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Pectus excavatum  

Microsoft Academic Search

One of the more common chest wall anomalies seen in children is pectus excavatum, which may present at birth, or more commonly during the teenage growth spurt. Symptoms of lack of endurance, shortness of breath with exercise, or chest pain are frequent. Although pectus excavatum may be a component of some uncommon syndromes, patients usually are healthy. Evaluation should include

Ivan Aloi; Annabella Braguglia; Alessandro Inserra



Pectus excavatum (image)  


Pectus excavatum is a condition in which the "breast bone" (sternum) appears sunken and the chest concave. It ... other condition (isolated findings). However, some syndromes include pectus excavatum.


Pectus excavatum and carinatum.  


Pectus excavatum and carinatum are the most common morphological chest wall abnormalities. For both pectus excavatum and carinatum the pathogenesis is largely unknown although various hypotheses exist. Usually, exclusion of an underlying syndromal or connective tissue disorder is the reason for referral for genetic evaluation. A detailed anamnesis and family history are needed as well as a complete dysmorphological physical examination. If no features of an underlying disorder are detected, then the pectus excavatum/carinatum can be considered as an isolated abnormality and no further genetic studies seem indicated. Although cases of non-syndromal pectus excavatum/carinatum with a positive family history fitting Mendelian inheritance have been described, it is possible that these pedigrees represent multifactorial inheritance, as no genetic cause for familial isolated pectus excavatum/carinatum has been described yet. The recurrence risk for a non-familial iolated pectus excavatum/carinatum is unknown, but thought to be low. If other symptoms are found then appropriate further diagnostic studies are indicated as pectus excavatum/carinatum can be part of many syndromes. However, the most important and most frequently observed monogenic syndromes with pectus excavatum/carinatum are Marfan Syndrome and Noonan Syndrome. PMID:24821303

Cobben, Jan M; Oostra, Roelof-Jan; van Dijk, Fleur S



Pectus excavatum repair  


Funnel chest repair; Chest deformity repair; Sunken chest repair; Cobbler's chest repair; Nuss repair ... The most common reason for pectus excavatum repair is to improve ... very self-conscious about the sunken look of their chest wall. ...


Pectus excavatum repair - series (image)  


Pectus excavatum is a deformity of the front of the chest wall with depression of the breastbone (sternum) ... Repair of pectus excavatum may be recommended for: improved appearance (cosmetic repair) improved breathing (respiratory function)


Pulmonary embolism: a late complication of pectus excavatum repair.  


The Ravitch operation is frequently performed to correct pectus excavatum with few and minor complications. We present a case of pulmonary embolism with pulmonary endarterectomy in a patient undergoing Ravitch repair for pectus excavatum 2 years ago. PMID:23721082

Abaci, Okay; Cetinkal, Gokhan; Kocas, Cuneyt; Evren, Emre; Yildiz, Mustafa; Yildizeli, Bedrettin; Yanarta?, Mehmet



Correction of pectus excavatum with breast hypoplasia using simultaneous pectus bar procedure and augmentation mammoplasty.  


Most women with asymmetric pectus excavatum suffer from hypoplastic breasts. Hence, aesthetic correction of pectus excavatum has to address thoracic wall deformity, breast hypoplasia, and asymmetry.In retrospective series, 21 patients with a diagnosis of pectus excavatum with hypoplastic breasts were corrected using the pectus bar procedure and subpectoral augmentation mammoplasty. Results were assessed by analyzing prospectively collected data and calculating pectus indices from computed tomographic scans. At 12 months postoperatively, cosmetic evaluations were performed by the patients and by an independent, board-certified plastic surgeon using score from 0 (very poor) to 4 (very good).Cosmetic results evaluated by plastic surgeon were good (3.33 ± 0.03) and patient satisfaction was high (3.52 ± 0.03). Furthermore, indices of pectus excavatum were corrected to near normal.The authors consider that the pectus bar procedure with subpectoral augmentation mammoplasty is useful for the aesthetic correction of pectus excavatum with hypoplastic breasts. PMID:23486122

Park, Hyung Joo; Gu, Ja Hea; Jang, Joon Chul; Dhong, Eun-Sang; Yoon, Eul-Sik



Identifying pectus excavatum in the primary care setting.  


This article reviews pectus excavatum and the role of the primary care provider in correct identification. Historically, pectus excavatum was viewed as a cosmetic concern. Research indicates that severe cases result in cardiopulmonary impairment and physiologic limitations. Evidence demonstrates that surgical repair improves cardiovascular function, exercise tolerance, and body image. PMID:24841462

Lew, Kathryn Baker



Pectus excavatum: history, hypotheses and treatment options  

PubMed Central

Pectus excavatum and pectus carinatum represent the most frequent chest wall deformations. However, the pathogenesis is still poorly understood and research results remain inconsistent. To focus on the recent state of knowledge, we summarize and critically discuss the pathological concepts based on the history of these entities, beginning with the first description in the sixteenth century. Based on the early clinical descriptions, we review and discuss the different pathogenetic hypotheses. To open new perspectives for the potential pathomechanisms, the embryonic and foetal development of the ribs and the sternum is highlighted following the understanding that the origin of these deformities is given by the disruption in the maturation of the parasternal region. In the second, different therapeutical techniques are highlighted and based on the pathogenetic hypotheses and the embryological knowledge potential new biomaterial-based perspectives with interesting insights for tissue engineering-based treatment options are presented. PMID:22394989

Brochhausen, Christoph; Turial, Salmai; Muller, Felix K.P.; Schmitt, Volker H.; Coerdt, Wiltrud; Wihlm, Jean-Marie; Schier, Felix; Kirkpatrick, C. James



Anesthesia and analgesia for pectus excavatum surgery.  


The technique of choice for surgical correction of pectus excavatum is the Nuss procedure, a minimally invasive technique in which rigid metal bars are placed transthoracically beneath the sternum and costal cartilages until permanent remodeling of the chest wall has occurred. Intraoperatively, anesthesia focuses on three areas: the potential for catastrophic blood loss caused by perforation of large capacitance vessels and the heart, the potential for malignant arrhythmias, and the consequences of bilateral iatrogenic pneumothoraces. Postoperatively, analgesia is institutionally dependent and controversial, based on usage and type of regional anesthesia. The necessity of multimodal analgesic techniques creates a common ground across different hospital systems. PMID:24491656

Mavi, Jagroop; Moore, David L



Complete cleft sternum associated with clavicular hypoplasia and pectus excavatum.  


A sternal cleft is a rare congenital and developmental disorder. In general, this disorder is associated with skeletal and extraskeletal abnormalities (eg, Cantrell syndrome), but isolated sternal clefts have also been reported. A sternal cleft with pectus excavatum is a rare congenital abnormality. We present a complete sternal cleft with right-sided clavicular hypoplasia and pectus excavatum in a 31-year-old female patient. PMID:20871419

Yahyayev, Aghakishi; Bulakci, Mesut; Agayev, Ayaz; Bakan, Selim; Dikici, Fatih; Dursun, Memduh



Elevation of serum lactate dehydrogenase in patients with pectus excavatum  

PubMed Central

Introduction Pectus excavatum is the most common congenital chest wall deformity and the depression of the anterior chest wall, which compresses the internal organs. The aim of the present study is to investigate the effects of pectus excavatum on blood laboratory findings. Material and Methods From March 2011 to December 2011, 71 patients with pectus excavatum who visited Seoul Saint Mary Hospital for Nuss procedure were reviewed and analyzed. The blood samples were routinely taken at the day before surgery and pectus bar removal was usually performed in 2 to 3 years after Nuss procedure. To investigate the effects on blood laboratory findings, preoperative routine blood laboratory data and postoperative changes of abnormal laboratory data were analyzed. Results Only lactate dehydrogenase (LDH), one of 26 separate routine laboratory tests, was abnormal and significantly elevated than normal value (age <10, p?=?0.008; age ?10, p?pectus excavatum. The symmetric subgroup had significantly higher LDH level than the asymmetric subgroup (p <0.001) and there was a significant decrease of LDH level after correction of deformity (p?=?0.017). Conclusion In conclusion, only LDH, one of the routine laboratory tests, was significantly elevated than normal value, which was thought to be caused by etiologies of pectus excavatum and the compression of the internal organs. Further studies on LDH including isoenzyme studies in patients with pectus excavatum will be needed, and these studies will provide a deeper and wider comprehension of pectus excavatum. PMID:24779631



Silastic molding method for pectus excavatum correction using a polyvinyl alcohol (ivalon) sponge.  


Pectus excavatum is rare, but it is the most common type of sternal congenital disorder. There are many surgical methods to correct pectus excavatum such as the Ravitch method, Wada method, Silastic mold method, and the Nuss operation. We report a case of minimal invasive surgery for pectus excavatum using a polyvinyl alcohol sponge. PMID:23275928

Lee, Jun-Ho; Kim, Sung-Jin; Kang, Jeong-Ho; Chung, Won-Sang; Kim, Hyuck; Chon, Soon-Ho



Pectus Excavatum and Heritable Disorders of the Connective Tissue  

PubMed Central

Pectus excavatum, the most frequent congenital chest wall deformity, may be rarely observed as a sole deformity or as a sign of an underlying connective tissue disorder. To date, only few studies have described correlations between this deformity and heritable connective tissue disorders such as Marfan, Ehlers-Danlos, Poland, MASS (Mitral valve prolapse, not progressive Aortic enlargement, Skeletal and Skin alterations) phenotype among others. When concurring with connective tissue disorder, cardiopulmonary and vascular involvement may be associated to the thoracic defect. Ruling out the concomitance of pectus excavatum and connective tissue disorders, therefore, may have a direct implication both on surgical outcome and long term prognosis. In this review we focused on biological bases of connective tissue disorders which may be relevant to the pathogenesis of pectus excavatum, portraying surgical and clinical implication of their concurrence. PMID:24198927

Tocchioni, Francesca; Ghionzoli, Marco; Messineo, Antonio; Romagnoli, Paolo



Method of pectus excavatum measurement based on structured light technique  

NASA Astrophysics Data System (ADS)

We present an automatic method for assessment of pectus excavatum severity based on an optical 3-D markerless shape measurement. A four-directional measurement system based on a structured light projection method is built to capture the shape of the body surface of the patients. The system setup is described and typical measurement parameters are given. The automated data analysis path is explained. Their main steps are: normalization of trunk model orientation, cutting the model into slices, analysis of each slice shape, selecting the proper slice for the assessment of pectus excavatum of the patient, and calculating its shape parameter. We develop a new shape parameter (I3ds) that shows high correlation with the computed tomography (CT) Haller index widely used for assessment of pectus excavatum. Clinical results and the evaluation of developed indexes are presented.

Glinkowski, Wojciech; Sitnik, Robert; Witkowski, Marcin; Koco?, Hanna; Bolewicki, Pawel; Górecki, Andrzej



Pectus excavatum imaging: enough but not too much  

Microsoft Academic Search

Background  Pectus excavatum (pectus) is a common congenital deformity of the chest wall resulting in a diminished anterior-posterior\\u000a dimension. Chest CT has become a common study for preoperative assessment. CT evaluation was initially described using a single\\u000a CT image; it is now common to perform a CT of the entire chest to evaluate pectus.\\u000a \\u000a \\u000a \\u000a Objective  To evaluate the efficacy of chest radiographs

Amit S. Rattan; Tal Laor; Frederick C. Ryckman; Alan S. Brody



Complex thoracic malformations: is there an association between adolescent idiopathic scoliosis and pectus excavatum?.  

E-print Network

??Study Design: This is a retrospective review of 220 patients with adolescent idiopathic scoliosis (AIS).Objectives: When combined thoracic malformations occur scoliosis and pectus excavatum (PE)… (more)

Berdan, Elizabeth Ann



Surgical Repair of Pectus Excavatum Markedly Improves Body Image and Perceived Ability for Physical Activity: Multicenter Study  

Microsoft Academic Search

OBJECTIVE. This study evaluated changes in both physical and psychosocial quality of life reported by the parent and child after surgical repair of pectus excavatum. METHODS. As part of a multicenter study of pectus excavatum, a previously validated tool called the Pectus Excavatum Evaluation Questionnaire was administered by the research coordinator, via telephone, to parents and patients (8 -21 years

Robert E. Kelly; Thomas F. Cash; Robert C. Shamberger; Karen K. Mitchell; Robert B. Mellins; M. Louise Lawson; Richard G. Azizkhan; Andre V. Hebra; Donald Nuss; Michael J. Goretsky; Ronald J. Sharp; George W. Holcomb; Walton K. T. Shim; Stephen M. Megison; R. Lawrence Moss; Annie H. Fecteau; Paul M. Colombani; Traci Bagley; Amy Quinn; Alan B. Moskowitz



Concomitant congenital heart defect repair and Nuss procedure for pectus excavatum.  


The combination of complex congenital cardiac anomalies and pectus excavatum represents a technical challenge. Most concomitant repairs have been performed in adult patients. We report the uncomplicated concomitant repair of double-outlet right ventricle with absent pulmonary valve syndrome and the Nuss procedure for pectus excavatum in a 3-year-old child. PMID:24585798

Kandakure, Pramod Reddy; Dhannapuneni, Ram; Venugopal, Prem; Franks, Roger; Alphonso, Nelson



Simultaneous repair of pectus excavatum and congenital heart disease without cardiopulmonary bypass or sternal osteotomy.  


A 8-year-old girl with severe pectus excavatum and an atrial septal defect had simultaneous repair of the both defects, using thransthoracic occlusion for atrial septal defect and improved Nuss technique for the pectus excavatum. Neither cardiopulmonary bypass nor sternotomy was required in this procedure. Details of the procedure and outcome are described. PMID:25319880

Sun, Yong; Zhu, Peng; Zheng, Shao-Yi



Free fat transplantation for the aesthetic correction of mild pectus excavatum.  


Pectus excavatum is a common type of congenital chest wall abnormality. The defect ranges in severity from mild to severe, and can lead to cardiopulmonary impairment caused by the caved-in chest. The case of a 27-year-old woman with mild pectus excavatum and a diagnosis of scleroderma is reported. Cosmetic correction of pectus excavatum malformation with the use of autologous fat transplantation has never been reported. The individual achievement of relief from the psychological consequences of such disfigurement and the improvement in quality of life are high. Autologous fat transfer could be a new option in the armamentarium of techniques for correction of mild pectus deformities. PMID:18185951

Pereira, L H; Sterodimas, A



Surgical correction of pectus excavatum in two cats  

PubMed Central

Two sexually intact male Bengal cats, one a 4-month-old weighing 2.8 kg and the other, a 3-month-old weighing 2.0 kg, were presented to the University of Missouri-Columbia Veterinary Teaching Hospital for evaluation of respiratory distress. On initial presentation, both cats were dyspneic, exercise intolerant, and had marked concave deformation of the caudal sternum. Surgical correction of pectus excavatum was performed using a cylindrical external splint and U-shaped external splint. Post-operative thoracic radiography revealed that there was decreased concavity of the sternum and increased thoracic height at the level of the caudal sternebrae in both cats. PMID:18716456

Yoon, Hun-Young; Mann, F.A.



Pectus excavatum: uncommon electrical abnormalities caused by extrinsic right ventricular compression.  


We report a case of pectus excavatum associated with ventricular tachycardia provoked by exercise in a 19-year-old man. Although this chest deformity has been associated with supraventricular dysrhythmias, documented ventricular tachycardia has only been reported once. Our patient's ventricular dysrhythmia was treated by surgical correction of his pectus excavatum only, and at 3 years follow-up he has had no recurrence of his ventricular tachycardia. PMID:24303874

Chan Wah Hak, Yee-Sen; Lim, Yeong-Phang; Liew, Reginald; Hsu, Li-Fern



Chest modeling and personalized surgical planning for pectus excavatum.  


Pectus excavatum is among the most common major congenital anomalies of the chest wall whose correction can be performed via minimally invasive Nuss technique that places a pectus bar to elevate the sternum anteriorly. However, the size and bending of the pectus bar are manually modeled intraoperatively by trial-and-error. The procedure requires intense pain management in the months following surgery. In response, we are developing a novel distraction device for incremental and personalized PE correction with minimal risk and pain, akin to orthodontic treatment using dental braces. To design the device, we propose in this study a personalized surgical planning framework for PE correction from clinical noncontrast CT. First, we segment the ribs and sternum via kernel graph cuts. Then costal cartilages, which have very low contrast in noncontrast CT, are modeled as 3D anatomical curves using the cosine series representation and estimated using a statistical shape model. The size and shape of the correction device are estimated through model fitting. Finally, the corrected/post-surgical chest is simulated in relation to the estimated shape of correction device. The root mean square mesh distance between the estimated cartilages and ground truth on 30 noncontrast CT scans was 1.28 +/- 0.81 mm. Our method found that the average deformation of the sterna and cartilages with the simulation of PE correction was 49.71 +/- 10.11 mm. PMID:25333157

Zhao, Qian; Safdar, Nabile; Duan, Chunzhe; Sandler, Anthony; Linguraru, Marius George



Pectus excavatum: current imaging techniques and opportunities for dose reduction.  


