: un análisis empírico para el caso español

    Directory of Open Access Journals (Sweden)

    Sala Garrido, Ramon

    2006-01-01

    Full Text Available La reutilización de recursos obtenidos de la regeneración de aguas residuales se muestra como una necesidad irrenunciable tanto desde el punto de vista social como ambiental y sanitario. La viabilidad de cualquier proyecto de reutilización requiere un funcionamiento óptimo de los procesos de tratamiento de las aguas residuales. En este sentido resulta necesario un conocimiento exhaustivo de la estructura de costes asociada a cada una de las tecnologías de tratamiento disponibles. En este trabajo se aplica una metodología de modelización de costes mediante el ajuste de una serie de funciones representativas. Se lleva a cabo una aplicación empírica para una muestra de plantas depuradoras de la Comunidad Valenciana.

  17. Recomendaciones para la prevención, diagnóstico y tratamiento de LA EPOC en la Argentina

    Directory of Open Access Journals (Sweden)

    Juan Carlos Figueroa Casas

    2012-08-01

    Full Text Available La enfermedad pulmonar obstructiva crónica (EPOC está aumentando marcadamente su morbimortalidad, costos e indicadores epidemiológicos. Por ello la Asociación Argentina de Medicina Respiratoria (AAMR convocó a un grupo de especialistas para actualizar conocimientos básicos y efectuar recomendaciones para su diagnóstico, prevención y tratamiento. Se revisan definición, avances en fisiopatología, presentación clínica, diagnóstico por imágenes y evaluación funcional. Se enfatiza su diagnóstico temprano mediante exploración funcional -esencialmente espirometría- y la prevención a través de la cesación del tabaquismo. Se describen estrategias para dejar de fumar, tratamiento farmacológico y no farmacológico. La administración de broncodilatadores, preferentemente de acción prolongada, es la primera opción de tratamiento farmacológico. Los corticoides inhalados se indican en combinación con los broncodilatadores en pacientes con obstrucción al flujo aéreo persistente asociada con exacerbaciones frecuentes, si bien se requieren estudios que confirmen su relación costo/beneficio. La vacuna antigripal es recomendada en todos los pacientes. Con respecto a las intervenciones no farmacológicas, la cirugía del enfisema solo se recomienda en circunstancias especiales. La rehabilitación respiratoria es una herramienta útil en pacientes con limitación en la actividad física habitual. La oxígenoterapia crónica domiciliaria mejora la supervivencia en pacientes con hipoxemia crónica grave. La ventilación no invasiva domiciliaria fuera de las exacerbaciones, tiene indicaciones en pacientes seleccionados. Las exacerbaciones agudas deben tratarse con broncodilatadores, oxígeno, corticoides, antibióticos y, bajo ciertas circunstancias, asistencia respiratoria mecánica tanto no invasiva como invasiva. El papel de la educación pública, del paciente y su familia, es considerada esencial en la prevención y tratamiento.

  18. Jalea Real (tabletas masticables una alternativa en el tratamiento de pacientes pediátricos con inmunodeficiencia celular

    Directory of Open Access Journals (Sweden)

    Odalis María de la Guardia Peña

    2004-03-01

    Full Text Available Para evaluar la eficacia del uso de la Jalea Real (tabletas masticables en el tratamiento de niños con inmunodeficiencias celulares, se estudió a 100 niños diagnosticados con esta afección, en la consulta de Inmunología del Hospital Infantil Norte Docente "Juan de la Cruz Martínez Maceira" de Santiago de Cuba; en los años 2000 al 2002. Se establecieron 3 grupos de tratamiento: grupo 1: Tratamiento habitual con levamisol y vitaminas; grupo 2: Tratamiento habitual más Jalea Real a mitad de dosis optima; grupo 3: Jalea Real a dosis optima. Se encontró una mejoría clínica y de laboratorio superior en los pacientes que usaron Jalea Real, sin aparición de reacciones adversas, aumento de la calidad de vida y del apetito, además de aumento del conteo de linfocitos T periféricos mediante la prueba de Roseta. Cuando se combinó Jalea Real con levamisol disminuyó considerablemente la aparición de neutropenia. De los resultados de este estudio se deriva que la Jalea Real pudiera ser usada como inmunomodulador celular.In order to evaluate the efficacy of the use of Royal Jelly (chewable tablets in children with cellular immunodeficiencies, 100 children that were diagnosed this affection at the Immunology Department of "Juan Cruz Martínez Maceira" Northern Children Teaching Hospital, in Santiago de Cuba, from 200 to 2002, were studied. 3 groups of treatment were established: group 1, usual treatment with levamisol and vitamins; group 2, usual treatment plus half of the optimun dose of Royal Jelly; group 3, Royal Jelly at optimum dose. A higher clinical and laboratory improvement was observed among patients using Royal Jelly. No adverse reactions were detected and there was an increase of the quality of life and of appetite . A rise of the peripheral T lymphocytes count was also proved by Roseta test. When the Royal Jelly was mixed with levamisol, the appearance of neutropenia decreased considerably. According to the results of this study, the

  19. Valoración del cumplimiento de los tratamientos hipoglucemiantes y antihipertensivos en Galicia (‘CumpleGa’

    Directory of Open Access Journals (Sweden)

    Fornos-Pérez JA

    2017-12-01

    Full Text Available Objetivo: Evaluar en las farmacias comunitarias (FC gallegas la prevalencia de la no adherencia terapéutica en diabetes e hipertensión arterial, identificando factores relacionados con el incumplimiento y la percepción de los pacientes sobre su tratamiento. Métodos: Estudio transversal descriptivo, aleatorizado, realizado en agosto y septiembre de 2016. Se seleccionaron pacientes mayores de edad, en tratamiento con hipoglucemiantes y/o antihipertensivos que llevaban al menos dos meses con la misma pauta terapéutica. Se midió el incumplimiento mediante la administración de tres cuestionarios: Batalla, Haynes-Sacket y Morisky-Green, en una hoja de recogida de datos que incluía los tres, además de las características demográficas de los pacientes. Resultados: Participaron 31 FC en 27 farmacias, que recogieron 1.588 (muestra necesaria: 1.537 cuestionarios válidos: 778 (49,0% mujeres y 810 (51,0% hombres, de edad media 67,6±11,1 años. El número de pacientes incumplidores al menos en uno de los tres tests fue de 1.245 (78,4%. El incumplimiento medio resultó del 42,6%. La percepción de los pacientes sobre su tratamiento fue negativa en el 35,6%. El 51,0% desconoce las complicaciones de su enfermedad, el 33,1% olvida tomar su medicación y el 29,5% no cree que los medicamentos que tienen prescritos sean los adecuados. Conclusiones: El incumplimiento de las pautas terapéuticas de DM y HTA en Galicia es elevado, afectando casi a la mitad de los pacientes. Mal conocimiento sobre la enfermedad, menor nivel de estudios, polimedicación, situación pensionista (mayor edad y percepción negativa sobre sus medicamentos parecen relacionarse con una peor prevalencia del incumplimiento de los tratamientos.

  20. Exercise-induced arteriovenous intrapulmonary shunting in dogs.

    Science.gov (United States)

    Stickland, Michael K; Lovering, Andrew T; Eldridge, Marlowe W

    2007-08-01

    We have previously shown, using contrast echocardiography, that intrapulmonary arteriovenous pathways are inducible in healthy humans during exercise; however, this technique does not allow for determination of arteriovenous vessel size or shunt magnitude. The purpose of this study was to determine whether large-diameter (more than 25 microm) intrapulmonary arteriovenous pathways are present in the dog, and whether exercise recruits these conduits. Through the right forelimb, 10.8 million 25-microm stable isotope-labeled microspheres (BioPAL, Inc., Worcester, MA) were injected either at rest (n = 8) or during high-intensity exercise (6- 8 mph, 10-15% grade, n = 6). Systemic arterial blood was continuously sampled during and for 3 minutes after injection. After euthanasia, tissue samples were obtained from the heart, liver, kidney, and skeletal muscle. In addition, 25- and 50-microm microspheres were infused into four isolated dog lungs that were ventilated and perfused at constant pressures similar to exercise. Blood and tissue samples were commercially analyzed for the presence of microspheres. No microspheres were detected in the arterial blood or tissue samples from resting dogs. In contrast, five of six exercising dogs showed evidence of exercise-induced intrapulmonary arteriovenous shunting, as microspheres were detected in arterial blood and/or tissue. Furthermore, shunt magnitude was calculated to be 1.4 +/- 0.8% of cardiac output (n = 3). Evidence of intrapulmonary arteriovenous anastomoses was also found in three of four isolated lungs. Consistent with previous human findings, these data demonstrate that intrapulmonary arteriovenous pathways are functional in the dog and are recruited with exercise.

  1. Immunohistochemical analysis of restenotic tissue after transjugular portosystemic shunt

    International Nuclear Information System (INIS)

    Lu Qin; An Yanli; Deng Gang; Fang Wen; Zhu Guangyu; Li Guozhao; Wei Xiaoying; Liu Yuanyuan; Teng Gaojun

    2005-01-01

    Objective: To investigate the changes of several restenotic tissue elements after transjugular portosystemic shunt, and to provide more informations for the mechanism of TIPS restenosis. Methods: TIPS was performed in 6 swine to set up TIPS animal models. 14-21 days after operation, the models were sacrificed to obtain the TIPS tissues for pathological examinations, including electric microscope, HE staining, and immunohistochemical staining of anti-SMC-actin-α, PCNA, Vementin, myoglobulin, eNOS and iNOS. Then , the results were comparatively analyzed between TIPS obstructed shunt tissues and non-obstructed shunt tissues. Results: Restenosis was occurred with different degrees in 4 swine of the 6 TIPS models. Electric microscopic results showed that the restenosis tissues were composed of over proliferated collagen, SMCs and fibroblasts. Anti-SMC-actin-α and PCNA were strongly positive expression in restenotic tissues, and also positive in patent tissues. Vimentin expressed strongly in unstenotic tissues, on the contrary, it expressed obviously weaker in restenotic tissues. Myoglobulin expressed more strongly in restenotic tissues and weakened in unstenotic tissues. eNOS expressed positive in normal liver tissues, and expressed weaker near TIPS restenotic tissues. iNOS showed stronger expression in restenotic tissues and could hardly expressed in normal liver tissues. Conclusions: Restenotic rate may be 67% in TIPS swine models. Restenotic tissues may be mainly composed of proliferated SMCs positively expressed anti-SMC-actin-α with strong ability of movement. eNOS may be expressed in normal liver tissues and instead iNOS be expressed in strongly injured liver tissues. (authors)

  2. Clinical results of the transjugular intrahepatic portosystemic shunt

    Energy Technology Data Exchange (ETDEWEB)

    Park, Auh Whan; Sim, Jae In; Ryeom, Hun Kyu; Kim, Yong Joo [Kyungpook National University Hospital, Daegu (Korea, Republic of)

    1994-04-15

    To evaluate the clinical results of transjugular intrahepatic portosystemic shunt(TIPS) for the control of variceal bleeding. TIPS creation was attempted in 23 patients with endoscopically confirmed variceal bleeding. Most patients had multiple episodes of bleeding in the past and have been treated with multiple endoscopic sclerotherapies. Pre-and post-procedural hepatic and portal vein pressures were measured. After creation of TIPS patients were followed up at regular intervals. TIPS has been successfully accomplished in 22 of 23 patients using Wallstent(n = 21) and Strecker stent(n = 1). Immediate bleeding control was achieved in all patients with shunt creation. No procedure-related complication was noted. Portal vein pressure was reduced from 30.7 {+-} 5.8 mmHg to 20.8 {+-} 4.7 mmHg. The mean pressure gradient of portosystemic shunt dropped from 22.8 {+-} 6.0 prior to TIPS to 12.2 {+-} 4.1 immediately after. During the follow-up period (6-556 days, mean; 10 months), seven patients died; progressive hepatic failure (n 4), variceal rebleeding (n = 2), and respiratory failure(n = 1). Hepatic encephalopathy after TIPS was noted in 7 patients(31.8%). Variceal rebleeding occurred in 3 patients(13.6%). The remaining 15 patients have survived an average of 11 months. This results suggest that TIPS is a safe and effective method for lowering portal pressure and controlling variceal bleeding. Furthermore if these initial results are encouraged by further long-term observation, TIPS could replace endoscopic and risky surgical intervention.

  3. Case of right atrial myxoma with right to left shunt

    Energy Technology Data Exchange (ETDEWEB)

    Nakai, Kenji; Suzuki, Tomoyuki; Ohzeki, Tetsuro (Iwate Medical Coll., Morioka (Japan). School of Medicine)

    1982-12-01

    A case of 49-year-old woman with right atrial myxoma resulting to right to left shunt, diagnosed by cardiac pool isotope image, was reported. She was admitted to our clinic because of progressive shortness of breath. At admission lip cyanosis was noted. Laboratory data included polycythemia, low O/sub 2/ saturation (89%) and high erythrocyte sedimentation rate (65 mm/1 h). Chest x-p showed slight right atrial enlargement, but no pulmonary congestion. The electrocardiogram showed sinus regular rhythm with biphasic p wave in leads II, III, aVf. Although 1st heart sound at the apex was splited, no heart murmur was heard. In usual echocardiographic approach, no abnormal echogram was obtained in the right ventricular region. Lung perfusion scintiscan with Tc-99 m-MAA showed visualization of thyroid gland and kidney, which suggested intracardiac right-to-left shunt. Cardiac pool image with Tc-99m-HSA revealed large photo-deficient area in the right atrium and early visualization of aortic arch. Computor tomography showed large round low density region 8 x 7 cm in size. Based on their findings, this patient was diagnosed as right atrial tumor. At operation a large tumor (diameter 8 x 7 x 7 cm, weight 160g) filled the lower part of the right atrium and was adherent to the anterolateral wall in the right atrium. As a cause of R-L shunt, streched foramen ovale (5 x 10 mm) was found. Tumor histology was typical of atrial myxoma. Post-operative gated cardiac isotope image showed no evidence of residual atrial tumor. Cardiac blood pool isotope imaging was a method for the noninvasive detection and assessment of right atrial myxoma.

  4. Respuesta citológica exfoliativa gingival en diferentes técnicas de tratamiento periodontal

    Directory of Open Access Journals (Sweden)

    Nereyda Riesgo Lobaina

    1996-08-01

    Full Text Available Se realizó una investigación con el propósito de identificar los patrones de exfoliación celular durante la evolución del tratamiento periodontal y comparar la respuesta citológica gingival en diversos métodos terapéuticos. Se estudiaron 90 pacientes de uno y otro sexos en edades comprendidas entre los 20 y 50 años. Se formaron 3 grupos de 30 pacientes, en cada uno se tuvo en cuenta que la enfermedad clínica fuera electiva de alguna de las modalidades de tratamiento previstas en el estudio (colgajo, gingiventomía, raspado y alisado radicular. Las muestras citológicas se tomaron en la zona vestibular de las encías marginal y papilar mediante raspado; se fijaron por rocío químico (cytospray y se colorearon con el método clásico de Shorr-Pundel. La evaluación celular se realizó considerando sólo 2 tipos citológicos: células superficiales sin núcleo (ST2 y células superficiales con núcleos (ST1. En cada preparación microscópica se contaron aleatoriamente 300 células. Para evaluar el grado de queratinización de la encía se utilizó el índice de queratinización. Se realizó un seguimiento citológico periódico en 4 etapas: antes del tratamiento, al finalizar la preparación inicial y después de 15 y 45 días de tratamiento. Se comprobó que la encía recupera su patrón citológico normal a los 45 días.This investigation was performed with the aim of identifiing the patterns of cell exfoliation during the course of periodontal treatment, and comparing the gingival cytologic response with different therapeutical methods. A number of 90 patients of both sexes with ages ranging from 20 to 50 years studied. Three groups with 30 patients each were formed taking into account that they presented with clinical disease elective for certain therapeutical modalities established in the study (flaps, gingivectomy, dental scaling, and root planing. Cytologic samples were taken in the vestibular zone of the marginal and papillar

  5. Shunting arc plasma source for pure carbon ion beam

    Energy Technology Data Exchange (ETDEWEB)

    Koguchi, H.; Sakakita, H.; Kiyama, S.; Shimada, T.; Sato, Y.; Hirano, Y. [Energy Technology Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), 1-1-1 Umezono, Tsukuba, Ibaraki 305-8568 (Japan)

    2012-02-15

    A plasma source is developed using a coaxial shunting arc plasma gun to extract a pure carbon ion beam. The pure carbon ion beam is a new type of deposition system for diamond and other carbon materials. Our plasma device generates pure carbon plasma from solid-state carbon material without using a hydrocarbon gas such as methane gas, and the plasma does not contain any hydrogen. The ion saturation current of the discharge measured by a double probe is about 0.2 mA/mm{sup 2} at the peak of the pulse.

