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Introducción: El cáncer de laringe es el tumor maligno de mayor prevalencia en la Otorrinolaringología. La topografía glótica es la más frecuente en Uruguay y suele detectarse en estadios tempranos dada la manifestación precoz y sostenida de disfonía. El objetivo de este estudio es describir la sobrevida libre de enfermedad (SLE) y la sobrevida global (SG) de los pacientes con cáncer de laringe glótico en estadio T1N0M0 en 4 instituciones de Montevideo. Metodología: Se analizó de forma retrospectiva la SG y SLE de 55 pacientes diagnosticados con cáncer de glotis T1 entre los años 2009 y 2019. Para el cálculo de la sobrevida se utilizó el método de Kaplan-Meier. Se estudió además el efecto de variables pronósticas de interés sobre la SG mediante análisis univariado y multivariado. Resultados: En la muestra analizada la SG de los pacientes con cáncer glótico T1N0M0 fue como media de 7.706 años (IC 95% 6.63 - 8.78). A los 5 años, la SG fue de 77.5% (± 7%) y de 62% (± 9.8%) a los 10 años. La SLE para todos los pacientes correspondió al 74.6% (± 7.5%) y 63.1% (± 9.8%), a 5 y 10 años respectivamente. No se alcanzaron las medianas de SG ni de SLE para los grupos. Conclusiones: Los valores de SG y SLE medios obtenidos en nuestro medio son comparables a los valores reportados en la bibliografía internacional. No se alcanzó la mediana de SG ni de SLE, por lo que se puede afirmar que ésta enfermedad tiene, cuando se realiza el tratamiento adecuado, un buen pronóstico vital a los 10 años. Se requiere un seguimiento más largo para determinar las medianas de SG y SLE de los grupos en estudio.

Introduction: Laryngeal cancer is the most prevalent malignant tumor in Otorhinolaryngology. Glottic topography is the most frequent in Uruguay and is usually detected in early stages given the early and sustained manifestation of dysphonia. The objective of this study is to analyze disease-free survival (DFS) and overall survival (OS) of patients with stage T1N0M0 glottic laryngeal cancer at 4 institutions in Montevideo. Methodology: The mean OS and DFS of 55 patients diagnosed with T1 glottic cancer between 2009 and 2019 were retrospectively analyzed. Kaplan-Meier method was used to calculate survival. The prognostic effect of certain variables of interest on OS was also studied using univariate and multivariate analysis. Results: In this study, mean odds survival (OS) for T1N0M0 glottic cancer was 7.706 years (CI 95% 6.63 - 8.78). At 5 years, OS was 77.5% (± 7%) and at 10 years was 62% (± 9.8%). Disease free survival (DFS) was 74.6% ± (7.5%) at 5 years and 63.1% (± 9.8%), at 10 years. Median OS and DFS for the groups were not reached. Conclusions: OS and DFS in our medium is comparable to that reported in the international literature. The median OS and DFS were not reached, so it can be stated that this disease has, when appropriate treatment is performed, a good vital prognosis at 10 years. Longer follow-up is required to determine the median OS and DFS of the study groups.

Introdução: O câncer de laringe é o tumor maligno mais prevalente na Otorrinolaringologia. A topografia glótica é a mais frequente no Uruguai e geralmente é detectada em estágios iniciais devido à manifestação precoce e sustentada da disfonia. O objetivo deste estudo é analisar a sobrevida livre de doença (DFS) e a sobrevida global (OS) de pacientes com câncer de laringe glótico estágio T1N0M0 em 4 instituições em Montevidéu. Metodologia: Foram analisados retrospectivamente o OS e DFS de 55 pacientes diagnosticados com câncer glótico T1 entre 2009 e 2019. O método de Kaplan-Meier foi usado para calcular a sobrevida. Resultados: Na amostra, a sobrevida global (OS) do câncer glótico T1N0M0 foi em média de 7.706 anos (IC 95% 6,63 - 8,78). Aos 5 anos, a OS foi de 77,5% (± 7%) e 62% (± 9,8%) aos 10 anos. A DFS para todos os pacientes correspondeu a 74,6% (± 7,5%) e 63,1% (± 9,8%), aos 5 e 10 anos, respectivamente. As medianas de OS e DFS para os grupos não foram alcançadas. Conclusões: OS e DFS em nosso ambiente é comparável ao relatado na literatura internacional. As medianas de SG e SLD não foram alcançadas, pelo que se pode afirmar que esta doença apresenta, quando realizado tratamento adequado, um bom prognóstico vital aos 10 anos. É necessário um acompanhamento mais longo para determinar a mediana da SG e da SLD dos grupos de estudo.