Pectus excavatum (PE) is the most common congenital chest wall deformity in children. It affects 1 in every 300-1000 live births with a male to female ratio of 5:1. Most of the patients present in their first year of life. During the teenage years, patients may have exercise intolerance and psychological strain because of their chest wall deformity. The Nuss and Ravitch procedures are established methods of surgical correction of PE. An index of severity known best as the Haller index, typically evaluated with computed tomography scan, when measuring greater than 3.2 is considered to indicate moderate or severe PE and is a prerequisite for third-party insurance reimbursement for these corrective procedures. This article reviews the clinical features of PE, the role of imaging, and the opportunities for radiation dose reduction. PMID:25129214

Sarwar, Zahir U; DeFlorio, Robert; O'Connor, Stephen C



Irregular location of major pectoral muscle can be a causative factor of pectus excavatum.  


Pectus excavatum-commonly known as funnel chest-is one of the most frequently observed congenital deformities, in which the patients' thoraces present concavity. This paper presents our original hypothesis that the abnormal positioning of the major pectoral muscle can be a potential factor in the occurrence of pectus excavatum, and evaluates the validity of the hypothesis by performing an anatomical and a biomechanical study. An anatomical study on clinical cases revealed that the major pectoral muscle tends to be positioned more superiorly in pectus excavatum patients than in normal persons. The biomechanical study, using three-dimensional finite element dynamic simulation, revealed that the major pectoral muscle functions to elevate the sternum and that the elevating effect is reduced when the muscle is located at superior regions on the thoracic wall. These findings support our hypothesis that the abnormal position of the major pectoral muscle is a potential causative factor for pectus excavatum. This hypothesis suggests that, during surgical correction of pectus excavatum with an open approach, surgeons should reposition the major pectoral muscle to its correct anatomical position to avoid recurrence. PMID:24602343

Nagasao, Tomohisa; Shimizu, Yusuke; Morotomi, Tadaaki; Takano, Naoki; Jiang, Hua; Kishi, Kazuo



Objective effect manifestation of pectus excavatum on load-stressed pulmonary function testing: a case report  

PubMed Central

Introduction Pectus excavatum is the most common congenital deformity of the anterior chest wall that, under certain conditions, may pose functional problems due to cardiopulmonary compromise and exercise intolerance. Case presentation We present the case of an otherwise physically-adept 21-year-old Chinese sportsman with idiopathic pectus excavatum, whose symptoms manifested only on bearing a loaded body vest and backpack during physical exercise. Corroborative objective evidence was obtained via load-stressed pulmonary function testing, which demonstrated restrictive lung function. Conclusion This report highlights the possible detrimental synergism of thoracic load stress and pectus excavatum on cardiopulmonary function. Thoracic load-stressed pulmonary function testing provides objective evidence in support of such a synergistic relationship. PMID:22188608



Pure pectus carinatum (not associated with pectus excavatum) solved by MIRPC (minimally invasive repair of pectus carinatum) associated with bilateral mamarian hypoplasia solved by bilateral breast implants.  


We present the case of a young 24-year-old woman with an important but symmetrical pectus carinatum, not associated with pectus excavatum, without cardiorespiratory symptoms but with significant psychosocial implications for the patient, solved by the minimally invasive technique described by Abramson(reversed Nuss procedure) - MIRPC (Minimally invasive Repair of Pectus carinatum). The sternal malformation was associated with bilateral mammary hypoplasia, solved by bilateral breast implants 10 months later. The evolution was favorable and the aesthetic result was satisfactory for the patient. PMID:24524485

Ciurea, M; Ulmeanu, D; Popa, D; Mercu?, R; Enache, M; Vânvu, A L; Demetrian, A



Metal allergy to titanium bars after the Nuss procedure for pectus excavatum.  


The Nuss procedure requires the placement of metal bars in the chest cage to repair pectus excavatum. Metal allergies are one of the complications associated with this procedure. Given that titanium is a biocompatible metal, it induces few allergic symptoms. Therefore, titanium bars are recommended for patients with metal sensitivity. We report the case of a 17-year-old boy with pectus excavatum who had a metal allergy to titanium bars, which occurred after the Nuss procedure. The administration of oral steroids is useful for treating metal allergies. Metal allergies to titanium bars are very rare; however, they can still occur. PMID:25087797

Sakamoto, Kazuhiro; Ando, Kohei; Noma, Daisuke



Chest x-ray as a primary modality for preoperative imaging of pectus excavatum  

Microsoft Academic Search

BackgroundAdolescents with a pectus excavatum mostly present with cosmetic complaints and rarely have significant physical limitations. The preoperative evaluation includes pulmonary functions tests, echocardiography, and chest computed tomography (CT) scan to measure the Haller index. In most patients, the chest CT is performed only to measure the Haller index. The purpose of this study was to evaluate whether indices measured

Claudia Mueller; Dickens Saint-Vil; Sarah Bouchard



Virtual simulation of the postsurgical cosmetic outcome in patients with Pectus Excavatum  

NASA Astrophysics Data System (ADS)

Pectus excavatum is the most common congenital deformity of the anterior chest wall, in which several ribs and the sternum grow abnormally. Nowadays, the surgical correction is carried out in children and adults through Nuss technic. This technic has been shown to be safe with major drivers as cosmesis and the prevention of psychological problems and social stress. Nowadays, no application is known to predict the cosmetic outcome of the pectus excavatum surgical correction. Such tool could be used to help the surgeon and the patient in the moment of deciding the need for surgery correction. This work is a first step to predict postsurgical outcome in pectus excavatum surgery correction. Facing this goal, it was firstly determined a point cloud of the skin surface along the thoracic wall using Computed Tomography (before surgical correction) and the Polhemus FastSCAN (after the surgical correction). Then, a surface mesh was reconstructed from the two point clouds using a Radial Basis Function algorithm for further affine registration between the meshes. After registration, one studied the surgical correction influence area (SCIA) of the thoracic wall. This SCIA was used to train, test and validate artificial neural networks in order to predict the surgical outcome of pectus excavatum correction and to determine the degree of convergence of SCIA in different patients. Often, ANN did not converge to a satisfactory solution (each patient had its own deformity characteristics), thus invalidating the creation of a mathematical model capable of estimating, with satisfactory results, the postsurgical outcome.

Vilaça, João L.; Moreira, António H. J.; L-Rodrigues, Pedro; Rodrigues, Nuno; Fonseca, Jaime C.; Pinho, A. C. M.; Correia-Pinto, Jorge



Simultaneous surgical correction of pectus excavatum and cardiac disease in two adults.  


Thoracic reconstruction in patients with pectus excavatum with concomitant cardiac or aortic surgery poses a major clinical challenge. The report describes two cases of adult patients undergoing simultaneous surgical correction of cardiac disease and sternal deformity using one of two different techniques: a sterno-turnover method preserving the rectus muscle or a sternal elevation method with A-O plates. PMID:23344753

Iino, Kenji; Oda, Makoto; Matusmoto, Isao; Tomita, Shigeyuki; Noda, Yukihiro; Koshida, Yoshinao; Yamaguchi, Shojiro; Ohtake, Hiroshi; Watanabe, Go



Pectus excavatum and pectus carinatum patients suffer from lower quality of life and impaired body image: a control group comparison of psychological characteristics prior to surgical correction  

Microsoft Academic Search

Objective: The aim of this study was to evaluate the effects of anterior chest-wall deformities on disease-specific and health-related quality of life, body image, and psychiatric comorbidity prior to surgical correction. Methods: A total of 90 patients (71 with pectus excavatum, 19 with pectus carinatum) presenting themselves for pectus repair and 82 control subjects were recruited for this study. The

Cornelia Steinmann; Stefanie Krille; Astrid Mueller; Peter Weber; Bertram Reingruber; Alexandra Martin



Late coronary artery and tricuspid valve injury post pectus excavatum surgery  

PubMed Central

We report the surgical case of a 25-year old man admitted because of progressive dyspnoea and stabbing chest pain, who had undergone a pectus excavatum correction using a retrosternal strut 8 years previously. The computerized tomography scan showed that the right tip of the pectus bar had migrated across his right ventricle and tricuspid valve into the right atrium. Intraoperatively, it was confirmed that in its path, the right coronary artery and the posterior leaflet of the tricuspid valve had been damaged. After removing the bar and repairing the tricuspid valve, the patient made a full recovery. PMID:23832922

Bibiloni Lage, Ignacio; Khan, Khalid; Kaabneh, Ahmed; Kendall, Simon



Body-image, self-concept and mental exposure in patients with pectus excavatum  

Microsoft Academic Search

Background  Pectus excavatum is the most common congenital anomaly of the sternum and anterior chest wall, which occurs about 3–4 times\\u000a more often in boys than girls [1]. Although most patients do not report physical symptoms as cardiovascular and respiratory problems, they show a loss of\\u000a self-esteem and a poor self-image. There exist very rare data about psychological state before the

Barbara HadoltA; A. Wallisch; J. W. Egger; M. E. Höllwarth



A four-directional body shape measurement system and its application for pectus excavatum severity assessment  

NASA Astrophysics Data System (ADS)

The paper presents an optical three-dimensional shape measurement system and an automatic method for assessment of pectus excavatum severity based on the measurement results. The measurement system consists of four directional modules utilizing structured light projection method (namely temporal phase shifting TPS and modified Gray code projection) to capture the shape of body surface of the patients. The measurement result is a three-dimensional point cloud representing the skin surface. The system setup is described and the typical measurement parameters are given. The automated data analysis path is explained. Its main stages are: point cloud segmentation, normalization of trunk orientation, cutting the model into slices, analysis of each slice shape, selecting the proper slice for the assessment of pectus excavatum of the patient and calculating its shape parameter. The analysis does not require any initial processing (e.g. surface fitting or mesh building) as it is conducted on raw 3-D point cloud data resulting from the measurement. A new shape parameter (I3ds) was developed that shows correlation with CT Haller Index widely used for assessment of pectus excavatum. Preliminary clinical results are presented.

Witkowski, Marcin; Glinkowski, Wojciech; Sitnik, Robert; Koco?, Hanna; Bolewicki, Pawe?; Górecki, Andrzej



Delayed-onset hypovolemic shock after the Nuss procedure for pectus excavatum  

PubMed Central

The Nuss procedure, which is a minimally invasive approach for treating pectus excavatum, has better functional and cosmetic outcomes than other invasive procedures. Cardiac perforation is the most serious complication and several methods for the prevention of intraoperative events has been developed. Although most cardiac injuries are detected in the operating room, in the case described herein the patient experienced sudden hypovolemic shock during the postoperative recovery period. This indicates that special caution is mandatory even after successful execution of the Nuss procedure. PMID:24422877



Delayed-onset hypovolemic shock after the Nuss procedure for pectus excavatum.  


The Nuss procedure, which is a minimally invasive approach for treating pectus excavatum, has better functional and cosmetic outcomes than other invasive procedures. Cardiac perforation is the most serious complication and several methods for the prevention of intraoperative events has been developed. Although most cardiac injuries are detected in the operating room, in the case described herein the patient experienced sudden hypovolemic shock during the postoperative recovery period. This indicates that special caution is mandatory even after successful execution of the Nuss procedure. PMID:24422877

Jeong, Jin Yong; Suh, Jong Hui; Yoon, Jeong Seob; Park, Chan Beom



Body Disfigurement and the Quality of Life of Adolescents with Pectus Excavatum: Effects of the Nuss Procedure  

ERIC Educational Resources Information Center

This article takes a comprehensive look at the effects of pectus excavatum, a congenital deformity with psychosocial and physical ramifications, and the Nuss procedure on the quality of life of adolescents. The Nuss procedure is a minimally invasive corrective surgery. Twenty-five participants from Calgary, Alberta were interviewed (10 adolescents…

Roberts, Jillian; MacMath, Sheryl; English, Margot; Martin, Joan; Hayashi, Al; Sigalet, David L.



Artificial neural networks for automatic modelling of the pectus excavatum corrective prosthesis  

NASA Astrophysics Data System (ADS)

Pectus excavatum is the most common deformity of the thorax and usually comprises Computed Tomography (CT) examination for pre-operative diagnosis. Aiming at the elimination of the high amounts of CT radiation exposure, this work presents a new methodology for the replacement of CT by a laser scanner (radiation-free) in the treatment of pectus excavatum using personally modeled prosthesis. The complete elimination of CT involves the determination of ribs external outline, at the maximum sternum depression point for prosthesis placement, based on chest wall skin surface information, acquired by a laser scanner. The developed solution resorts to artificial neural networks trained with data vectors from 165 patients. Scaled Conjugate Gradient, Levenberg-Marquardt, Resilient Back propagation and One Step Secant gradient learning algorithms were used. The training procedure was performed using the soft tissue thicknesses, determined using image processing techniques that automatically segment the skin and rib cage. The developed solution was then used to determine the ribs outline in data from 20 patient scanners. Tests revealed that ribs position can be estimated with an average error of about 6.82+/-5.7 mm for the left and right side of the patient. Such an error range is well below current prosthesis manual modeling (11.7+/-4.01 mm) even without CT imagiology, indicating a considerable step forward towards CT replacement by a 3D scanner for prosthesis personalization.

Rodrigues, Pedro L.; Moreira, António H. J.; Rodrigues, Nuno F.; Pinho, ACM; Fonseca, Jaime C.; Correia-Pinto, Jorge; Vilaça, João. L.



Routine postoperative chest X-ray is unnecessary following the Nuss procedure for pectus excavatum  

PubMed Central

OBJECTIVES Pneumothorax is the most common complication after the Nuss procedure for pectus excavatum. The majority of pneumothoraces are small, and the patients have no symptoms. The aim of this study was to evaluate the necessity for routine chest X-ray immediately after surgery. METHODS Group I consists of 644 patients who were operated on with a Nuss procedure for pectus excavatum between 2001 and 2009 (85% male, median age 16 [range 7–48 years]) at Aarhus University Hospital. The standard procedure included chest X-ray immediately after surgery and before discharge. Group II consists of 294 patients (88% male, median age 16 [range 11–54 years]) who had a Nuss procedure in the period January 2011 to October 2012, where the standard procedure only included chest X-ray before discharge. RESULTS In Group I, pneumothorax was found on the chest X-ray obtained immediately after surgery in 333 (52%) patients. Fifteen (4.5%) were treated with chest-tube drainage. Six of these patients had no symptoms, but a 2- to 3-cm pneumothorax, 2 had progression of the pneumothorax and 7 had respiratory symptoms. The median size of those drained was 3 (range 2–6 cm). At the normal 6-week control, no pneumothorax remained. Group II: Among the 294 patients, 1 (0.3%) had a chest tube. CONCLUSIONS Only patients with respiratory symptoms after the Nuss procedure need a chest X-ray. A routine chest X-ray can be limited to the time of discharge where the position of the bar(s) is also checked. PMID:23439441

Knudsen, Mette Reinholdt; Nyboe, Camilla; Hjortdal, Vibeke E.; Pilegaard, Hans K.



[Correlation between Haller index and echocardiographic and spirometric findings in children with pectus excavatum].  


