Abstract Introduction: The endoscopic retrograde colangiopancreatography (ERCP) is an important diagnostic and therapeutic tool for the pancreatobiliary diseases. A procedure that requires expertise due to its complexity and has a high complication rate. The American Association of Gastrointestinal Endoscopy (ASGE) established in 2015, quality indicators for the use of CPRE. Outcome: Determine the level of quality indicators in the use of ERCP in the endoscopy service of the Hospital Juarez de Mexico. Material and Methods: Observational, cross-sectional study by reviewing quality indicators of the ERCP performed in the Hospital Juarez de Mexico, between January 2016 and December 2019. Results: 688 ERCP were included, 521 were women (60%), average age was 58 years ± 12. The most common ERCP indication was bile duct disease in 405 procedures (47%) biliary stenosis 137 (16%), pancreatitis 84 (10%), bile leak 77 (9%), jaundice 62 (7%), acute cholangitis 55 (6%) biliary stent exchange 47 (5%). Quality indicators previous to the procedure were a correct indication of the study in 863 (99%), all of them with a previous consent (100%), correct administration of antibiotic 849 (96%). All of the procedures, were made or supervised by a trained endoscopist and were reported annually. During the procedure a Deep cannulation was obtained in 851(98%) and without alteration of anatomy in 824 (95%), bile duct resolution 445 (91%) and adequate biliary stent in 200 (93%), but frequency and dosage of radiation was not documented. Post procedure quality indicators included a complete report in all patients. (100%) Adverse events reported in 33 procedures (100%), post ERCO pancreatitis in 32 (4%), post sphincterotomy/sphincteroplasty hemorrhage in 9 (1%) and intestinal perforation in 2 procedures (0.3%). There was no record of the patient follow up at 14 days. Conclusions: Quality indicators in ERCP in our hospital are within the percentages required by ASGE, we offer quality procedures of ERCP to our population, according to international standards.

Resumen Introducción: La colangiopancreatografía endoscópica retrograda (CPRE) en la actualidad es una herramienta endoscópica importante para el diagnostico y tratamiento de diferentes enfermedades biliopancreáticas. Debido a la complejidad del procedimiento y a la alta tasa de complicaciones, se han desarrollado indicadores para estandarizar un estudio de calidad. La asociación americana de endoscopia gastrointestinal (ASGE) publico los indicadores de calidad para la CPRE en 2015. Objetivo: Determinar el el apego a los indicadores de calidad de la CPRE en el servicio de endoscopia del Hospital Juárez de México. Material y métodos: Estudio transversal, observacional en donde se analizaron indicadores de calidad en las CPRE realizadas en el Hospital Juárez de México entre Enero 2016 y Diciembre 2018. Resultados: Se incluyeron 688 CPRE, de los cuales 521 son femeninos (60%), la mediana de edad de 58 años ± 12. La indicación mas común fue coledocolitiasis en 405 pacientes (47%), seguido de estenosis biliar 137 (16%), pancreatitis biliar 84 (10%), fistula biliar 77 (9%), síndrome ictérico 62 (7%), colangitis aguda 55 (6%) recambio de prótesis biliar 47 (5%), respectivamente. Los indicadores previo al procedimiento, indicación correcta de la CPRE 863 (99%), todos con firma de consentimiento informado (100%), indicación y administración correcta del antibiótico 849 (96%).Todos los procedimientos fueron realizados o supervisados por un endoscopista avalado por la Asociación Mexicana de Endoscopía Gastrointestinal (AMEG) y reportados en la bitácora anual (100%). Los indicadores durante el procedimiento fueron: canulación de papila profunda 851(98%), sin anatomía alterada 824 (95%), resolución de la coledocolitiasis (91%), colocación de stent biliar por debajo de hilio hepático (93%) y no se realizo medida de dosis ni frecuencia de radiación en ningún procedimiento. Indicadores posterior a CPRE, se obtuvo un reporte completo en los 866 procedimientos (100%), 33 eventos adversos reportados (100%), pancreatitis post CPRE 32 (4%), hemorragia 9 (1%), perforación intestinal 2 CPRE (0.3%). No se contacto de manera particular a los pacientes a los 14 días. Conclusión: Los indicadores de calidad en la realización de colangiopancreatografías endoscópicas evaluados en este estudio se encuentran dentro de los porcentajes establecidos por la ASGE; por lo que es un estudio de adecuada calidad el que se ofrece a nuestra población.