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Introducción: La hipopotasemia es un trastorno hidroelectrolítico frecuente, asociado a enfermedades sistémicas y multifactoriales, cuya forma aguda puede complicarse y causar la muerte, pero en su presentación crónica puede ser un marcador de nefropatía. Objetivo: Caracterizar el perfil del paciente con hipopotasemia no medicamentosa atendidos de emergencia. Métodos: Se revisaron los registros de pacientes mayores de 18 años con diagnóstico de hipopotasemia, ingresados en el hospital en el período de junio 2018 a diciembre de 2019. Se colectaron datos demográficos, antecedentes médicos y evolución postratamiento. Se comparó con 108 pacientes sin hipopotasemia atendidos en el período de estudio. Resultados: Se encontraron 87 casos con edad media de 38,5 años. El 90,8 por ciento eran hombres menores de 50 años, de oficio agricultor (29,9 por ciento), con historia de exposición a plaguicidas y a altas temperaturas ambientales. La mayoría de ellos no tenía historia de enfermedad cardiometabólicas o renal previa. El 48,3 por ciento de todos los pacientes con hipopotasemia (n = 42) tenía creatinina mayor a 1,2 mg/dL y 63 por ciento tenía hiponatremia. La hipopotasemia fue moderada en 39 por ciento y severa en 12 por ciento, los hombres 4,7 veces más afectados que las mujeres. Respecto al grupo sin hipopotasemia y creatinina anormal, tenían mayor frecuencia de enfermedad crónica (92,5 por ciento versus 8 por ciento). Conclusiones: Se encontró hipopotasemia no medicamentosa en varones agricultores, sin enfermedad crónica, pero con datos de nefropatía temprana e hiponatremia, se sugirió la posibilidad de nefropatía mesoamericana. Debe establecerse una alerta epidemiológica regional y un programa de prevención y control(AU)

Introduction: Hypokalemia is a frequent hydroelectrolytic disorder, associated with systemic and multifactorial diseases, whose acute form can be complicated and cause death, but in its chronic presentation it can be a marker of nephropathy. Objective: To characterize the profile of the patient with non-drug hypokalemia seen in an emergency. Methods: The records of patients older than 18 years diagnosed with hypokalemia, admitted to the hospital from June 2018 to December 2019, were reviewed. Demographic data, medical history, and post-treatment evolution were collected. It was compared with 108 patients without hypokalemia seen in the same period. Results: 87 cases with mean age of 38.5 years were studied. 90.8% were men under 50 years of age, who worked as farmers (29.9percent), with history of exposure to pesticides and high ambient temperatures. Most of them had no history of previous cardiometabolic or renal disease. 48.3percent of all patients with hypokalemia (n = 42) had creatinine higher than 1.2 mg/dL and 63percent had hyponatremia. Hypokalemia was moderate in 39% and severe in 12percent, and it was found that men were affected 4.7 times more than women. Regarding the group without hypokalemia and abnormal creatinine, they had higher frequency of chronic disease (92.5percent versus 8percent). Conclusions: Non-drug hypokalemia was found in male farmers, without chronic disease, but with evidence of early nephropathy and hyponatremia. The possibility of Mesoamerican nephropathy was suggested. A regional epidemiological alert and a prevention and control program should be established(AU)