Objectives: In this study, we evaluated the correlation between severity of deformity and cardiopulmonary function with regards to echocardiographic and spirometric findings. Study design: Twenty-five children, mean age 13.6 years, presenting with pectus excavatum between August 2012 and May 2013, were included. Haller index (HI) was calculated for each patient. Patients with an index of <2.5 were accepted as Group 1, 2.5-3.6 as Group 2, and >3.6 as Group 3. Left ventricle dimension, ejection fraction, and shortening fraction were evaluated with echocardiography. Using spirometry, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and FEV1/FVC ratio were calculated. Groups were compared using these parameters. Results: There were 18 males and 7 females. The mean index was 3.48±0.78. Though there was no significant difference in the index with regards to sex, the index increased with age. Eight percent of patients were in Group 1, 52% in Group 2 and 40% in Group 3. A significant decrease in ejection and shortening fractions was evident as the index increased. A statistically significant relation between HI and cardiac dysfunction was evident (p<0.01). As the index increased, there was significant decrease in FEV1 and the FEV1/FVC ratio, while there was no significant difference in FVC. As the deformity worsened, incidence of pulmonary dysfunction was found to be higher. Conclusion: This study revealed that pectus excavatum leads to cardiac and pulmonary problems, and functions of the left ventricle may be affected by the deformity. Furthermore, the relation between the severity of the deformity and cardiovascular function is evident. PMID:24769818

Gürsu, Alper Haz?m; Karagün, Barbaros Sahin; Korkmaz, Ozlem; Gürsu, Sarper Sükrü; Uçar, Mehmet Ali



Systematic review of surgical treatment techniques for adult and pediatric patients with pectus excavatum  

PubMed Central

This compares outcome measures of current pectus excavatum (PEx) treatments, namely the Nuss and Ravitch procedures, in pediatric and adult patients. Original investigations that stratified PEx patients based on current treatment and age (pediatric?=?0–21; adult 17–99) were considered for inclusion. Outcome measures were: operation duration, analgesia duration, blood loss, length of stay (LOS), outcome ratings, complications, and percentage requiring reoperations. Adult implant patients (18.8%) had higher reoperation rates than adult Nuss or Ravitch patients (5.3% and 3.3% respectively). Adult Nuss patients had longer LOS (7.3 days), more strut/bar displacement (6.1%), and more epidural analgesia (3 days) than adult Ravitch patients (2.9 days, 0%, 0 days). Excluding pectus bar and strut displacements, pediatric and adult Nuss patients tended to have higher complication rates (pediatric - 38%; adult - 21%) compared to pediatric and adult Ravitch patients (12.5%; 8%). Pediatric Ravitch patients clearly had more strut displacements than adult Ravitch patients (0% and 6.4% respectively). These results suggest significantly better results in common PEx surgical repair techniques (i.e. Nuss and Ravitch) than uncommon techniques (i.e. Implants and Robicsek). The results suggest slightly better outcomes in pediatric Nuss procedure patients as compared with all other groups. We recommend that symptomatic pediatric patients with uncomplicated PEx receive the Nuss procedure. We suggest that adult patients receive the Nuss or Ravitch procedure, even though the long-term complication rates of the adult Nuss procedure require more investigation. PMID:24506826



Systematic review of surgical treatment techniques for adult and pediatric patients with pectus excavatum.  


This compares outcome measures of current pectus excavatum (PEx) treatments, namely the Nuss and Ravitch procedures, in pediatric and adult patients. Original investigations that stratified PEx patients based on current treatment and age (pediatric=0-21; adult 17-99) were considered for inclusion. Outcome measures were: operation duration, analgesia duration, blood loss, length of stay (LOS), outcome ratings, complications, and percentage requiring reoperations. Adult implant patients (18.8%) had higher reoperation rates than adult Nuss or Ravitch patients (5.3% and 3.3% respectively). Adult Nuss patients had longer LOS (7.3 days), more strut/bar displacement (6.1%), and more epidural analgesia (3 days) than adult Ravitch patients (2.9 days, 0%, 0 days). Excluding pectus bar and strut displacements, pediatric and adult Nuss patients tended to have higher complication rates (pediatric - 38%; adult - 21%) compared to pediatric and adult Ravitch patients (12.5%; 8%). Pediatric Ravitch patients clearly had more strut displacements than adult Ravitch patients (0% and 6.4% respectively). These results suggest significantly better results in common PEx surgical repair techniques (i.e. Nuss and Ravitch) than uncommon techniques (i.e. Implants and Robicsek). The results suggest slightly better outcomes in pediatric Nuss procedure patients as compared with all other groups. We recommend that symptomatic pediatric patients with uncomplicated PEx receive the Nuss procedure. We suggest that adult patients receive the Nuss or Ravitch procedure, even though the long-term complication rates of the adult Nuss procedure require more investigation. PMID:24506826

Johnson, William Rainey; Fedor, David; Singhal, Sunil



Pain and Anxiety Management in Minimally Invasive Repair of Pectus Excavatum  

PubMed Central

The Nuss procedure for the correction of Pectus Excavatum (PE) is associated with intense postoperative pain. Our strategy to control early postoperative pain is to combine epidural with intravenous analgesia. Our aim was to analyse our pain control strategy by reviewing all the PE cases treated at our institution. Sixty consecutive patients, aged between 12 and 26 years old, received the PE operation at our institution from January, 2007 to September, 2010. The median age was 16 (12-27) with a male/female ratio of about 7/1. An epidural catheter was employed in all the cases, with 38 patients (63%) requiring additional drugs to control pain, which remained in place for 74 hours (72-96). The pain score was higher in male patients, but lower in those younger than 16 years old. Moreover, patients that consumed benzodiazepines had a significant decrease in cumulative opioid intake (P = 0.0408). Both gender and age had an impact on pain control, while we noticed a synergistic effect between opiates and tranquillizers. PMID:23091689

Ghionzoli, Marco; Brandigi, Elisa; Messineo, Antonio



A Sensorized Nuss Bar for Patient-Specific Treatment of Pectus Excavatum  

PubMed Central

Pectus Excavatum is an anatomical deformation characterized by a depression of the anterior chest wall. Nuss technique (representing the current clinical golden standard) consists in the introduction of a corrective metal bar, in order to raise the sternum in its anatomic natural position. Nowadays, the bar plays purely a mechanical/corrective action and is kept implanted for about three years, supporting up to a maximum force of 250 N. Our study aims at optimizing the procedure of correction, in terms of monitoring the bar effect, minimizing the body response, and facilitating the bar removal. The sensorized Nuss bar prototype inserted in a platform for telemedicine described in this article is able to monitor in vitro pressure data variations, with more than 150 discrete measurements during the operating period. This behavior is promising for future clinical applications, in which the device could be exploited to monitor the forces at work, thus, providing a customized therapeutic protocol, which in turn may optimize the period of implant. The sensorized bar was also provided with a polymeric coating, able to influence human dermal fibroblast behavior in vitro. This highlights the possibility to minimize, in future in vivo applications, tissue fibrotic responses. PMID:25268912

Betti, Stefano; Ciuti, Gastone; Ricotti, Leonardo; Ghionzoli, Marco; Cavallo, Filippo; Messineo, Antonio; Menciassi, Arianna



A sensorized Nuss bar for patient-specific treatment of Pectus Excavatum.  


Pectus Excavatum is an anatomical deformation characterized by a depression of the anterior chest wall. Nuss technique (representing the current clinical golden standard) consists in the introduction of a corrective metal bar, in order to raise the sternum in its anatomic natural position. Nowadays, the bar plays purely a mechanical/corrective action and is kept implanted for about three years, supporting up to a maximum force of 250 N. Our study aims at optimizing the procedure of correction, in terms of monitoring the bar effect, minimizing the body response, and facilitating the bar removal. The sensorized Nuss bar prototype inserted in a platform for telemedicine described in this article is able to monitor in vitro pressure data variations, with more than 150 discrete measurements during the operating period. This behavior is promising for future clinical applications, in which the device could be exploited to monitor the forces at work, thus, providing a customized therapeutic protocol, which in turn may optimize the period of implant. The sensorized bar was also provided with a polymeric coating, able to influence human dermal fibroblast behavior in vitro. This highlights the possibility to minimize, in future in vivo applications, tissue fibrotic responses. PMID:25268912

Betti, Stefano; Ciuti, Gastone; Ricotti, Leonardo; Ghionzoli, Marco; Cavallo, Filippo; Messineo, Antonio; Menciassi, Arianna



Pectus excavatum postsurgical outcome based on preoperative soft body dynamics simulation  

NASA Astrophysics Data System (ADS)

Pectus excavatum is the most common congenital deformity of the anterior chest wall, in which an abnormal formation of the rib cage gives the chest a caved-in or sunken appearance. Today, the surgical correction of this deformity is carried out in children and adults through Nuss technic, which consists in the placement of a prosthetic bar under the sternum and over the ribs. Although this technique has been shown to be safe and reliable, not all patients have achieved adequate cosmetic outcome. This often leads to psychological problems and social stress, before and after the surgical correction. This paper targets this particular problem by presenting a method to predict the patient surgical outcome based on pre-surgical imagiologic information and chest skin dynamic modulation. The proposed approach uses the patient pre-surgical thoracic CT scan and anatomical-surgical references to perform a 3D segmentation of the left ribs, right ribs, sternum and skin. The technique encompasses three steps: a) approximation of the cartilages, between the ribs and the sternum, trough b-spline interpolation; b) a volumetric mass spring model that connects two layers - inner skin layer based on the outer pleura contour and the outer surface skin; and c) displacement of the sternum according to the prosthetic bar position. A dynamic model of the skin around the chest wall region was generated, capable of simulating the effect of the movement of the prosthetic bar along the sternum. The results were compared and validated with patient postsurgical skin surface acquired with Polhemus FastSCAN system.

Moreira, Antonio H. J.; Rodrigues, Pedro L.; Fonseca, Jaime; Pinho, A. C. M.; Rodrigues, Nuno F.; Correia-Pinto, Jorge; Vilaça, João L.



[A rare case of mediastinal neuroblastoma with pectus excavatum in a 4-month-old boy--a surgical report].  


Screening of neuroblastoma is commonly performed on 6-month-old infants; therefore, its discovery in children younger than that age is extremely rare. However, a 4-month-old boy with pectus excavatum was found to also have mediastinal neuroblastoma after close examination. This 7 kg child had no apparent symptoms, yet revealed an egg-sized shadow along the right atrium in the chest X-ray film, and along the right side of the vertebrae on CT. Due to the increase in the size of the tumor after two months of observation, we suspected malignant neurogenic tumor and performed a thoracotomy. With a right posterolateral thoracotomy we removed the dark-brown, elastic tumor measuring 6 x 4 x 3 cm and located along the right side of the vertebrae from III through VIII ribs. The origin was the thoracic sympathicus and the pathological diagnosis of the tumor was neuroblastoma with rosset formation. After conducting a post-operative chemotherapy (Jame's protocol), no evidence of recurrence was observed at 33 months after surgical treatment. We summarized the previously reported seven surgically treated cases of Stage I mediastinal neuroblastoma at less than 12 months of age. Among the 2500 pectus excavatum surgeries that have been held at our department, non has been found to have mediastinal neuroblastoma. PMID:1491204

Yoh, T; Ohnuki, T; Ishikura, T; Kei, J; Obara, T; Nitta, S



Thoracic wall reconstruction using ultrasound images to model/bend the thoracic prosthesis for correction of pectus excavatum  

NASA Astrophysics Data System (ADS)

Pectus excavatum is the most common congenital deformity of the anterior thoracic wall. The surgical correction of such deformity, using Nuss procedure, consists in the placement of a personalized convex prosthesis into sub-sternal position to correct the deformity. The aim of this work is the CT-scan substitution by ultrasound imaging for the pre-operative diagnosis and pre-modeling of the prosthesis, in order to avoid patient radiation exposure. To accomplish this, ultrasound images are acquired along an axial plane, followed by a rigid registration method to obtain the spatial transformation between subsequent images. These images are overlapped to reconstruct an axial plane equivalent to a CT-slice. A phantom was used to conduct preliminary experiments and the achieved results were compared with the corresponding CT-data, showing that the proposed methodology can be capable to create a valid approximation of the anterior thoracic wall, which can be used to model/bend the prosthesis.

Fonseca, João Gomes; Moreira, Antonio H. J.; Rodrigues, Pedro L.; Fonseca, Jaime C.; Pinho, A. C. M.; Correia-Pinto, Jorge; Rodrigues, Nuno F.; Vilaça, João L.



Investigating an approach to identifying the biomechanical differences between intercostal cartilage in subjects with pectus excavatum and normals in vivo: preliminary assessment of normal subjects  

NASA Astrophysics Data System (ADS)

The cause of pectus excavatum (PE) is unknown and little research has been done to assess the material properties of the PE costal cartilage. One source reported, after studying ex vivo various properties of the costal cartilage in cases of PE that the biomechanical stability of PE cartilage is decreased when compared to that of normals. Building on this idea, it would be beneficial to measure the biomechanical properties of the costal cartilages in vivo to further determine the differences between PE subjects and normals. An approach to doing this would be to use a modified FARO arm, which can read applied loads and resulting deflections. These values can be used to establish a finite element model of the chest area of a person with PE. So far, a validated technique for the registration between a CT based 3D model of the ribcage and a skin surface scan in case of PE has been addressed. On the basis of the data gathered from 10 subjects with normal chests using a robot arm, stylus and 3D laser scanner, we tried to evaluate the influence of inter-measurement respiration of a subject on results accuracy and the possibility of using the stylus for deflection measurement. In addition, we established the best strategy for taking measurements.

Rechowicz, Krzysztof; McKenzie, Frederic; Yan, Zhenzhen; Bawab, Sebastian; Ringleb, Stacie



Overcorrection during treatment of pectus deformities with DCC orthoses: experience in 17 cases  

PubMed Central

Treatment of pectus carinatum and pectus excavatum with dynamic chest compressor (DCC) orthoses have been reported by Haje and others. The goal of this study was to demonstrate that overcorrection during orthotic treatment of children and adolescents with pectus deformities can occur and requires medical attention. Of 3,028 children and adolescents with pectus deformities, observed between 1977 and October 2005, 1,824 were prescribed treatment with DCC orthoses and, after a few months of treatment, some overcorrection was noted in 30 patients. Of the patients who received orthoses, 738 had a minimum follow-up of 1 year and 17 of these, 2 with pectus excavatum and 15 with pectus carinatum, presented overcorrection and were studied. The dynamic remodeling method (DCC orthoses + exercises) was applied. The procedures, adopted according to each patient’s needs, were: decreasing the time of orthosis wear and/or the tightening of the screws, introducing a second orthosis, and improving the prescribed exercises and/or encouraging the patient to perform them more intensively. The therapy was successful in all patients, and the result was maintained in one case of pectus excavatum followed up until adulthood. It was concluded that overcorrection during DCC orthosis wear can occur and that careful medical follow-up is necessary if this complication is to be successfully reversed. PMID:16474937

Haje, D. P.



Technical innovation in minimally invasive repair of pectus excavatum.  


The aim of study was to introduce technical innovation of MIRPE which reduces the risk of cardiac injury. Modification of MIRPE method with semiflexible thoracoscope and sternum elevating technique has been used. Volkmann bone hook has been inserted percutaneously to the sternum. The hook elevates the sternum forward and enlarges the retrosternal space for safer passage of thoracoscopically guided introducer. Using semiflexible thoracoscope allows better view from various angles via one site of insertion. During the period 2005-2012, the MIRPE was performed on 29 girls and 151 boys; the mean age at the time of surgery was 15.9 years (range 13-18.7 years). The mean Haller index was 4.7 (range 2.7-20.5). The most common complication was pneumothorax (3.3 %) and the incidence of bar displacement was 2 %. The most serious complication was cardiac perforation when inserting Lorenz introducer. This occurred in a 16-year-old girl; she required urgent sternotomy with right atrial repair and recovered well. External elevation of sternum with the hook was used since this case. Subsequent 113 patients underwent surgery without any serious complications. Technical innovation using semiflexible thoracoscope and hook elevation of the sternum reduces the risk of cardiac injury. The hook opens the anterior mediastinum space effectively and makes the following dissection relatively safe and straightforward. PMID:24292408

Rygl, Michal; Vyhnanek, M; Kucera, A; Mixa, V; Kyncl, M; Snajdauf, J



An intragenic deletion of the gene MNAT1 in a family with pectus deformities.  


Pectus carinatum and excavatum have multiple genetic associations. We report on a novel association of these deformities in a 34-month-old male and his father, likely due to a small intragenic deletion of MNAT1 (ménage a trois 1 gene). Both individuals share a deletion of MNAT1 located at 14q23.1 and an interstitial duplication of CHRNA7 located at 15q13.3. Deletion of MNAT1 has been associated with connective tissue abnormalities and is likely the etiology of the malformations, whereas the duplication of CHNRA7 is unlikely related due to the lack of association with any such connective tissue abnormalities. PMID:24664931

Heithaus, Jennifer L; Davenport, Sandra; Twyman, Kimberly A; Torti, Erin E; Batanian, Jacqueline R



Effect of the compressive brace in pectus carinatum  

Microsoft Academic Search

Background: Patients with pectus carinatum complain of cosmetic problems because they stand out in spite of wearing clothes. Surgical treatment of pectus carinatum is resection of the deformed cartilage but a wide operative scar, postoperative pain and complications related with the operation can occur. Therefore we have performed compressive brace therapy as a non-operative treatment of pectus carinatum, and observed

Seock Yeol Lee; Seung Jin Lee; Cheol Woo Jeon; Cheol Sae Lee; Kihl Rho Lee


Lung Function after the Minimal Invasive Pectus Excavatum Repair (Nuss Procedure)  

Microsoft Academic Search

Background  The Nuss procedure was introduced at our center in 1999. The operation was mainly performed for cosmesis. Little information\\u000a is available regarding the influence of this operation on lung function.\\u000a \\u000a \\u000a \\u000a Methods  The aim of this study, a prospective analysis, was to analyze the effect of the Nuss procedure on lung function variables.\\u000a Between 1999 and 2007 a total of 203 patients

Daniel C. Aronson; Remko P. Bosgraaf; Eva-Maria Merz; Reindert P. van Steenwijk; Wim M. C. van Aalderen; Robertine van Baren



Brace Compression for Treatment of Pectus Carinatum  

PubMed Central

Background Surgery has been the classical treatment of pectus carinatum (PC), though compressive orthotic braces have shown successful results in recent years. We propose a non-operative approach using a lightweight, patient-controlled dynamic chest-bracing device. Materials and Methods Eighteen patients with PC were treated between July 2008 and June 2009. The treatment involved fitting of the brace, which was worn for at least 20 hours per day for 6 months. Their degree of satisfaction (1, no correction; 4, remarkable correction) was measured at 12 months after the initiation of the treatment. Results Thirteen (72.2%) patients completed the treatment (mean time, 4.9±1.4 months). In patients who completed the treatment, the mean overall satisfaction score was 3.73±0.39. The mean satisfaction score was 4, and there was no recurrence of pectus carinatum in patients who underwent the treatment for at least 6 months. Minimal recurrence of pectus carinatum after removal of the compressive brace occurred in 5 (38.5%) patients who stopped wearing the compressive brace at 4 months. Conclusion Compressive bracing results in a significant improvement in PC appearance in patients with an immature skeleton. However, patient compliance and diligent follow-up appear to be paramount for the success of this method of treatment. We currently offer this approach as a first-line treatment for PC. PMID:23275922

Jung, Joonho; Chung, Sang Ho; Cho, Jin Kyoung; Park, Soo-Jin; Choi, Ho



What Are the Signs and Symptoms of Marfan Syndrome?  


... in or sticks out. These conditions are called pectus excavatum and pectus carinatum, respectively. Teeth that are too ... Conditions such as scoliosis (a curved spine) and pectus excavatum (a chest that sinks in) can prevent the ...


A mother and daughter with a novel phenotype of hand and foot abnormalities and severe pectus excavatum.  


A mother and daughter with an overlapping Catel-Manzke and Temtamy preaxial brachydactyly hyperphalangism syndrome phenotype are reported. We describe a phenotype with a previously undescribed genetic basis. . PMID:23824731

Low, Karen; Smith, James; Lee, Simon; Newbury-Ecob, Ruth



Briacavatolides D–F, New Briaranes from the Taiwanese Octocoral Briareum excavatum  

PubMed Central

In the continued search for novel bioactive substances from the Taiwanese octocoral Briareum excavatum collected at Orchid Island, three new briarane-type diterpenoids, briacavatolides D–F (1–3) were isolated from the acetone extract. The structures of these compounds were elucidated by extensive NMR spectroscopic analysis and physical data. The anti-HCMV (human cytomegalovirus) activity of 1–3 and their cytotoxicity against selected cancer cell lines were evaluated. PMID:23118724

Wang, Shang-Kwei; Yeh, Tsun-Tai; Duh, Chang-Yih



Does overgrowth of costal cartilage cause pectus carinatum? A three-dimensional computed tomography evaluation of rib length and costal cartilage length in patients with asymmetric pectus carinatum  

PubMed Central

OBJECTIVES To evaluate whether the overgrowth of costal cartilage may cause pectus carinatum using three-dimensional (3D) computed tomography (CT). METHODS Twenty-two patients with asymmetric pectus carinatum were included. The fourth, fifth and sixth ribs and costal cartilages were semi-automatically traced, and their full lengths were measured on three-dimensional CT images using curved multi-planar reformatted (MPR) techniques. The rib length and costal cartilage length, the total combined length of the rib and costal cartilage and the ratio of the cartilage and rib lengths (C/R ratio) in each patient were compared between the protruding side and the opposite side at the levels of the fourth, fifth and sixth ribs. RESULTS The length of the costal cartilage was not different between the more protruded side and the contralateral side (55.8 ± 9.8 mm vs 55.9 ± 9.3 mm at the fourth, 70 ± 10.8 mm vs 71.6 ± 10.8 mm at the fifth and 97.8 ± 13.2 mm vs 99.8 ± 15.5 mm at the sixth; P > 0.05). There were also no significant differences between the lengths of ribs. (265.8 ± 34.9 mm vs 266.3 ± 32.9 mm at the fourth, 279.7 ± 32.7 mm vs 280.6 ± 32.4 mm at the fifth and 283.8 ± 33.9 mm vs 283.9 ± 32.3 mm at the sixth; P > 0.05). There was no statistically significant difference in either the total length of rib and costal cartilage or the C/R ratio according to side of the chest (P > 0.05). CONCLUSIONS In patients with asymmetric pectus carinatum, the lengths of the fourth, fifth and sixth costal cartilage on the more protruded side were not different from those on the contralateral side. These findings suggest that overgrowth of costal cartilage cannot explain the asymmetric protrusion of anterior chest wall and may not be the main cause of pectus carinatum. PMID:23868604

Park, Chul Hwan; Kim, Tae Hoon; Haam, Seok Jin; Lee, Sungsoo



Briacavatolides A–C, New Briaranes from the Taiwanese Octocoral Briareum excavatum  

PubMed Central

In order to search for novel bioactive substances from marine organisms, we have investigated the organic extracts of the Taiwanese octocoral Briareum excavatum collected at Orchid Island. Three new briarane-type diterpenoids, briacavatolides A–C (1–3) as well as two known briaranes, briaexcavatolide U (4) and briaexcavatin L (5) were isolated from the acetone extract. The structures of these compounds were elucidated by extensive NMR spectroscopic analysis and physical data. The anti-HCMV (human cytomegalovirus) activity of 1–5 and their cytotoxicity against selected cancer cell lines were evaluated. PMID:22822353

Yeh, Tsun-Tai; Wang, Shang-Kwei; Dai, Chang-Feng; Duh, Chang-Yih



Finite element analysis of pectus carinatum surgical correction via a minimally invasive approach.  


Pectus carinatum (PC) is a chest deformity caused by a disproportionate growth of the costal cartilages compared to the bony thoracic skeleton, pulling the sternum towards, which leads to its protrusion. There has been a growing interest on using the 'reversed Nuss' technique as a minimally invasive procedure for PC surgical correction. A corrective bar is introduced between the skin and the thoracic cage and positioned on top of the sternum highest protrusion area for continuous pressure. Then, it is fixed to the ribs and kept implanted for about 2-3 years. The purpose of this work was to (a) assess the stresses distribution on the thoracic cage that arise from the procedure, and (b) investigate the impact of different positioning of the corrective bar along the sternum. The higher stresses were generated on the 4th, 5th and 6th ribs backend, supporting the hypothesis of pectus deformities correction-induced scoliosis. The different bar positioning originated different stresses on the ribs' backend. The bar position that led to lower stresses generated on the ribs backend was the one that also led to the smallest sternum displacement. However, this may be preferred, as the risk of induced scoliosis is lowered. PMID:24428546

Neves, Sara C; Pinho, Acm; Fonseca, Jaime C; Rodrigues, Nuno F; Henriques-Coelho, Tiago; Correia-Pinto, Jorge; Vilaça, João L



Pectus carinatum  


... a solitary abnormality or in association with other genetic disorders or syndromes.The condition causes the sternum to protrude, with a narrow depression along the sides of the chest. This gives ...


Contact toxicity of permethrin-impregnated fabric to Hyalomma anatolicum excavatum (Acari: Ixodidae): effects of laundering and exposure and recovery times.  


A previous study that documented enhanced host attachment by the camel ticks Hyalomma dromedarii Koch after permethrin exposure prompted a similar investigation of permethrin effects in H. anatolicum excavatum Koch, an Old World hardbacked tick suspected of vectoring human pathogens. Contact toxicity tests were conducted with laboratory-colonized male and female H. a. excavatum of the same age exposed for periods of 5, 10, 30, and 60 min to each of 5 fabric treatments: unwashed/untreated; unwashed and treated; and treated fabric given 1, 2, or 3 laundry cycles of warm-water detergent machine washing, followed by hot-air drying. Fabric was tropical weight 100% cotton military uniform. Treated fabric was impregnated with permethrin at 0.125 mg (AI)/cm2. Contact toxicity was measured immediately after and 24 h after fabric contact as proportion of ticks that attached mouthparts to the skin of a host (rabbit) within a 60-min quest period and time lapse (minutes) between contact with the host and attachment. Attachment response immediately after permethrin contact was exposure time- and wash-dependent in both sexes. Proportion of attaching ticks and times to attachment were comparable in controls and in groups exposed to all permethrin-treated fabrics for 5 or 10 min. Contact periods of 30 and 60 min with 0-wash/treated or 1-wash and treated fabric significantly reduced the frequency of attachment and significantly prolonged mean times to attachment. Compared with low levels of attachment response observed immediately after fabric contact, recovery of attachment response was observed 24 h after exposure in these wash/treatment groups, but inhibition was still evident. Permethrin-induced intoxication was more pronounced in males than females. Mortality 24 h after exposure was only significant among females exposed to 0-wash/treated fabric for 60 min. There was no evidence of permethrin-mediated stimulation of the attachment response in H. a. excavatum. PMID:9615556

Fryauff, D J; Shoukry, M A; Wassef, H Y; Gray, G; Schreck, C E



[Differentiation of closely related species Hyalomma anatolicum and H. excavatum (Acari: Ixodidae) based on a study of all life cycle stages, throughout entire geographical range].  


Species status is stated for Hyalomma anatolicum and H. excavatum, based on numerous material from the territory of their distribution. The differentiation of species is recovered for all stages of the life cycle. Diagnosis of Hyalomma anatolicum. Female: small tick--length of scutum commonly less than 2 mm; width of scutum commonly less than 1.9 mm; color of scutum, gnathosoma and coxae light, yellowish- or reddish-brown; whitish enameled pigment on scutum absent; posterolateral ledges of scutum weakly expressed or absent; cervical and lateral grooves more shallow (than in H. excavatum) (fig. 1); setae of scutum, alloscutum, sternal setae and ventromedian setae of second article of palpae more tapering to the apex, narrow rounded or acute (fig. 2, 1, 2, 5, 8). Male: small tick--length of conscutum, as a rule, less than 4 mm; width of scutum, as a rule, less than 2.3 mm; shape of conscutum marrow oval (fig. 3), widest in the midlevel; color of conscutum, anal shields, gnathosoma and coxae light, yellowish- or reddish-brown; whitish enameled pigment on conscutum absent; caudal depression with less dense and more large punctuations (than in H. excavatum); ridges lateral to caudal field less high and sharp (than in H. excavatum); posteromedian groove separated from parma by contiguous punctuations or smooth non high area; setae of conscutum conus-like, more sharpening (fig. 4, 1-3); posterior dorsal margin of gnathosoma straight or slightly concave (fig. 4, 8); segments of leg IV not swallowed. Nymph: large tick (see description). Scutum more narrow. Dorsal tale of spiracular plates clear expressed, marginal perforations distant from margin of spiracular plates at the base of tale (fig. 5, 3); anterolateral side of basis capituli approximately equal to half of gnathosoma width; ventrally lateral projections of gnathosoma situated in posterior half of capitulum base (fig. 5, 4, 5). Hypostome more longer and narrow (fig. 5, 5). Larva: large tick (see description). Diagnosis of Hyalomma excavatum. Female: large tick--length of scutum commonly more than 2 mm; width of scutum commonly more than 1.9 mm; color of scutum, gnathosoma and coxae dark, reddish- or black-brown; whitish enameled pigment commonly present; posterolateral ledges of scutum clearly expressed; cervical and lateral grooves more dipper (than in H. anatolicum) (fig. 7). Setae of scutum, alloscutum, sternal setae and ventromedian setae of second article of palpae more stick-like, more widely obtuse (fig. 8, 1-5). Male: large tick--length of conscutum more than 4 mm; width of scutum more than 2.3 mm; shape of conscutum wide oval (fig. 9), widest in posterior half of length; color of conscutum, anal shields, gnathosoma and coxae dark, reddish- or black-brown; whitish enameled pigment often present; caudal depression with more dense and more small punctuations (than in H. anatolicum); ridges lateral to caudal field more high and sharp (than in H. anatolicum); posteromedian groove separated from parma by strong elevations fused with paraparmal festoons; setae of conscutum more obtuse, often stick-like (fig. 10, 1, 2); posterior dorsal margin of gnathosoma straight or lightly concave. (fig. 10, 3); segments of leg IV swallowed. Nymph: small tick (see description). Scutum more wide. Dorsal tale of spiracular plates weakly expressed, marginal perforations not distant from margin of spiracular plates at the base of tale (fig. 11, 3); anterolateral side of basis capituli clearly shorter than half of gnathosoma width; ventrally lateral projections situated in the middle of or anterior half of capitulum base (fig. 11, 4, 5). Hypostome more shorter and wider (fig. 5, 5). Larva: small tick (see description). Established taxonomical independence of H. anatolicum and H. excavatum is confirmed by several criteria: external morphology (see diagnoses); morphometrical data (see diagnoses and fig. 12, 13); size inversion: larva and nymph of H. anatolicum are large, but females and males are small; while H. excavatum vise versa--larva and nymph are small, but adults--large; host speci

Apanaskevich, D A



Neoplasias mielodisplásicas o mieloproliferativas: Tratamiento (PDQ®)

Resumen de información revisada por expertos acerca del tratamiento de las neoplasias mielodisplásicas o mieloproliferativas incluso las leucemias mielomonocíticas crónicas o juveniles y la LMC atípica.


Neoplasias mielodisplásicas o mieloproliferativas: Tratamiento (PDQ®)

Resumen de información revisada por expertos acerca del tratamiento de las neoplasias mielodisplásicas o mieloproliferativas, incluso las leucemias mielomonocíticas crónicas o juveniles, y la LMC atípica.


Fumar durante el tratamiento de cáncer (PDQ®)

Resumen de información revisada por expertos acerca de la influencia de seguir fumando sobre el tratamiento del cáncer y el riesgo de segundos cánceres. Se mencionan las intervenciones que estimulan dejar el hábito de fumar.


Molecular characterization of Bm86 gene orthologs from Hyalomma excavatum, Hyalomma dromedarii and Hyalomma marginatum marginatum and comparison with a vaccine candidate from Hyalomma scupense.  


The ixodid ticks from the Hyalomma genus are important pests of livestock, having major medical and veterinary significance in Northern Africa. Beside their direct pathogenic effects, these species are vectors of important diseases of livestock and in some instances of zoonoses. Anti-tick vaccines developed in Australia and Cuba based on the concealed antigen Bm86 have variable efficacy against H. anatolicum and H. dromedarii. This variation in vaccine efficacy could be explained by the variability in protein sequence between the recombinant Bm86 vaccine and Bm86 orthologs expressed in different Hyalomma species. Bm86 orthologs from three Hyalomma tick species were amplified in two overlapping fragments and sequenced. The rate of identity of the amino acid sequence of Hm86, He86 and Hdr86, the orthologs of Bm86, respectively, in H. marginatum marginatum, H. excavatum and H. dromedarii, with the Bm86 proteins from Rhipicephalus microplus (Australia, Argentina and Mozambique) ranged between 60 and 66%. The obtained amino-acid sequences of Hmm86, He86 and Hdr86 were compared with the Hd86-A1 sequence from H. scupense used as an experimental vaccine. The results showed an identity of 91, 88 and 87% for Hmm86, He86 and Hdr86, respectively. A specific program has been used to predict B cells epitopes sites. The comparison of antigenic sites between Hd86-A1 and Hm86/Hdr86/He86 revealed a diversity affecting 4, 8 and 12 antigenic peptides out of a total of 28 antigenic peptides, respectively. When the Bm86 orthologs amplification protocol adopted in this study was applied to H. excavatum, two alleles named He86p2a1 and He86p2a2 were detected in this species. This is the first time that two different alleles of Bm86 gene are recorded in the same tick specimen. He86p2a1 and He86p2a2 showed an amino acid identity of 92%. When He86p2a1 and He86p2a2 were compared to the corresponding sequence of Hd86-A1 protein, an identity of 86.4 and 91.0% was recorded, respectively. When compared to He86, Hdr86 and Hm86, Bm86 used in commercial and experimental vaccines, showed a greater extent of diversity than noted when the same Hyalomma orthologs were compared to Hd86-A1. Although significant, these variations were less extensive within the Hyalomma genus. Accordingly, thus suggesting that Hd86-A1 vaccine candidate might be more appropriate to target Hyalomma tick species than corresponding Bm86 commercial vaccines. However, vaccination trials with both antigens are required to validate this hypothesis. PMID:22683299

Ben Said, Mourad; Galai, Yousr; Mhadhbi, Moez; Jedidi, Mohamed; de la Fuente, José; Darghouth, Mohamed Aziz



Severe bronchomalacia treated by combination of Nuss procedure and aortopexy: an unusual therapy combination.  


Aortopexy is the treatment of choice for clinically significant tracheobronchomalacia from external vascular compression. When a marked chest depression is present, aortopexy may be less effective. We report 2 patients with pectus excavatum and vascular compression of the trachea who, despite their young age, benefited from combined Nuss bar insertion and aortopexy. PMID:21172474

Speggiorin, Simone; Atamanyuk, Iryna; Wallis, Colin; Roebuck, Derek J; McLaren, Clare A; Noctor, Clair; Elliott, Martin J



Age-related normal ranges for the Haller index in children  

Microsoft Academic Search

Purpose The Haller index is an accepted CT method for evaluating thoracic dimensions in patients with pectus excavatum. The purpose of this study is to establish age- and gender-related norms for the Haller index in childhood. Materials and methods We retrospectively reviewed 574 consecutive chest CT examinations (M=285, F=289) performed at our institution from August 2001 through March 2002. Seventeen

Stephen W. Daunt; Justine H. Cohen; Stephen F. Miller



Autosomal dominant transmission of ureteral triplication and bilateral amastia.  


We report a case of ureteral triplication as part of an autosomal dominant syndrome comprising bilateral amastia, pectus excavatum, umbilical hernia, patent ductus arteriosus, dysmorphic low set ears, ptosis, epicanthic folds with an antimongoloid slant to the eyes, hypertelorism, high arched palate, flat broad nasal bridge, tapered digits, cubitus valgus and syndactyly. PMID:3795344

Rich, M A; Heimler, A; Waber, L; Brock, W A



Deletion of short arm of chromosome 18, Del(18p) syndrome.  


Deletion of the short arm of chromosome 18 is a rare syndrome clinically presenting with variable mental retardation, growth retardation, low height, pectus excavatum, craniofacial malformations including long ear, ptosis, microcephaly and short neck. This case report presents with characteristic features along with rare feature of single nostril. PMID:24531606

Babaji, Prashant; Singh, Anurag; Lau, Himani; Lamba, G; Somasundaram, P



Tratamiento inmunosupresor de la miastenia gravis con tacrolimus (FK506).  

E-print Network

??La miastenia gravis es una enfermedad autoinmune mediada por anticuerpos anti-receptor de acetilcolina del músculo esquelético. Su tratamiento incluye: La timectomia y la inmunosupresión con… (more)

Abderrazek, Jamal Azem



Tratamiento del paludismo pediátrico: Papel de las intervenciones nutricionales  

Microsoft Academic Search

ResumenEl paludismo es una causa primordial de morbilidad y mortalidad en niños, particularmente en África subsahariana. Aunque se ha logrado un progreso considerable en el tratamiento del paludismo pediátrico con el tratamiento de combinación basado en la artemisinina, siguen existiendo numerosos obstáculos que se oponen a la puesta en práctica efectiva de estas nuevas opciones terapéuticas sumamente eficaces. Análogamente, si

Akoto Kwame Osei; Davidson H. Hamer



Siga adelante: la vida después del tratamiento del cáncer

E-book con consejos para supervivientes de cáncer e información sobre temas relacionados con la vida después del tratamiento, entre ellos, la atención médica de seguimiento, los cambios físicos y emocionales y los cambios en el estilo de vida.


Cánceres poco comunes en la niñez: Tratamiento (PDQ®)

Resumen de información revisada por expertos acerca del tratamiento de los cánceres poco comunes en la niñez como los cánceres de la cabeza y el cuello, el tórax, el abdomen, el aparato reproductor, la piel y otros.


Management of Congenital Chest Wall Deformities  

PubMed Central

Congenital chest wall deformities are considered to be anomalies in chest wall growth. These can be categorized as either rib cage overgrowth or deformities related to inadequate growth (aplasia or dysplasia). Rib cage overgrowth leads to depression of the sternum (pectus excavatum) or protuberance of the sternum (pectus carinatum) and accounts for greater than 90% of congenital chest wall deformities. The remaining deformities are a result of inadequate growth. Evolution in the management of congenital chest wall deformities has made significant progress over the past 25 years. This article will review chest wall deformities and the current management strategies of these interesting anomalies. PMID:22294949

Blanco, Felix C.; Elliott, Steven T.; Sandler, Anthony D.



Positioning challenges in mammography.  


Patients presenting for mammography are different ages and sizes and have varying body habitus; they include men, those who arrive on a stretcher or in a wheelchair, and those with very small breasts, large or wide breasts, pectus excavatum or pectus carinatum, a barrel chest, or kyphosis. The true professional must know how to image patients who deviate from the norm. In addition to competent positioning skills and anatomical knowledge, the mammographer needs a thorough knowledge of the various projections and the skills to modify any projection to meet the needs of individual patients. PMID:24614444

Peart, Olive



Flail chest stabilization with Nuss operation in presence of multiple myeloma  

PubMed Central

Nowadays the Nuss operation has been widely adopted as a minimally invasive procedure and standard surgical choice in pectus excavatum. However, much debate and concern have been raised regarding its applicability in adults with pectus excavatum flail chest and other thoratic wall deformities, as compared with younger patients, in terms of complications after surgery. To stabilize the segment of paradoxical chest wall movement we performed the Nuss operation on a patient with multiple myeloma who sustained blunt thoracic trauma. The patient presented with paradoxical movement of the thoracic wall and sternum instability due to multiple myeloma, which led to severe dyspnea, hypoxemia, hypercapnea, and bedridden state. His condition progressed to acute respiratory distress syndrome and did not respond to conservative treatment. We performed the Nuss operation on the patient, and his clinical symptoms were relieved after surgery. The patient regained the ability to walk unassisted and was discharged from the hospital without any specific events. PMID:24822124

Lee, Song Am; Hwang, Jae Joon; Chee, Hyun Keun; Kim, Yo Han



Flail chest stabilization with Nuss operation in presence of multiple myeloma.  


Nowadays the Nuss operation has been widely adopted as a minimally invasive procedure and standard surgical choice in pectus excavatum. However, much debate and concern have been raised regarding its applicability in adults with pectus excavatum flail chest and other thoratic wall deformities, as compared with younger patients, in terms of complications after surgery. To stabilize the segment of paradoxical chest wall movement we performed the Nuss operation on a patient with multiple myeloma who sustained blunt thoracic trauma. The patient presented with paradoxical movement of the thoracic wall and sternum instability due to multiple myeloma, which led to severe dyspnea, hypoxemia, hypercapnea, and bedridden state. His condition progressed to acute respiratory distress syndrome and did not respond to conservative treatment. We performed the Nuss operation on the patient, and his clinical symptoms were relieved after surgery. The patient regained the ability to walk unassisted and was discharged from the hospital without any specific events. PMID:24822124

Lee, Song Am; Hwang, Jae Joon; Chee, Hyun Keun; Kim, Yo Han; Lee, Woo Surng



Anterior chest wall elevation using a T-fastener suture technique during a Nuss procedure.  


The most critical part of the Nuss procedure is the passage of the introducer across the anterior mediastinum without cardiac injury. For patients with severe pectus excavatum, passing the introducer can be difficult and hazardous. We describe a technique that resembles a use of T-fastenerlike suture material to elevate the anterior chest. The elevation of the chest allows safe, blunt anterior mediastinal dissection before the passage of the introducer. The risk of intraoperative cardiac perforation is minimized. PMID:25087810

Kim, Daabin; Idowu, Olajire; Palmer, Barnard; Kim, Sunghoon



Tratamiento pasivo de aguas de mina con altas  

E-print Network

Tratamiento pasivo de aguas de mina con altas concentraciones de metales Resultados de ensayos en · Metodología · Resultados · Trabajos pendientes #12;Introducción Problemática de las aguas ácidas de mina 2.5 H2O Faja Pirítica Ibérica: · Mayor reserva de pirita del mundo · Aguas ácidas de mina con

Politècnica de Catalunya, Universitat


Nueva opción de tratamiento para mujeres jóvenes con cáncer de seno sensible a las hormonas

Un fármaco usado para el tratamiento del cáncer de seno (mama), conocido como exemestano, es más eficaz que tamoxifeno, un fármaco preventivo de uso común para el cáncer de seno, en la prevención de la recidiva del cáncer de seno en mujeres jóvenes que también reciben tratamiento posoperativo para suprimir el funcionamiento ovárico. Los resultados de este estudio se presentaron en mujeres que tenían un tipo de cáncer de seno en estadio inicial sensible al tratamiento hormonal.


Prospectus2 pectus2O1OProsp  

E-print Network

O #12;CONTENTS ORIGIN AND HISTORY CHRONOLOGY DEANS PAST AND PRESENT EXECUTIVE STAFF ORGANIZATION important development in recent years has thus been a ORIGIN AND HISTORY Clock Tower, Bldg. 1 #12;4 change, and an increasing social responsibility in graduate education to provide new intel- lectual paradigms

Miyashita, Yasushi


Estudio de Asignación de Opciones Individualizadas de Tratamiento (TAILORx): preguntas y respuestas

Hoy se inició el Estudio de Asignación de Opciones Individualizadas de Tratamiento (Trial Assigning IndividuaLized Options for Treatment (Rx), o TAILORx, el cual evaluará si los genes que están frecuentemente asociados con el riesgo de recurrencia entre las mujeres con cáncer de seno en etapa inicial pueden ser utilizados para asignar a las pacientes el tratamiento más adecuado y efectivo.


Lanzamiento del estudio de tratamiento personalizado para el cáncer de seno

Hoy se inició el Estudio de Asignación de Opciones Individualizadas de Tratamiento (Trial Assigning IndividuaLized Options for Treatment (Rx), o TAILORx, el cual evaluará si los genes que están frecuentemente asociados con el riesgo de recurrencia entre las mujeres con cáncer de seno en etapa inicial pueden ser utilizados para asignar a las pacientes el tratamiento más adecuado y efectivo. Preguntas y respuestas


Isolated asymptomatic short sternum in a healthy young girl.  


Congenital sternal defects are rare deformities frequently associated with other anomalies of the chest wall and other organ systems. Although pectus excavatum, pectus carinatum, and cleft sternum can present as isolated deformity, in most cases they are associated with heart and inner organs anomalies and described as symptoms of syndromes like Marfan syndrome, Noonan syndrome, Poland anomaly, and Cantrell pentalogy. In contrast, the etiology of an isolated defect is not well understood. We observed a short sternum (dysmorphic manubrium, hypoplastic body, and complete absence of the xiphoid process) in a completely asymptomatic 13-year-old woman. A comprehensive instrumental exams panel was performed to exclude associated anomalies of the heart and of the other organ systems. The patient was completely asymptomatic and she did not need any medical or surgical treatment. To our knowledge, this is the first case of isolated short sternum reported in literature. PMID:25143854

Turturro, Francesco; Calderaro, Cosma; Montanaro, Antonello; Labianca, Luca; Argento, Giuseppe; Ferretti, Andrea



Spontaneous bilateral pneumothorax resulting from iatrogenic buffalo chest after the nuss procedure.  


We describe a case of iatrogenic buffalo chest resulting in spontaneous bilateral pneumothorax in a 14-year-old boy with pectus excavatum in the late postoperative period after the Nuss procedure. The patient presented with a sudden onset of dyspnea 2 months after the Nuss procedure, and a chest roentgenogram showed a bilateral pneumothorax. We performed an emergency operation and found a communication between the chest cavities and a ruptured bulla in the left lung. This case highlights the potential development of simultaneous bilateral pneumothorax caused by a communication between the chest cavities after the Nuss procedure. PMID:25282216

Sakamoto, Kazuhiro; Ando, Kohei; Noma, Daisuke



Jeune's syndrome (asphyxiating thoracic dystrophy): congenital and acquired.  


Familial asphyxiating thoracic dystrophy (ATD), also known as Jeune's syndrome, is a rare autosomal recessive disorder with variable severity and multiple musculo-skeletal manifestations. Respiratory distress may be severe, resulting in death during infancy. Surgical repair techniques have typically involved median sternotomy (with graft interposition), resulting in poor outcomes. Acquired ATD may rarely result from impairment of chest wall growth following "open" (Ravitch-type) repair of pectus excavatum or carinatum deformities. Symptomatic patients may have profound restriction of pulmonary function. Repair techniques typically involve re-do Ravitch-type procedures or median sternotomy with rib graft interposition. Mild to moderate improvements in pulmonary function tests have been documented. PMID:18582822

Phillips, J Duncan; van Aalst, John A



Colocación de marcapasos diafragmático por toracotomía mínima para tratamiento de hipoincoercible  

Microsoft Academic Search

RESUMEN Presentamos un caso de hipo incoercible de cuatro años de duración y con clínica de pérdida de peso y fatiga. Refractario al tratamiento médico. Se le implantó un marcapasos diafragmático por vía intratorácica. Este aparato controla los movimientos del diafragma por estimulación eléctrica del nervio frénico. Se consiguió con ello disminuir la intensidad de los episodios de hipo. Este




Microsoft Academic Search

El presente estudio trata de sintetizar, integrar y discutir los principales re- sultados constatados en la investigación con respecto a la eficacia de las interven- ciones farmacológicas más frecuentemente utilizadas en el tratamiento de la hipe- ractividad. Este trabajo constituye la primera parte de un estudio más amplio basa- do en una selectiva revisión y análisis cualitativo de la literatura

Ana Miranda Casas; Juan Carlos Pastor Soriano



E-print Network

EEES 2012/13 POSGRADO EN GESTI�N Y OPERACI�N DE PLANTAS DE TRATAMIENTO DE AGUAS #12;Joaquim Olivé agua con más de 140 años de experiencia. Agbar es un referente a nivel nacional e internacional con expertise de Agbar, ofreciendo a las empresas del agua y del medio ambiente soluciones y tecnologías basadas

Politècnica de Catalunya, Universitat


Tratamiento pasivo de aguas cidas de mina con caliza y MgO  

E-print Network

Tratamiento pasivo de aguas ácidas de mina con caliza y MgO: Resultados de los ensayos de campo en de lodos piríticos 200m Pozo de desagüe #12;Lugar de estudio (III): Calidad del agua de mina · pH: 2 debajo de la balsa de lodos Toma de agua Decantador de salida del bidón B Decantador de salida del bidón

Politècnica de Catalunya, Universitat


Al tratamiento del agua potable para mejo-rar su sanidad o calidad bacteriolgica se  

E-print Network

Al tratamiento del agua potable para mejo- rar su sanidad o calidad bacteriológica se le refiere desinfección usado por los proveedores locales para disminuir la contami- nación bacteriológica del agua. Este método tam- bién puede ser usado por los propietarios de pozos de agua particulares. Pozos de agua Los


El tratamiento con cloro es un mtodo para desinfectar un pozo de agua. Se recomien-  

E-print Network

El tratamiento con cloro es un método para desinfectar un pozo de agua. Se recomien- da cuando un sistema de agua está contam- inado con bacterias. La contaminación puede ocurrir en la instalación del exceso de lluvia entran en el pozo. Si el agua subterránea constituye en sí la fuente de bacterias, el


Se inicia estudio de los NIH sobre respuestas excepcionales al tratamiento del cáncer

La Iniciativa de Respuestas Excepcionales (Exceptional Responders Initiative), un estudio que investiga los factores moleculares de los tumores en pacientes de cáncer que responden en forma excepcional al tratamiento con medicamentos, se inició hoy bajo la guía del Instituto Nacional del Cáncer (NCI). Los científicos tratarán de identificar en los tumores las características moleculares que predicen si un medicamento o una clase de medicamento en particular será beneficioso o no.