  6. Shunting arc plasma source for pure carbon ion beam.

    Science.gov (United States)

    Koguchi, H; Sakakita, H; Kiyama, S; Shimada, T; Sato, Y; Hirano, Y

    2012-02-01

    A plasma source is developed using a coaxial shunting arc plasma gun to extract a pure carbon ion beam. The pure carbon ion beam is a new type of deposition system for diamond and other carbon materials. Our plasma device generates pure carbon plasma from solid-state carbon material without using a hydrocarbon gas such as methane gas, and the plasma does not contain any hydrogen. The ion saturation current of the discharge measured by a double probe is about 0.2 mA∕mm(2) at the peak of the pulse.

  7. Ectopic cystoperitoneal shunt demonstrated by valvulography. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Jofre, M J; Sierralta, M P [Military Hospital Nuclear Medicine Department, Santiago (Chile)

    2002-09-01

    The most important and frequent complications in the management of hydrocephalus treated with a derivation system are the infection and obstruction of the ventriculoperitoneal or ventriculoatrial shunt. However, another less frequent problem is the migration of the distal catheter. The case report presented is a 20 year-old girl who started, when she was 12, with severe headaches and epileptogenic seizures. She was diagnosed with a left parietotemporal aracnoidal cyst and a cystoperitoneal shunt was installed. However, she continued to have headaches. In September 1999, the derivation system was controlled with a radionuclide valvulography, which demonstrated shunt patency, with mild ectasis in the distal region. In July 2000, another valvulography showed a malfunction of the cystoperitoneal system. The distal catheter was surgically reviewed and repositioned. A few months of being asymptomatic, the headaches returned with a cough, which didn't respond to treatment. In February of 2002, she was referred to the Military Hospital Nuclear Medicine Department and a radionuclide valvulography was performed with 370 MBq of Tc99m-DTPA, injected in the derivative system reservoir. Images showed a slow descension of the radionuclide until the xifoides region where the distal catheter had formed a loop into the chest. Free activity was observed at the end of the catheter with another abnormal traject in the middle chest up to the top of the sternum. A pumping test was done and the patient coughed and said that she 'felt water' in her mouth. A simple abdomen X-ray was performed confirming the distal catheter in the upper side of the diaphragm. A third surgery was performed demonstrating that the catheter had an intraperitoneal loop with the distal end in the chest. They pulled the catheter and the distal end was repositioned into the peritoneal cavity, controlling its functioning. A simple abdomen X-ray verified the position. In the following days the patient had no headache

  8. Ectopic cystoperitoneal shunt demonstrated by valvulography. A case report

    International Nuclear Information System (INIS)

    Jofre, M.J.; Sierralta, M.P.

    2002-01-01

    The most important and frequent complications in the management of hydrocephalus treated with a derivation system are the infection and obstruction of the ventriculoperitoneal or ventriculoatrial shunt. However, another less frequent problem is the migration of the distal catheter. The case report presented is a 20 year-old girl who started, when she was 12, with severe headaches and epileptogenic seizures. She was diagnosed with a left parietotemporal aracnoidal cyst and a cystoperitoneal shunt was installed. However, she continued to have headaches. In September 1999, the derivation system was controlled with a radionuclide valvulography, which demonstrated shunt patency, with mild ectasis in the distal region. In July 2000, another valvulography showed a malfunction of the cystoperitoneal system. The distal catheter was surgically reviewed and repositioned. A few months of being asymptomatic, the headaches returned with a cough, which didn't respond to treatment. In February of 2002, she was referred to the Military Hospital Nuclear Medicine Department and a radionuclide valvulography was performed with 370 MBq of Tc99m-DTPA, injected in the derivative system reservoir. Images showed a slow descension of the radionuclide until the xifoides region where the distal catheter had formed a loop into the chest. Free activity was observed at the end of the catheter with another abnormal traject in the middle chest up to the top of the sternum. A pumping test was done and the patient coughed and said that she 'felt water' in her mouth. A simple abdomen X-ray was performed confirming the distal catheter in the upper side of the diaphragm. A third surgery was performed demonstrating that the catheter had an intraperitoneal loop with the distal end in the chest. They pulled the catheter and the distal end was repositioned into the peritoneal cavity, controlling its functioning. A simple abdomen X-ray verified the position. In the following days the patient had no headache

  9. Tratamientos eficaces para el Trastorno de Ansiedad Social

    Directory of Open Access Journals (Sweden)

    Carolina Baeza Velasco

    2007-01-01

    Full Text Available www.neuropsicologia.cl 127 Tratamientos eficaces para el Trastorno de Ansiedad Social Efficient Treatments for Social Anxiety Disorder Carolina Baeza Velasco * Resumen El Trastorno de Ansiedad Social (TAS, también cono cido como Fobia Social, es reconocido hoy en día como una condición psiquiátri ca crónica e incapacitante. La alta prevalencia y la significancia clínica de la enferm edad, enfatizan la necesidad de reconocimiento temprano y de tratamiento eficaz. El objetivo de este trabajo es exponer los principales tratamientos existentes, poniendo a tención a las investigaciones y estudios meta-analíticos que intentan diferenciar los distin tos tipos de intervención en relación a su eficacia.

  10. El tratamiento insulinico de engorde en el hipertiroidismo

    Directory of Open Access Journals (Sweden)

    Francisco Gnecco Mozzo

    1940-06-01

    Full Text Available Fuera de comunicaciones aisladas, como la de Andreeva, que empleará pequeñas dosis de insulina, en combinación con el yodo para el tratamiento de la enfermedad de Basedow, y la bien reciente de Soskin y Mirsky de Chicago, que usaron una dieta calórica de gran valor hidrocarbonado en una enferma que había rehusado someterse a la intervención quirúrgica como tratamiento radical para su bocio, no hemos encontrado en la literatura médica de varios años el empleo sistemático de ambos medios, la insulina y la dieta de alto valor calórico hidrocarbonado y graso para el tratamiento del hipertiroidismo.

  11. The CHESS score: a simple tool for early prediction of shunt dependency after aneurysmal subarachnoid hemorrhage.

    Science.gov (United States)

    Jabbarli, R; Bohrer, A-M; Pierscianek, D; Müller, D; Wrede, K H; Dammann, P; El Hindy, N; Özkan, N; Sure, U; Müller, O

    2016-05-01

    Acute hydrocephalus is an early and common complication of aneurysmal subarachnoid hemorrhage (SAH). However, considerably fewer patients develop chronic hydrocephalus requiring shunt placement. Our aim was to develop a risk score for early identification of patients with shunt dependency after SAH. Two hundred and forty-two SAH individuals who were treated in our institution between January 2008 and December 2013 and survived the initial impact were retrospectively analyzed. Clinical parameters within 72 h after the ictus were correlated with shunt dependency. Independent predictors were summarized into a new risk score which was validated in a subsequent SAH cohort treated between January and December 2014. Seventy-five patients (31%) underwent shunt placement. Of 23 evaluated variables, only the following five showed independent associations with shunt dependency and were subsequently used to establish the Chronic Hydrocephalus Ensuing from SAH Score (CHESS, 0-8 points): Hunt and Hess grade ≥IV (1 point), location of the ruptured aneurysm in the posterior circulation (1 point), acute hydrocephalus (4 points), the presence of intraventricular hemorrhage (1 point) and early cerebral infarction on follow-up computed tomography scan (1 point). The CHESS showed strong correlation with shunt dependency (P = 0.0007) and could be successfully validated in both internal SAH cohorts tested. Patients scoring ≥6 CHESS points had significantly higher risk of shunt dependency (P CHESS may become a valuable diagnostic tool for early estimation of shunt dependency after SAH. Further evaluation and external validation will be required in prospective studies. © 2016 EAN.

  12. Cellophane banding for the gradual attenuation of single extrahepatic portosystemic shunts in eleven dogs.

    Science.gov (United States)

    Youmans, K R; Hunt, G B

    1998-08-01

    To evaluate the efficacy and short term effects of a cellophane banding technique for progressive attenuation of canine single extrahepatic portosystemic shunts. A prospective trial of 11 dogs with single congenital extrahepatic shunts. Rectal ammonia tolerance testing and routine biochemical tests were performed preoperatively on all dogs. In seven dogs, preoperative abdominal Doppler ultrasonography was also performed. Exploratory laparotomy revealed a single extrahepatic portocaval shunt in each animal, which was attenuated using a cellophane band with an internal diameter of 2 to 3 mm. The abdomen was closed routinely. Follow-up biochemical analysis and abdominal Doppler ultrasonography or splenoportography were performed postoperatively. The shunt was not amenable to total ligation in 11 dogs, based upon reported criteria. All dogs recovered uneventfully from surgery without evidence of portal hypertension, and showed clinical improvement thereafter. Shunt occlusion was deemed to have occurred in 10 dogs based on resolution of biochemical and/or sonographic abnormalities. One dog continued to have sonographic evidence of portosystemic shunting when evaluated 3 weeks after surgery, despite normal ammonia tolerance, but was lost to subsequent follow-up. Two dogs, in which 3 mm cellophane bands were placed, experienced delayed shunt occlusion. Cellophane banding is simple to perform, and causes progressive attenuation of single extrahepatic shunts in dogs. Further work is needed to determine the maximum diameter of a cellophane band which will produce total attenuation, and the long-term safety and reliability of the treatment.

  13. Multi-resonant electromagnetic shunt in base isolation for vibration damping and energy harvesting

    Science.gov (United States)

    Pei, Yalu; Liu, Yilun; Zuo, Lei

    2018-06-01

    This paper investigates multi-resonant electromagnetic shunts applied to base isolation for dual-function vibration damping and energy harvesting. Two multi-mode shunt circuit configurations, namely parallel and series, are proposed and optimized based on the H2 criteria. The root-mean-square (RMS) value of the relative displacement between the base and the primary structure is minimized. Practically, this will improve the safety of base-isolated buildings subjected the broad bandwidth ground acceleration. Case studies of a base-isolated building are conducted in both the frequency and time domains to investigate the effectiveness of multi-resonant electromagnetic shunts under recorded earthquake signals. It shows that both multi-mode shunt circuits outperform traditional single mode shunt circuits by suppressing the first and the second vibration modes simultaneously. Moreover, for the same stiffness ratio, the parallel shunt circuit is more effective at harvesting energy and suppressing vibration, and can more robustly handle parameter mistuning than the series shunt circuit. Furthermore, this paper discusses experimental validation of the effectiveness of multi-resonant electromagnetic shunts for vibration damping and energy harvesting on a scaled-down base isolation system.

  14. Ventriculoperitoneal shunt for treatment of hydrocephalus in a French bulldog puppy

    Science.gov (United States)

    Giacinti, Jolene A.

    2016-01-01

    A 6.5-week-old bulldog was presented with lethargy, anorexia, and stunted growth. A domed skull, ventrolateral strabismus, hypermetria, and delayed hopping were observed. Congenital hydrocephalus was diagnosed and a ventriculoperitoneal shunt was placed. After surgery, a shunt obstruction occurred but resolved with treatment. The puppy responded well and neurological deficits continued to improve after surgery. PMID:26933271

  15. Medication overuse as a cause of chronic headache in shunted hydrocephalus patients

    DEFF Research Database (Denmark)

    Willer, Lasse; Jensen, R H; Juhler, M

    2010-01-01

    To highlight the group of hydrocephalus patients known to have a long history of shunt revisions and refractory chronic headache. When a shunt in perfect working order has no effect on headache, other causes of headache should be investigated. In this paper, patients with medication overuse...

  16. Creation of transcatheter aortopulmonary and cavopulmonary shunts using magnetic catheters: feasibility study in swine.

    Science.gov (United States)

    Levi, Daniel S; Danon, Saar; Gordon, Brent; Virdone, Nicky; Vinuela, Fernando; Shah, Sanjay; Carman, Greg; Moore, John W

    2009-05-01

    Surgical shunts are the basic form of palliation for many types of congenital heart disease. The Glenn shunt (superior cavopulmonary connection) and central shunt (aortopulmonary connection) represent surgical interventions that could potentially be accomplished by transcatheter techniques. We sought to investigate the efficacy of using neodymium iron boron (NdFeB) magnetic catheters to create transcatheter cavopulmonary and aortopulmonary shunts. NdFeB magnets were machined and integrated into catheters. "Target" catheters were placed in the pulmonary arteries (PAs), and radiofrequency "perforation" catheters were placed in either the descending aorta (DAo) for central shunts or the superior vena cava (SVC) for Glenn shunts. The magnet technique or "balloon target" method was used to pass wires from the DAo or the SVC into the PA. Aortopulmonary and cavopulmonary connections were then created using Atrium iCAST covered stents. Magnet catheters were used to perforate the left pulmonary artery from the DAo, thereby establishing a transcatheter central shunt. Given the orientation of the vasculature, magnetic catheters could not be used for SVC-to-PA connections; however, perforation from the SVC to the right pulmonary artery was accomplished with a trans-septal needle and balloon target. Transcatheter Glenn or central shunts were successfully created in four swine.

  17. 21 CFR 882.5550 - Central nervous system fluid shunt and components.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Central nervous system fluid shunt and components... Central nervous system fluid shunt and components. (a) Identification. A central nervous system fluid... central nervous system to an internal delivery site or an external receptacle for the purpose of relieving...

  18. Medication overuse as a cause of chronic headache in shunted hydrocephalus patients

    DEFF Research Database (Denmark)

    Willer, Lasse; Jensen, R H; Juhler, M

    2010-01-01

    To highlight the group of hydrocephalus patients known to have a long history of shunt revisions and refractory chronic headache. When a shunt in perfect working order has no effect on headache, other causes of headache should be investigated. In this paper, patients with medication overuse...... headache are identified and the positive effect of medication withdrawal are described....

  19. l-Arginine Pathway Metabolites Predict Need for Intra-operative Shunt During Carotid Endarterectomy

    DEFF Research Database (Denmark)

    Szabo, P; Lantos, J; Nagy, L

    2016-01-01

    lactate levels were increased during reperfusion (p = .02). The median pre-operative concentration of l-arginine was lower in patients requiring an intra-operative shunt than in patients without need of shunt (median: 30.3 μmol/L [interquartile range 24.4-34.4 μmol/L] vs. 57.6 μmol/L [interquartile range...

  20. Reducción de pentaclorofenol en el agua cruda del río Cauca mediante adsorción con carbón activado en procesos de potabilización

    OpenAIRE

    Torres, Patricia; Cruz, Camilo; González, Magally; Gutiérrez, Héctor Mario; Barba, Luz Edith; Escobar, Juan Carlos; Delgado, Luis Germán

    2008-01-01

    La reducción del riesgo químico del agua cruda del río Cauca causado por la presencia de pentaclorofenol y materia orgánica (color real, absorbancia UV254) se evaluó a escala de laboratorio mediante tres secuencias de tratamiento: adsorción con carbón activado en polvo (CAP); adsorción-coagulación y adsorción-desinfección-coagulación. Los resultados mostraron que el CAP es un compuesto adecuado para la remoción del pentaclorofenol y que su uso conjunto con el coagulante (sulfato de aluminio) ...

  1. Reducción de pentaclorofenol en el agua cruda del río cauca mediante adsorción con carbón activado en procesos de potabilización

    OpenAIRE

    Cruz Vélez, Camilo Hernán; González, Magally; Gutiérrez, Héctor Mario; Barba, Luz Edith; Escobar, Juan Carlos; Germán Delgado, Luis; Torres, Patricia

    2010-01-01

    La reducción del riesgo químico del agua cruda del río Cauca causado por la presencia de pentaclorofenol y materia orgánica (color real, absorbancia UV254) se evaluó a escala de laboratorio mediante tres secuencias de tratamiento: adsorción con carbón activado en polvo (CAP); adsorción–coagulación y adsorción–desinfección-coagulación. Los resultados mostraron que el CAP es un compuesto adecuado para la remoción del pentaclorofenol y que su uso conjunto con el coagulante (sulfato de aluminio) ...