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This work studied the feasibility of using a novel microreactor based on torus geometry to carry out a sample pretreatment before its analysis by graphite furnace atomic absorption. The miniaturized retention of total arsenic was performed on the surface of a magnetic sorbent material consisting of 6 mg of magnetite (Fe3O4) confined in a very small space inside (20.1 µL) a polyacrylate device filling an internal lumen (inside space). Using this geometric design, a simulation theoretical study demonstrated a notable improvement in the analyte adsorption process on the solid extractant surface. Compared to single-layer geometries, the torus microreactor geometry brought on flow turbulence within the liquid along the curvatures inside the device channels, improving the efficiency of analyte-extractant contact and therefore leading to a high preconcentration factor. According to this design, the magnetic solid phase was held internally as a surface bed with the use of an 8 mm-diameter cylindric neodymium magnet, allowing the pass of a fixed volume of an arsenic aqueous standard solution. A preconcentration factor of up to 60 was found to reduce the typical "characteristic mass" (as sensitivity parameter) determined by direct measurement from 53.66 pg to 0.88 pg, showing an essential improvement in the arsenic signal sensitivity by absorption atomic spectrometry. This methodology emulates a miniaturized micro-solid-phase extraction system for flow-through water pretreatment samples in chemical analysis before coupling to techniques that employ reduced sample volumes, such as graphite furnace atomic absorption spectroscopy.

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This study presents the feasibility of using various functionalized substrates, Fe3O4 nanoparticles (NPs) and Al2O3 spheres, for the removal of Cd from aqueous solution. To improve the materials' affinity to Cd, we explored four different surface modifications, namely (3-Aminopropyl) triethoxysilane (APTES), L-Cysteine (Cys) and 3-(triethoxysilyl) propylsuccinic anhydride (CAS). Particles were characterized by FTIR, FIB-SEM and DLS and studied for their ability to remove metal ions. Modified NPs with APTES proved to be effective for Cd removal with efficiencies of up to 94%, and retention ratios up to 0.49 mg of Cd per g of NPs. Batch adsorption experiments investigated the influence of pH, contact time, and adsorbent dose on Cd adsorption. Additionally, the recyclability of the adsorbent and its potential phytotoxicity and animal toxicity effects were explored. The Langmuir, Freundlich, pseudo-first-order and pseudo-second-order models were applied to describe the behavior of the Cd adsorption processes. The adsorption and desorption results showed that Fe3O4 NPs modified with APTES are promising low-cost platforms with low phytotoxicity for highly efficient heavy metal removal in wastewater.

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Introduction/Objective: Anterior canalithiasis is an uncommon and challenging diagnosis. This is due in part to the difficulty of defining the affected side, the extreme positioning required to carry out described therapeutic maneuvers, and the infrequent use of specific maneuvers. Our objective is to present a new treatment alternative for anterior canalithiasis which is based on the well-known canalith repositioning procedure (CRP) described by Epley and which is used routinely in the treatment of both posterior and anterior canalithiasis. Analysis of the standard CRP for anterior canalithiasis with a biomechanical model validates that this new maneuver is an enhanced treatment option for anterior canalithiasis. We call the new maneuver the "short CRP." Methods: A previously published 3D biomechanical model of the human labyrinths for the study of BPPV was used to analyze the conventional CRP in the treatment of anterior canalithiasis. The expected position of free otoliths near the anterior ampulla of the anterior semicircular duct was followed while recreating the sequential positions of the CRP. Although the standard CRP was possibly effective, certain enhancements were evident that could increase successful repositioning. These enhancements were incorporated into the modification of the CRP presented here as the "short CRP" for anterior canalithiasis. Results: The traditional CRP used for posterior canalithiasis can also be used for anterior canalithiasis. Although in the traditional CRP the head hangs 30° below horizontal, our simulation shows that a 40° head-hang below horizontal is an enhancement and may ensure progression of anterior otolith debris. Elimination of Position 4 of the classic CRP, in which the face is turned 45° toward the floor, was also seen as an enhancement as this position is predicted to cause retrograde movement of otoliths back into the anterior canal if the patient tucks the chin in position 4 or when sitting up. Conclusion: A modification of the CRP called the "short CRP" can be used to treat anterior canalithiasis. Model analysis predicts possible increased efficacy over the standard CRP. Model analysis of existing BPPV treatments is a valuable exercise for examination and can lead to realistic enhancements in patient care.