Prevalence of Swimming Puppy Syndrome in 2,443 Puppies during the Years 2006-2012 in Thailand  

PubMed Central

The purpose of this study was to report on the prevalence of swimming puppy syndrome (SPS) and investigate predisposing factors. Data were recorded from 2,443 puppies (1,183 males and 1,260 females) in Thailand, October 2006–September 2012, including breed, sex, number of puppies per litter, type of nest floor, number of affected limbs, and occurrence of pectus excavatum. Fifty-two puppies (2.13%) were diagnosed with SPS. The breed most frequently affected was English Bulldog (8.33%). There was no significant difference (P > 0.05) between presence and absence of disease based on sex, breed, and nest floor type. The number of puppies per litter was associated with SPS; puppies from smaller litters (1.92?±?1.12) had a higher prevalence of the disease (P < 0.01) than puppies from larger litters (3.64?±?2.24). Moreover, 15.38% of puppies with affected limbs showed signs of pectus excavatum (8/52); this clinical sign was more prevalent (P < 0.01) in puppies with all four limbs affected with SPS. PMID:23819102

Yano, Terdsak



A Simple and Safe Technique for Manipulation of Retrosternal Dissection in the Nuss Procedure  

PubMed Central

Objective: The Nuss procedure has become the first choice for repairing the pectus excavatum because of the advantages of the technique including minimal invasiveness and short operative duration. Although this technique appears simple and easy, life-threatening complications during dissection such as intraoperative cardiac perforation have been reported. We developed a new approach for safer dissection of retrosternal space. Methods: We use a dissector that is commonly used for laparoscopic operation, instead of the Nuss introducer. The dissector goes through the same skin incision where the Nuss bar will be inserted. The major difference is the position of dissector insertion, which is set up more dorsally than usual, and the use of a laparoscopic dissector instead of the Nuss introducer. In this new approach, the direction of dissection is from dorsal toward the anterior thoracic wall, which allows us to visually follow the tip of the dissector throughout the surgery. Moreover using the dissector that has better manipulation capability enables us the fine dissection and also is able to precisely determine both the layer and the area of the dissection level. Results: We have treated more than 150 patients using this technique without any complications since 2008. In all the cases, safer dissection of the retrosternal space was performed with good results. Conclusion: We believe every surgeon can easily apply this procedure to patients with pectus excavatum, and this procedure can reduce the stress during the dissection. PMID:24570769

Noguchi, Masahiko; Kondoh, Shoji; Fujita, Kenya



engineering POstGraDuatePrOsPectus2011  

E-print Network

of Scotland's many islands and enjoy picturesque landscapes and fascinating wildlife. In addition to rural spaces, you can easily discover a haven away from the rush of modern urban life. welcome to Glasgow 5 #12 research power and its continuing growth in areas of strategic importance ­ engineering, science, business

Mottram, Nigel



Microsoft Academic Search

Resumen Los tratamientos aerobios y anaerobios constituyen las dos grandes alternativas de depuración biológica de aguas residuales y residuos orgánicos fermentables. Sin embargo, el hecho de no necesitar aireación y la generación de biogas, que se puede utilizar en la misma planta con finalidades energéticas, hacen que la digestión anaerobia resulte mucho más favorable económicamente, permitiendo en muchos casos la

Isabel Ruiz; Juan Antonio Álvarez; Manuel Soto


Tratamiento ayuda a las mujeres jóvenes a preservar la fertilidad durante la quimioterapia para el cáncer de seno

Las mujeres jóvenes con cáncer de seno (mama) lograron preservar la fertilidad durante los tratamientos del cáncer con un fármaco inyectable bloqueador de hormonas que les provocó menopausia temporal. Los resultados del estudio se anunciaron hoy en el congreso anual de la Sociedad Americana de Oncología Clínica (ASCO), y provienen del Estudio de Prevención de la Menopausia Temprana (POEMS), patrocinado por el Instituto Nacional del Cáncer (NCI).


Trazodona: ¿Nuevo enfoque selectivo para el tratamiento de los sofocos generados por la deprivación androgénica en el carcinoma prostático?  

Microsoft Academic Search

toxicidad nada despreciable. Dentro del tratamiento no hormonal de esta patología juegan un papel destacado los antidepresivos. Latrazodona,unantidepresivoSARI(inhibidoresdelarecaptacióndeserotonina\\/antagonistadela2A),conunperfildeactua - ciónmásselectivosobrelosreceptoresimplicadosenlossofocos;podríaserdegraninterés.Trazodonamuestraunagranafinidad por los receptores 5-HT 2A y una moderada afinidad por los receptores 5-HT 1A. Comoesconocidolosnivelesdeserotonina(5-hidroxitriptaminao5-HT)enmujerespostmenopáusicasestándisminuidos,nor - malizándoseconlasterapiassustitutivas.Todoellosugierequeladeprivaciónabruptadehormonassexualesdalugaraunareduc - ción en la circulación de serotonina, con el consiguiente aumento de sus receptores 5-HT 2A hipotalámicos. Estos receptores esta - rían implicados

Santiago Vilar González; Francesc Montañá Puig; Sebastiá Sabater Martí; Manuel Aguayo Martos



Classic phenotype of Coffin-Lowry syndrome in a female with stimulus-induced drop episodes and a genotype with preserved N-terminal kinase domain.  


An adolescent female presented with intellectual disability, stimulus-induced drop episodes (SIDEs), facial characteristics that include wide set eyes, short nose with wide columella, full and everted lips with wide mouth and progressive skeletal changes: scoliosis, spondylolisthesis and pectus excavatum. These findings were suggestive of Coffin-Lowry syndrome (CLS), and this was confirmed by the identification of a novel mutation in RPS6KA3, a heterozygous one basepair duplication at nucleotide 1570 (c.1570dupA). This mutation occurs within the C-terminal kinase domain of the protein, and, therefore contradicts the previous report that SIDEs is only associated with premature truncation of the protein in the N-terminal kinase domain or upstream of this domain. As CLS is X-linked, it is unusual for a female to have such a classic phenotype. PMID:24311527

Rojnueangnit, Kitiwan; Jones, Julie R; Basehore, Monica J; Robin, Nathaniel H



Phenotype of a patient with pure partial trisomy 2p(p23-->pter).  


We present the case of a 7-month-old girl with the karyotype 46,XX, der(13) t(2;13)(p23;p11.2).ish der(13)(wcp2+) de novo. Painting confirmed that the additional segment on 13p was of chromosome 2 origin, resulting in trisomy 2p23 -->2pter. The child had a prominent forehead with a flat hemangioma, depressed nasal bridge, protruding tongue, posteriorly angulated ears, esotropia with poor abduction of the right eye, bilateral severe myopia (-5.5 D), retinal hypopigmentation, foveal hypoplasia, and striking left optic nerve hypoplasia. She also had pectus excavatum, a protruding abdomen with diastasis recti, generalized hypotonia, delayed fine and gross motor development, grade II reflux on the left side, and grade III-IV reflux on the right side. An EEG showed epileptiform discharges. Computed tomographic scan of the brain showed decreased white matter, but magnetic resonance imaging showed normal results. PMID:11050631

Al-Saffar, M; Lemyre, E; Koenekoop, R; Duncan, A M; Der Kaloustian, V M



Physical medicine respiratory muscle aids to avert respiratory complications of pediatric chest wall and vertebral deformity and muscle dysfunction.  


The purpose of this article was to describe the use of noninvasive inspiratory and expiratory muscle aids to prevent chest wall deformities including pectus excavatum, to prevent respiratory complications of vertebral surgery, to prevent acute and long-term ventilatory insufficiency and failure in children with paralytic disorders who develop these deformities, and to permit the extubation and tracheostomy tube decanulation of "unweanable" patients. Noninvasive airway pressure aids can provide up to continuous ventilator support for patients with little or no vital capacity and can provide for effective cough flows for patients with severely dysfunctional expiratory muscles. An April 2010 consensus of clinicians from 20 centers in 14 countries reported over 1500 spinal muscular atrophy type 1 (SMA1), Duchenne muscular dystrophy (DMD), and amyotrophic lateral sclerosis (ALS) patients who survived using continuous ventilatory support without tracheostomy tubes. Four of the centers routinely extubated unweanable DMD patients so that none of their over 250 such patients has undergone tracheotomy. PMID:21224790

Ishikawa, Y; Bach, J R



Developing clinically relevant aspects of the nuss procedure surgical simulator.  


Surgical simulators can avail minimizing the risk of surgery and help achieving a better outcome. This is also the case for the Nuss procedure, a minimally invasive surgery for correcting pectus excavatum (PE) - a congenital chest wall deformity. A simulator can be of great benefit if it provides realistic behavior and representation of the actual surgery. In this paper, we address various clinical aspects of the procedure for a training simulation, reproducing a virtual model of the patient's thoracic cavity and internal organs with realistic textures, as well as physical behaviors. In addition, a high fidelity haptic force feedback system is constructed to provide the surgeon with a close-to-real sensation while interacting with the virtual model. PMID:24732479

Chemlal, Salim; Rechowicz, Krzysztof J; Obeid, Mohammad F; Kelly, Robert E; McKenzie, Frederic D



Congenital dyserythropoietic anemia type I presenting as persistent pulmonary hypertension with pigeon chest deformity.  


Congenital dyserythropoietic anemia (CDA) type-1 is a rare genetic disorder of ineffective erythropoiesis, which manifests in macrocytic anemia. We report a CDA1 patient who as a newborn presented with macrocytic anemia and persistent pulmonary hypertension of the newborn (PPHN) requiring mechanical ventilation. Post-infancy, the patient developed acral dysmorphism and pectus excavatum the latter rarely found in CDA1. Patient is a compound heterozygote for a known maternal-derived missense-mutation (c.1796A?>?G/p.Asn589Ser) and a novel paternal-derived deletion-mutation (c.1104_1106del/Phe365del) in CDAN1. This report highlights the importance of recognizing PPHN as a presenting symptom of CDA1 and expands the repertoire of the accompanying mutations and axial skeletal malformations. PMID:24420417

El-Sheikh, Ayman A; Hashem, Hasan; Holman, Carol; Vyas, Yatin M



Uso del agua activada y con tratamiento magnético del tomate en condiciones de organopónico Use of the activated water and with magnetic treatment of the tomato under organoponics conditions  

Microsoft Academic Search

RESUMEN. Se realizó una investigación en el organopónico del Instituto de Investigaciones de Riego y Drenaje (IIRD), durante dos años sobre la aplicación del agua con tratamientos físico- químicos (activación y magnetización) para el riego del tomate variedad Rilia. Durante el período, se estudió la dinámica de crecimiento estableciéndose las diferencias entre los tratamientos de magnetización y activación del agua

Carmen E. Duarte; Greter Guevara; Maykel Méndez


Tratamiento del linfoma cutáneo de células T con bexaroteno a dosis bajas en combinación con fototerapia o interferon alfa: comunicación de ocho casos tratados en el Hospital Edgardo Rebagliati Martins, 2003-2007, Lima, Perú  

Microsoft Academic Search

RESUMEN Introducción: bexaroteno es un rexinoide aprobado en el tratamiento de estadios tempranos y avanzados del linfoma cutáneo de células T (LCCT). Caso Clínico: el presente reporte de casos mostramos los resultados del empleo de bexaroteno en dosis bajas más fototerapia o Interferon alfa 9 millones en el tratamiento del LCCT. Ocho pacientes fueron tratados , cinco fueron Micosis fungoides,

Brady Beltrán Gárate; Antonio Paredes Arcos; Celia Moisés Alfaro; Gadwin Sanchez Félix; Luis Riva Gonzales; Fernando Hurtado de Mendoza; Esther Cotrina Montenegro; Renzo Salas Rojas



A comprehensive newborn exam: part II. Skin, trunk, extremities, neurologic.  


Skin findings are common during the newborn examination. Although these findings are often benign, it is important to visualize the entire skin surface to distinguish these findings and appropriately reassure parents. The chest should be observed for symmetric movement, pectus excavatum, pectus carinatum, prominent xiphoid, or breast tissue. The infant should be as relaxed as possible so that the physician can more easily detect any abdominal masses, which are often renal in origin. A single umbilical artery may be associated with another congenital abnormality, especially renal anomalies, and intrauterine growth restriction and prematurity. Signs of ambiguous genitalia include clitoromegaly and fused labia in girls, and bilateral undescended testes, a micropenis, or a bifid scrotum in boys. Sacral dimples do not warrant further evaluation if they are less than 0.5 cm in diameter, are located within 2.5 cm of the anal verge, and are not associated with cutaneous markers; dimples that do not fit these criteria require ultrasonography to evaluate for spinal dysraphism. Brachial plexus injuries are most common in newborns who are large for gestational age, and physical therapy may be required to achieve normal function. Patients with abnormal findings on Ortolani and Barlow maneuvers should be evaluated further for hip dysplasia. It is also important to assess newborns for tone and confirm the presence of normal primitive reflexes. PMID:25251089

Lewis, Mary L



Three-Dimensional Computed Tomography (3-D CT) for Evaluation and Management of Children with Complex Chest Wall Anomalies: Useful Information or Just Pretty Pictures?  

PubMed Central

Purpose Shaded Surface Display (SSD) technology, with 3-D CT reconstruction, has been reported in a few small series of patients with congenital or acquired chest wall deformities. SSD images are visually attractive and educational, but many institutions are hesitant to utilize these secondary to cost and image data storage concerns. This study was designed to assess the true value of SSD to the patient, family, and operating surgeon, in the evaluation and management of these children. Methods Following IRB approval, we performed a retrospective review of records of 82 patients with chest wall deformities, evaluated with SSD, from 2002 to 2009. SSD usefulness, when compared with routine 2-D CT, was graded on a strict numerical scale from 0 (added no value besides education for the patient/family) to 3 (critical for surgical planning and patient management). Results There were 56 males and 26 females. Median age was 15.3 years (range: 0.6–41.1). Deformities included 56 pectus excavatum, 19 pectus carinatum, and 8 other/mixed deformities. 6 patients also had acquired asphyxiating thoracic dystrophy (AATD). Eleven (13%) had previous chest wall reconstructive surgery. In 25 (30%) patients, SSD was useful or critical. Findings underappreciated on 2-D images included: sternal abnormalities (29), rib abnormalities (28), and heterotopic calcifications (7). SSD changed or influenced operation choice (4), clarified bone versus soft tissue (3), helped clarify AATD (3), and aided in rib graft evaluation (2). Point biserial correlation coefficient analysis (Rpb) displayed significance for SSD usefulness in patients with previous chest repair surgery (Rpb=0.48, p?0.001), AATD (Rpb=0.34, p=0.001), pectus carinatum (Rpb=0.27, p=0.008), and females (Rpb=0.19, p=0.044). Conclusions Shaded Surface Display, when used to evaluate children and young adults with congenital or acquired chest wall deformities, provides useful or critical information for surgical planning and patient management in almost 1/3 of patients, especially those requiring a second operation, with acquired asphyxiating thoracic dystrophy, pectus carinatum, and females. PMID:21496531

Calloway, E. Hollin; Chhotani, Ali N.; Lee, Yueh Z.; Phillips, J. Duncan



Prognostic factors in multiple myeloma: definition of risk groups in 410 previously untreated patients: a Grupo Argentino de Tratamiento de la Leucemia Aguda study.  


Four hundred ten previously untreated multiple myeloma patients entered onto two consecutive Grupo Argentino de Tratamiento de la Leucemia Aguda (GATLA) protocols were analyzed to identify significant prognostic factors influencing survival. The univariate analysis selected the following variables: performance status, renal function, percentage of bone marrow plasma cells at diagnosis, hemoglobin, and age. A multivariate analysis showed that performance status, renal function, percentage of bone marrow plasma cells, hemoglobin, and age were the best predictive variables for survival. A score was assigned to each patient according to these variables, which led to their classification in three groups: good, intermediate, and poor risk, with a probability of survival of 26% and 10% at 96 months, and 5% at 56 months, and median survival of 60, 37, and 14 months, respectively (P = .0000). In our patient population, this model proved to be superior to the Durie-Salmon staging system in defining prognostic risk groups, and separating patients with significantly different risks within each Durie-Salmon stage. PMID:2585023

Corrado, C; Santarelli, M T; Pavlovsky, S; Pizzolato, M



Clinical report: Two patients with atelosteogenesis type I caused by missense mutations affecting the same FLNB residue.  


We present two patients with Atelosteogenesis Type I (AO type I) caused by two novel Filamin B (FLNB) mutations affecting the same FLNB residue: c.542G > A, predicting p.Gly181Asp and c.542G > C, predicting p.Gly181Arg. Both children had typical manifestations of AO type I, with severe rhizomelic shortening of the extremities, limited elbow and knee extension with mild webbing, pectus excavatum, broad thumbs with brachydactyly that was most marked for digits 3-5, dislocated hips and bilateral talipes equinovarus. Facial features included proptosis, hypertelorism, downslanting palpebral fissures, cleft palate, and retromicrognathia. The clinical course of one child was influenced by airway instability and bronchopulmonary dysplasia that complicated intubation and prevented separation from ventilator support. Respiratory insufficiency with tracheal hypoplasia, laryngeal stenosis, and pulmonary hypoplasia have all been described in patients with AO type I and we conclude that compromised pulmonary function is a major contributor to morbidity and mortality in this condition. PMID:23401428

Li, Ben C; Hogue, Jacob; Eilers, Meg; Mehrotra, Pavni; Hyland, James; Holm, Tara; Prosen, Tracy; Slavotinek, Anne M



Small terminal 10q26 deletion in a male patient with Noonan-like stigmata: diagnosis by cytogenetic and FISH analysis.  


A male patient is reported with terminal 10q26 deletion, developmental retardation, special behaviour, and multiple clinical anomalies including hypotonia, short stature of postnatal onset, short webbed neck, craniofacial dysmorphism, pectus excavatum with widely spaced small nipples, cryptorchidism with scrotal hypoplasia, limb and musculoskeletal anomalies. The facial dysmorphism mainly consisted of trigonocephaly, a long, triangular and asymmetrical face, hypertelorism with pseudoepicanthus, broad nasal bridge, high-arched palate, retrognathia, low-set dysplastic auricles and, on ophthalmologic examination, strabismus, astigmatism and myopia. Some of these clinical stigmata were suggesting the diagnosis of Noonan syndrome. The extremities showed special features including shortening of proximal limbs, brachydactyly with syndactyly of toes II-III and left fingers III-IV, hypoplastic toenails and joint abnormalities. A diastasis of abdominal muscles was noted and, on X-rays a thoracic scoliosis and bilateral coxa valga were evidenced. Analyses of G- and T-banded chromosomes complemented by FISH analyses using different subtelomere probes detected a terminal 10q26 deletion. Subsequent FISH studies using different probes of the 10q26 region were performed in an attempt to closely define the breakpoint and the extent of the deletion and, thereby, to allow karyotype/phenotype comparison between this patient and a previously reported case with an apparently similar 10q26 deletion. PMID:12558112

Lukusa, T; Smeets, E; Vermeesch, J R; Fryns, J P



A new mutation in the C-SH2 domain of PTPN11 causes Noonan syndrome with multiple giant cell lesions.  