  2. Programa de cribaje de la retinopatía diabética en el Vallès Oriental mediante cámara no midriática. Estudio de 5228 pacientes diabéticos tipo 2

    OpenAIRE

    Hernecki, Jaroslaw

    2010-01-01

    Descripció del recurs: 4 novembre 2010 La presente tesis doctoral recoge los resultados del programa de cribaje de la retinopatía diabética mediante la cámara no midriática en la comarca de Vallès Oriental (Barcelona). Es un estudio de 5228 pacientes diabéticos tipo 2 no cribados previamente. Se analizan las características demográficas del grupo estudiado, los datos de la diabetes (el tipo de tratamiento, tiempo de evolución de la diabetes y el control metabólico) y la prevalencia de la r...

  3. Reciclado en suelos de lodos de refinería : nuevas aproximaciones para la biodegradación de hidrocarburos mediante el manejo de enmiendas orgánicas.

    OpenAIRE

    Rodríguez Alhama, Irene

    2013-01-01

    Los lodos procedentes de las plantas de refino del petróleo, son residuos con una elevada concentración de hidrocarburos, que son unas moléculas altamente tóxicas para las plantas y los microorganismos e invertebrados que habitan el suelo donde se encuentran, y constituyen un riesgo potencial para la salud. Una de las prácticas de gestión de los mismos ha sido su vertido a suelo en zonas controladas y su posterior tratamiento mediante técnicas de biorremediación de bajo coste, como son el lan...

  4. Tratamiento especializado del abuso o dependencia del alcohol

    Directory of Open Access Journals (Sweden)

    Josep M. Suelves

    2014-01-01

    Full Text Available Fundamentos.El Plan Nacional sobre Drogas (PNSD impulsó la prevención y el tratamiento de los trastornos por uso de drogas ilegales, y ahora abarca los trastornos por uso de alcohol. El objetivo de este trabajo es realizar una estimación de las personas en tratamiento especializado por alcohol en la red pública. Métodos.Se revisan documentos del PNSD, del sistema de información sobre drogodependencias de Cataluña y del de Barcelona. Para Cataluña y Barcelona se presentan datos de 1991 a 2010. Resultados.Para el conjunto de España hay información disponible desde hace pocos años, con exhaustividad y validez variable. En Catalunya, el número de admisiones a tratamiento por alcohol notificadas se incrementó: el alcohol causa anualmente más del 40% del total de admisiones a tratamiento en la red de drogodependencias; la edad media es de 44 años y el 23% son mujeres. En Barcelona las admisiones a tratamiento por alcohol superan las 2.000 al año, suponiendo 217 por 100.000 habitantes mayores de 15 años varones y 67 en mujeres. Conclusiones.Los datos disponibles sugieren que por lo que respecta al alcohol el sistema de información sobre drogas ha de desarrollarse más en España, resolviendo problemas metodológicos. Los datos disponibles para Cataluña sugieren que la red de atención a drogas ha permitido abordar la necesidad asistencial por dependencia al alcohol conjuntamente con la de drogas ilegales. Esta información es relevante, pues apenas existen datos de tratamiento referidos a la población.

  5. Fitoterapia como coadyuvante en el tratamiento de la obesidad

    OpenAIRE

    López-Regueiro, Sofía; Ramos Sáiz, Eva María; López-Picado, Amanda; Burgos-Alonso, Natalia; Arana-Salaberría, Ainara

    2012-01-01

    La obesidad es uno de los problemas de salud más importantes a nivel mundial debido a su relación con numerosas patologías como la diabetes mellitus tipo 2, la hipertensión y el aumento importante en el riesgo cardiovascular. La base del tratamiento es la dieta y el ejercicio físico, pero en muchos casos no es sufi ciente y es necesario combinarlo con tratamiento farmacológico. Recientemente se ha retirado sibutramina del mercado por lo que sólo se dispone de orlistat, que no está exento de c...

  6. La Terapia Familiar en el tratamiento de las adicciones

    OpenAIRE

    Marcos Sierra, Juan Antonio; Garrido Fernández, Miguel

    2009-01-01

    En este trabajo se presenta un breve recorrido histórico sobre el papel de la terapia familiar en el tratamiento de las adicciones. Siguiendo la propuesta de Rolland y Walsh (1996) se analizan con detenimiento los modelos centrados en la resolución de problemas y los modelos intergeneracionales. El objetivo básico del artículo es mostrar las aportaciones de las diferentes perspectivas y contribuir a enfoques más integradores en el tratamiento familiar de las adicciones. En esta...

  7. Tratamiento de las adiciones en los establecimientos penitenciarios

    OpenAIRE

    Cerezo Sánchez, Carmen

    2016-01-01

    Bajo la ponencia titulada “Tratamiento de las adicciones en los establecimientos penitenciarios”, la comunicación está dirigida a dar a conocer la forma en la que, de acuerdo con la normativa vigente, actúan los profesionales con aquellos internos que sufren algún tipo de adicción en prisión. Se exponen las novedades que han sido incorporadas en las últimas reformas, manifestando de manera sucinta cómo afectan al tratamiento de las adicciones en los centros penitenciarios, haciendo un recorri...

  8. Tratamientos eficaces para el Trastorno de Ansiedad Social

    OpenAIRE

    Carolina Baeza Velasco

    2007-01-01

    www.neuropsicologia.cl 127 Tratamientos eficaces para el Trastorno de Ansiedad Social Efficient Treatments for Social Anxiety Disorder Carolina Baeza Velasco * Resumen El Trastorno de Ansiedad Social (TAS), también cono cido como Fobia Social, es reconocido hoy en día como una condición psiquiátri ca crónica e incapacitante. La alta prevalencia y la significancia clínica de la enferm edad, enfatizan la necesidad de reconocimiento temprano y de tratamiento ef...

  9. Valeriana en el tratamiento a largo plazo del insomnio

    OpenAIRE

    Medina Ortiz, Oscar; Sánchez-Mora, Nora; Fraguas Herraez, David; Arango López, Celso

    2008-01-01

    Introducción: La valeriana se ha utilizado desde la antigua Grecia y China para inducir el sueño, debido a sus propiedades ansiolíticas. Hoy en día, aun cuando no es un producto aprobado por la Agencia de Administración de Drogas y Alimentos de Estados Unidos (FDA) para el tratamiento del insomnio, se utiliza en diferentes países con esta finalidad. Objetivo: Llevar a cabo una revisión que permita determinar la eficacia de la valeriana en el tratamiento a largo plazo del insomnio y considerar...

  10. Clinical and ultrasonographic criteria for using ventriculoperitoneal shunts in newborns with myelomeningocele

    Directory of Open Access Journals (Sweden)

    Jose Roberto Tude Melo

    2015-09-01

    Full Text Available Objective Hydrocephalus is one of the main complications associated with myelomeningocele (MM. This study aimed to identify clinical and ultrasonographic criteria for using ventriculoperitoneal (VP shunts in this group of patients.Method A retrospective cohort study, based on established protocol for VP shunt implant in hydrocephalic children with MM. Parameters used to guide the indication of VP shunts included measurement of head circumference (HC, evaluation of fontanels, and measurement of lateral ventricular atrium (LVA width by transcranial ultrasonography.Results 43 children were included in the analysis, of which 74% had hydrocephalus and required a VP shunt. These children had LVA width ≥ 15 mm, showed increased HC, or had bulging fontanels.Conclusion VP shunt is required in children with increased HC (≥ 2 standard deviation regarding age group, bulging fontanels, or LVA width of ≥ 15 mm after the closure of MM.

  11. Ventriculoperitoneal shunt-related infections caused by Staphylococcus epidermidis: pathogenesis and implications for treatment.

    LENUS (Irish Health Repository)

    Stevens, Niall T

    2012-12-01

    The insertion of medical devices, such as intraventricular shunts, is often complicated by infection leading to ventriculitis. Frequently, such infections result from colonisation and subsequent biofilm formation on the surfaces of the shunts by Staphylococcus epidermidis. The pathogenesis of neurosurgical shunt-related infection is complex with interactions between the pathogen, the device and the unique local immunological environment of the central nervous system (CNS). An ability to form biofilm, the main virulence determinant of Staphylococcus epidermidis, facilitates protection of the organism from the host defences while still initiating an immunological response. The presence of the blood brain barrier (BBB) and the biofilm itself also complicates treatment, which presents many challenges when managing shunt infections. A greater understanding of the interplay between S. epidermidis and the CNS could potentially improve the diagnosis, treatment and management of such infections. This review describes the pathogenesis, treatment and implications of S. epidermidis ventriculoperitoneal shunt-related infections, concentrating on recent research and the implications for treatment.

  12. Intrahepatic portal-hepatic venous shunt diagnosed by ultrasonography and computed tomography. Report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Shinagawa, Takashi; Iino, Yasuo; Ukaji, Haruyasu; Ishizuka, Masaharu

    1986-02-01

    Two cases of intrahepatic portal-hepatic venous shunt found by ultrasonography and computed tomography are reported. The first case came to the hospital because of hematuria. A large shunt between the portal vein and the hepatic vein was demonstrated by ultrasonography done for screening, and confirmed by percutaneous transhepatic portography (PTP). The second case was admitted because of cholelithiasis. Computed tomography with contrast enhancement revealed a dilated portal vein in the upper portion of the right lobe. It was subsequently shown by PTP to be a portal-hepatic venous shunt. Portal vein pressure and histological finding of the liver were normal in both cases. The etiology of the shunt was thought to be congenital in these cases for lack of liver disease, portal hypertension and history of trauma. Both cases had no history of hepatic encephalopathy and did not show any symptom attributable to the shunt.

  13. Communicating hydrocephalus due to cerebral venous sinus thrombosis treated with ventriculoperitoneal shunt

    Directory of Open Access Journals (Sweden)

    Rahul T Chakor

    2012-01-01

    Full Text Available Cerebral venous sinus thrombosis (CVT is a rare cerebrovascular disease with variable presentation. CVT rarely causes hydrocephalus. Communicating hydrocephalus due to CVT is extremely rare. We describe a patient of CVT presenting with chronic headache and communicating hydrocephalus. The patient was successfully treated with ventriculoperitoneal (VP shunt. A 40 year old man presented with moderate to severe headache since six months and progressive visual loss since two months. Head Computed tomogram showed mild hydrocephalus without obstruction. Lumbar puncture (LP demonstrated elevated pressure but was otherwise normal. Magnetic resonance venogram showed extensive CVT. Repeated CSF drainage and thecoperitoneal shunt did not relieve the severe headache hence a VP shunt was placed. Post shunt headache subsided with resolution of hydrocephalus. CVT can present as communicating hydrocephalus. Gradual reduction of intra-ventricular pressure by repeated LPs followed by VP shunt can safely treat hydrocephalus due to CVT.

  14. Quantitative determination of peripheral arterio-venous shunts by means of radioactively labelled microspheres

    International Nuclear Information System (INIS)

    Friese, K.H.

    1981-01-01

    In the present work a nuclear method of quantitative measurement of peripheral arterio-venous shunts with a whole-body scanner is standardized. This method, developed at the beginning of the 70s at Tuebingen, stands out in contrast with earlier measuring methods by the application of the theory of quantitative scintiscanning. This means that the scintigram obtained after injection of sup(99m)technetium-labelled human albumin microspheres into an artery before the shunt is corrected for the quantitative shunt calculation by several factors using a computer, to avoid systematic mistakes. For the standardization of the method, 182 scintigrams were taken during model experiments and experiments on animals and human beings. This method, having a deviation of 10% at most, is excellently suited for the quantitative determination of peripheral arterio-venous shunts. Already for a pulmonary activity of 3% a peripheral shunt is proved with 97.5% probability. (orig./MG) [de

  15. A rare cause of pediatric urinary incontinence: Ventriculoperitoneal shunt with bladder perforation

    Directory of Open Access Journals (Sweden)

    Manuel C See IV

    2016-04-01

    Full Text Available We present a case of 2-year-old boy with long term dysuria and intermittent incontinence, and new onset of fever and headache. Significant past medical history includes congenital hydrocephalus with a ventriculoperitoneal shunt placement two years prior to consult. On physical examination, a tubular structure was noted underneath the prepuce suspected to be the distal tip of ventriculoperitoneal shunt, which was confirmed by kidney, ureter and bladder (KUB X-ray and CT scan. Patient was treated with a novel approach of extraperitoneal removal of ventriculoperitoneal shunt distal tip with cystorrhaphy via a low transverse pfannenstiel incision, separate left ventriculostomy tube insertion and complete removal of ventriculoperitoneal shunt from the right ventricle. This report accounts a rare pediatric case with ventriculoperitoneal shunt perforation into a normal bladder successfully treated with mini-open surgery.

  16. Early mediastinal seroma secondary to modified Blalock-Taussig shunts - successful management by percutaneous drainage

    International Nuclear Information System (INIS)

    Connolly, Bairbre L.; Temple, Michael J.; Chait, Peter G.; Restrepo, Ricardo; Adatia, Ian

    2003-01-01

    Large symptomatic mediastinal seroma following modified-BT shunts, traditionally required revisional thoracotomy. We describe percutaneous image-guided pigtail catheter drainage in the successful treatment of early mediastinal seroma secondary to PTFE Blalock-Taussig shunt, avoiding thoracotomy. A retrospective review of all relevant clinical and imaging records in five patients was performed. All five presented with intermittent stridor, respiratory distress and/or episodic desaturation within 6 weeks of their surgery. In four of five infants, percutaneous drainage was effective and reoperation was avoided. In one of five, rather than urgent surgical evacuation and BT shunt revision, we were able to perform an elective stage-II bidirectional Glenn SVC-RA anastamosis in a stable infant. There were no complications. Percutaneous image-guided drainage of mediastinal seroma secondary to PTFE-BT shunt is a safe, minimally invasive, and effective treatment. This may avoid BT shunt revision. (orig.)

  17. Tunable band gaps in acoustic metamaterials with periodic arrays of resonant shunted piezos

    International Nuclear Information System (INIS)

    Chen Sheng-Bing; Wen Ji-Hong; Wang Gang; Wen Xi-Sen

    2013-01-01

    Periodic arrays of resonant shunted piezoelectric patches are employed to control the wave propagation in a two-dimensional (2D) acoustic metamaterial. The performance is characterized by the finite element method. More importantly, we propose an approach to solving the conventional issue of the nonlinear eigenvalue problem, and give a convenient solution to the dispersion properties of 2D metamaterials with periodic arrays of resonant shunts in this article. Based on this modeling method, the dispersion relations of a 2D metamaterial with periodic arrays of resonant shunted piezos are calculated. The results show that the internal resonances of the shunting system split the dispersion curves, thereby forming a locally resonant band gap. However, unlike the conventional locally resonant gap, the vibrations in this locally resonant gap are unable to be completely localized in oscillators consisting of shunting inductors and piezo-patches

  18. Symptomatic spinal cord deformity secondary to a redundant intramedullary shunt catheter

    International Nuclear Information System (INIS)

    Quencer, R.M.; Montalvo Morse, B.M.; Green, B.A.; Eismont, F.J.

    1985-01-01

    Right arm pain, motor and sensory loss in the right arm and right facial numbness recurred in a 27 year old quadraplegic shortly after a posttraumatic spinal cord cyst (PTSCC) was shunted via a catheter into the adjacent subarachnoid space. Although shunt malfunction was clinically suspected, metrizamide computed tomography (MCT) suggested that redundancy of the catheter had caused deformity of the spinal cord. This hypothesis was confirmed at surgery when intraoperative spinal sonography (IOSS) showed that the spinal cord deformity at C 1 -C 2 disappeared when the catheter was withdrawn. This case shows that new or recurrent spinal cord symptoms may be due to a mechanical deformity of the cord rather than shunt malfunction, that restricting the length of the shunt catheter which is used to decompress PTSCCs is important, and that IOSS is an indispensible tool for visualizing the changes in spinal cord morphology during shunting procedures. (orig.)

  19. Intrahepatic portal-hepatic venous shunt diagnosed by ultrasonography and computed tomography

    International Nuclear Information System (INIS)

    Shinagawa, Takashi; Iino, Yasuo; Ukaji, Haruyasu; Ishizuka, Masaharu

    1986-01-01

    Two cases of intrahepatic portal-hepatic venous shunt found by ultrasonography and computed tomography are reported. The first case came to the hospital because of hematuria. A large shunt between the portal vein and the hepatic vein was demonstrated by ultrasonography done for screening, and confirmed by percutaneous transhepatic portography (PTP). The second case was admitted because of cholelithiasis. Computed tomography with contrast enhancement revealed a dilated portal vein in the upper portion of the right lobe. It was subsequently shown by PTP to be a portal-hepatic venous shunt. Portal vein pressure and histological finding of the liver were normal in both cases. The etiology of the shunt was thought to be congenital in these cases for lack of liver disease, portal hypertension and history of trauma. Both cases had no history of hepatic encephalopathy and did not show any symptom attributable to the shunt. (author)

  20. Contaminación aguda por vertidos textiles: Tratamiento de carpines dorados (Carassius auratus) con dicromato potásico; determinación de la toxicidad y niveles de cromo en branquias.

