Seguimiento de áreas cruentas cubiertas con queratinocitos autólogos cultivados en suero autólogo: Estudio multicéntrico en Bogotá

En 2009 se presento la estandarización de cultivos de queratinocitos autólogos cultivados en suero autólogo. En este estudio los autores describen la efectividad de estos parches de regeneración de piel, para la cobertura de áreas cruentas con indicación de injerto de piel parcial. El porcentaje de epitelización del área cruenta fue el punto principal. Métodos: 47 pacientes fueron incluidos consecutivamente, equivalentes a 78 áreas cruentas. Las áreas fueron estratificadas según la profundidad: grupo 1:IIA (n=8) grupo 2: IIB (n=39); grupo 3,III (n=24) y grupo 4, etiología diferente: Otras (n=7). Todas las áreas fueron tratadas con injertos de queratinocitos autólogos cultivados en suero autólogo y se realizo registro fotográfico y del porcentaje de epitelización al día 5, 7, 15 y 30. Resultados: La efectividad de los injertos de queratinocitos autólogos es de 53.16% ± 46.46%. El porcentaje de epitelización es mayor para el grupo 1 (100%) y grupo 2 (62.79%) que para el grupo 3 (27.57%) y el grupo 4 (33.86%). Se encontró relación entre la interacción de las medianas del porcentaje de epitelización entre área corporal y grado de quemadura (p<0.001 KW) siendo mayor para el grupo 1 en todas las áreas, grupo 2 en cara, grupo 3 en tronco y grupo 4 en cara; y el menor porcentaje de epitelización en el grupo 3 y grupo 4 de las áreas ubicadas tronco. Conclusión: Los injertos de queratinocitos autólogos cultivados en suero autólogo son un método de cobertura eficaz para áreas cruentas producidas por quemaduras IIA y IIB independientemente del tamaño y la localización , y para las áreas cruentas pequeñas (<9cm2) de etiología diferente o grado III de profundidad. Palabras Clave: Cultivo queratinocitos, cobertura áreas cruentas, efectividad.

Comparación de la anestesia espinal con anestesia general endovenosa para legrado uterino obstétrico

Introducción: La elección de la técnica anestésica para cualquier procedimiento quirúrgico debe estar basada en su seguridad, la rapidez para su aplicación, la recuperación óptima para el paciente y minimización de los efectos secundarios, la anestesia raquídea es una técnica anestésica que puede ser utilizada con buenos resultados clínicos y minimas complicaciones . Materiales y métodos: Se realizó un estudio observacional con recolección prospectiva en mujeres clasificadas como ASA I - II y que posteriormente fueron llevadas a la realización de legrado uterino obstétrico por embarazo no viable durante las primeras 12 semanas de gestación, las técnicas anestésicas fueron anestesia espinal o anestesia general endovenosa dependiendo de la elección hecha por el anestesiólogo previo al procedimiento. Se midieron variables hemodinámicas, control del dolor postoperatorio, tiempo de recuperación y complicaciones perioperatorias con el fin de determinar si se presentaban diferencias significativas entre estas dos técnicas anestésicas. Resultados: Se incluyeron un total de 110 pacientes, 63.6% (n=70) con anestesia general y 36.4% (n40) con anestesia espinal. Ambas poblaciones fueron comparables. Se presentaron menos efectos secundarios con la técnica espinal, hay una diferencia estadísticamente significativa en cuanto al dolor a favor de la anestesia espinal (p0,000) Discusión: La anestesia raquídea es una opción viable, sencilla , fácil y eficaz para la realización de legrados obstétricos, se puede realizar con monitorización básica y las complicaciones son mínimas. Se requieren estudios más amplios para determinar el papel de cual es la mejor técnica. Palabras claves: legrado uterino instrumentado, anestesia espinal, anestesia general endovenosa

