[Safety of rush immunotherapy with Hymenoptera venom].

Objectives: To determine the incidence and nature of adverse events associated with the induction of rush Hymenoptera venom immunotherapy.

Material And Methods: Between 1998 and 2003, we administered venom immunotherapy to 48 patients allergic to bee or wasp venom, by means of a rush immunotherapy protocol (3 days).

Results: We observed no severe adverse reactions in any patients.

[Valve repair for chronic mitral regurgitation].

Valve repair is the best surgical treatment for mitral regurgitation. In the present article we describe the results of mitral valve repair in patients with chronic mitral regurgitation treated at our center during the last eight years. The degree of correction of valve insufficiency, functional benefit, in-hospital morbidity and mortality, postoperative outcome of ventricular function, and middle-term overall and reoperation-free survival are analyzed.

[Lung transplant therapy for suppurative diseases].

Objective: Lung transplantation is a valid therapeutic approach for patients with bronchiectasis. The objective of the present study was to evaluate our experience with bronchiectasis patients and compare the results in patients with cystic fibrosis to results in those with bronchiectasis caused by other processes.

Patients And Method: We carried out a retrospective study of bronchiectasis patients treated by lung transplantation in order to analyze demographic, functional and microbiological characteristics before and after transplantation, and survival.

Tissue heart valve mineralization: Review of calcification mechanisms and strategies for prevention.

Attempts to replace diseased human valves with prostheses began more than 30 yrs ago. Heart valve prostheses can be broadly classified into mechanical prostheses (made out of non-biological materials) and bioprostheses made out of biological tissue. Biological valves are made from animal tissue bovine pericardium and porcine valves.

Dual spinal cord stimulation for complex pain: preliminary study.

Objectives  To retrospectively analyze by indices of success, patients with chronic complex pain, including, axial low back pain, receiving dual spinal cord stimulation (SCS) systems. Methods  Eighteen patients with dual spinal cord stimulators have been retrospectively and nonrandomly analyzed. The preponderance of patients in our study group had failed back surgery syndrome (FBSS).

Resistance and stability of a new method for bonding biological materials using sutures and biological adhesives.

The valve leaflets of cardiac bioprostheses are secured and shaped by sutures which, given their high degree of resistance and poor elasticity, have been implicated in the generation of stresses within the leaflets, contributing to the failure of the bioprostheses. Bioadhesives are bonding materials that have begun to be utilized in surgery, although there is a lack of experience in their use with inert tissues or bioprostheses. Tensile testing is performed until rupture in samples of calf pericardium, a biomaterial employed in the manufacture of bioprosthetic heart valve leaflets.

[Multiple sclerosis in the XXI century].

Multiple sclerosis is possibly one of the diseases that bets illustrates progress in Neurology over the last years. The present article reviews the most significant changes that have occurred in almost all the aspects of this disease. These changes have produced a profound modification in the understanding of multiple sclerosis and have encouraged the development of innovative therapies.

Mechanical resistance of a new biomaterial, ostrich pericardium, and a new method of joining tissues combining suturing and a biological adhesive.

We studied the mechanical behavior in response to tensile stress of samples of ostrich pericardium bonded with a cyanoacrylate glue or sewn with a rectangular, overlapping suture that was subsequently sealed with the same bioadhesive. Seventy-two trials were performed in three series of 24 samples each: series AG, glued with an overlap of 1 cm2; series ASG, sewn with a rectangular, overlapping suture and sealed; and series AC, control samples that were left intact. The mean stress at rupture in series AG (glued) was 0.

Mechanical effects of increases in the load applied in uniaxial and biaxial tensile testing: Part I. Calf pericardium.

The authors analyzed the mechanical behavior of the calf pericardium employed in the construction of valve leaflets for cardiac bioprostheses. Forty samples of pericardium were subjected to uniaxial tensile testing, 20 as controls and 20 exposed to loads increasing stepwise until rupture, with a return to zero load between each new increment. Another 20 samples were used similarly in biaxial tensile tests involving loads increasing stepwise until rupture, again returning to zero load between steps.

Mechanical effects of increases in the load applied in uniaxial and biaxial tensile testing. Part II. Porcine pericardium.

The mechanical behavior of porcine pericardium was analyzed to compare it with that of calf pericardium employed in valve leaflets for cardiac bioprostheses. Forty samples of pericardium were subjected to uniaxial tensile testing, 20 as controls and 20 exposed to loads increasing stepwise from 0.5 to 1.

Sutured calf pericardium: influence of the type and angle of the suture on mechanical behavior.

Careful selection of the biological tissue to be used in cardiac bioprostheses and a thorough knowledge of its mechanical behavior, facilitating both the prediction of this behavior and the interactions between the tissue and the other materials employed, is the best approach to designing a durable implant. For this purpose, a study involving uniaxial tensile testing of calf pericardium was carried out. Two sets of three contiguous strips of tissue were obtained from each pericardial membrane, to perform a total of 144 trials.