    OpenAIRE

    Riva Juan, María del Carmen; Flos Bassols, Rosa; Crespi Rosell, Martí; Balash, J.

    1980-01-01

    El cromo es el metal pesado cuantitativamente más importante en el vertido de la Industria Textil; procede esencialmente de los procesos de tintura con colorantes cromatables. Hemos sometido carpines dorados al tratamiento agudo con dicromato potásico disuelto en el agua de tanques experimentales. Se determina la toxicidad y los niveles de cromo en branquias. La concentración de cromo en el tejido branquia1 se halla mediante espectrofotometría de absorción atómica, previa digestión c...

  1. Evaluación de Riesgo Ecológico en la Aplicación de Lodos de Plantas de Tratamiento de Aguas Servidas a Suelos en la Región de la Araucanía

    OpenAIRE

    Carolina Soto

    2014-01-01

    Los lodos generados en plantas de tratamiento de aguas servidas contienen materiales orgánicos ricos en nutrientes como nitrógeno (N), fósforo (P) y potasio (K), además de metales y pequeñas cantidades de otros elementos tales como celulosa, ácidos orgánicos. Los lodos pueden ser considerados como residuos o reciclados mediante la incorporación a suelos. Frente a esta situación de disposición de lodos primarios en suelos, se determinó el efecto de dos muestras de lodos (una ya incorporada ...

  2. Tratamiento Manual Postcirugía en un caso Clínico de Transposición muscular del Romboides y Angular de la Escápula

    OpenAIRE

    Gómez García, Ana

    2009-01-01

    Descripción de un caso clínico en la que se secciona el nervio espinal derecho (neurotmesis) tras la exéresis de un quiste en el cuello. Debido a la falta de transmisión neuronal se produce una parálisis funcional en el músculo trapecio y en el músculo esternocleidomastoideo derecho y se suple sus funciones mediante una reinserción del músculo elevador de la escápula y del músculo romboides de dicho lado que recibe el nombre de transposición muscular. Se realiza tratamiento de fisioter...

  3. Management of Ventriculoperitoneal Shunt Infections in Adults: Analysis of Risk Factors Associated With Treatment Failure.

    Science.gov (United States)

    Pelegrín, Iván; Lora-Tamayo, Jaime; Gómez-Junyent, Joan; Sabé, Nuria; García-Somoza, Dolors; Gabarrós, Andreu; Ariza, Javier; Viladrich, Pedro Fernández; Cabellos, Carmen

    2017-04-15

    Little is known regarding the optimal treatment of ventriculoperitoneal (VP) shunt infections in adults. Our aim was to assess the efficacy of treatment strategies and to identify factors that predict failure. Retrospective, observational study of patients aged ≥12 years with VP shunt infections (1980 -2014). Therapeutic approaches were classified under 4 headings: only antibiotics (OA), one-stage shunt replacement (OSSR), two-stage shunt replacement (TSSR), and shunt removal without replacement (SR). The primary endpoint was failure of the treatment strategy, defined as the absence of definite cerebrospinal fluid (CSF) sterilization or related mortality. The parameters that predicted failure were analyzed using logistic regression. Of 108 episodes (51% male, median age 50 years), 86 were analyzed. Intravenous antibiotics were administered for a median of 19 days. Eighty episodes were treated using strategies that combined antibiotic and surgical treatment (37 TSSR, 24 SR, 19 OSSR) and 6 with OA. Failure occurred in 30% of episodes, mostly due to lack of CSF sterilization in OSSR and OA groups. Twelve percent died of related causes and 10% presented superinfection of the CSF temporary drainage/externalized peritoneal catheter. TSSR was the most effective strategy when VP shunt replacement was attempted. The only independent risk factor that predicted failure was retention of the VP shunt, regardless of the strategy. This is the largest series of VP shunt infections in adults reported to date. VP shunt removal, particularly TSSR when the patient is shunt dependent, remains the optimal choice of treatment and does not increase morbidity. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  4. Shunt-dependent hydrocephalus: management style among members of the American Society of Pediatric Neurosurgeons.

    Science.gov (United States)

    Kraemer, Mark R; Sandoval-Garcia, Carolina; Bragg, Taryn; Iskandar, Bermans J

    2017-09-01

    OBJECTIVE The authors conducted a survey to evaluate differences in the understanding and management of shunt-dependent hydrocephalus among members of the American Society of Pediatric Neurosurgeons (ASPN). METHODS Surveys were sent to all 204 active ASPN members in September 2014. One hundred thirty responses were received, representing a 64% response rate. Respondents were asked 13 multiple-choice and free-response questions regarding 4 fundamental problems encountered in shunted-hydrocephalus management: shunt malfunction, chronic cerebrospinal fluid (CSF) overdrainage, chronic headaches, and slit ventricle syndrome (SVS). RESULTS Respondents agreed that shunt malfunction occurs most often as the result of ventricular catheter obstruction. Despite contrary evidence in the literature, most respondents (66%) also believed that choroid plexus is the tissue most often found in obstructed proximal catheters. However, free-text responses revealed that the respondents' understanding of the underlying pathophysiology of shunt obstruction was highly variable and included growth, migration, or adherence of choroid plexus, CSF debris, catheter position, inflammatory processes, and CSF overdrainage. Most respondents considered chronic CSF overdrainage to be a rare complication of shunting in their practice and reported wide variation in treatment protocols. Moreover, despite a lack of evidence in the literature, most respondents attributed chronic headaches in shunt patients to medical reasons (for example, migraines, tension). Accordingly, most respondents managed headaches with reassurance and/or referral to pain clinics. Lastly, there were variable opinions on the etiology of slit ventricle syndrome (SVS), which included early shunting, chronic overdrainage, and/or loss of brain compliance. Beyond shunt revision, respondents reported divergent SVS treatment preferences. CONCLUSIONS The survey shows that there is wide variability in the understanding and management of

  5. Transjugular Intrahepatic Portosystemic Shunts in Children with Biliary Atresia

    International Nuclear Information System (INIS)

    Huppert, Peter E.; Goffette, Pierre; Astfalk, Wolfgang; Sokal, Emil M.; Brambs, Hans-Juergen; Schott, Ullrich; Duda, Stephan H.; Schweizer, Paul; Claussen, Claus D.

    2002-01-01

    Purpose: We retrospectively evaluated the technical and long-term clinical results of transjugularintrahepatic portosystemic shunts (TIPS) in children with portal hypertension and biliary atresia (BA). Methods: Nine children with BA and recurrent bleeding from esophagogastric and/or intestinal varices were treated by TIPS at the age of 34-156 months and followed-up in two centers. Different types of stents were used. Results: Shunt insertion succeeded in all patients, but in two a second procedure was necessary. Seven procedures lasted more than 3 hr, mainly due to difficult portal vein puncture.Variceal bleeding ceased in all patients; however, 16 reinterventions were performed in eight patients for clinical reasons (n =11) and sonographically suspected restenosis (n =5). Four patients underwent successful liver transplantation 4-51 months after TIPS and five are in good clinical conditions 64-75 months after TIPS. Conclusions: TIPS in children with BA is technically difficult, mainly due to periportal fibrosis and small portal veins. Frequency of reinterventions seems to be higher compared with adults

  6. Effect of amusement park rides on programmable shunt valve settings.

    Science.gov (United States)

    Strahle, Jennifer; Collins, Kelly; Stetler, William R; Smith, Brandon W; Garton, Thomas; Garton, Catherine; Garton, Hugh J L; Maher, Cormac O

    2013-01-01

    Magnetically programmable shunt valves are susceptible to environmental factors including magnetic fields and accelerative forces. It is unknown if rollercoasters with or without magnetic brakes or linear induction motors (LIMs) are capable of altering the setting of a programmable shunt valve. Two different valve types (type A, n = 10; type B, n = 9) were tested at varying resistance settings in 2 trials on 6 different amusement park rides including 2 rides with LIMs, 2 rides with magnetic brakes, and 2 rides without magnetic technology. The performance level of valve type A and the setting of valve type B changed on rollercoasters with magnets (A = 2.5% [2/80]; B = 5.6% [4/72]) and without magnets (A = 7.5% [3/40]; B = 2.8% [1/36]). Neither valve setting changed when exposed to a Ferris wheel or during ambulation throughout the park. Magnetically programmable valves are susceptible to changes in pressure settings when exposed to amusement park rides with elevated vertical gravitational forces, irrespective of the presence of LIMs or magnetic brakes. © 2013 S. Karger AG, Basel.

  7. Transjugular Intrahepatic Portosystemic Shunt (TIPS): Current Status and Future Possibilities

    International Nuclear Information System (INIS)

    Bilbao, Jose Ignacio; Quiroga, Jorge; Herrero, Jose Ignacio; Benito, Alberto

    2002-01-01

    Since the insertion of the first TIPS in 1989 much has been learned about this therapeutic procedure. It has an established role for the treatment of some complications of portal hypertension: prevention of recurrent variceal bleeding and rescue of patients with acute uncontrollable variceal bleeding. In addition TIPS is useful for Budd-Chiari syndrome, refractory ascites and hepatorenal syndrome, although its specific role in these indications remains to be definitively established. However, the decrease in sinusoidal blood flow induced by TIPS can lead to the patient developing hepatic encephalopathy and liver failure in some cases. Therefore, TIPS should be used with caution in patients with very poor liver function. From a technical point of view, successful placement of TIPS is achieved in more than 98% of cases by experienced groups. At present, evaluation of TIPS dysfunction based on morphology probably leads to an overdiagnosis of this complication since most of these cases are not associated with clinical manifestations (recurrent bleeding or refractory ascites). The major disadvantage of TIPS remains its poor long-term patency requiring a mandatory surveillance program. The indicator for shunt function/malfunction should be the portosystemic pressure gradient, which is best assessed by intravascular measurements. Shunt obstructions may be prevented or reduced by the use of stent-grafts in the future

  8. Recubrimientos metálicos sobre alúmina mediante procesos de reducción autocatalítica

    Directory of Open Access Journals (Sweden)

    Gómez de Salazar, J. M.

    2000-10-01

    Full Text Available In this work, a method for obtaining copper coating on alumina is described. One of the main applications for this coating is in the electronic industry, although it can be used as well as interlayer for dissimilar bonding between metals and alumina, both by solid state joining and by active brazing. The optimal activation conditions for the alumina using Ni salts and the influence of the surface preparation on the copper coating characteristic are described. The coating application is based on an autocatalithic reduction method. The influence of the deposition rate on the adherence of the copper coating has been studied as well. A kinetic study was carried out applying gravimetric and electrochemical methods. To obtaining coating with high adherence, it was necessary to apply heat treatments after the metallization process. The main objective of them was to achieve a chemical bond between the alumina substrate and the copper coating by formation of Al-Cu spinels, instead of the single mechanical bond.

    En el presente trabajo se describe un método de obtención de recubrimientos de cobre sobre un cerámico tenaz como es la alúmina. Una de sus principales aplicaciones se encuentra en la industria electrónica, aunque también puede ser empleado como intermediario en la fabricación de uniones disimilares entre un metal y un cerámico mediante técnicas de unión en estado sólido o en soldadura fuerte reactiva. Se describen las condiciones óptimas de activación de la alúmina mediante sales de Ni, y la influencia que posee la preparación superficial de este substrato (Al2O3 sobre las capas de Cu obtenidas. Este proceso se realiza mediante reducción autocatalítica, habiéndose estudiado como influye la velocidad de deposición sobre la adherencia de la capa de cobre. También se realizaron estudios cinéticos del proceso de recubrimiento mediante ensayos gravimétricos y electroquímicos. Con el fin de obtener recubrimientos que

  9. Evolución de la fibrosis hepática en reclusos coinfectados por VIH y VHC que inician tratamiento con inhibidores de la proteasa potenciados

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    P. Saiz de la Hoya Zamácola

    2013-10-01

    Full Text Available Objetivos: Analizar la evolución de la fibrosis hepática medida por elastografía y pruebas bioquímicas en reclusos coinfectados por VIH y VHC que han iniciado tratamiento antirretroviral con lopinavir/ritonavir u otros inhibidores de la proteasa potenciados con ritonavir. Métodos: Estudio prospectivo, observacional y multicéntrico. Se comprobó durante 48 semanas la evolución de la fibrosis hepática medida mediante elastografía de transición (FibroScan y pruebas bioquímicas en población penitenciaria española coinfectada por VIH y VHC. Resultados: De los 94 pacientes incluidos, 54 (57,4% fueron seguidos durante 48 semanas. En la semana 48, no hubo cambios significativos en el grado de fibrosis medida mediante FibroScan (8,1 Kpa vs 8,3; p=0.20 o índice de FORNS (5,6 vs 5,1; p=0,50, aunque sí con el índice APRI (0.7 vs 0.6; p=0.05 y el índice FIB-4 (p=0,02. Cuando la medición se realizó en función del grado de fibrosis basal, se observó que el tratamiento redujo el porcentaje de pacientes con fibrosis basal de grado 3/4 (50% vs 15%; p=0,001, pero no hubo cambios en los que ya tenían basalmente grado 4 (20,4% vs 20,4%. Conclusión: Los reclusos coinfectados por VIH y VHC que inician tratamiento antirretroviral con lopinavir/ritonavir muestran una estabilización de la fibrosis hepática medida con FibroScan® tras un año de seguimiento. En conjunto, el tratamiento mejoró la fibrosis cuando la referencia de medición fue el índice APRI y el FIB-4, pero no con el índice FORNS o la elastografía.

  10. Algoritmo para el tratamiento mínimamente invasivo de la coledocolitiasis

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    Javier Ernesto Barreras González

    Full Text Available La coledocolitiasis se presenta en más del 10 % de los pacientes jóvenes sometidos a la colecistectomía laparoscópica y se incrementa por encima de 25 % en los pacientes mayores de 60 años. Una vez que se identifica el cálculo en la vía biliar principal (VBP, esto puede convertirse en un dilema terapéutico. En la actualidad, diferentes algoritmos se han planteado y están establecidos, pero las publicaciones internacionales continúan redefiniendo las indicaciones de la colangiopancreatografía retrógrada endoscópica sobre la exploración laparoscópica de la vía biliar principal y viceversa. El objetivo de este estudio fue presentar el algoritmo para el tratamiento de la coledocolitiasis del Centro Nacional de Cirugía de Mínimo Acceso de La Habana. Se realizó una amplia revisión bibliográfica acerca del manejo actual de la coledocolitiasis con vesícula in situ y se evaluaron los resultados de dichas técnicas en el Centro Nacional de Cirugía de Mínimo Acceso. Las opciones para el manejo de la coledocolitiasis incluyen la exploración transcística de la vía biliar principal, la exploración laparoscópica de la vía biliar principal mediante coledocotomía, la colangiopancreatografía retrógrada endoscópica preoperatoria e intraoperatoria con esfinterotomía. Se presenta el algoritmo para el tratamiento mínimamente invasivo de la coledocolitiasis. El manejo de esta enfermedad en la actualidad depende de la experiencia de cada equipo quirúrgico y de su disponibilidad de acceso a los avances tecnológicos.