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Mercury (Hg) is a toxic metal frequently used in illegal and artisanal extraction of gold and silver which makes it a cause of environmental poisoning. Since biosorption of other heavy metals has been reported for several Lysinibacillus sphaericus strains, this study investigates Hg removal. Three L. sphaericus strains previously reported as metal tolerant (CBAM5, Ot4b31, and III(3)7) were assessed with mercury chloride (HgCl2). Bacteria were characterized by scanning electron microscopy coupled with energy dispersive spectroscopy (EDS-SEM). Sorption was evaluated in live and dead bacterial biomass by free and immobilized cells assays. Hg quantification was achieved through spectrophotometry at 508 nm by reaction of Hg supernatants with dithizone prepared in Triton X-114 and by graphite furnace atomic absorption spectroscopy (GF-AAS). Bacteria grew up to 60 ppm of HgCl2. Non-immobilized dead cell mixture of strains III(3)7 and Ot4b31 showed a maximum sorption efficiency of 28.4 µg Hg/mg bacteria during the first 5 min of contact with HgCl2, removing over 95% of Hg. This process was escalated in a semi-batch bubbling fluidized bed reactor (BFB) using rice husk as the immobilization matrix leading to a similar level of efficiency. EDS-SEM analysis showed that all strains can adsorb Hg as particles of nanometric scale that can be related to the presence of S-layer metal binding proteins as shown in previous studies. These results suggest that L. sphaericus could be used as a novel biological method of mercury removal from polluted wastewater.

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Genetic data from 17 autosomal short tandem repeat (STR) loci found in the Powerplex® ESX 17 System (Promega, Madison, WI, USA) was evaluated in 162 unrelated Mexican Mestizo individuals from Mexico City. Allele frequencies and forensic parameters were estimated for the 17 STRs. All loci analyzed were in Hardy-Weinberg equilibrium in the studied population and showed not any signs of linkage between loci. The combined power of discrimination and the power of exclusion for the 16 aSTRs studied were 1-2.56409·10-19 and 99.999938 %, respectively. Genetic distances reveal a close relationship within different populations of Mexican Mestizos. The obtained data might be useful for population genetics research and for individual identification and paternity testing in forensic science.

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UNLABELLED: Knowledge of the anatomy and physiology of the semicircular canals and their central pathways is essential for the diagnosis of vestibular pathology. This 3 dimensional (3D) scheme of the Semicircular Canals (SSCC) is a teaching tool and a useful reference guide for rapid consultation. MATERIAL AND METHODS: A multicolored cardboard model is accompanied by a user manual which provides a thorough description of the tool for the most common vestibular diseases. RESULTS: Although results cannot be quantitatively assessed, the model has been well received at several Latin American scientific conferences. The model is often understood with verbal instruction only; nevertheless, a printed user manual is included. CONCLUSIONS: This 3 dimensional (3D) model of the Semicircular Canals (SSCC) is a practical, low cost tool for use in private and academic settings.

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Knowledge of the anatomy and physiology of the semicircular canals and their central pathways is essential for the diagnosis of vestibular pathology. This 3 dimensional (3D) scheme of the Semicircular Canals (SSCC) is a teaching tool and a useful reference guide for rapid consultation. MATERIAL AND METHODS: A multicolored cardboard model is accompanied by a user manual which provides a thorough description of the tool for the most common vestibular diseases. RESULTS: Although results cannot be quantitatively assessed, the model has been well received at several Latin American scientific conferences. The model is often understood with verbal instruction only; nevertheless, a printed user manual is included. CONCLUSIONS: This 3 dimensional (3D) model of the Semicircular Canals (SSCC) is a practical, low cost tool for use in private and academic settings.

A identificação de determinadas afecções vestibulares exige conhecimento prévio sobre anatomia e fisiologia dos canais semicirculares (CSC) e de suas conexões centrais, que apresentam complexidade anatômica tridimensional e funcional. OBJETIVO: Propor um modelo anatômico e funcional dos CSC, em 3 dimensões (3D), para servir como uma ferramenta didática e um guia útil de consulta rápida. MATERIAL E MÉTODOS: O modelo é projetado em cartão, com impressão em cores diferentes, acompanhados de um texto explicativo de 22 folhas, que detalha sua descrição topográfica, descritiva e sua utilização com base em exemplos das doenças vestibulares mais frequentes. RESULTADOS: Embora os resultados não possam ser avaliados numericamente, este modelo já foi compreendido por diversos especialistas e tem sido bastante utilizado por eles. Além disso, o produto deste trabalho já foi apresentado em diferentes eventos científicos latino-americanos com excelente aceitação. CONCLUSÃO: Trata-se de ferramenta útil e de baixo custo para o ensino, a prática clínica diária em otoneurologia.