Noonan syndrome (NS), an autosomal dominant multisystem disorder, is caused by the dysregulation of the RAS-MAPK pathway and is characterized by short stature, heart defects, pectus excavatum, webbed neck, learning problems, cryptorchidism and facial dysmorphism. We here present the clinical and molecular characterization of a family with NS and multiple giant cell lesions (MGCLs). The proband is a 12-year-old girl with NS and MGCL. Her mother shows typical NS without MGCL. Whole-exome sequencing of the girl, her mother and her healthy maternal grand parents revealed a previously unobserved mutation in exon 5 of the PTPN11 gene (c.598 A>T; p.N200Y), transmitted from the mother to the proband. As no other modification in the RAS-MAPK pathway genes as related to Rasopathies was detected in the proband, this report demonstrates for the first time that a unique mutation affecting this, otherwise unaffected signaling route, can cause both NS and NS/MGCL in the same family. This observation further confirms that NS/MGCL is not a distinct entity but rather that MGCL represents a rare complication of NS. Moreover, the localization of the p.N200Y mutation suggests an alternative molecular mechanism for the excessive phosphatase activity of the PTPN11-encoded protein. PMID:24225993

Carapito, Raphael; Paul, Nicodème; Untrau, Meiggie; Ott, Louise; Corradini, Nadège; Poignant, Sylvaine; Geffroy, Loïc; Caldagues, Emmanuelle; Heymann, Marie-Françoise; Cassagnau, Elisabeth; Isidor, Bertrand; Bahram, Seiamak



A t(5;16)(p15.32;q23.3) generating 16q23.3 --> qter duplication and 5p15.32 --> pter deletion in two siblings with mental retardation, dysmorphic features, and speech delay.  


We report on two siblings (half brothers on the paternal side) with a syndrome consisting of delayed development, cardiac anomalies, chest deformity, hip rotation, metatarsus adductus, genital hypoplasia, dysmorphic face, depressed nasal bridge, mental retardation, and speech delay. All metaphases examined showed a normal karyotype in the patients, their father, and both mothers. High-resolution array CGH examination revealed a 16q (6 Mb) duplication dup(16)(16q23.3 --> 16qter) and a 5p (0.97 Mb) terminal deletion del(5)(p15.32 --> pter) in both affected boys but not their healthy siblings or parents. Interphase fluorescence in situ hybridization (FISH) confirmed both the 16q duplicated region and the 5p terminal deletion. Clinical abnormalities in the patients included thin upper lip, clinodactyly, and foot deformity, which were reported previously with duplications in 16q23.3. Pectus excavatum, hip rotation, metatarsus adductus, umbilical hernia, brachycephaly, and esotropia were not reported previously in chromosome 16q duplications but may be features that occur intermittently. The 5p deleted region has been associated previously only with speech delay, which was present in both patients. These patients display certain phenotypic characteristics not reported previously in 16q duplication and confirm 5p terminal deletion as an important chromosome anomaly for speech delay. PMID:20503335

Hellani, Ali; Mohamed, Sarar; Al-Akoum, Siham; Bosley, Thomas M; Abu-Amero, Khaled K



Interstitial Deletions at 6q14.1q15 Associated with Developmental Delay and a Marfanoid Phenotype  

PubMed Central

There are a number of reports of interstitial deletions of the long arm of chromosome 6 that have developmental delay and obesity suggesting that this is a distinct phenotype almost like Prader-Willi syndrome. Here we report a patient with a similar deletion but a strikingly different phenotype, one more in keeping with Marfan syndrome, although he does not fulfil the criteria for that syndrome. Array comparative genomic hybridization was performed to investigate a patient with a striking phenotype. This revealed an interstitial deletion of 6q14.1q15. Parental FISH studies were normal, indicating that this is a de novo deletion. Our patient has a completely different phenotype compared to other patients reported to have similar deletions. The common feature is developmental delay, but the body features are quite different in that our patient is tall, strikingly thin with pectus excavatum, scoliosis, skin striae, arachnodactyly, pes planus, cataracts, and a high-arched palate. This contrasts with other patients who have a similar deletion but have short stature and obesity. 6q14.1q15 interstitial deletions can have a very variable phenotype and do not necessarily conform to a clinical recognizable microdeletion syndrome caused by haploinsufficiency of dosage-sensitive genes in that region as proposed by others. PMID:24167463

Lowry, R.B.; Chernos, J.E.; Connelly, M.S.; Wyse, J.P.H.



Prevalence of congenital abnormalities in Turkish school children.  


19750 school children, ages 6 to 15 years, were examined by the authors of this study, 1,220 (6.18%) had congenital abnormalities. In this group, 4.23% were boys and 1.88% were girls. Case histories revealed inbreeding amongst the parents (families) of children with congenital malformation to be 8.9% and 8.2% for the rest of the families in this study. There were 27 different congenital abnormalities identified, with prevalence rates of 0.05/1,000 to 15.85/1,000. The most prevalent abnormalities were umbilical hernia (15.85/1000), inguinal hernia (14.50/1,000), pectus carinatum and excavatum (7.68/1,000), undescended testes (9.00/1,000 boys), congenital nevus (3.54/1,000), retractile testis (4.45/1,000 boys), pilonidal sinus (2.63/1,000), pes planus (2.28/1,000), and hemangioma (1.16/1,000). Of the 19,750 children, 70 had multiple anomalies (3.75/1,000). PMID:8243591

Yücesan, S; Dindar, H; Olcay, I; Okur, H; Kiliçaslan, S; Ergören, Y; Tüysüz, C; Koca, M; Civilo, B; Sen, I



Moyamoya disease associated with asymptomatic mosaic turner syndrome: a rare cause of hemorrhagic stroke.  


Moyamoya disease is a rare cerebrovascular anomaly involving the intracranial carotid arteries that can present clinically with either ischemic or hemorrhagic disease. Moyamoya syndrome, indistinguishable from moyamoya disease at presentation, is associated with multiple clinical conditions including neurofibromatosis type 1, autoimmune disease, prior radiation therapy, Down syndrome, and Turner syndrome. We present the first reported case of an adult patient with previously unrecognized mosaic Turner syndrome with acute subarachnoid and intracerebral hemorrhage as the initial manifestation of moyamoya syndrome. A 52-year-old woman was admitted with a subarachnoid hemorrhage with associated flame-shaped intracerebral hemorrhage in the left frontal lobe. Physical examination revealed short stature, pectus excavatum, small fingers, micrognathia, and mild facial dysmorphism. Cerebral angiography showed features consistent with bilateral moyamoya disease, aberrant intrathoracic vessels, and an unruptured 4-mm right superior hypophyseal aneurysm. Genetic analysis confirmed a diagnosis of mosaic Turner syndrome. Our case report is the first documented presentation of adult moyamoya syndrome with subarachnoid and intracerebral hemorrhage as the initial presentation of mosaic Turner syndrome. It illustrates the utility of genetic evaluation in patients with cerebrovascular disease and dysmorphism. PMID:24103673

Manjila, Sunil; Miller, Benjamin R; Rao-Frisch, Anitha; Otvos, Balint; Mitchell, Anna; Bambakidis, Nicholas C; De Georgia, Michael A



Mosaic and partial monosomy of chromosome 21 in a case with low platelets count  

PubMed Central

Background Monosomy is defined as the presence of only one chromosome instead of two in humans. Partial monosomy occurs when only a portion of the chromosome is present in a single copy, while the rest has two copies. It can occur in unbalanced translocations or deletions. Case report In this report, a 6 years old girl was presented who was referred to the Pediatric Dep, Shahid Sadoughi Hospital,Yazd, Iran, due to multiple congenital anomalies such as: frontal bossing, horizontal palpebral fissure, small deepest eyes, aplastic nasal bridge, broad philtrum, low set ears, large prominent ears, short neck, microcephaly, pectus excavatum, mental retardation, and dislocation of the hip. In peripheral blood smear, platelets were decreased but other hematological levels were normal. The karyotype result indicated a mosaic monosomy and partial monosomy of chromosome 21. Conclusion According to this and other case reports of monosomy of chromosome 21, this disease had very low prevalence rate among live infants or children. The present case had some congenital anomalies that present with abnormal medical condition. Therefore these patients must be evaluated for chromosomal studies. PMID:24734163

Hashemi, A; Sheikhha, MH; Manouchehri, MA; Kalantar, SM



Tratamiento nutricional de la fenilcetonuria  

Microsoft Academic Search

ResumenLa fenilcetonuria (FCU) está causada por la actividad deficiente de la enzima fenilalanina hidroxilasa, necesaria para convertir el aminoácido (AA) esencial fenilalanina (phe) en tirosina. Con objeto de prevenir el daño neurológico es necesaria la adhesión permanente a una dieta pobre en phe, que restringe los alimentos naturales y requiere la ingestión de una fórmula de AA libre de phe

Erin L. MacLeod; Denise M. Ney



Embarazo ectópico intersticial: tratamiento laparoscópico  

Microsoft Academic Search

The interstitial ectopic pregnancy is a rare condition, accounting for 2-4% of all ectopic pregnancies. It is difficult to diagnose both for its location and for its rarity. The treatment of choice is laparoscopic management. We present a case of interstitial ectopic pregnancy in which laparoscopy was useful in two ways, as a diagnostic tool and for its treatment.

Belén Moliner Renau; Víctor Martín González; Lorena Camps Selva; Ana Martínez Aspas; Rosa Sánchez García; Fernando Bonilla-Musoles



Tratamiento conservador del embarazo ectópico  

Microsoft Academic Search

SUMMARY Objetive: To evaluate the efficacy, side effects a short-term and effects in the future fertility of conservative treatment of the ectopic pregnancy (EP) by means of single dose of intramuscular methotrexate i.m. MTX). Material and method: Retrospective study of clinical histories of patients eith EP treated with i.m. MTX methotrexate in the Maternal Hospital La Paz from the 1

E. Martín Boado


Lipomodelling: an important advance in breast surgery.  


Based on long-term experiences, the authors consider lipomodelling to be a major advance in plastic, reconstructive and aesthetic surgery of the breast. The technique is now well established and the complication rate is very low. The risk of focal fat necrosis is around 3%. Oncological follow-up (now 14 years for the first patients) shows no increased risk of local recurrence or development of a new cancer. 30-40% of the injected fat is absorbed. Volume of the breast becomes stable in 3 to 4 months and remains definitive if the patient maintains constant weight. Because of very good results obtained and excellent acceptance of the procedure by the patients, this technique has completely modified our indications. In breast reconstruction, lipomodelling with autologous latissimus dorsi flap enables obtaining an entirely autologous breast in the majority of the patients. Analogically, lipomodelling can improve results of implant reconstructions, especially if the expander or the implant is planned to be exchanged. Lipomodelling is an effective tool for correction deformities especially in the décolleté after breast reconstruction with abdominal flap (DIEP, SIEA and TRAM). Lipomodelling is also progressively used in the correction of breast and chest wall deformities. In Poland syndrome, this technique appears to be a major advance that will probably revolutionize the treatment of severe cases. This is mainly due to its ability to achieve previously unachievable quality of reconstruction with minimal scaring. The application of lipomodelling in the treatment of pectus excavatum deformities is promising. Lipomodelling represents an advanced therapeutic alternative for tuberous breasts without the need to use an implant, as well as for breast asymmetry due to unilateral hypoplasia. Lipomodelling is an ideal option for cosmetic breast augmentation in patients who wish to achieve moderate, natural enlargement of breasts and who have considerable fat deposits. PMID:24467681

Delay, E; Streit, L; Toussoun, G; La Marca, S; Ho Quoc, C



Germline TGF-beta receptor mutations and skeletal fragility: a report on two patients with Loeys-Dietz syndrome.  


Loeys-Dietz syndrome (LDS, OMIM # 609192) caused by heterozygous mutations in TGFBR1 and TGFBR2 has recently been described as an important cause of familial aortic aneurysms. These patients have craniofacial and skeletal features that overlap with the Marfan syndrome (MFS), and more importantly, have significant vascular fragility as is seen in MFS and Ehlers-Danlos syndrome Type IV (EDS-IV). The skeletal phenotype with respect to low bone mineral density and skeletal fragility is not clear. We present two patients with LDS with significant skeletal fragility. The first is a 17-year-old male who had talipes equinovarus, diaphragmatic and inguinal and herniae, aortic root dilatation necessitating surgical repair, craniofacial and skeletal dysmorphism consistent with LDS, and a history of numerous fragility fractures leading to significant skeletal deformity. He was found to be heterozygous for a c.923T > C transition in exon 4 of TGFBR2. The second is a 26-year-old male with submucous cleft palate, talipes equinovarus, pectus excavatum requiring surgery, inguinal hernia, and aneurysms in the ascending aorta, abdominal aorta, carotid, subclavian, vertebral and brachial arteries requiring surgical repairs. He also had craniofacial and skeletal dysmorphism consistent with LDS, multiple fractures in childhood, low bone mineral density, and was found to be heterozygous for a c.1561 T > C transition in exon 7 of TGFBR2. These case studies highlight the importance of paying close attention to fractures and bone density in patients with LDS. Osteopenia or osteoporosis may become increasingly important issues as earlier detection and treatment of the vascular complications of LDS improves life expectancy in these patients. PMID:20358619

Kirmani, Salman; Tebben, Peter J; Lteif, Aida N; Gordon, David; Clarke, Bart L; Hefferan, Theresa E; Yaszemski, Michael J; McGrann, Pamela S; Lindor, Noralane M; Ellison, Jay W



Pediatric congenital bilateral perisylvian syndrome: clinical and MRI features in 12 patients.  


In 1926, Foix, Chavany and Marie described an acquired syndrome of fasciopharyngoglossomasticatory diplegia resulting from bilateral infarction of the anterior operculum. Clinical features consisted of facial diplegia, dysarthria, pseudobulbar palsy, mild to severe mental retardation, and seizures. A developmental form, similar in presentation in adults with MRI findings consisting of bilateral perisylvian cortical malformation consistent with polymicrogyria involving the sylvian fissure and opercular cortex, has been recognized; but few pediatric cases of congenital bilateral perisylvian syndrome (CBPS) have been reported. Over the past four years, we have encountered 12 cases of CBPS presenting in childhood. Age ranges were from 1 week to 11 years with a median of 2.25 years; six were less than two years of age. Seven were male and five female. Ten had bilateral perisylvian polymicrogyria on MRI; two had unilateral perisylvian schizencephaly with contralateral perisylvian polymicrogyria. Clinical manifestations included developmental delay in 7; poor palatal function in 5; hypotonia in 4; arthrogryposis in 4; hemiparesis in 3; apnea in 3; paraparesis in 2; micrognathia in 2; pectus excavatum in 2; quadriparesis in 1; and hearing loss in 1. Seizures occurred in seven (58%) and consisted of infantile spasms (n = 1), generalized tonic-clonic (n = 1), complex partial (n = 2), partial motor (n = 2; 1 with secondary generalization), and febrile convulsions (n = 1). CBPS has different manifestations in the pediatric population than in adults. CBPS is more common than previously thought, is recognizable by MRI and should be suspected clinically in any infant or child presenting with oromotor dysfunction/pseudobulbar signs and developmental delay, especially if there are associated congenital malformations. Epilepsy is not a constant feature in the pediatric presentation and is variable in type and severity. PMID:9309709

Gropman, A L; Barkovich, A J; Vezina, L G; Conry, J A; Dubovsky, E C; Packer, R J



Del(18p) shown to be a cryptic translocation using a multiprobe FISH assay for subtelomeric chromosome rearrangements.  

