RESUMO
The dynamic retrograde intercrural columellar strut graft placement is a novel technique for a columellar strut insertion via a hemi-transfixion incision in patients undergoing endonasal functional or cosmetic surgery. It has a maximally concealed incision and does not disrupt major or minor tip support mechanisms. In our article, we give a detailed description of this unique surgical technique. Laryngoscope, 134:1246-1248, 2024.
Assuntos
Rinoplastia , Humanos , Rinoplastia/métodos , Nariz/cirurgia , Septo Nasal/cirurgia , Próteses e Implantes , Estética , Técnicas de Sutura , Resultado do TratamentoRESUMO
Auxiliary density functional theory (ADFT) hybrid calculations are based on the variational fitting of the Coulomb and Fock potential and, therefore, are free of four-center electron repulsion integrals. So far, ADFT hybrid calculations have been validated successfully for standard enthalpies of formation. In this work the accuracy of ADFT hybrid calculations for the description of pericyclic reactions was quantitatively validated at the B3LYP/6-31G*/GEN-A2* level of theory. Our comparison with conventional Kohn-Sham density functional theory (DFT) results shows that the DFT and ADFT activation and reaction enthalpies are practically indistinguishable. A systematic study of various functionals (PBE, B3LYP, PBE0, CAMB3LYP, CAMPBE0 and HSE06) and basis sets (6-31G*, DZVP-GGA and aug-cc-pVXZ; X = D, T and Q) revealed that the ADFT HSE06/aug-cc-pVTZ/GEN-A2* level of theory yields best balanced accuracy for the activation and reaction enthalpies of the studied pericyclic reactions. With the successfully validate ADFT composite approach consisting of PBE/DZVP-GGA/GEN-A2* structure and transition state optimizations and single-point HSE06/aug-cc-pVTZ/GEN-A2* energy calculations, an accurate, reliable and efficient computational approach for the study of pericyclic reactions in systems at the nanometer scale is proposed.
RESUMO
BACKGROUND: The conventional treatment for idiopathic intracranial hypertension involves weight loss, steroids, diuretics, and/or serial lumbar punctures; however, if the symptoms persist or worsen, surgical intervention is recommended. Surgical options include cerebrospinal fluid diversion procedures, such as ventriculoperitoneal and lumboperitoneal shunts, and optic nerve decompression with nerve sheath fenestration. The latter can be carried out using an endoscopic approach, but the outcomes of this technique have not been firmly established. METHODS: This systematic review examined the outcomes of performing endoscopic optic nerve decompression (EOND) in patients with idiopathic intracranial hypertension (IIH). Six studies were included for a total of 34 patients. RESULTS: The patients presented with visual field disturbances (32 of 32 [100%]), visual acuity disruptions (33 of 34 [97.1%]), papilledema (26 of 34 [76.5%]), and persistent headache (30 of 33 [90.1%]). The mean duration of symptoms ranged from 7 to 32 months. Overall, the patients showed post-EOND improvement in signs and symptoms associated with IIH, specifically visual field deficits (93.8%), visual acuity (85.3%), papilledema (81.4%), and headaches (81.8%). Interestingly, 11 cases showed postoperative improvement in their symptoms with bony decompression of the optic canal alone, without nerve sheath fenestration. There were no major adverse events or complications reported with this approach. CONCLUSION: EOND appears to be a promising and safe surgical alternative for patients with IIH who fail to respond to medical treatment. Further studies are needed before we can attest to the clinical validity of this procedure.
Assuntos
Descompressão Cirúrgica , Endoscopia , Nervo Óptico/cirurgia , Pseudotumor Cerebral/cirurgia , Humanos , Resultado do TratamentoRESUMO
BACKGROUND: Salamanca, Mexico occupied fourth place nationally in contaminating emissions. The aim of the study was to determine the impact of air pollution on the frequency of pulmonary function alterations and respiratory symptoms in school-age children in a longitudinal repeated-measures study. METHODS: We recruited a cohort of 464 children from 6 to 14 years of age, from two schools differing in distance from the major stationary air pollution sources. Spirometry, respiratory symptoms and air pollutants (O3, SO2, NO, NO2, NOx, PM10,) were obtained for each season. Mixed models for continuous variables and multilevel logistic regression for respiratory symptoms were fitted taking into account seasonal variations in health effects according to air pollution levels. RESULTS: Abnormalities in lung function and frequency of respiratory symptoms were higher in the school closer to major stationary air pollution sources than in the distant school. However, in winter differences on health disappeared. The principal alteration in lung function was the obstructive type, which frequency was greater in those students with greater exposure (10.4% vs. 5.3%; OR = 1.95, 95% CI 1.0-3.7), followed by the mixed pattern also more frequent in the same students (4.1% vs. 0.9%; OR = 4.69, 95% CI, 1.0-21.1). PM10 levels were the most consistent factor with a negative relationship with FVC, FEV1 and PEF but with a positive relationship with FEV1/FVC coefficient according to its change per 3-month period. CONCLUSIONS: Students from the school closer to major stationary air pollution sources had in general more respiratory symptoms than those from the distant school. However, in winter air pollution was generalized in this city and differences in health disappeared. PM10 levels were the most consistent factor related to pulmonary function according, to its change per 3-month period.