  11. Uso del tratamiento acupuntural en pacientes con episodio depresivo leve

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    Roberto Anselmo Ramos Valverde

    2014-08-01

    Full Text Available Se realizó un estudio experimental en el Centro Comunitario Provincial de Salud Mental de Las Tunas, con el objetivo de determinar la efectividad del empleo de la acupuntura en pacientes portadores de episodio depresivo leve. El universo estuvo constituido por todos los pacientes diagnosticados clínicamente con la enfermedad, que acudieron a la consulta de Medicina Natural y Tradicional de esta entidad entre marzo de 2011 a marzo de 2013. La muestra quedó constituida por 60 pacientes que cumplieron los criterios diagnósticos y de inclusión establecidos para la investigación, se aplicó un muestreo aleatorio simple que permitió conformar dos grupos, uno de estudio, al que se le aplicó tratamiento acupuntural, y uno control, que recibió tratamiento con amitriptilina. Los resultados mostraron que el insomnio fue el síntoma asociado más frecuente. Al terminar el tratamiento se obtuvo que la depresión se eliminó en la totalidad de los pacientes, pero fue más inmediato el efecto antidepresivo en los pacientes del grupo estudio, los síntomas asociados desaparecieron en casi la totalidad de ellos. Se concluye que el tratamiento tradicional acupuntural constituye una terapia efectiva en los pacientes con episodio depresivo leve

  12. Angioedema hereditario: Guía de tratamiento

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    Alejandro Malbrán

    2012-04-01

    Full Text Available El angioedema hereditario (HAE es una enfermedad rara, autosómica dominante, caracterizada por episodios que comprometen la piel, el tracto gastrointestinal y la laringe. Tiene una mortalidad histórica por asfixia del 15 al 50%. Es producida por la deficiencia funcional del C1 inhibidor. La identificación de la bradiquinina como mediador principal ha estimulado el desarrollo de nuevos medicamentos para tratar la enfermedad. El tratamiento del HAE se establece en consensos internacionales. El desarrollo de guías para el tratamiento de la enfermedad permite ordenar el uso de procedimientos diagnósticos y drogas. Describimos aquí algunas características farmacológicas de los medicamentos utilizados en el tratamiento del HAE en la Argentina: el concentrado plasmático de C1 inhibidor, el antagonista de la bradiquinina, icatibant, el andrógeno atenuado danazol y los agentes anti-fibrinolíticos ácidos épsilon aminocaproico (EACA y tranexámico. Asimismo, se describe su forma de uso y del control de los eventos adversos más frecuentes, así como las recomendaciones del último consenso internacional, aplicables para conformar una primera guía de tratamiento del HAE en la Argentina.

  13. ESTIMACIÓN DE LA PREVALENCIA DE HIPOTIROIDISMO SEGÚN DIFERENTES MÉTODOS: DOSIS DIARIA DEFINIDA, DOSIS DIARIA PRESCRITAY REGISTRO DE PACIENTES EN TRATAMIENTO

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    José Escribano-Serrano

    2014-01-01

    Full Text Available Fundamentos: El hipotiroidismo (HT es una patología frecuente en la práctica clínica diaria. No existen datos recientes sobre su prevalencia en España. El objetivo de este trabajo fue conocer su prevalencia en la provincia de Cádiz. Métodos: Se estudió el consumo del grupo terapéutico H03AA realizado en receta oficial por las unidades de Atención Primaria (AP de Cádiz, durante el año 2012. La prevalencia se estimó mediante tres métodos: la Dosis Diaria Definida (DDD, la Dosis Diaria Prescrita (DDP y el Registro Pacientes en Tratamiento (RPT. Los resultados se presentaron según sexo y edad con intervalos de confianza del 95%. Resultados: La prevalencia de HT durante 2012 en población mayor de 15 años de la provincia fue del 1,36% (IC95: 1,33%-1,38% mediante DDD, del 2,60% (IC95: 2,54%-2,66% mediante DDP y del 3,10% (IC95: 2,85%-2,93% mediante RPT. La mediana de edad fue de 56 años (rango intercuartílico 43 a 68 años. La prevalencia (RPT por sexo fue de 0,75% en hombres y 5,36% en mujeres [OR 7,26 (IC95: 7,02-7,52], siendo del 9,35% la correspondiente a mujeres de 51 a 70 años. Conclusiones: El método de estimación por rptdemuestra ser una herramienta más válida que el método DDD para evaluar la prevalencia de HT. El HT muestra, en nuestra provincia una prevalencia elevada con mayor afectación del sexo femenino.

  14. Treatment of extrahepatic portal hypertension following a whipple procedure with a Rex shunt: report of a case.

    Science.gov (United States)

    Reichman, Trevor W; Anthony, Tiffany; Testa, Giuliano

    2011-02-01

    The Rex shunt is a mesenteric vein to left portal vein decompressive shunt used for the treatment of portal vein thrombosis and portal hypertension. Its use has been reported primarily in the pediatric population where portal vein thrombosis occurs with some frequency. The shunt is thought to represent a more physiologic shunt, since it restores hepatopedal blood flow through the liver. This report describes the use of this shunt in an adult who had frequent gastrointestinal bleeding secondary to extrahepatic portal vein thrombosis, which occurred as a complication after a pancreaticoduodenectomy.

  15. An in vitro lung model to assess true shunt fraction by multiple inert gas elimination.

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    Balamurugan Varadarajan

    Full Text Available The Multiple Inert Gas Elimination Technique, based on Micropore Membrane Inlet Mass Spectrometry, (MMIMS-MIGET has been designed as a rapid and direct method to assess the full range of ventilation-to-perfusion (V/Q ratios. MMIMS-MIGET distributions have not been assessed in an experimental setup with predefined V/Q-distributions. We aimed (I to construct a novel in vitro lung model (IVLM for the simulation of predefined V/Q distributions with five gas exchange compartments and (II to correlate shunt fractions derived from MMIMS-MIGET with preset reference shunt values of the IVLM. Five hollow-fiber membrane oxygenators switched in parallel within a closed extracorporeal oxygenation circuit were ventilated with sweep gas (V and perfused with human red cell suspension or saline (Q. Inert gas solution was infused into the perfusion circuit of the gas exchange assembly. Sweep gas flow (V was kept constant and reference shunt fractions (IVLM-S were established by bypassing one or more oxygenators with perfusate flow (Q. The derived shunt fractions (MM-S were determined using MIGET by MMIMS from the retention data. Shunt derived by MMIMS-MIGET correlated well with preset reference shunt fractions. The in vitro lung model is a convenient system for the setup of predefined true shunt fractions in validation of MMIMS-MIGET.

  16. Frontal and occipital horn ratio is associated with multifocal intraparenchymal hemorrhages in neonatal shunted hydrocephalus.

    Science.gov (United States)

    Oushy, Soliman; Parker, Jonathon J; Campbell, Kristen; Palmer, Claire; Wilkinson, Corbett; Stence, Nicholas V; Handler, Michael H; Mirsky, David M

    2017-11-01

    OBJECTIVE Placement of a cerebrospinal fluid diversion device (i.e., shunt) is a routine pediatric neurosurgical procedure, often performed in the first weeks of life for treatment of congenital hydrocephalus. In the postoperative period, shunt placement may be complicated by subdural, catheter tract, parenchymal, and intraventricular hemorrhages. The authors observed a subset of infants and neonates who developed multifocal intraparenchymal hemorrhages (MIPH) following shunt placement and sought to determine any predisposing perioperative variables. METHODS A retrospective review of the electronic medical record at a tertiary-care children's hospital was performed for the period 1998-2015. Inclusion criteria consisted of shunt placement, age hydrocephalus. Markers of severity of ventriculomegaly (FOR) and ventricular response to CSF diversion (∆FOR) were significantly associated with occurrence of MIPH. Choice of shunt and etiology of hydrocephalus were also significantly associated with MIPH. After adjusting for corrected age, etiology of hydrocephalus, and shunt setting, the authors found that ∆FOR after shunting was still associated with MIPH. A prospective study of MIPH prevention strategies and assessment of possible implications for patient outcomes is needed.

  17. Controversies: Optic nerve sheath fenestration versus shunt placement for the treatment of idiopathic intracranial hypertension

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    Arielle Spitze

    2014-01-01

    Full Text Available Background: Idiopathic intracranial hypertension (IIH has been increasing in prevalence in the past decade, following the obesity epidemic. When medical treatment fails, surgical treatment options must be considered. However, controversy remains as to which surgical procedure is the preferred surgical option - optic nerve sheath fenestration (ONSF or cerebrospinal fluid (CSF shunting - for the long-term treatment of this syndrome. Purpose: To provide a clinical update of the pros and cons of ONSF versus shunt placement for the treatment of IIH. Design: This was a retrospective review of the current literature in the English language indexed in PubMed. Methods: The authors conducted a PubMed search using the following terms: Idiopathic IIH, pseudotumor cerebri, ONSF, CSF shunts, vetriculo-peritoneal shunting, and lumbo-peritoneal shunting. The authors included pertinent and significant original articles, review articles, and case reports, which revealed the new aspects and updates in these topics. Results: The treatment of IIH remains controversial and lacks randomized controlled clinical trial data. Treatment of IIH rests with the determination of the severity of IIH-related visual loss and headache. Conclusion: The decision for ONSF versus shunting is somewhat institution and surgeon dependent. ONSF is preferred for patients with visual symptoms whereas shunting is reserved for patients with headache. There are positive and negative aspects of both procedures, and a prospective, randomized, controlled trial is needed (currently underway. This article will hopefully be helpful in allowing the reader to make a more informed decision until that time.

  18. A novel method for passing cerebrospinal fluid shunt tubing: a proof of principle study.

    Science.gov (United States)

    Tubbs, R Shane; Goodrich, Dylan; Tubbs, Isaiah; Loukas, Marios; Cohen-Gadol, Aaron A

    2014-12-01

    Few innovations in the method of tunneling shunt tubing for cerebrospinal fluid (CSF) shunt diversion have been made since this treatment of hydrocephalus was first developed. Therefore, this feasibility study was performed with the hope of identifying an improved technique that could potentially carry fewer complications. On 10 cadaver sides and when placed in the supine position, small skin incisions were made at the clavicle and ipsilateral subcostal region, and magnets were used to pass standard shunt tubing between the two incisions. Nickel-plated magnets were less effective in pulling the shunt tubing below the skin compared with ceramic magnets. Of these, magnets with pull strengths of 150-200 lbs were the most effective in dragging the subcutaneous tubing between the two incisions. No obvious damage to the skin from the overlying magnet was seen in any specimen. Few options exist for tunneling distal shunt tubing for CSF shunt procedures. Future patient studies are needed to determine if the technique described herein is superior to current methods, particularly when examining patient groups that are at a greater risk for injury during tunneling shunt catheters.

  19. Numerical and experimental studies of stack shunt current for vanadium redox flow battery

    International Nuclear Information System (INIS)

    Yin, Cong; Guo, Shaoyun; Fang, Honglin; Liu, Jiayi; Li, Yang; Tang, Hao

    2015-01-01

    Highlights: • A coupled three-dimensional model of VRB cell stack is developed. • Shunt current of the stack is studied with the model and experiment. • Increased electrolyte resistance in channel and manifold lowers the shunt current. • Shunt current loss increases with stack cell number nonlinearly. - Abstract: The stack shunt current of VRB (vanadium redox flow battery) was investigated with experiments and 3D (three-dimensional) simulations. In the proposed model, cell voltages and electrolyte conductivities were calculated based on electrochemical reaction distributions and SOC (state of charge) values, respectively, while coulombic loss was estimated according to shunt current and vanadium ionic crossover through membrane. Shunt current distributions and coulombic efficiency are analyzed in terms of electrolyte conductivities and stack cell numbers. The distributions of cell voltages and shunt currents calculated with proposed model are validated with single cell and short stack tests. The model can be used to optimize VRB stack manifold and channel designs to improve VRB system efficiency

  20. Correlation of experimental rCBF determinations in goats with flow measurements from a Doppler-modified carotid artery shunt

    International Nuclear Information System (INIS)

    Loftus, C.M.; Silvidi, J.A.; Becker, J.A.; Miller, B.V.; Bernstein, D.D.

    1989-01-01

    A carotid artery shunt system has been developed that continuously monitors blood flow rates by embedding a Doppler crystal in the shunt wall. The crystal ranges through a liquid lens that enables it to be placed without violation of the shunt lumen. Because the crystal is at a fixed angle (45 degrees) to the axis of blood flow and the diameter of the lumen remains constant, a linear relationship exists between flow rates and the Doppler velocity signal. This shunt system was previously tested in vitro using a pulsatile pump and was found to be accurate to within 4.7% of the actual flow rate. In the present study, animal (goat) experiments were performed consisting of simultaneous carotid shunt flow and bilateral rCBF measurements by the radiolabeled microsphere technique to determine in vivo the accuracy of this Doppler modified shunt and to ascertain the ability of shunt flow to increase in the face of acute contralateral carotid occlusion. Data from five animals show that in vivo shunt flow can be recorded to within 13% of control rCBF and that shunt flow increases nearly 50% under conditions of distal demand (contralateral carotid occlusion). This device may prove useful in laboratory studies of carotid shunt dynamics and in clinical practice to quickly detect correctable shunt flow abnormalities

  1. Avances en el tratamiento de la aspergilosis broncopulmonar alérgica

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    Peña Durán A

    2018-03-01

    Full Text Available Los objetivos del tratamiento de la aspergilosis broncopulmonar alérgica (ABPA son la reducción de la inflamación pulmonar, el control del asma, el tratamiento del estadio agudo de ABPA, prevenir las exacerbaciones, evitar la apari- ción o progresión a la bronquiectasia y la aspergilosis pulmonar crónica. El tratamiento utilizado hasta la actualidad han sido corticoides a largo plazo, azoles y LABA/CI. En pacientes graves sin respuesta al tratamiento con corticoides ora- les y antifúngico recientemente se han utilizado otros tratamientos como omalizumab y antiIL5 (mepolizumab.

  2. Continuous monitoring of intracranial pressure after endoscopic third ventriculostomy in the management of CSF shunt failure.

    Science.gov (United States)

    Elgamal, E A

    2010-04-01

    The effectiveness of continuous intracranial pressure (ICP) monitoring in the adaptation period, after endoscopic third ventriculostomy (ETV), and removal of the failed shunt in the management of CSF shunt failure is assessed. Nine patients with active hydrocephalus presenting with CSF shunt obstruction or infection were managed by ETV, removal of the shunt and insertion of an external ventricular drain (EVD) containing an ICP sensor for the purpose of postoperative monitoring of the ICP, and intermittent drainage of CSF. Patient ages ranged from 8 months to 24 years, and six of them were females. Hydrocephalus was obstructive in seven patients, and multiloculated in two. Six patients had an ventriculoperitoneal shunt (VPS), one with a bilateral VPS, one patient had a ventriculoatrial shunt, and one had a VPS and cystoperitoneal shunt (CPS). Shunt failure was caused by obstruction in six patients and infection in three. The post-operative ICP monitoring period ranged from 1-7 days. Intracranial hypertension was persistent in the first day after ETV in 3 patients, and up to 110 mL of CSF were drained to improve its symptoms. ETV was successful in six patients and 3 had permanent VPS. Post-operative continuous ICP monitoring and EVD insertion were very useful in the treatment of CSF shunt failure with ETV. This procedure allowed intermittent CSF drainage, relieving symptoms of elevated ICP, and provided accurate assessment of the success of the ETV and patency of the stoma in the early postoperative days by CT ventriculography and can also be used to install antibiotics in cases of infection.

  3. Staged Transcatheter Treatment of Portal Hypoplasia and Congenital Portosystemic Shunts in Children

    International Nuclear Information System (INIS)

    Bruckheimer, Elchanan; Dagan, Tamir; Atar, Eli; Schwartz, Michael; Kachko, Ludmila; Superina, Riccardo; Amir, Gabriel; Shapiro, Rivka; Birk, Einat

    2013-01-01

    Purpose: Congenital portosystemic shunts (CPSS) with portal venous hypoplasia cause hyperammonemia. Acute shunt closure results in portal hypertension. A transcatheter method of staged shunt reduction to afford growth of portal vessels followed by shunt closure is reported. Methods: Pressure measurements and angiography in the CPSS or superior mesenteric artery (SMA) during temporary occlusion of the shunt were performed. If vessels were diminutive and the pressure was above 18 mmHg, a staged approach was performed, which included implantation of a tailored reducing stent to reduce shunt diameter by ∼50 %. Recatheterization was performed approximately 3 months later. If the portal pressure was below 18 mmHg and vessels had developed, the shunt was closed with a device. Results: Six patients (5 boys, 1 girl) with a median age of 3.3 (range 0.5–13) years had CPSS portal venous hypoplasia and hyperammonemia. Five patients underwent staged closure. One patient tolerated acute closure. One patient required surgical shunt banding because a reducing stent could not be positioned. At median follow-up of 3.8 (range 2.2–8.4) years, a total of 21 procedures (20 transcatheter, 1 surgical) were performed. In all patients, the shunt was closed with a significant reduction in portal pressure (27.7 ± 11.3 to 10.8 ± 1.8 mmHg; p = 0.016), significant growth of the portal vessels (0.8 ± 0.5 to 4.0 ± 2.4 mm; p = 0.037), and normalization of ammonia levels (202.1 ± 53.6 to 65.7 ± 9.6 μmol/L; p = 0.002) with no complications. Conclusion: Staged CPSS closure is effective in causing portal vessel growth and treating hyperammonemia

  4. Impaired arm development after Blalock-Taussig shunts in adults with repaired tetralogy of Fallot.

    Science.gov (United States)

    Le Gloan, Laurianne; Marcotte, François; Leduc, Hugues; Mercier, Lise-Andrée; Dore, Annie; Mongeon, François-Pierre; Ibrahim, Reda; Miro, Joaquim; Asgar, Anita; Poirier, Nancy; Khairy, Paul

    2013-09-30

    Many adults with repaired tetralogy of Fallot have had prior Blalock-Taussig shunts. These shunts may theoretically hinder growth and development of the ipsilateral arm. We prospectively enrolled consecutive patients with tetralogy of Fallot in a cross-sectional study to measure arm length and assess handgrip strength. Bilateral handgrip strength was quantified by a dynamometer in a standing position after instructing patients to clench each hand tightly in succession. The maximum force achieved, in kilograms, was measured. A total of 80 consecutive adults with tetralogy of Fallot, aged 36.0 ± 12.5 years, 49% female, were prospectively enrolled. Thirty-eight (47.5%) patients had prior Blalock-Taussig shunts at a median age of 1.0 year. Twenty-one (55.3%) were left-sided and 23 (60.5%) were classic shunts. All but six patients with right-sided shunts and one without a prior shunt were right-handed. The shunts were present for a median of 4.0 years prior to takedown during corrective surgery. The arm ipsilateral to the shunt was significantly shorter than the contralateral arm (71.5 ± 6.1 versus 73.6 ± 5.6 cm, Ptetralogy of Fallot, Blalock-Taussig shunts may impair normal development of the ipsilateral arm with repercussions in adulthood that include shorter limb length and reduced handgrip strength. These changes are most pronounced in patients with classic end-to-side anastomoses. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  5. Our initial experience with ventriculo-epiplooic shunt in treatment of hydrocephalus in two centers.