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INTRODUCTION: The aim of this study is to determine whether the incidence of hypothyroidism in patients with Head and Neck Cancer who have undergone neck radiotherapy justifies the inclusion of thyroid function monitoring in the pre-operative and follow-up evaluation protocols. MATERIAL AND METHODS: A retrospective study was conducted with all the patients seen in the Oncology Section of the Otorhinolaryngology Department in the "Hospital de Clínicas", Montevideo, Uruguay, from January 1970 to May 2008. A total of 550 case records were analyzed. Of the 550 patients, 188 were excluded due to the fact they had not received radiotherapy as part of their treatment and 362 were included in the study. Of these, 55 patients had thyroid stimulating hormone (TSH) level determination after treatment with radiation therapy. Hypothyroidism was defined as a TSH value greater than or equal to 4.5 mIU/L, regardless of whether or not any symptoms were presented. RESULTS: 36.4% of the patients were diagnosed as having clinical or sub-clinical hypothyroidism. The type of treatment carried out, particularly whether or not surgical resection was performed, was found to be the most significant predictive factor for the development of hypothyroidism (P=0.054). CONCLUSION: Monitoring of the thyroid function on a six-month or annual basis, at least during the first 5 post-treatment years, has to be included in the follow-up and control protocols of every patient undergoing neck RT, and patients with TSH values over 4.5 mIU/L should be referred to the endocrinologist for hormone replacement, whether they present symptoms or not.

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A flow injection (FIA) method was designed for the determination of chlorophylls a and b in small in vitro Dieffenbachia maculata "Sublime" plants. In the first step, the pigments from spinach leaves were separated, purified by solvent extraction and freeze-dried, to obtain standards for the FIA optimization. The sample extraction procedure was optimized. Four solvents were tested: diethyl ether, methanol, acetone and ethanol. The ethanol 96% was the optimal solvent for FIA purposes. It allows to the efficient extraction of the pigments and water can be used as carrier. The best FIA conditions found for the quasi-simultaneous quantification of chlorophylls a and b were a flow rate of 10.84mLmin(-1), a sample injection volume of 1.45mL and a reactor length of 63cm. The detection was performed with the automatic wavelength scanning Cintra 10e spectrometer, at 649 and 665nm. The results obtained by the FIA method were compared to those obtained by the Arnon method. A deviation less than 5% was found between results for both methods. The concentration (mgg(-1)) of chlorophylls a and b during three periods of the plants (in vitro, acclimatization, and adult) was determined to evaluate the whole in vitro procedure. It was found an increment of both pigment concentrations since the in vitro step till the adult stage, while the chlorophylls a to b ratio decreases. The designed method is suitable especially for the determination of the pigments at low concentrations in small samples with appropriate analytical quality.

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Evalua el diagnóstico y tratamiento conservador del trauma renal cerrado a lo largo de 6 años en el Hospital de Emergencias Médicas (MSP y BS) y presenta datos para el manejo de este tipo de afecciones

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Se trató quirúrgicamente a 27 pacientes por fractura de escápula, en el Hospital de Traumatología y Ortopedia Lomas Verdes del IMSS, en el Servicio de Extremidad Torácica; en el periodo comprendido de Enero de 1989 a Diciembre de 1992. Se realizó el diagnóstico clínico y radiográfico; para posteriormente ser clasificadas las lesiones de acuerdo a la clasificación hecha en el servicio de acuerdo a los criterios actuales AO. Se encontró en un caso (4 por ciento) una lesión 91E.A2; dos casos (7 por ciento) una lesión 91E.A3, siete casos (26 por ciento) una lesión 91E.B2, ocho casos (30 por ciento) una lesión 91E.B3, dos casos (7 por ciento) una lesión 91E.C2, y siete casos (26 por ciento) una lesión 91E.C3. Se realizó tratamiento quirúrgico por vía anterior en tres casos, por fractura de la coracoides; el resto de pacientes fueron tratados mediante un acceso posterior. En la evolución final de tratamiento quirúrgico se obtuvieron 19 casos excelentes (70.37 por ciento), dos casos buenos (7.40 por ciento), cuatro casos regulares (14.8 por ciento) y dos casos con malos resultados (7.40 por ciento)

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