Neogene and Quaternary paleoenvironmental history at DSDP Leg 71 Holes

The Neogene and Quaternary sedimentary record of Leg 71 and previously drilled sequences from the Southern Ocean reveal evidence of a major late Miocene change of oceanic and glacial conditions in the southern high latitudes during paleomagnetic Chron 9. The characteristics of late Miocene sedimentation and in particular the study of erosional patterns and ice-rafted debris suggest the following conclusions. 1) In the late Miocene, the Polar Front first migrated to the northern latitudes of the Southern Ocean and surface water temperatures became similar to those of today. 2) Extensive ice shelves or ice tongues were not present along the Antarctic margin until late Chron 9 (about 9.0 Ma). 3) Before Chron 9, West Antarctica was occupied by an archipelago and the West Antarctic Sea. 4) Extensive ice shelves formed in the West Antarctic region, eventually coalescing and thickening to form the grounded West Antarctic ice sheet by Chron 9. 5) The newly formed West Antarctic ice sheet was probably unstable and frequently became an ungrounded ice shelf, thus accounting for the scarcity of late Miocene ice-rafted debris. 6) Extensive erosion or nondeposition of sediment was probably the result of increased Antarctic Bottom Water (AABW) formation in the West Antarctic region during the initial formation of extensive West Antarctic ice shelves and during periods when the West Antarctic ice sheet was ungrounded. 7) In the Southwest Atlantic, AABW velocity waned during the latest Miocene. During the late Gilbert Chron a major and permanent change occurred in the pattern of ice-rafting to the South Atlantic, and after 4.35 Ma the increased IRD accumulation rate and frequency of major episodes of IRD accumulation suggest increased stability of the West Antarctic ice sheet. In addition, radiolarian faunas of Hole 514 record at least eight migrations of the Polar Front to the north of the site during the past 4.07 m.y. An apparent increase in the frequency of Polar Front migrations occurred about 2.7-2.6 Ma, possibly in response to oceanic change induced by fluctuations in glacial conditions of the Northern Hemisphere.

Occurrence of hiatuses PH and NH 1 through NH 7 in DSDP holes

Miocene paleoceanographic evolution exhibits major changes resulting from the opening and closing of passages, the subsequent changes in oceanic circulation, and development of major Antarctic glaciation. The consequences and timing of these events can be observed in variations in the distribution of deep-sea hiatuses, sedimentation patterns, and biogeographic distribution of planktic organisms. The opening of the Drake Passage in the latest Oligocene to early Miocene (25-20 Ma) resulted in the establishment of the deep circumpolar current, which led to thermal isolation of Antarctica and increased global cooling. This development was associated with a major turnover in planktic organisms, resulting in the evolution of Neogene assemblages and the eventual extinction of Paleogene assemblages. The erosive patterns of two widespread hiatuses (PH, 23.0-22.5 Ma; and NH 1, 20-18 Ma) indicate that a deep circumequatorial circulation existed at this time, characterized by a broad band of carbonate-ooze deposition. Siliceous sedimentation was restricted to the North Atlantic and a narrow band around Antarctica. A major reorganization in deep-sea sedimentation and hiatus distribution patterns occurred near the early/middle Miocene boundary, apparently resulting from changes in oceanic circulation. Beginning at this time, deep-sea erosion occurred throughout the Caribbean (hiatus NH 2, 16-15 Ma), suggesting disruption of the deep circumequatorial circulation and northward deflection of deep currents, and/or intensification of the Gulf Stream. Sediment distribution patterns changed dramatically with the sudden appearance of siliceous-ooze deposition in the marginal and east equatorial North Pacific by 16.0 to 15.5 Ma, coincident with the decline of siliceous sedimentation in the North Atlantic. This silica switch may have been caused by the introduction of Norwegian Overflow Water into the North Atlantic acting as a barrier to outcropping of silica-rich Antarctic Bottom Water. The main aspects of the present oceanic circulation system and sediment distribution pattern were established by 13.5 to 12.5 Ma (hiatus NH 3), coincident with the establishment of a major East Antarctic ice cap. Antarctic glaciation resulted in a broadening belt of siliceous-ooze deposition around Antarctica, increased siliceous sedimentation in the marginal and east equatorial North Pacific and Indian Oceans, and further northward restriction of siliceous sediments in the North Atlantic. Periodic cool climatic events were accompanied by lower eustatic sea levels and widespread deep-sea erosion at 12 to 11 Ma (NH 4), 10 to 9 Ma (NH 5), 7.5 to 6.2 Ma (NH 6), and 5.2 to 4.7 Ma (NH 7).

Oligocene strontium isotope stratigraphy of Indian Ocean sediments

Strontium isotope (87Sr/86Sr) ages have been established for Oligocene samples of Leg 119 Site 744, Leg 120 Sites 747 and 748, and Leg 121 Sites 756 and 757. Ages were determined using the strontium isotope age equation of Miller et al. (1988) and preliminary correlations have been made with available nannofossil biostratigraphy. The strontium isotope ages calculated here augment biostratigraphy, which for the Oligocene is characterized by long biozones, and provide additional detail where the paleomagnetic record is not clear (Sites 756 and 757). Results from the lower latitude Ninetyeast Ridge sites where standard calcareous nannofossil datums are present are compared to those of the higher latitude Kerguelen Plateau sites in order to examine biostratigraphic events across latitude in the Indian Ocean. The 87Sr/86Sr determined ages are used here as a tool for correlation.