Ocular microcirculation. Scanning electron microscopic study.

A simple vascular casting technique utilizing a low-viscosity plastic was used to study the three-dimensional ocular microcirculation of the cat eye. Vascular arrangements in different anatomic areas of the eye, i.e., iris, ciliary body, retina, optic nerve, and choroid, were clearly elucidated by scanning electron microscopy. This modified technique is described in detail, and scanning electron micrographs are presented to illustrate the reliable results

Factores maternos y socioeconómicos asociados a la anemia en niños de 6 a 24 meses de edad, Hospital el Esfuerzo, Trujillo, 2022

La presente investigación tuvo como finalidad determinar los factores maternos y socioeconómicos asociados a la anemia en niños de 6 a 24 meses de edad en el Hospital El Esfuerzo, Trujillo, 2022. La muestra estuvo compuesta por 162 mujeres de 14 a 40 años de edad, en las cuales se les aplicó un cuestionario de 15 preguntas sobre los factores maternos, socioeconómicos y la anemia. Asimismo, el programa estadístico que se utilizó fue el SPSS versión 26.0 y la prueba estadística Chi cuadrado y el coeficiente de correlación Tau-b de Kendall para relacionar las variables y determinar su grado de asociación, con un intervalo de confianza del 95% y un nivel de significancia del 5%. Se determinó que el 22% de niños presentó anemia leve, en relación a las características de la madre, la edad del embarazo < 19 años 51.7%, Hb de la madre <11 g/dL 50%, tiempo suplementación de Fe < 4 meses 48.6%, ingreso económico bajo 33% y grado quintil inferior 33%, están relacionados significativamente con la anemia leve en niños. Se concluye, que se presentó una asociación negativa baja entre el IMC de la madre, enfermedades en la gestación, el espacio intergenésico, la suplementación de Fe de la madre, alimentación complementaria, lactancia materna exclusiva, tiempo de lactancia, nivel educativo de la madre y del padre con la hemoglobina en niños

Choroidal microvascular repair after argon laser photocoagulation. Ultrastructural observations

Acute laser injury to the tapetum of the feline retina produces thrombosis of the choriocapillaris. Early changes are characterized by the appearance of platelet-fibrin thrombi within capillary loops and disruption of endothelial integrity. By 4 days, thrombi have disappeared, and the endothelium shows regenerative changes. No endothelial cell mitotic activity is seen. The endothelial cytoplasm becomes plump, and there is a loss of the fenestrations adjacent to Bruch's membrane. By 10-20 days, the capillary structure shows gradual restoration. At 30 days, endothelial cell fenestrae are clearly evident adjacent to Bruch's membrane. The reparative process in this model appears to evolve as a result of thrombolysis and endothelial cell activation

Teatro historico de las iglesias del reyno de Aragon : tomo primero preliminar en que se defienden diez Obispos de la Santa Iglesia Cesaraugustana, excluidos de su catalogo por ... Manuel Risco de la Orden de San Agustin ... continuador de la España Sagrada /

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Teatro historico de las iglesias del reyno de Aragon : tomo II contiene las noticias de el reyno y las de la ciudad de Zaragoza... se añade el examen del papel del R.P.M. Fr. Manuel Risco del Orden de San Agustin nititulado juicio y convencimiento de la obra que el R.P. Fr. Lamberto de Zaragoza del orden de Capuchinos publicó el año pasado de 1780 contra el tomo XXX de la España Sagrada /

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Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine