Preseptostomy Myocardial Infarction in a Patient with Complex Transposition of the Great Arteries

In transposition of the great arteries, systemic venous return is preferentially routed to the aorta, and any spontaneous or iatrogenic emboli may therefore cause organ infarction. We present a patient with transposition of the great arteries who developed myocardial infarction prior to balloon septostomy and, also, was later documented to have sustained brain infarction despite adequate precautionary measures. Minimal handling of venous sites in these patients is crucial.     

Effects of mechanical forces on the formation of cutaneous wounds during skin expansion and emerging therapies for wound healing and scar prevention

Objectives:To update a possible role of cosmeceutical topic treatment to obtain a better scar.Methods:This is a preliminary supportive study. A total of 14 patients who went to the General Hospital of Mexico City, Mexico, between May and December 2020, for breast reconstruction were included in the current study. The biopsies were carried out to the scar area of the previous I° and II° surgery. The patients were thus divided into 2 groups: those who used Cicolea cream® as a treatment supplement and those who used only petrolatum.Results:Collagen fibers arranged in a regular pattern in the group treated with Cicolea compared to dispersed collagen fibers in the group treated with pure petrolatum. Furthermore, the patients who presented hypertrophic or keloid scars secondary to mastectomy, developed after insertion of breast expanders an organized scarring process, with improvement of scar if treated with Cicolea.Conclusion:Based on our observations, it is possible to propose that the action of the polyphenols present in the different components of Cicolea® cream leads to a better evolution of the wound healing compared to the action of petrolatum composition.     

Improvement of digestive symptoms in fibromyalgia patients following a diet modification according to histamine release test – an observational study

IntroductionThere is growing interest in the relationship between fibromyalgia and processes related to food, such as food intolerances. In fact, different associations have been described between the control of dietary habits and the improvement of the different symptoms of fibromyalgia.Material and methodsWe collected the results of applying a specific test of histamine release related to the diet of patients with fibromyalgia, and evaluated the changes in terms of the symptoms usually described by the patients. A total of 84 patients who met the established criteria were recruited; 40 of them underwent the exclusion diet for a period of 6 months, while the remaining ones continued with their usual dietary habits. All patients were instructed not to modify any other parameter during the study, such as medication, exercise, or other complementary treatments. The parameters studied were as follows: the Fibromyalgia Impact Questionnaire (FIQ), the Gastrointestinal Symptoms Rating Scale (GSRS), the pain Visual Analogue Scale (VAS), as well as the patients’ body weight was controlled.ResultsThere was a significant improvement (p < 0.05) in the group of patients who underwent the exclusion diet in assesment by GSRS and in total in total body weight. There were no differences compared to the rest of the patients in terms of VAS and FIQ.ConclusionsDiet modification in patients with fibromyalgia by specific histamine relase test improves certain clinical parameters related to the symptoms of the digestive sphere, compared to the control group. Our work opens a possible way of non-pharmacological treatment to improve some symptoms of this very prevalent disease.     

Association of Pre-S/S and Polymerase Mutations with Acute and Chronic Hepatitis B Virus Infections in Patients from Rio de Janeiro,Brazil

Several hepatitis B virus (HBV)-related factors, including the viral load, genotype, and genomic mutations, have been linked to the development of liver diseases. Therefore, in this study we aimed to investigate the influence of HBV genetic variability during acute and chronic infection phases. A real-time nested PCR was used to detect HBV DNA in all samples (acute, n = 22; chronic, n = 49). All samples were sequenced for phylogenetic and mutation analyses. Genotype A, sub-genotype A1, was the most common genotype in the study population. A total of 190 mutations were found in the pre-S/S gene area and the acute profile revealed a greater number of nucleotide mutations (p < 0.05). However, both profiles contained nucleotide mutations linked to immune escape and an increased risk of hepatocellular carcinomas (acute, A7T; chronic, A7Q). Furthermore, 17 amino acid substitutions were identified in the viral polymerase region, including the drug resistance mutations lamivudine and entecavir (rtL180M), with statistically significant differences between the mutant and wild type strains. Owing to the natural occurrence of these mutations, it is important to screen for resistance mutations before beginning therapy.     

WATER METABOLISM IN HYPERTENSIVE RATS

The water intake in hypertensive rats was investigated. Rats made hypertensive by renal ischemia increased their water consumption by 75 per cent over the preoperative level. Polyuria was associated with this polydipsia and the independence of these occurrences from a number of other factors was demonstrated. It was found that the presence of a normal kidney exerted a compensatory influence which may mask either hypertension or polyuria or both. The appearance or exacerbation of the changes upon removal of the normal kidney, on the one hand, and the elimination or mitigation of the symptoms upon removal of the ischemic kidney on the other support the view that the changes observed cannot have been due to passive elimination of the kidney tissue by ischemia, but to active malfunction of the renal, and especially the tubular, mechanism upon withdrawal of oxygen. The view is put forward that polyuria is a primary sequel of ischemia rather than secondary to the intra- and extrarenal effects of hypertension. A number of concomitant observations are in harmony with this hypothesis.     

STUDIES ON SPREADING FACTORS : I. THE IMPORTANCE OF MECHANICAL FACTORS IN HYALURONIDASE ACTION IN SKIN

The spreading response induced by intradermal administration of hyaluronidase is influenced not only by enzyme concentration, but also by the volume and pressure of the injection. These pressure-volume factors influence the rate of spreading and determine the final area of spreading. When a constant volume is injected, the rate of spreading to the area determined by the volume of injection is a function of the enzyme concentration. These and other findings have led to the conclusion that hyaluronidase is an effective spreading agent only when the slow diffusion of enzyme in skin is accelerated by a localized increase of interstitial pressure and volume. These considerations of hyaluronidase action in skin have been utilized to explain the shape of the dosage-response curve of hyaluronidase spreading activity, and the differences in the spreading reactions between crude snake venoms and purified hyaluronidase. The significance of the findings as related to the rôle of hyaluronidase in bacterial invasiveness, and in the assay of S. F. are briefly discussed.     

Observations on the management of suppurative arthritis of the knee joint

High ligation of the great saphenous vein at the fossa ovalis, multiple sectional phlebectomies, supplemented by multiple percutaneous ligations, using a special ligation knife, is described and recommended as a surgical procedure for the eradication of varicose veins.The retrograde injection of sclerosing agents following high ligation is abandoned as being too hazardous and defeating the aim of keeping the patient ambulatory. Sclerotherapy has to be done as a post-operative measure.Multiple ligations increase the effect of postoperative sclerotherapy as they reduce the retrograde venous pressure more efficiently than high ligation alone.The use of a specially designed ligation knife renders the procedure simple, saves time and aids keeping the patient ambulatory.The veinsector between two hypodermic ligations is divided by subcutaneous dissections from a lateral stabincision, using a narrow blade or a cataract knife.