RESUMO O objetivo deste estudo foi investigar o efeito da odontoplastia sobre a digestibilidade aparente de dieta para equinos, o tempo de consumo e o tamanho de partícula das fezes. Foram utilizados nove equinos, com idade de 14,5±3,3 anos e peso de 531±38,7kg. A dieta consistiu do oferecimento de 1,5% do peso vivo (PV) em feno de Tifton 85 e 0,75% do PV em concentrado para ambos os ensaios. O experimento compôs-se de dois ensaios de digestibilidade aparente pelo método de coleta total, antes e após a odontoplastia, em que também foi avaliado o tempo de consumo do feno e do concentrado e analisado o tamanho de partícula das fezes. Foi observado efeito (P<0,05) da odontoplastia sobre os coeficientes de digestibilidade aparente da matéria seca, matéria orgânica, proteína bruta, fibra em detergente neutro e fibra em detergente ácido. Verificou-se efeito do tempo de consumo para o concentrado (P<0,05), porém não se observou para o volumoso (P<0,05). Houve maior retenção (P<0,05) das partículas das fezes nas peneiras de maior granulometria. A odontoplastia aumenta a digestibilidade dos nutrientes da dieta e o tamanho de partículas nas fezes, sem alterar a qualidade destas. Animais após o procedimento apresentam menor tempo de consumo de concentrado.

ABSTRACT The aim of this study was to investigate the effect of odontoplasty on apparent digestibility of diet for horses, consumption time, and particle size of feces. Nine horses were used, aged 14.5±3.3 years and weightng 531±38.7kg. The diet consisted of 1.5% of live weight (LW) in Tifton 85 hay and 0.75% of LW in concentrate for both assays. The experiment consisted of two tests of apparent digestibility using the method of total collection, before and after the odontoplasty, where the consumption time of hay and concentrate was also evaluated and the particle size of the feces was analyzed. An effect (P<0.05) of odontoplasty on the apparent digestibility coefficients of dry matter, organic matter, crude protein, neutral detergent fiber and acid detergent fiber was observed. Effect of the consumption time for the concentrate (P<0.05) was observed, but not for the forage (P<0.05). There was more retention (P<0.05) of the fecal particles in the sieves of bigger granulometry. The odontoplasty increases the digestibility of dietary nutrients and feces particle size, without changing feces quality. Animals after the procedure have shorter concentrate consumption time.

O objetivo deste estudo foi avaliar a eficácia do diquat, hidróxido de cobre, oxicloreto de cobre e suas associações (diquat + 0,1% de oxicloreto de cobre e diquat + 0,1% de hidróxido de cobre) para o controle de Cerathophyllum demersum em condições de laboratório. Para isso, foram utilizadas as concentrações de 0,1, 0,3, 0,5, 0,7, 1,0 e 1,5 mg L-1 do oxicloreto e hidróxido de cobre e de 0,2, 0,4, 0,8 e 1,2 mg L-1 do diquat e suas associações com 0,1% de oxicloreto de cobre e 0,1% de hidróxido de cobre e um controle. O delineamento experimental utilizado foi o inteiramente casualizado com dez repetições, ao longo de 45 dias de avaliação. Na avaliação foi empregada uma escala de notas de controle (0-100%) e avaliado o peso (g) e o comprimento (cm) dos ponteiros ao final do período experimental. O diquat apresentou 100% de eficácia aos 30 DAA, e as associações em 21 DAA; as fontes de cobre promoveram a rebrota de C. demersum. O diquat e suas associações foram mais eficazes no controle de C. demersum. A utilização de herbicida em associação com uma fonte de cobre é mais eficiente para controle de macrófitas submersas, pois potencializa o efeito do herbicida no controle das plantas.

The aims of this study were to evaluate the effectiveness of diquat, copper hydroxide, copper oxychloride and their associations diquat + 0.1% copper oxychloride and diquat + 0.1% copper hydroxide to control Cerathophyllum demersum. Therefore, the concentrations used were 0.1, 0.3, 0.5, 0.7, 1.0 and 1.5 mg L-1 oxychloride and copper hydroxide and 0.2, 0.4, 0.8 and 1.2 mg L-1 diquat and their associations with 0.1% copper oxychloride and 0.1% copper and a control hydroxide. The experimental design was completely randomized with ten replications for 45 days. For evaluation we used a scale of 0-100% control of notes and rated the weight (g) and length (cm) of pointers at the end of the trial period. Diquat showed 100% efficacy at 30 DAA, associations in 21 DAA and copper sources promoted regrowth of C. demersum. Diquat and its associations were more effective in controlling C. demersum. The use of herbicide in combination with a copper source is more efficient for the control of submerged weeds because it potentiates the effect of the herbicide in weed control

Polypyrrole (PPy) and polypyrrole/polyethylene glycol (PPy/PEG) implants synthesized by chemical, electro-chemical, and plasma polymerization methods were implanted into the injured spinal cord of rats to determine their effect on motor function recovery. Before implantation, the materials were characterized by infrared (IR) spectroscopy. An experimental model of traumatic spinal cord injury (TSCI) by complete transection at thoracic level 9, in rats was used. The polymer implants were inserted immediately after transection. Motor function recovery was evaluated once a week during 5 weeks using the Basso, Beattie and Bresnahan (BBB) motor scale. Histological evaluation was done at the end of the recovery evaluation period using hematoxylin/eosin stain. Results showed that animals implanted with polymers synthesized by plasma had a better integration into the nerve tissue, less inflammatory response and a better functional recovery than animals implanted with polymers synthesized by chemical or electrochemical methods.