Calcification and identification of metalloproteinases in bovine pericardium after subcutaneous implantation in rats.

The purpose of this study was to evaluate the influence of two anticalcification pre-treatments (chloroform/methanol and ethanol) and serum conditioning of glutaraldehyde-crosslinked bovine pericardium on the calcification degree and the presence of gelatinase activities in a subcutaneous implantation model in rats. Regarding calcification of the implants, glutaraldehyde control treatments showed a significatively higher calcification degree than pericardium treated with anticalcification reagents. Serum conditioning of glutaraldehyde treated tissues did not influence the calcification degree; moreover, no differences were found in these samples with the time of implantation (30 and 90 days).

Porcine pericardial membrane subjected to tensile testing: preliminary study of the process of selecting tissue for use in the construction of cardiac bioprostheses.

The durability of cardiac bioprostheses is limited fundamentally by structural failure due to mechanical fatigue and calcification. In the present report, we analyze, using an in vitro hydraulic simulator to test tensile strength, the mechanical behavior of porcine pericardium for the purpose of establishing the criteria for selecting the biomaterial, taking into account both morphological criteria (thickness and homogeneity of the specimens) and mechanical criteria (stress at breaking point), using the epidemiological model of paired samples. The stress at breakage was found to range widely from 24.

A new method for selecting calf pericardium for use in cardiac bioprostheses on the basis of morphological and mechanical criteria.

The durability of existing calf pericardium bioprostheses is limited by phenomena such as mechanical stress and calcification, the factors most frequently implicated in valve failure. Varying the preferred direction of the collagen fibers influences the mechanical behavior of the pericardial membrane. Given this possible variation, a strict control of the selection of the biomaterial employed in the construction of valve leaflets is essential, but a reliable method of selection has yet to be established.

The influence of chemical treatment and suture on the elastic behavior of calf pericardium utilized in the construction of cardiac bioprostheses.

Poor mechanical properties of biological tissue are known to cause wear, leading to the failure of cardiac bioprostheses made of calf pericardium. Different chemical agents such as sodium dodecyl sulfate (SDS) are presently being tested as possible inhibitors of the calcification process. The objective of this report was to determine the mechanical behavior of calf pericardium treated with SDS for 24 h and the influence of the suture on the mechanical properties of the tissue.

Comparative study of the mechanical behaviour of a cyanoacrylate and a bioadhesive.

We compared the mechanical resistance of 18 samples of calf pericardium bonded with a 100 mm2 overlap, by two types of glues: a cyanoacrylate (Loctite 4011) and a bioadhesive (BioGlue). Comparative tensile testing was also carried out in 40 paired samples, 20 bonded with the cyanoacrylate and 20 unbonded controls. The findings at rupture showed a greater resistance of the calf pericardium glued with cyanoacrylate, with a mean tensile strength of 0.

[Surgical treatment for hypertrophic obstructive cardiomyopathy].

Introduction And Objectives: Five percent of the patients with hypertrophic obstructive cardiomyopathy (HOCM) have symptoms unresponsive to medical treatment and are candidates for invasive therapy. The objective of this study was to analyze our results with surgical treatment of HOCM during the last 10 years.

Patients And Method: Between July 1993 and January 2004 26 patients with HOCM refractory to drug therapy were operated on.

[Mechanisms of disease in Mycoplasma pneumoniae infection. Clinical manifestations and complications].

Context: Mycoplasma pneumonia has been related to several conditions. With this study we have tried to establish the condition more frequently associated and their physiopathological mechanism.

Method: One-hundred and five patients admitted to Puerta de Hierro Hospital between March 1996 and July 2001, with IgM positive serology to Mycoplasma were evaluated.

Perceived mental health at the start of dialysis as a predictor of morbidity and mortality in patients with end-stage renal disease (CALVIDIA Study).

Background: Health-related quality of life may affect morbidity and survival in end-stage renal disease, but it is not clear whether coexisting comorbidity and other known prognostic variables could account for such an association.

Methods: To study the relationship between health-related quality of life and morbidity and survival, we carried out an inception cohort study in patients starting chronic dialysis, mostly diabetics, with a follow-up of 1-3 years in 34 Spanish hospitals. Health-related quality of life was measured by the SF-36 Health Survey and Karnofsky scale.

[Rapidly progressive glomerulonephritis in a 68-year-old man].

A 68-year-old male with macroscopic hematuria and constitutional symptoms as fever and weight loss. There was nothing interesting in the anamnesis or in the physical exploration. The laboratory test had an elevation of creatinine of 4 mg/dL and ten days before it had been 1.