    Science.gov (United States)

    Grigorean, Valentin Titus; Sandu, Aurelia Mihaela; Popescu, Mihai; Florian, Ioan Stefan; Lupascu, Cristian Dumitru; Ursulescu, Corina Lupascu

    Hydrocephalus represents impairment in cerebrospinal fluid (CSF) dynamics. If the treatment of hydrocephalus is considered difficult, the repeated revisions of ventriculo-peritoneal (VP) shunts are even more challenging. The aim of this article is to evaluate the efficiency of ventriculo-epiplooic (VEp) shunt as a feasible alternative in hydrocephalic patients. A technical modification regarding the insertion of peritoneal catheter was imagined: midline laparotomy 8-10cm long was performed in order to open the peritoneal cavity; the great omentum was dissected between its two layers; we placed the distal end of the catheter between the two epiplooic layers; a fenestration of 4cm in diameter into the visceral layer was also performed. A retrospective study of medical records of 15 consecutive patients with hydrocephalus treated with VEp shunt is also presented. Between 2008 and 2014 we performed VEp shunt in 15 patients: 5 with congenital hydrocephalus, 8 with secondary hydrocephalus and 2 with normal pressure hydrocephalus. There were 7 men and 8 women. VEp shunt was performed in 13 patients with multiple distal shunt failures and in 2 patients, with history of abdominal surgery, as de novo extracranial drainage procedure. The outcome was favorable in all cases, with no significant postoperative complications. VEp shunt is a new, safe and efficient surgical technique for the treatment of hydrocephalus. VEp shunt is indicated in patients with history of recurrent distal shunt failures, and in patients with history of open abdominal surgery and high risk for developing abdominal complications. Copyright © 2017 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  6. Gravitational shunt units may cause under-drainage in bedridden patients.

    Science.gov (United States)

    Kaestner, S; Kruschat, T; Nitzsche, N; Deinsberger, W

    2009-03-01

    Implantation of a shunt in a hydrocephalic patient still carries a risk of complications such as over-drainage and under-drainage. Gravitational shunt units are especially designed to minimize the problem of over-drainage. Nevertheless, these valves carry a risk of under-drainage. The best choice of valve for a patient is still challenging. The purpose of this survey was to identify in which patients a gravitational shunt valve is liable to lead to under-drainage. Patients with hydrocephalus entered prospectively into a data base were reviewed retrospectively. The patients were treated between January 2006 to the end of Feb 2007 and those experiencing under- or over-drainage were identified. Thirty-five ventriculo-peritoneal shunt systems were implanted in adult patients. The cause of the hydrocephalus was: normal pressure hydrocephalus in 18 patients, post-haemorrhagic following subarachnoid or intracerebral haemorrhage in 11, associated with a tumour in four and followed a head injury in two patients. Three different valves were used: an adjustable shunt valve with gravitational unit (Pro-GAV 0-20/25 in 21 patients), a gravitational shunt valve with fixed opening pressure (GAV 5/30 in nine patients) and an adjustable differential valve (Hakim medos in five patients). Four patients developed severe, valve-related under-drainage. Each had received a gravitational shunt valve and all were bedridden. In two of these patients it was necessary to change the valve. One patient who had received a differential valve, after regaining mobility developed severe over-drainage with bilateral subdural haematomas. Over-drainage was not seen in long-term bedridden patients with a differential shunt valve. If a bedridden patient with a gravitational shunt valve system lies with a slightly elevated head, this leads to activation of the gravitational unit and this may cause under drainage. As a result, we advise not using an anti-siphon devices in a patient who is bedridden for a

  7. Renal Arteriovenous Shunts: Clinical Features, Imaging Appearance, and Transcatheter Embolization Based on Angioarchitecture.

    Science.gov (United States)

    Maruno, Miyuki; Kiyosue, Hiro; Tanoue, Shuichi; Hongo, Norio; Matsumoto, Shunro; Mori, Hiromu; Sagara, Yoshiko; Kashiwagi, Junji

    2016-01-01

    Renal arteriovenous (AV) shunt, a rare pathologic condition, is divided into two categories, traumatic and nontraumatic, and can cause massive hematuria, retroperitoneal hemorrhage, pain, and high-output heart failure. Although transcatheter embolization is a less-invasive and effective treatment option, it has a potential risk of complications, including renal infarction and pulmonary embolism, and a potential risk of recanalization. The successful embolization of renal AV shunt requires a complete occlusion of the shunted vessel while preventing the migration of embolic materials and preserving normal renal arterial branches, which depends on the selection of adequate techniques and embolic materials for individual cases, based on the etiology and imaging angioarchitecture of the renal AV shunts. A classification of AV malformations in the extremities and body trunk could precisely correspond with the angioarchitecture of the nontraumatic renal AV shunts. The selection of techniques and choice of adequate embolic materials such as coils, vascular plugs, and liquid materials are determined on the basis of cause (eg, traumatic vs nontraumatic), the classification, and some other aspects of the angioarchitecture of renal AV shunts, including the flow and size of the fistulas, multiplicity of the feeders, and endovascular accessibility to the target lesions. Computed tomographic angiography and selective digital subtraction angiography can provide precise information about the angioarchitecture of renal AV shunts before treatment. Color Doppler ultrasonography and time-resolved three-dimensional contrast-enhanced magnetic resonance angiography represent useful tools for screening and follow-up examinations of renal AV shunts after embolization. In this article, the classifications, imaging features, and an endovascular treatment strategy based on the angioarchitecture of renal AV shunts are described. (©)RSNA, 2016.

  8. Staged Transcatheter Treatment of Portal Hypoplasia and Congenital Portosystemic Shunts in Children

    Energy Technology Data Exchange (ETDEWEB)

    Bruckheimer, Elchanan, E-mail: elchananb@bezeqint.net; Dagan, Tamir [Schneider Children' s Medical Center Israel, Section of Pediatric Cardiology (Israel); Atar, Eli; Schwartz, Michael [Schneider Children' s Medical Center Israel, Section of Radiology (Israel); Kachko, Ludmila [Schneider Children' s Medical Center Israel, Section of Anesthesiology (Israel); Superina, Riccardo; Amir, Gabriel [Schneider Children' s Medical Center Israel, Section of Pediatric Cardiology (Israel); Shapiro, Rivka [Schneider Children' s Medical Center Israel, Section of Gastroenterology (Israel); Birk, Einat [Schneider Children' s Medical Center Israel, Section of Pediatric Cardiology (Israel)

    2013-12-15

    Purpose: Congenital portosystemic shunts (CPSS) with portal venous hypoplasia cause hyperammonemia. Acute shunt closure results in portal hypertension. A transcatheter method of staged shunt reduction to afford growth of portal vessels followed by shunt closure is reported. Methods: Pressure measurements and angiography in the CPSS or superior mesenteric artery (SMA) during temporary occlusion of the shunt were performed. If vessels were diminutive and the pressure was above 18 mmHg, a staged approach was performed, which included implantation of a tailored reducing stent to reduce shunt diameter by {approx}50 %. Recatheterization was performed approximately 3 months later. If the portal pressure was below 18 mmHg and vessels had developed, the shunt was closed with a device. Results: Six patients (5 boys, 1 girl) with a median age of 3.3 (range 0.5-13) years had CPSS portal venous hypoplasia and hyperammonemia. Five patients underwent staged closure. One patient tolerated acute closure. One patient required surgical shunt banding because a reducing stent could not be positioned. At median follow-up of 3.8 (range 2.2-8.4) years, a total of 21 procedures (20 transcatheter, 1 surgical) were performed. In all patients, the shunt was closed with a significant reduction in portal pressure (27.7 {+-} 11.3 to 10.8 {+-} 1.8 mmHg; p = 0.016), significant growth of the portal vessels (0.8 {+-} 0.5 to 4.0 {+-} 2.4 mm; p = 0.037), and normalization of ammonia levels (202.1 {+-} 53.6 to 65.7 {+-} 9.6 {mu}mol/L; p = 0.002) with no complications. Conclusion: Staged CPSS closure is effective in causing portal vessel growth and treating hyperammonemia.

  9. Percutaneous Transjugular Direct Porto-caval Shunt in Patients with Budd-Chiari Syndrome

    International Nuclear Information System (INIS)

    Quateen, A.; Pech, M.; Berg, T.; Bergk, A.; Podrabsky, P.; Felix, R.; Ricke, J.

    2006-01-01

    The purpose of the study was to evaluate the feasibility and effectiveness of direct porto-caval shunts in patients with Budd-Chiari syndrome (BCS) in whom there is no access to the hepatic veins during transjugular intrahepatic portosystemic shunt (TIPSS). We included six consecutive patients with fulminant/acute Budd-Chiari syndrome (mean age: 35 years) in whom a conventional TIPSS was not possible due to inaccessible hepatic veins. We performed a direct porto-caval shunt via a transhepatic approach. Patients were followed up by means of clinical examination, laboratory investigations, and Doppler ultrasound. TIPSS implantation from the inferior vena cava (IVC) was successful in all six patients (100%). The median transhepatic shunt length was 9 cm (8-10 cm). No procedure-related complications were observed in our patients. Early shunt occlusion occurred in three out of six patients (50%). In all three of these patients, the stent used to stabilize the shunt ended 1-2 cm before reaching the IVC. All occlusions were successfully recanalized. One of these patients developed recurrent early shunt as well as mesenteric and splenic vein occlusions. She died 7 days after TIPSS placement due to an unmanageable coagulation disorder. The remaining five patients were followed up by planned clinical examination and laboratory investigations (mean follow-up time was 15 months; patient 1 was followed up for 13 months, patient 2 for 14 months, patient 3 for 15 months, and patients 4 and 5 for 16 months) and all displayed a complete and durable resolution of liver failure and ascites without reintervention. In patients with acute liver failure originating from BCS and inaccessible hepatic veins, a direct transhepatic porto-caval shunt can be performed safely and effectively under ultrasound guidance. Future studies in larger patient groups should investigate if the patency of transcaval TIPSS with long transhepatic shunt segments is similar compared to conventional TIPSS via

  10. Developmental intrahepatic shunts of childhood: radiological features and management

    International Nuclear Information System (INIS)

    Paley, M.R.; Farrant, P.; Kane, P.; Karani, J.B.; Heaton, N.D.; Howard, E.R.

    1997-01-01

    The purpose of this study was to evaluate the role of radiological techniques in the diagnosis and management of developmental intrahepatic shunts. Hepatic vascular fistulae are recognised sequelae of liver trauma and intrahepatic tumours. However, there are rare developmental malformations which may present in childhood or later life and which may carry life-threatening complications. Retrospective analysis of clinical and radiological data was carried out in 24 patients. Anomalies evaluated were: (a) direct communication between hepatic artery and hepatic veins; (b) congenital hepatoportal arteriovenous malformations; and (c) congenital portocaval anastomosis with persistent flow through the ductus venosus. Although rare, the prompt recognition of these vascular anomalies allows early surgical or radiological intervention and reversal of the haemodynamic complications. (orig.)

  11. Developmental intrahepatic shunts of childhood: radiological features and management

    Energy Technology Data Exchange (ETDEWEB)

    Paley, M.R.; Farrant, P.; Kane, P.; Karani, J.B. [Department of Radiology, King`s College Hospital, Denmark Hill, London SE5 9RS (United Kingdom); Heaton, N.D.; Howard, E.R. [Department of Paediatric Hepatobiliary Surgery, King`s College Hospital Denmark Hill, London SE5 9RS (United Kingdom)

    1997-12-01

    The purpose of this study was to evaluate the role of radiological techniques in the diagnosis and management of developmental intrahepatic shunts. Hepatic vascular fistulae are recognised sequelae of liver trauma and intrahepatic tumours. However, there are rare developmental malformations which may present in childhood or later life and which may carry life-threatening complications. Retrospective analysis of clinical and radiological data was carried out in 24 patients. Anomalies evaluated were: (a) direct communication between hepatic artery and hepatic veins; (b) congenital hepatoportal arteriovenous malformations; and (c) congenital portocaval anastomosis with persistent flow through the ductus venosus. Although rare, the prompt recognition of these vascular anomalies allows early surgical or radiological intervention and reversal of the haemodynamic complications. (orig.) With 7 figs., 4 tabs., 22 refs.

  12. Analysis of new actuation methods for capacitive shunt micro switchs

    Directory of Open Access Journals (Sweden)

    Ben Sassi S

    2016-01-01

    Full Text Available This work investigates the use of new actuation methods in capacitive shunt micro switches. We formulate the coupled electromechanical problem by taking into account the fringing effects and nonlinearities due to mid-plane stretching. Static analysis is undertaken using the Differential Quadrature Method (DQM to obtain the pull in voltage which is verified by means of the Finite Element Method (FEM. Based on Galerkin approximation, a single degree of freedom dynamic model is developed and limit-cycle solutions are calculated using the Finite Difference Method (FDM. In addition to the harmonic waveform signal, we apply novel actuation waveform signals to simulate the frequency-response. We show that, biased signals, using a square wave signal reduces significantly the pull-in voltage compared to the triangular and harmonic signal . Finally, these results are validated experimentally.

  13. CT-control of the H-graft interposition mesocaval shunt patency

    Energy Technology Data Exchange (ETDEWEB)

    Partanen, P L.K.; Oksala, I

    1984-02-01

    A method for assessing the patency of the H-graft interposition mesocaval shunts by computerized tomography is described. Five patients with such shunts were examined with a 5.5 second CT scanner. After locating the graft a 50 cc bolus of 76% diatrizoate was injected into a cubital vein and 3-4 scans were executed at a preselected level. A distinct vessel like enhancement appeared if the shunt was open. With dynamic CT-scanning the flow can be demonstrated in graphical form as time-density curves.

  14. Intrahepatic Portosystemic Venous Shunt: Successful Embolization Using the Amplatzer Vascular Plug II

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Ju; Shin, Byung Seok; Lee, In Ho; Ohm, Joon Young; Lee, Byung Seok; Ahn, Moon Sang [Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon (Korea, Republic of); Kim, Ho Jun [Dept. of Radiology, Konyang University Hospital, Konyang University College of Medicine, Daejeon (Korea, Republic of)

    2012-11-15

    A 67-year-old woman presented with memory impairment and behavioral changes. Brain MRI indicated hepatic encephalopathy. Abdominal CT scans revealed an intrahepatic portosystemic venous shunt that consisted of two shunt tracts to the aneurysmal sac that communicated directly with the right hepatic vein. The large tract was successfully occluded by embolization using the newly available AMPLATZERTM Vascular Plug II and the small tract was occluded by using coils. The patient's symptoms disappeared after shunt closure and she remained free of recurrence at the 3-month follow-up evaluation.

  15. Detection of intracardiac shunts with contrast-enhanced dynamic MR imaging

    International Nuclear Information System (INIS)

    Manning, W.J.; Atkinson, D.J.; Parker, J.A.; Edelman, R.R.