En el presente trabajo se comparó el efecto de implantes poliméricos derivados del pirrol (polipirrol o PPy) y del copolímero polipirrol/polietilenglicol (PPy/PEG), obtenidos por diferentes métodos de síntesis: químico, electroquímico y polimerización por plasma con el propósito de determinar si el método de síntesis puede influir sobre el efecto que producen al ser implantados después de una lesión traumática de la médula espinal de ratas. Antes de realizar el implante, las características químicas y estructurales de los polímeros fueron analizadas por espectroscopia de infrarrojo (IR). Se utilizó un modelo experimental de lesión traumática de médula espinal (LTME) por sección completa en ratas. La LTME se realizó a nivel torácico 9 y el polímero fue implantado de inmediato en la zona de lesión. La recuperación de la función motora se evaluó mediante la escala Basso, Beattie y Bresnahan (BBB) una vez por semana durante 5 semanas. La evaluación histológica se realizó al término del seguimiento con la tinción de hematoxilina/eosina. Los resultados muestran que los animales implantados con polímeros sintetizados por plasma se integraron mejor al tejido nervioso, redujeron la respuesta inflamatoria y favorecieron una mayor recuperación funcional en comparación con los animales implantados con materiales sintetizados por métodos químicos o electroquímicos.

Introdução:A dissecção endoscópica da submucosa (ESD) já é procedimento consagrado no tratamento do câncer gástrico e esofagiano em suas fases precoces. As lesões colorre-tais, inicialmente abordadas por mucossectomia, em bloco ou em fragmentos, são o foco atual para a abordagem submucosa, principalmente para os tumores de crescimento lateral superficial a partir de 20 mm de diâmetro. A experiência de centros japoneses, referências em endoscopia terapêutica, demonstram redução no índice de recidiva da doença com esta abordagem e, segundo critérios histopatológicos específicos, podem evitar uma colectomia em alguns casos de neoplasia maligna.1-3Relato de caso:Trata-se de paciente de 50 anos, submetida à dissecção endoscópica da submucosa de lesão de crescimento lateral, com 50 mm, localizada no reto, a 8 cm da margem anal. O procedimento foi realizado sem maiores intercorrências, com apenas dois pontos de afastamento da muscular, sem perfuração grosseira, fechados com clipe. Entretanto, a paciente evoluiu com escape aéreo para peritônio, retroperitônio, mediastino e subcútis, sendo tratada sem intervenção adicional, apenas com manejo clínico.Conclusão:É de fundamental importância conhecer e saber aplicar a técnica da ESD, além de abordar suas complicações, uma vez que, mesmo repleta de benefícios em relação à cirurgia, ela pode apresentar desfechos graves.4,5

Introduction:Endoscopic submucosal dissection (ESD) is an already established procedure in the treatment of gastric and esophageal cancer in its early stages. Colorectal lesions, initially approached by endoscopic mucosal resection en bloc or in fragments, are the current focus for submucosal approach, especially for superficial lateral spreading tumor of 20 mm-diameter. The experience of Japanese centers, which are reference in therapeutic endoscopy, demonstrates reduction in the rate of disease recurrence with this approach and, according to specific histopathological criteria, may avoid colectomy in some cases of malignant neoplasia.1-3Case report:The patient was 50-year-old female. She underwent endoscopic submucosal dissection of a rectal lateral spreading tumor measuring 50 mm, located 8 cm from the anal margin. The procedure was performed without major complications, with just two points for muscle layer detachment, without gross perforation and closed with metal clips. However, the patient developed air leakage to the peritoneum, retroperitoneum, mediastinum and subcutaneous tissue, being only treated with clinical procedures and without additional intervention.Conclusion:It is vital to know and be able to apply the technique of ESD, in addition to addressing its complications, since despite the numerous benefits compared to surgery, ESD can result in serious outcomes.4,5

The water sorption isotherms of nixmalized maize flour were determinated at three different temperatures (24, 30, 35°C) and water activity range of 0.074 to 0.970 by using the method of equilibrium cell (PEC). The sorption isotherms exhibited type II behavior. The BET, GAB and Henderson models were tested to fit the experimental data by using nonlinear regression analysis. The GAB and Henderson models satisfactorily described the sorption isotherms (mean relative error < 4.4%) The isosteric heat (Qs) and the entropy (ΔS), estimated as functions of the moisture content, decreased as the nixtamalized maize flour increased.

