No abstract

Both desogestrel/ethinylestradiol and gestodene/ethinylestradiol provide effective oral contraception with comparable cycle control and acceptability.

Background:Ventriculoperitoneal shunts are supplied with long peritoneal catheters, most commonly between 80 and 120 cm long. ISO/DIS 7197/2006[15] shunt manufacturing procedures include peritoneal catheter as an integrate of the total resistance. Cutting pieces of peritoneal catheters upon shunt implantation or revision is a common procedure.Methods:We evaluated five shunts assembled with different total pressure resistances and variable peritoneal catheter lengths in order to clarify the changes that occurred in the hydrodynamic profile when peritoneal catheters were cut upon shunt implantation or shunt revision.Results:Originally, all shunts performed within the operational range. Shunt 1 performed in a lower pressure range at 200 mm cut off peritoneal catheter and as a low-pressure shunt with –300 mm cut off. Shunt 2 was manufactured to run at the higher border pressure range, and it went out of specification with a 300 mm cut off. Shunt 3 was manufactured to run close to the lower border pressure range, and at 100 mm cutoff, it was already borderline in a lower resistive category. Other shunts also responded similarly.Conclusion:The limit to maintain a shunt in its original pressure settings was 20 cm peritoneal catheter cutting length. By cutting longer pieces of peritoneal catheter, one would submit patients to a less-resistive regimen than intended and his reasoning will be compromised. The pediatric population is more prone to suffer from the consequences of cutting catheters. Shunt manufacturers should consider adopting peritoneal catheters according to the age (height) of the patient.

Cardiac allograft vasculopathy is still a major issue, with significative mortality in heart transplant patients, and the best therapeutic options are not yet established. The progressively higher survival rates after transplantation have made it a major concern. This is a case report about a patient who underwent cardiac transplantation due to chagasic cardiomiopathy. During an endomyocardial biopsy more than 2 years after the transplant, the patient arrested in ventricular fibrillation, with ST-elevation in anterior leads after defibrillation. The angiography showed total occlusion of proximal left anterior descending artery, promptly treated with primary angioplasty, with excellent angiographic and clinical results.