Assuntos
Poluição do Ar/efeitos adversos , Pneumopatias Obstrutivas/epidemiologia , Pneumopatias Obstrutivas/fisiopatologia , Pulmão/fisiopatologia , Adolescente , Monóxido de Carbono/efeitos adversos , Criança , Estudos de Coortes , Feminino , Volume Expiratório Forçado/fisiologia , Humanos , Modelos Logísticos , Estudos Longitudinais , Masculino , México/epidemiologia , Óxidos de Nitrogênio/efeitos adversos , Prevalência , Estações do Ano , Dióxido de Enxofre/efeitos adversos , Capacidade Vital/fisiologiaRESUMO
Reportamos un caso de Aneurisma Postraumático de la Arteria Temporal Superficial Derecha, el paciente presentó 4 semanas antes de aparecer la tumoración en la zona periauricular derecha, un fuerte traumatismo con un objeto duro en dicha zona, a los 8 meses es remitido a nuestra consulta de cirugía vascular por el maxilofacial, donde constatamos una tumoración de aproximadamente 4cm x 4cm, que a la palpación era dolorosa, latía, se expandía, tenía thril y a la auscultación un soplo olosistólico. Se le realiza una Ecografía Doppler Color, demostrándose la Arteria Temporal Superficial Derecha aneurismática. Se decide la operación, comprobándose el Aneurisma en el acto quirúrgico y posteriormente se confirma el diagnóstico de Aneurisma Verdadero por anatomía patológica
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Aneurisma , Artérias Temporais , Ferimentos e LesõesRESUMO
En el presente estudio se evaluan 11 pacientes con Sarcoma de Kaposi Epidémico, 55% de ellos se encontraban en estudio IV y el 45% en estadio II; el 75% tenían síntomas sistémicos. El 89% de los enfermos tenían linfocitos totales y linfocitos T bajos, todos ellos tenían una población cooperadora muy baja así como la razón cooperadora/supresora. La mayoría de ellos (89%) presentaron una actividad proliferativa baja frente a fitohemaglutinina (PHA). Nueve pacientes recibieron alguna forma de tratamiento: 5 recibieron Interferona *2-3 monoquimioterapia con Adriamicina y uno de ellos además simultáneamente Azidotimidina (AZT), 1 enfermo recibió radioterapia. Solo se obtuvo estabilización de la enfermedad en 5 pacientes 3 que recibieron Interferona *2,1 Adriamicina y 1 driamicina junto a Azidotimidina. En 2 enfermos que recibieron Adriamicina y Adriamicina junto con Azidotimidina hubo la necesidad de administrar Litio para incrementar las cifras de leucocitos y plaquetas. Para mayo de 1989 el 73% de los pacientes habían muerto (sobrevida media 8 ñ 2 meses). Con estos datos se puede concluir que: 1. Hay que seleccionar aquellos pacientes con Sarcoma de Kaposi que pueden beneficiarse con alguna forma de tratamiento, 2. a respuesta de Interferon *-2 o monoquimioterapia es sabia y no modifica la sobrevida global, 3. Un número bajo de células T-cooperadoras, un valor bajo de la razón cooperadora/supresora, baja proliferación de células T frente a mitógenos y síntomas sistémicos son factores de mal pronóstico; 4. La toxicidad producida por el tratamiento fue aceptable; 5. El Carbonato de Litio fue efectivo en aumentar los neutrófilos y las plaquetas
Assuntos
Adulto , Humanos , Masculino , Síndrome da Imunodeficiência Adquirida , Sarcoma de Kaposi/tratamento farmacológico , Sarcoma de Kaposi/radioterapiaRESUMO
El síndrome de Klippel-Trenaunay- Weber está constituido por una tríada de anomalías congénitas caracterizada por la presensia de nevus vascular, várice e hipertrofia ósea y de tejidos blandos. Esta rara enfermedad se clasifica dentro de las facomatosis y ocasionalmente se asocia a la neurofibromatosis, el síndrome de Sturge-Weber y la esclerosis tuberosa. Se describe la evolución de cinco pacientes, 3 varones y 2 hembras con edad promedio de 25,6 años (15-32 años), ingresados en el Servicio de Medicina 2 del Hospital Vargas de Caracas, desde 1980 a 1989, enfatizando las características de presentación del síndrome en nuestros casos y las entidades patológicas con las que puede ser confundido