    1990-01-01

    This paper reports on ultrafast MR imaging with bolus administration of Gd-DTPA used to detect intracardiac shunts. Ten patients who had recently undergone cardiac catheterization or first-pass radionuclide evaluation were selected for study. These included five patients without intracardiac shunts and five patients with shunts (three with atrial septal defect, two with ventricular septal defect). Resting four-chamber cardiac images were obtained during intravenous injection of Gd-DTPA (0.02 mmol/kg) with an ultrafast, T1-weighted sequence. Images were acquired over 380 msec, with repetitive images obtained with each QRS for 50 beats. In addition, standard MR cine examinations were performed

  16. Congenital hepatic arteriovenous fistula with intrahepatic portosystemic shunt and aortic stenosis in a dog

    International Nuclear Information System (INIS)

    Koide, K.; Koide, Y.; Wada, Y.; Nakaniwa, S.; Yamane, Y.

    2004-01-01

    Examination of a 2-month-old male golden retriever presented to the hospital revealed malnutrition, ascites, cardiac murmur and hyperammonemia. Identification of subaortic stenosis and hepatic arteriovenous fistula was made through ultrasonography and angiocardiography. In addition, intrasurgical mesenteric portography showed an intrahepatic portosystemic shunt. The dog did not show portal hypertension and secondary multiple extrahepatic portosystemic shunts. Surgical correction was attempted after medical treatment. The hepatic artery branch which was connected to the hepatic arteriovenous fistula was separated, and completely ligated using silk ligature. However, the separation of the intrahepatic shunt blood vessel was unsuccessful and the dog died 15 hr postoperatively

  17. Tunable elastic parity-time symmetric structure based on the shunted piezoelectric materials

    Science.gov (United States)

    Hou, Zhilin; Assouar, Badreddine

    2018-02-01

    We theoretically and numerically report on the tunable elastic Parity-Time (PT) symmetric structure based on shunted piezoelectric units. We show that the elastic loss and gain can be archived in piezoelectric materials when they are shunted by external circuits containing positive and negative resistances. We present and discuss, as an example, the strongly dependent relationship between the exceptional points of a three-layered system and the impedance of their external shunted circuit. The achieved results evidence that the PT symmetric structures based on this proposed concept can actively be tuned without any change of their geometric configurations.

  18. Two-port laparoscopic management of a giant pseudocyst complicating ventriculoperitoneal shunt

    Directory of Open Access Journals (Sweden)

    Sandesh V Parelkar

    2014-01-01

    Full Text Available Insertion of a ventriculo-peritoneal (VP shunt is the most common operative procedure for the treatment of hydrocephalus in children. Of the several causes of shunt malfunction, cerebrospinal fluid (CSF pseudocyst is relatively uncommon. There are several modalities to treat a CSF pseudocyst. Laparotomy is required, at times, more than once. We managed a patient of CSF pseudocyst with two-port laparoscopy, by deroofing the psuedocyst and repositioning of the shunt. This minimally invasive technique avoids morbidity associated with laparotomy and aids in early recovery.

  19. Brain abscesses associated with right-to-left shunts in adults.

    Science.gov (United States)

    Memon, Kashif A; Cleveland, Kerry O; Gelfand, Michael S

    2012-04-01

    Although brain abscesses are frequently cryptogenic in origin, bacteria must reach the brain either by direct or hematogenous spread. Right-to-left shunts, caused either by intrapulmonary vascular malformations or congenital heart defects, may allow microorganisms to evade the normal host defenses in the lungs and lead to development of brain abscesses. Two patients recently presented with brain abscesses and were found to have conditions associated with right-to-left shunts. The diagnosis of brain abscess should prompt the clinician to consider right-to-left shunts as a possible predisposing condition for brain abscess.

  20. Scrotal migration of ventriculoperitoneal shunt: a case report at Haji Adam Malik hospital, Medan

    Science.gov (United States)

    Dharmajaya, R.

    2018-03-01

    Ventriculoperitoneal (VP) shunting is one of the most common pediatric neurosurgery operations performed for dealing with hydrocephalus. We report an unusual case of a 1-year-old child with communicating hydrocephalus, who experienced right scrotum swelling after 11 months of shunting. Abdominal x-ray showed the shunt tubing, which was kinked in its distal portion of thescrotum. Ultrasound examination was performed, revealing hydrocele along with the presence of thedistal catheter in the scrotum. The patient underwent distal catheter trimming via laparoscopic approach with general surgery and managed with asuccessful outcome. Prompt surgical management of catheter repositioning is recommended to avoid the risk of further complications.

  1. Severe Juxtahepatic Venous Injury: Survival after Prolonged Hepatic Vascular Isolation Without Shunting

    Directory of Open Access Journals (Sweden)

    J. E. J. Krige

    1990-01-01

    Full Text Available Survival following major juxtahepatic venous injury is rare in blunt liver trauma despite the use of intracaval shunting. Prolonged liver arterial inflow control, total hepatic venous isolation and lobectomy without shunting was used in a patient to repair a combined vena caval and hepatic venous injury after blunt liver injury. An extended period of normothermic hepatic ischemia was tolerated. Early recognition of retrohepatic venous injury and temporary liver packing to control bleeding and correct hypovolemia are essential before caval occlusion. Hepatic vascular isolation without shunting is an effective simple alternative technique allowing major venous repair in complex liver trauma.

  2. The design and implementation of on-line monitoring system for UHV compact shunt capacitors

    Science.gov (United States)

    Tao, Weiliang; Ni, Xuefeng; Lin, Hao; Jiang, Shengbao

    2017-08-01

    Because of the large capacity and compact structure of the UHV compact shunt capacitor, it is difficult to take effective measures to detect and prevent the faults. If the fault capacitor fails to take timely maintenance, it will pose a threat to the safe operation of the system and the life safety of the maintenance personnel. The development of UHV compact shunt capacitor on-line monitoring system can detect and record the on-line operation information of UHV compact shunt capacitors, analyze and evaluate the early fault warning signs, find out the fault capacitor or the capacitor with fault symptom, to ensure safe and reliable operation of the system.

  3. Vivencias psicosociales reveladas por niños que reciben tratamiento con quimioterapia por cáncer

    Directory of Open Access Journals (Sweden)

    BLANCA CECILIA VANEGAS DE AHOGADO

    2009-12-01

    Full Text Available Se realizó un estudio cualitativo con el propósito de descubrir las vivencias psicosociales de niños y niñas de 9 a 12 años que recibían tratamiento con quimioterapia por cáncer. La recolección de la información se hizo mediante encuentros lúdicos con el apoyo de algunas preguntas básicas que facilitaron las revelaciones narrativas. Tres aspectos se destacan en los hallazgos del estudio: vivencias desfavorables, vivencias relacionadas con la autoestima y vivencias favorables; las dos primeras, de diversa manera, afectan en estos niños su vida personal, familiar, escolar y, en general, todo su entorno. Es de resaltar que, como consecuencia de la caída del cabello, con frecuencia han sido objeto de burla y de rechazo por sus compañeros de estudio, lo que produce el más notorio efecto sobre su autoimagen; por otra parte, el ausentismo escolar conlleva dificultades académicas y sentimientos de tristeza en estos niños, situación que empeora cuando, por motivos de tratamiento, su lugar de residencia está alejado de la ciudad, viéndose sometidos a largos periodos de separación, no solo de su familia sino de sus pares. Se concluye que la mayor parte de las revelaciones son impactantes por su gran contenido de sufrimiento y dolor para estos niños, lo que demuestra la urgencia de retomar los hallazgos del estudio para orientar el cuidado de enfermería de manera más integral y apoyar para que se haga lo propio en el hogar y en las instituciones educativas.

  4. EFICIENCIA DEL TRATAMIENTO QUÍMICO EN LA PREVENCIÓN DEL TAPONAMIENTO DE GOTEROS APLICANDO AGUA RESIDUAL SANITARIA TRATADA

    Directory of Open Access Journals (Sweden)

    RAFAEL OLIVEIRA BATISTA

    2009-01-01

    Full Text Available El objetivo de este trabajo fue el de verificar la eficiencia del tratamiento químico en la prevención del taponamiento de los sistemas de goteo, cuando se usa aguas residuales sanitarias tratadas. Para la realización del ensayo experimental fue construida una plataforma de ensayos con la finalidad de abastecer cuatro unidades de irrigación por goteo con aguas residuales sanitarias, tratada y filtradas mediante un filtro de disco de 120 mesh. Fueron ensayados tres modelos de goteros (M1, M2 y M3 durante un período de 560 horas. En el tratamiento químico fueron ensayadas las concentraciones de cloro residual libre de 0; 0,4; 1,0 y 1,9 mg L-1. A partir de los resultados obtenidos se tienen las siguientes conclusiones: el agua residual sanitaria, tratada por aplicación vía sistema de irrigación por goteo propicio la formación de un biofilme en los goteros, resultante de la interacción entre colonias de bacterias y algas. La aplicación de cloro en el agua residual sanitaria tratada, minimizó el desarrollo del biofilme en el interior de los goteros y de las líneas laterales de irrigación; además, se encontró que los goteros con mayor diámetro en el laberinto y con mas de un filtro secundario (M2 y M3, son mas susceptibles al taponamiento cuando trabajan con aguas residuales tratadas. La concentración de cloro residual libre de 0,4 mg L-1 fue mas sustentable en la prevención de taponamiento por biofilme en sistemas de riego por goteo que operan con agua residual domestica tratada.

  5. Caracterización superficial de nuevos pre-tratamientos a base de silanos aplicados sobre aluminio

    Directory of Open Access Journals (Sweden)

    Gener, M.

    2005-12-01

    Full Text Available Silane- based pre-treatments are an alternative process for the chrome-based corrosionpreventive commercial pre-treatments, without salubrity problems and that in initial exploratory studies have yielded promising results regarding corrosion protection and adhesion promotion. In the framework of the research about the anticorrosive capacity of these compounds that it's being undertaken for different silane and substrates, some preliminary results are presented in this paper. Specifically, the results of the surface characterisation through SEM-EDS (Scanning Electron Microscopy and XPS (X-Ray Photoelectron Spectroscopy for two silanes with different functional groups (3-aminopropyltriethoxysilane or γ-APS and 3-glycidyloxypropyltrimethoxysilane or γ-GPS, prepared at different pH and applied as primers on an aluminium substrate, are discussed.

    Un proceso alternativo a los pre-tratamientos comerciales anticorrosivos a base de cromo, sin problemas de salubridad y que en estudios exploratorios iniciales ha dado resultados prometedores en cuanto a la protección frente a la corrosión y la mejora de la adherencia, son los pre-tratamientos a base de silanos. En el marco de la investigación sobre la capacidad anticorrosiva de estos compuestos que se está realizando para diferentes silanos y substratos, se presentan en este artículo algunos de los resultados preliminares. En concreto, se discuten los resultados de la caracterización superficial mediante técnicas de SEM-EDS (Scanning Electron Microscopy y XPS (X-Ray Photoelectron Spectroscopy para dos silanos con distintos grupos funcionales (3-aminopropiltrietoxisilano o γ-APS y 3-glicidiloxipropiltrimetoxisilano o γ-GPS, preparados a distintos pH y aplicados como imprimación sobre un substrato de aluminio.

  6. Tratamientos y diseños alternativos de las instalaciones de riesgo de proliferación de Legionella neumophila

    Directory of Open Access Journals (Sweden)

    José Macias Macias

    2006-12-01

    Full Text Available La dilatada experiencia del autor en el campo de la ingeniería de mantenimiento hospitalario, ha servido de base para sugerir distintas alternativas para prevenir la aparición de la bacteria Legionella neumophila en las instalaciones de riesgo. Lo que se pretende con las recomendaciones propuestas de diseño, uso y tratamiento de dichas instalaciones, es crear en ellas entornos hostiles para la vida microbiana y especialmente para la legionela, combinando métodos físicos y químicos. De esta forma lograremos disminuir las poblaciones de la bacteria, por debajo de los niveles que a la luz de los conocimientos actuales, resultan infectivos.Se describen opciones diferentes a los métodos de tratamiento tradicionales, que permiten obtener los mismos resultados minimizando los riesgos, tanto para las personas como para el medio ambiente. También se exponen los resultados de varios experimentos, mediante los cuales se ha intentado conocer como se comportan las instalaciones y los materiales que las componen, frente a la agresión que producen los métodos biocidas. Y por último, se comparan los distintos tipos de instalaciones centralizadas de producción y almacenamiento de agua caliente y se estudian las ventajas e inconvenientes de cada una de ellas.Las propuestas que se formulan pretenden tres cosas y por este orden: controlar las poblaciones de legionela evitando que originen la enfermedad en las personas, proteger las instalaciones en las que puede desarrollarse la bacteria, y en la medida de lo posible, evitar daños al medio ambiente derivados del vertido de sustancias peligrosas.

  7. Cambios en el tono muscular en dos niños con parálisis cerebral espástica mediante la hipoterapia: reporte de casos

    Directory of Open Access Journals (Sweden)

    Yasmín Andrea Rodríguez Laiseca

    2015-06-01

    Full Text Available Introducción: Estudios previos han demostrado que la hipoterapia como terapia complementaria mejora la función motora gruesa en niños con parálisis cerebral. Sin embargo la evidencia no es concluyente. Objetivo: Determinar los cambios en el tono muscular de dos pacientes con parálisis cerebral tipo cuadriparesia espástica mediante la hipoterapia. Descripción del caso: El estudio se llevó a cabo con dos sujetos de género masculino de dos años de edad, con diagnóstico de parálisis cerebral tipo cuadriparesia espástica, nivel V según la escala Gross Motor Function Clasification System (GMFCS. Los niños realizaron 27 sesiones de hipoterapia distribuidas de la siguiente manera: 3 sesiones de acoplamiento en hipoterapia en la primera semana y 24  sesiones de monta terapéutica con una frecuencia de tres veces por semana y una intensidad de 20 minutos por sesión. Se llevó a cabo la valoración del tono muscular mediante la escala de Ashworth modificada (MAS de la siguiente forma: una inicial, dos de control, cuatro post-monta, una final tras 9 semanas de tratamiento continuo y tres mediciones más en la semana uno, dos y tres de inactividad terapéutica. Resultados y discusión: La hipoterapia demostró efecto modulador sobre el tono muscular de los dos sujetos finalizadas las 27 sesiones de hipoterapia, pero este se pierde progresivamente durante el periodo de inactividad terapéutica. Por lo tanto se confirma que esta técnica puede ser una estrategia de tratamiento para el manejo de la espasticidad en pacientes con parálisis cerebral, siempre y cuando se aplique continuamente.

  8. Tratamiento curricular de la imagen corporal, autoestima y autoconcepto en España

    Directory of Open Access Journals (Sweden)

    Antonio V. Rodríguez

    2015-03-01

    Full Text Available La adolescencia es un periodo del desarrollo del ser humano en el que proliferan problemas con la percepción de la imagen corporal, la autoestima y el autoconcepto, mientras el niño se encuentra cursando estudios de Educación Secundaria Obligatoria. Este estudio analiza el tratamiento curricular que se dedica a la imagen corporal, la autoestima y el autoconcepto en los diferentes elementos legislativos en el ámbito educativo de la Comunidad Valenciana (España, mediante una metodología cualitativa, a través de la técnica del análisis documental no interactiva. Los resultados del análisis de los documentos, correspondientes a la ordenación académica de la etapa en esta comunidad autónoma, mostraron una presencia de estos contenidos tanto en los planteamientos del ámbito nacional concerniente a la LOE (2006 y el Real Decreto 1631/2006, como en los regionales materializados en el Decreto 112/2007. Aparecen específicamente en algunos elementos del currículo de materias como Educación Física, Educación para la Ciudadanía, Matemáticas, Biología y Geología, Ciencias de la Naturaleza y Música, a pesar de que no en todas ellas adquieren el mismo protagonismo, destacando en este sentido la Educación Física como materia que más se centra tanto en el trabajo como en el desarrollo de estos aspectos. Dentro de ella se muestra un desequilibrio en cuanto al protagonismo alcanzado en lo que se pretende que aprendan (objetivos y en su ínfima plasmación en las herramientas para alcanzarlo (contenidos, así como en el cómo evaluarlo (criterios de evaluación.

  9. Perspectivas futuras de tratamiento en la insuficiencia cardíaca: del trasplante de células a la regeneración cardíaca

    OpenAIRE

    Prosper, F. (Felipe); Herreros, J. (Jesús); Barba, J. (Joaquín)

    2004-01-01

    En los últimos años hemos asistido a un interés creciente por el tratamiento de la insuficiencia cardíaca mediante el trasplante de células madre. Mientras que los estudios con células madre de músculo (mioblastos) se iniciaron hace más de 10 años, la posibilidad de que las células madre de la médula ósea tengan un enorme potencial de diferenciación y proliferación ha estimulado la investigación con otros tipos de células madre. Estos estudios experimentales han demost...