Se construyeron isotermas de sorción a tres temperaturas (24, 30 y 35°C), en un intervalo de actividad acuosa de 0.074 a 0.970 por el método de celda en equilibrio (PEC). Se obtuvieron isotermas tipo II. La predicción de las curvas con los modelos de B.E.T., G.A.B. y Henderson, se realizaron utilizando análisis de regresión no lineal. Los modelos de G.A.B. y Henderson fueron los de mayor ajuste (error relativo medio <4.4%). Los valores de calor isostérico (Qs) y la entropía (ΔS) evaluados como una función del contenido de humedad, disminuyeron cuando el contenido de humedad de la harina de maíz nixtamalizado aumentó.

Um dos principais fatores de risco para a morte súbita e inesperada na epilepsia (SUDEP) é a alta freqüência de crises epilépticas. Seguindo este raciocínio, tem sido estabelecido que as crises epilépticas associadas à hemodiálise seja uma complicação do procedimento dialítico. Baseado neste fato, este estudo investigou uma possível associação entre anormalidades cardiovasculares e SUDEP nos pacientes com insuficiência renal crônica em um programa regular de hemodiálise. Para isto, um histórico médico retrospectivo de 209 pacientes foi revisado para avaliar a ocorrência de crises epilépticas e possíveis anormalidades no ECG durante o programa de diálise. Três pacientes apresentaram crises tônico-clonica generalizadas, um apresentou crise parcial com generalização secundária e um apresentou crise não-classificada. Não detectamos anormalidades no ECG e ocorrência de SUDEP em todos os pacientes avaliados. Em conclusão, na presente amostra constatou-se como rara a ocorrência de crises epilépticas e SUDEP. Provavelmente, o número reduzido de casos avaliados tenha sido responsável pela não observação de uma relação direta entre SUDEP e as doenças cardiovasculares na hemodiálise.

Of the many risk factors suggested for sudden unexpected death in epilepsy (SUDEP), higher frequency of seizures is a very consistent issue. Following this reasoning, it has been established that hemodialysis-associated seizure is a complication of dialysis procedure. Based on these facts, this study investigated a possible association between cardiovascular abnormalities and SUDEP among patients with chronic renal insufficiency in regular hemodialysis program. For that, a retrospective medical history of 209 patients was reviewed to investigate the occurrence of convulsive seizures and EKG abnormalities during dialytic program. Three patients presented generalized tonic-clonic seizures, one had partial seizure with secondary generalization, and one presented unclassified seizure. Any EKG abnormalities and SUDEP event were found in all patients evaluated. In conclusion, the present findings demonstrated uncommon the occurrence of seizures and also SUDEP. Probably, the main justification to not allow us to demonstrated a direct relation between SUDEP and cardiovascular diseases in hemodialysis are the reduced number of cases examined.

This work presents a superficial modification of low molecular weight polyethylene (PE) with the addition of alkaline phosphatase (FA). This enzyme promotes the biomineralization, hydrolysis of orthophosphates and increase the absorption of calcium. The superficial modification of PE starts with the addition of a thin layer of polypyrrole (PPy) synthesized by plasma to add amine groups on the surface. After that, sequential layers of two polyelectrolytes with different ionic charge were added to the PE-PPy surface by immersion in solutions of poly(allylamine hydrochloride) (+) (PAH) and polystyrene sulfonate (-) (PSS). The polyelectrolytes were self-assembled because of their opposite ionic charge. After this step, another layer of FA was added. Several sequences of polyelectrolytes were tested on the PE-PPy surface.. The characterization of the surfaces was done by attenuated reflectance infrared spectroscopy (ATR-IR) and scanning electron microscopy (SEM).

Se presenta un estudio sobre la modificación de polietileno de bajo peso molecular (PE) mediante la adición de fosfatasa alcalina (FA), enzima que facilita el proceso de biomineralización, promueve la hidrólisis de los ortofosfatos y aumenta la absorción de calcio. El trabajo se desarrolla en dos etapas. En la primera se sintetiza por plasma una capa delgada de polipirrol (PPy) buscando que se adhiera la mayor cantidad de grupos amina sobre la superficie. En la segunda etapa se agregan capas delgadas, por inmersión en solución de los polielectrolitos, de polialilamina hidroclorada (+) (PAH) y poliestireno sulfonado (-) (PSS), que se autoensamblan debido a su naturaleza iónica; y al final se adiciona la FA. Se probaron varias secuencias de adición de polielectrolitos sobre el sustrato funcionalizado PE-PPy. Los materiales compuestos se caracterizaron por espectroscopia infrarroja con reflectancia total atenuada, ATR-IR y SEM. Los resultados muestran las diferentes etapas del autoensamble.