  10. Tratamiento Protésico en un Lactante con amputación de miembro inferior por Bridas Amnióticas. Presentación de caso.

    OpenAIRE

    Yeney Díaz Díaz; Juan Carlos Gómez Benítez; Carlos César Santín Alfaro

    2015-01-01

    Las bridas amnióticas son cordones de sacos llenos de líquido que rodean a un bebé en el útero y que pueden causar una deformidad congénita. Se realizó un estudio observacional descriptivo con diseño experimental .Con el objetivo de explicar mediante la presentación de un caso con amputación de miembro inferior a causa de una malformación congénita por bridas amnióticas, el tratamiento rehabilitador y la elaboración de la prótesis en la edad pediátrica. Se muestra el caso de una lactante ...

  11. Tratamiento de aguas residuales con tecnologías alternativas en una pequeña unidad doméstica–productiva

    OpenAIRE

    Cynthia Pérez Rodríguez; Juana María Coto Campos; Viviana Salgado Silva; Jacqueline Herrera Núñez; José Francisco Fernández Araya; Cristina Benavides Benavides

    2013-01-01

    Se evaluó el sistema de tratamiento de aguas residuales instalado en una pequeña unidad doméstica-productiva ubicada en la zona de Escazú de la provincia de San José, mediante la medición de la demanda bioquímica de oxígeno, demanda química de oxígeno, fosfatos solubles, nitratos, sólidos totales, sólidos sedimentables, turbiedad, pH y coliformes fecales, en seis muestreos. Además, se realizaron tres muestreos en el Río Catalina, receptor del efluente final, en épocas de transición seca-lluvi...

  12. Propiedades biomecánicas de la membrana limitante interna tras recibir tratamiento intravítreo con ocriplasmina.

    Science.gov (United States)

    Vielmuth, Franziska; Schumann, Ricarda G; Spindler, Volker; Wolf, Armin; Scheler, Renate; Mayer, Wolfgang J; Henrich, Paul B; Haritoglou, Christos

    2017-01-01

    Objetivo: Evaluar la rigidez de la membrana limitante interna (MLI) humana y evaluar los posibles cambios de las propiedades mecánicas tras administrar una inyección intravítrea de ocriplasmina para tratar la tracción vitreomacular. Métodos: Este estudio se compone de una serie de casos intervencionales y comparativos de 12 muestras de MLI extraídas mediante cirugía y obtenidas de forma consecutiva de 9 ojos de 9 pacientes después de someterse sin éxito a vitreólisis farmacológica con ocriplasmina. Durante el mismo periodo de tiempo, 16 muestras de otros 13 ojos sin tratamiento con ocriplasmina se obtuvieron mediante vitrectomía y sirvieron como controles. Todos los pacientes presentaron agujeros maculares o tracción vitreomacular y se sometieron a vitrectomía con disección de la MLI tanto con tinción con azul brillante (AB) como sin ella. Todas las muestras se analizaron con un microscopio de fuerza atómica con imágenes de las regiones de 25 × 25 μm. En todas las muestras, se analizaron tanto la parte de la retina como la del vítreo de la MLI. Resultados: La microscopia de fuerza atómica no reveló diferencias significativas en cuanto a elasticidad de las muestras de MLI extraídas de ojos con o sin tratamiento con ocriplasmina. Las áreas onduladas de la parte de la retina presentaron una mayor rigidez que la parte del vítreo de la MLI. La cartografía topográfica tanto de la parte del vítreo como de la retina de la MLI no mostró ninguna alteración aparente de la morfología en ojos tratados con ocriplasmina en comparación con los ojos no tratados. La tinción con azul brillante conllevó un aumento de la rigidez tisular. Conclusiones: Las inyecciones intravítreas de ocriplasmina no varían las propiedades biomecánicas de la MLI humana. No existen pruebas de un posible efecto enzimático que interfiera con la rigidez de esta membrana basal. © 2017 S. Karger AG, Basel.

  13. Cálculo del poder de la lente intraocular mediante biometría ultrasónica

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    Yileika Elías García

    Full Text Available Objetivo: caracterizar el comportamiento del cálculo de la lente intraocular mediante biometría ultrasónica. Métodos: se realizó un estudio descriptivo y prospectivo, con un grupo de pacientes atendidos por el Servicio de Catarata del Centro Oftalmológico «Enrique Cabrera», que recibieron tratamiento quirúrgico por catarata con implante de lente intraocular, mediante técnica de Blumenthal. La muestra se conformó con 160 ojos y se estudiaron las variables: sorpresa refractiva, edad, longitud axial y promedio queratométrico según resultado refractivo, poder dióptrico de la lente y componente esférico según edad. Resultados: como resultados más sobresalientes, se obtuvo que el 78,7 % no presentó error en el cálculo de la lente, la mayoría de los pacientes tenían 60 años y más, predominó el rango de longitud axial entre 22 y 24,4 (67,5 %, el promedio queratométrico de 43 a 44,99 (64,3 %, el poder dióptrico del lente de + 20 a + 23 dioptrías (48,2 % y el componente esférico entre 0,00 y +/-1,00 dioptrías (78,8%. Conclusiones: se considera que la biometría ultrasónica resulta adecuada para el cálculo correcto del lente.

  14. Shunt occlusion for portosystemic shunt syndrome related refractory hepatic encephalopathy-A single-center experience in 21 patients from Kerala.

    Science.gov (United States)

    Philips, Cyriac Abby; Kumar, Lijesh; Augustine, Philip

    2017-09-01

    Large spontaneous portosystemic shunts (SPSS) are seen in a subset of patients with liver disease and medically refractory recurrent/persistent hepatic encephalopathy (MRHE). Shunt occlusion has been shown to improve clinical outcomes. We retrospectively analyzed patient characteristics, SPSS attributes, procedural features, baseline clinical and investigational parameters, neurological outcomes, adverse effects (procedure and portal hypertension related), and risk factors predicting outcomes in liver disease patients undergoing shunt occlusion procedure for MRHE. Between October 2016 and July 2017, 21 patients (Child-Pugh score, CTP 6 to 13) with mean model of end-stage liver disease (MELD) and MELD-sodium scores 15.7 and 19.3 respectively with MRHE [3-cirrhotic Parkinsonism (CP)] were diagnosed to have single or multiple large SPSSs. A total of 29 shunts were occluded (1 surgical, 20 non-surgical). Recurrent and persistent HE and CP markedly improved in the short (n=20, 1 to 3 months), intermediate (n=12, 3 to 6 months), and long (n=7, 6 to 9 months) follow up. None had spontaneous or persistent HE at a median follow up 105 (30 to 329) days (p11 predicted mortality post shunt occlusion (p=0.04). Embolization of large SPSS in liver disease patients with MRHE and modestly preserved liver function is safe and efficacious and associated with improved quality of life and can function as a bridge to liver transplantation in accurately selected patients.

  15. Estrategia para mejorar el acceso al tratamiento etiológico para la enfermedad de Chagas en el primer nivel de atención en Argentina

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    Karen Klein

    2017-05-01

    Full Text Available RESUMEN Objetivo Mejorar la distribución del tratamiento etiológico para la enfermedad de Chagas mediante la identificación de barreras para su descentralización al primer nivel de atención en Argentina. Métodos Se llevó a cabo un estudio cualitativo, de carácter exploratorio y descriptivo, en base a entrevistas semiestructuradas a actores clave pertenecientes al Programa Nacional de Chagas y miembros de los equipos de salud del primer nivel de atención con el objetivo de identificar barreras para el diagnóstico y tratamiento de la enfermedad de Chagas en diferentes niveles (administrativo, efectores de salud y comunidad que podrían afectar una estrategia descentralizada de distribución. Además, se implementó un piloto de descentralización en diez centros de atención primaria en una provincia argentina. Resultados Se realizaron 22 entrevistas semiestructuradas con responsables de programas y profesionales de la salud. Los principales obstáculos hallados fueron la falta de búsqueda sistemática de casos, la poca articulación entre los niveles de atención y los actores del sistema de salud, la falta de capacitación del equipo de salud respecto al tratamiento, el seguimiento de los pacientes y las barreras asociadas a los pacientes. Se llevó a cabo un programa piloto de descentralización y se evaluaron estrategias para optimizar la intervención a gran escala. Conclusiones Los resultados permitieron mejorar la implementación del plan de descentralización del tratamiento a través de una mejor articulación interprogramática, la capitalización de herramientas de monitoreo y de comunicación ya existentes, y la sensibilización de los equipos de salud. Además, se formularon recomendaciones tendientes a mejorar el diagnóstico y el tratamiento de la enfermedad de Chagas.

  16. Características clínicas y toxicidad del tratamiento de tuberculosis en pacientes con cáncer

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    Luis Cuéllar

    Full Text Available Objetivos. Evaluar las características clínico-epidemiológicas de la tuberculosis activa en pacientes portadores de neoplasia maligna y evaluar la influencia del tratamiento antituberculoso sobre el manejo de cáncer en el Instituto Nacional de Enfermedades Neoplásicas entre el 2008 y 2013. Materiales y métodos. Estudio observacional de casos de tuberculosis diagnosticados mediante baciloscopía positiva en pacientes con cáncer. Se revisó la información clínica, evolución, e información patológica de la neoplasia. Resultados. Se encontraron 76 casos de tuberculosis activa luego del diagnóstico de cáncer. La mediana de edad fue 51,3 años. La mediana de seguimiento fue 2,1 años. Las neoplasias más frecuentes fueron leucemia linfática aguda (14,5% para las hematológicas y cáncer de cérvix (14,5%, mama (10,5% y gástrico (7,9% para las no hematológicas. El 27,6% de los pacientes presentó recurrencia de la neoplasia; el diagnóstico de tuberculosis confundió el estadiaje inicial en 6,9% y se planteó inicialmente como recurrencia del cáncer en 11,1% (neoplasias de mama y colon. El diagnóstico de tuberculosis retrasó o influyó en la reducción de dosis del tratamiento antineoplásico en 11,1% de los casos (leucemia linfática aguda y linfoma no Hodgkin. El 8,3% de los pacientes presentó toxicidad al tratamiento antituberculoso. Conclusiones. Los pacientes con cáncer pueden presentar infección activa por tuberculosis. El efecto de interferencia del diagnóstico y tratamiento de tuberculosis sobre la evaluación del cáncer y el tratamiento antineoplásico en nuestra serie es mínimo.

  17. Tratamiento multimodal en los carcinomas anaplásicos de tiroides

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    José Luis Guerra Mesa

    2001-06-01

    Full Text Available Se reporta que el carcinoma anaplásico del tiroides (CAT es una de las neoplasias más malignas que afectan al ser humano, con una supervivencia menor de 6 meses posterior al diagnóstico. El objetivo de este trabajo es analizar la forma de presentación, el tratamiento multimodal y la evolución de los pacientes con CAT en el Instituto Nacional de Oncología y Radiobiología. Se estudiaron 25 pacientes que padecían CAT entre diciembre de 1967 y diciembre de 1997 en el Servicio de Cirugía Esplácnica de dicho centro, los que fueron atendidos íntegramente (diagnóstico, tratamiento, seguimiento y deceso. El diagnóstico positivo se hizo mediante citología aspirativa con aguja fina. El tratamiento consistió en una combinación de radioterapia y quimioterapia neoadyuvantes más cirugía. La edad promedio de los pacientes fue de 64 años (rango 55-70; la relación hombre-mujer, de 1:1,5 y la frecuencia de la enfermedad de 4,6 %. La forma de presentación más frecuente fue un rápido crecimiento de la glándula asociado con dolor cervical, disfonía, disnea y disfagia. La invasión a estructuras vecinas, las metástasis a distancia y las metástasis ganglionares cervicales regionales estuvieron presentes en el 68, el 32 y el 20 % de los casos, respectivamente al momento del diagnóstico. Se logró resección completa en 7 pacientes y parcial en 10. No ocurrió mortalidad quirúrgica. El tipo histológico más frecuente fue el CAT de células fusiformes. La supervivencia de los pacientes a los cuales se les practicó resección completa del tumor fue de 24 meses como promedioThyroid anaplastic carcinoma (TAC is one of the most malignant neoplasias affecting the human beign, with a survival of less than 6 months after diagnosis. The aim of this paper is to analyze its form of presentation, combined modality treatment and the evolution of those patients presenting with TAC at the National Institute of Oncology and Radiobiology. We studied 25

  18. Tratamiento de aguas residuales con tecnologías alternativas en una pequeña unidad doméstica–productiva

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    Cynthia Pérez Rodríguez

    2013-03-01

    Full Text Available Se evaluó el sistema de tratamiento de aguas residuales instalado en una pequeña unidad doméstica-productiva ubicada en la zona de Escazú de la provincia de San José, mediante la medición de la demanda bioquímica de oxígeno, demanda química de oxígeno, fosfatos solubles, nitratos, sólidos totales, sólidos sedimentables, turbiedad, pH y coliformes fecales, en seis muestreos. Además, se realizaron tres muestreos en el Río Catalina, receptor del efluente final, en épocas de transición seca-lluviosa, lluviosa, transición lluviosa-seca, en los que se evaluaron oxígeno disuelto, fosfatos solubles, nitratos, sólidos totales, turbiedad, pH, coliformes fecales y macroinvertebrados bentónicos. La calidad del agua del río se expresó mediante el Índice de la Calidad de Agua de la Fundación Nacional de Sanidad de los Estados Unidos de América (ICAFNS y el índice biótico BMWP-CR. El sistema estudiado resultó efectivo en la remoción de los contaminantes del agua, y con excepción de los coliformes fecales, el efluente final cumplió con los límites permisibles para cada uno de los parámetros establecidos para el reúso de aguas residuales tratadas con fines agrícolas y para el vertido de aguas residuales en cuerpos receptores. En términos generales, puede concluirse que el efluente del sistema de tratamiento no afecta la calidad del agua del Río Catalina.

  19. Análisis coste-efectividad del empleo de celecoxib en el tratamiento de la artrosis

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    Moreno A.

    2003-01-01

    Full Text Available Antecedentes: Los antiinflamatorios no esteroideos (AINE, utilizados en el tratamiento de la artrosis, pueden producir reacciones adversas gastrointestinales (GI graves. Celecoxib, un inhibidor específico de la ciclooxigenasa 2 (COX-2, ha demostrado una eficacia equivalente a los AINE convencionales con un mejor perfil de tolerabilidad y seguridad. Objetivo: La finalidad de este estudio ha sido realizar un análisis coste-efectividad sobre el uso de celecoxib frente a los AINE clásicos en el tratamiento de la artrosis. Material y métodos: El análisis coste-efectividad se ha diseñado mediante un modelo farmacoeconómico, definiéndose como unidad de efectividad a cada año de vida ganado tras la toma de celecoxib o AINE. La probabilidad de que aparezcan los diferentes resultados clínicos se ha obtenido de artículos publicados y de asunciones incorporadas. Sólo se han valorado los costes directos médicos (medicación, hospitalización, pruebas complementarias, analíticas, visitas extras, etc., sin haberse incluido otros costes. La perspectiva del estudio ha sido la del Sistema Nacional de Salud y el horizonte temporal elegido ha sido de 6 meses. Resultados: El coste adicional por cada año de vida ganado secundario al uso de celecoxib frente a los AINE clásicos asciende a 8.017 ? (1.333.834 ptas.. El análisis de sensibilidad muestra cómo estos valores son sensibles a la modificación del coste de AINE y gastroprotector, así como a la inclusión de grupos poblacionales con edades más bajas. Conclusiones: Celecoxib puede ser considerado como una opción coste-efectiva en el tratamiento de la artrosis, ya que va a evitar muertes y a ganar años de vida para los pacientes con un coste adicional razonable y moderado, cuando se compara con los AINE. Su eficiencia aumenta a medida que se utiliza en poblaciones con menor edad media y, probablemente, en aquellas con mayor riesgo de desarrollar complicaciones GI.

  20. Metformin reduces intrahepatic fibrosis and intrapulmonary shunts in biliary cirrhotic rats

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    Mu-Tzu Ko

    2017-08-01

    Conclusion: Metformin reduced liver injury and improved hepatic fibrosis in cirrhotic rats. It also attenuated the intrapulmonary shunts. However, the effects of metformin on pulmonary angiogenesis and hypoxia were insignificant.