PubMed Central

We have previously described a fluorescence in situ hybridisation (FISH) assay for the simultaneous analysis of all human subtelomeric regions using a single microscope slide. Here we report the use of this multiprobe FISH assay in the study of a patient whose karyotype was reported by G banding analysis as 46,XX,del(18)(p11.2). Although the proband had some features suggestive of a chromosomal abnormality, relatively few of the specific features of del(18p) were present. She was a 37 year old female with mild distal spinal muscular atrophy (SMA), arthritis of the hands, an abnormal chest shape (pectus excavatum), and an unusual skin condition (keratosis pilaris). Reverse chromosome painting with degenerate oligonucleotide primer-polymerase chain reaction (DOP-PCR) amplified del(18p) chromosomes as a probe confirmed the abnormality as del(18p), with no evidence of any other chromosome involvement. Subsequently, the multiprobe FISH assay confirmed deletion of 18p subtelomeric sequence. However, the assay also showed that sequences corresponding to the 2p subtelomeric probe were present on the tip of the shortened 18p. The patient is therefore monosomic for 18p11.2-pter and trisomic for 2p25-pter, and the revised karyotype is 46,XX,der(18)t(2;18)(p25; p11.2). We believe that a proportion of all cases reported as telomeric deletions may be cryptic translocations involving other chromosome subtelomeric regions. Further studies such as this are necessary to define accurately the clinical characteristics associated with pure monosomy in chromosomal deletion syndromes. Images PMID:9733029

Horsley, S W; Knight, S J; Nixon, J; Huson, S; Fitchett, M; Boone, R A; Hilton-Jones, D; Flint, J; Kearney, L



Homozygous frameshift mutation in TMCO1 causes a syndrome with craniofacial dysmorphism, skeletal anomalies, and mental retardation  

PubMed Central

We identified an autosomal recessive condition in 11 individuals in the Old Order Amish of northeastern Ohio. The syndrome was characterized by distinctive craniofacial dysmorphism, skeletal anomalies, and mental retardation. The typical craniofacial dysmorphism included brachycephaly, highly arched bushy eyebrows, synophrys, long eyelashes, low-set ears, microdontism of primary teeth, and generalized gingival hyperplasia, whereas Sprengel deformity of scapula, fusion of spine, rib abnormities, pectus excavatum, and pes planus represented skeletal anomalies. The genome-wide homozygosity mapping using six affected individuals localized the disease gene to a 3.3-Mb region on chromosome 1q23.3-q24.1. Candidate gene sequencing identified a homozygous frameshift mutation, c.139_140delAG, in the transmembrane and coiled-coil domains 1 (TMCO1) gene, as the pathogenic change in all affected members of the extended pedigree. This mutation is predicted to result in a severely truncated protein (p.Ser47Ter) of only one-fourth the original length. The TMCO1 gene product is a member of DUF841 superfamily of several eukaryotic proteins with unknown function. The gene has highly conserved amino acid sequence and is universally expressed in all human tissues examined. The high degree of conservation and the ubiquitous expression pattern in human adult and fetal tissues suggest a critical role for TMCO1. This report shows a TMCO1 sequence variant being associated with a genetic disorder in human. We propose “TMCO1 defect syndrome” as the name of this condition. PMID:20018682

Xin, Baozhong; Puffenberger, Erik G.; Turben, Susan; Tan, Haiyan; Zhou, Aimin; Wang, Heng



Reversal of childhood idiopathic scoliosis in an adult, without surgery: a case report and literature review  

PubMed Central

Background Some patients with mild or moderate thoracic scoliosis (Cobb angle <50-60 degrees) suffer disproportionate impairment of pulmonary function associated with deformities in the sagittal plane and reduced flexibility of the spine and chest cage. Long-term improvement in the clinical signs and symptoms of childhood onset scoliosis in an adult, without surgical intervention, has not been documented previously. Case presentation A diagnosis of thoracic scoliosis (Cobb angle 45 degrees) with pectus excavatum and thoracic hypokyphosis in a female patient (DOB 9/17/52) was made in June 1964. Immediate spinal fusion was strongly recommended, but the patient elected a daily home exercise program taught during a 6-week period of training by a physical therapist. This regime was carried out through 1992, with daily aerobic exercise added in 1974. The Cobb angle of the primary thoracic curvature remained unchanged. Ongoing clinical symptoms included dyspnea at rest and recurrent respiratory infections. A period of multimodal treatment with clinical monitoring and treatment by an osteopathic physician was initiated when the patient was 40 years old. This included deep tissue massage (1992-1996); outpatient psychological therapy (1992-1993); a daily home exercise program focused on mobilization of the chest wall (1992-2005); and manipulative medicine (1994-1995, 1999-2000). Progressive improvement in chest wall excursion, increased thoracic kyphosis, and resolution of long-standing respiratory symptoms occurred concomitant with a >10 degree decrease in Cobb angle magnitude of the primary thoracic curvature. Conclusion This report documents improved chest wall function and resolution of respiratory symptoms in response to nonsurgical approaches in an adult female, diagnosed at age eleven years with idiopathic scoliosis. PMID:20003501



Homozygous frameshift mutation in TMCO1 causes a syndrome with craniofacial dysmorphism, skeletal anomalies, and mental retardation.  


We identified an autosomal recessive condition in 11 individuals in the Old Order Amish of northeastern Ohio. The syndrome was characterized by distinctive craniofacial dysmorphism, skeletal anomalies, and mental retardation. The typical craniofacial dysmorphism included brachycephaly, highly arched bushy eyebrows, synophrys, long eyelashes, low-set ears, microdontism of primary teeth, and generalized gingival hyperplasia, whereas Sprengel deformity of scapula, fusion of spine, rib abnormities, pectus excavatum, and pes planus represented skeletal anomalies. The genome-wide homozygosity mapping using six affected individuals localized the disease gene to a 3.3-Mb region on chromosome 1q23.3-q24.1. Candidate gene sequencing identified a homozygous frameshift mutation, c.139_140delAG, in the transmembrane and coiled-coil domains 1 (TMCO1) gene, as the pathogenic change in all affected members of the extended pedigree. This mutation is predicted to result in a severely truncated protein (p.Ser47Ter) of only one-fourth the original length. The TMCO1 gene product is a member of DUF841 superfamily of several eukaryotic proteins with unknown function. The gene has highly conserved amino acid sequence and is universally expressed in all human tissues examined. The high degree of conservation and the ubiquitous expression pattern in human adult and fetal tissues suggest a critical role for TMCO1. This report shows a TMCO1 sequence variant being associated with a genetic disorder in human. We propose "TMCO1 defect syndrome" as the name of this condition. PMID:20018682

Xin, Baozhong; Puffenberger, Erik G; Turben, Susan; Tan, Haiyan; Zhou, Aimin; Wang, Heng



[Prune-Belly Syndrome: a case report].  


Prune-Belly Syndrome (PBS) is a rare congenital syndrome characterized by the absence of abdominal muscles, anomalies in the urinary tract, megaureter, cryptorchidism or testicular agenesis, hypertension and worsening chronic kidney disease (CKD). The incidence is estimated between 1 out of 35,000 and 1 out of 50,000 born alive, and it affects males in prevalence (97%). In the present study we describe the case of a 38 year old male patient (followed since May 2011) affected by PBS, CKD, one functional kidney at the scintigraphy, pediatric testicular implants, bladder surgery and correction of pectus excavatum. At the beginning of the observation, renal function was deteriorated, with a creatinine 3.3 mg/dl, GFR calculated at MDRD 23 ml/min, proteinuria in nephrotic range (4 g/day), high blood pressure, anemia and hyperparathyroidism. In the following examinations renal function framework worsened, despite the adoption of a low-protein diet. Due to the functional trend, the patient was prescribed hemodialysis as substitute treatment. In January 2013 a first attempt of artero-venous fistula (AVF) did not succeed, while a new AVF in March 2013 resulted effective. In July hemodialysis was started. In the future, we expect to insert the patient in the Kidney Transplant List (since surgical feasibility has already been positively evaluated). Our case is quite peculiar due to the late beginning of substitute treatment. Further, SPB represents a challenge that, in the absence of a prompt and effective treatment, inevitably it leads to terminal uremia; nevertheless, given a proper treatment, a transplant with good chances of success can be envisaged. PMID:25030009

Tattoli, Fabio; De Prisco, Ornella; Gherzi, Maurizio; Falconi, Daniela; Marazzi, Federico; Marengo, Marita; Serra, Ilaria; Tamagnone, Michela; Formica, Marco



Nuevos enfoques del tratamiento de la fenilcetonuria  

Microsoft Academic Search

ResumenDesde su descubrimiento por Følling en 1934, la fenilcetonuria (FCU) ha sido objeto de numerosos estudios de investigación, abarcando varias disciplinas como genética humana, bioquímica, desarrollo, neurobiología y otras. Durante los últimos 75 años se han mapeado diferentes mutaciones en los genes responsables de la enfermedad, se ha aclarado su base bioquímica y se han revelado los mecanismos conducentes al

Ronen Eavri; Haya Lorberboum-Galski



Embarazo ectópico cervical. Tratamiento médico conservador  

Microsoft Academic Search

ObjectiveCervical ectopic pregnancy is a rare complication that can have severe consequences if an early diagnosis is not made. This diagnosis should always be considered in vaginal bleeding in the first trimester of pregnancy.

A. Rubio; F. Jiménez; M. Herrero; S. Alcalá; C. Sabadell; I. Bruna; M. L. Cano



Embarazo ectópico cervical: diagnóstico y tratamiento  

Microsoft Academic Search

We report a case of cervical ectopic pregnancy treated with methotrexate and abdominal hysterectomy.A 34-year-old woman with three previous cesarean sections was diagnosed with a cervical ectopic pregnancy through transvaginal ultrasound at 7 weeks of amenorrhea.Cervical ectopic pregnancy is an uncommon event that usually presents as irregular bleeding in the first trimester. Diagnosis is based on ?-human chorionic gonadotrophin and

Clara Crespo Ferrer; Arantxa Jaca Navarro; Noelia Juárez Sabater; Regina Aliaga Parreño; Yousef Mahmoud Jaddou; Mariano Sanz Martínez



Embarazo ectópico intersticial: ¿tratamiento médico o quirúrgico?  

Microsoft Academic Search

Interstitial pregnancy is a rare event, which produces high morbidity and mortality if diagnosis is delayed. Current treatment options consist of methotrexate or surgery. Which of these two options is the most effective remains to be established. Recent publications consider medical treatment as an acceptable method when there is appropriate patient selection and close follow-up after methotrexate therapy.

A. González-López; A. Sánchez-Muñoz; L. Sánchez-Hipólito; M. Arana; J. Rodríguez-González; C. Martín



Tratamiento conservador del embarazo ectópico cornual  

Microsoft Academic Search

Cornual pregnancy is and infrequent type of ectopic pregnancy. With the use of transvaginal ultrasounds we can make an earlier diagnostic and try a conservative treatment with metotrexate.The hysteroscopy can be used as a complementary technique in the following of these patients. We present three cases of cornual ectopic pregnancies diagnosticated in our hospital during a year.With the use of

M. V. San Román; D. Andía; J. L. Lobato; T. Campelo; M. Huarte; E. Beiro; M. López-Valverde



Neumonía organizada asociada a tratamiento con trastuzumab  

Microsoft Academic Search

Organizing pneumonia is a clinical and histological condition in which the onset is usually subacute with respiratory symptoms and pulmonary infiltrates. It may be unknown origin (cryptogenic) or associated with other illnesses, infectious diseases or drugs. We present a 60 year-old female patient with a previous history of breast cancer, who was being treated with trastuzumab, an antiHER2 monoclonal antibody.

Álvaro Taus-García; Sònia Servitja-Tormo; Lara Pijuan; José María Maiques-Llácer; Víctor Curull



Prescripción de ejercicio en el tratamiento de deshabituación del tabaco  

Microsoft Academic Search

Tobacco is one of the main causes of mortality in industrialized countries, yet there is no treatment that is wholly efficacious for helping smokers to quit the habit. Physical exercise is one of the low-cost nonpharmacologic strategies in rehabilitation therapies in several diseases and its practice offers a way of combating the harmful effects of smoking on health. Studies have

Carlos Ayán Pérez



Guía clínica de diagnóstico y tratamiento de la dermatitis herpetiforme  

Microsoft Academic Search

Dermatitis herpetiformis is an autoimmune blistering disease that appears as a cutaneous manifestation of gluten intolerance. It is one of a group of disorders that have gluten sensitivity in common, including celiac disease and gluten ataxia. Patients with dermatitis herpetiformis present with a pruritic papulovesicular rash on extensor surfaces and on the buttocks. Immunological studies demonstrate the presence of specific

J. E. Herrero-González




Microsoft Academic Search

SUMMARY Acute primary glaucoma is a pathology in which produce an intraocular pressure increase abrupt way and if it persist for a long time it can to take even blindness. The method utilized to make this work is a bibliographical revision. The treatment's ways are two:- a medical one to resolve the acute episode (in local form with aqueous humor

Raúl Andrés Fernández; Fernando Camilo Grenón; Jorge Santiago Lazaroff; Paola Elisabeth Lazaroff


Factores condicionantes en la elección del tratamiento sustitutivo renal  

Microsoft Academic Search

Despite the advantages of peritoneal dialysis (PD) in terms of clinical results, survival–especially at the start of renal replacement therapy (RRT)–, health-related quality of life and costs, the use of this therapeutic modality is low, varies widely among countries, regions and center and–more worryingly and surprisingly–is generally decreasing. Experts situate the ideal prevalence of PD at around 30–40% of patients

Francisco Ortega-Suárez



Tratamiento fisioterápico de la epicondilitis en un tenista joven  

Microsoft Academic Search

This case-study analyzed the physical therapy applied to a young tennis player with tennis elbow. It was placed in an interdisciplinary health team system for recovery based on the collaboration of physical therapist and trainer, permitting a rigorous and objective analysis of the different aspects considered as determinants for the injury, as well as the seriousness, the causes that provoked

M. Menayo Antúnez; R. Menayo Antúnez; J. P. Fuentes García; D. Sanz Rivas



La espiritualidad en el tratamiento del cáncer (PDQ®)

Resumen de información revisada por expertos acerca de la influencia que tiene la espiritualidad y la religión en las personas que tienen cáncer. Se discuten varios métodos sobre manejo e intervención.


Complejidad de la EPOC. Tratamiento individualizado, nuevas aproximaciones, fenotipos, comorbilidades  

Microsoft Academic Search

The current definition and severity stages of chronic obstructive pulmonary disease (COPD) focus excessively on spirometric criteria alone. Measurement of chronic airflow obstruction and its degree of reversibility is complex. The etiology of this disease cannot be fully explained in relation to smoking and the heterogeneity of this systemic disease septiemthat affects mainly the lung cannot be expressed through forced

J. C. Martín-Escudero




Microsoft Academic Search

Survey of chest physicians regarding COPD diagnosis and treatment. A survey on COPD diag- nostic procedures, treatment and management was conducted in a group of 517 chest physicians randomized from a list of the 1121 affiliates to the Asociación Argentina de Medicina Respiratoria. One hundred eighty- seven responses were obtained (36.2% of the questionnaires mailed). They treat an average of



Tratamiento cognitivo-conductual para niños mexicanos con fobia social  

Microsoft Academic Search

Participaron 17 niños, entre 7 y 12 años, con fobia social asignados aleatoriamente a 3 condiciones: (a) niños bajo el protocolo Intervención en Adolescentes con Fobia Social (IAFS; Olivares, 2005), (b) el mismo protocolo a los niños e información a sus padres sobre el trastorno, y (c) lista de espera. En evaluaciones de pretest, postest, 3 y 6 meses después,

Flor Gil-Bernal; Laura Hernández-Guzmán



Embarazo ectópico abdominal. Diagnóstico y tratamiento médico con metotrexato  

Microsoft Academic Search

Abdominal pregnancy is a rare form of ectopic pregnancy and is associated with high maternal and fetal morbidity and mortality. The diagnosis of this entity is difficult and is generally delayed. We report the case of a patient with an abdominal pregnancy diagnosed by transvaginal ultrasound in the first trimester of pregnancy. The patient was treated with methotrexate until complete

Yasmina José Gutiérrez; Álvaro Alvir Alvaro; José Manuel Campillos Maza; Pilar Garrido Fernández; Belén Rodríguez Solanilla; Sergio Castán Mateo



Curetaje cornual como tratamiento conservador del embarazo ectópico accidentado  

Microsoft Academic Search

The classical treatment of cornual ectopic pregnancy is cornual resection or hysterectomy. Currently, a more conservative approach is feasible. We describe a case of cornual ectopic pregnancy treated with tubal cornual curettage and review the various options in the management of this entity. This technique may reduce the risk of uterine rupture in future pregnancies, even though studies on this

Ainhoa Becerro Cortizas; Mikel Gorostidi Pulgar; Iordana Aizpitarte Gorrotxategi; Elisa Ecenarro González-Echavarri; Marina Navarro López



Tratamiento quirúrgico mediante histerectomía de un embarazo ectópico cervical  

Microsoft Academic Search

Cervical pregnancies are a rare form of ectopic pregnancy. Diagnosis is established by ultrasound, biochemical findings and histopathology. We report the case of a patient with hemorrhage, requiring hysterectomy to control the bleeding.Early identification of a cervical ectopic pregnancy can help to prevent significant morbidity and mortality in patients seeking emergency care.

G. Bueno; E. Martínez-Gómez; A. Pascual; R. Martínez-Cabañero; C. García-Garrido; A. Tello; G. González de Merlo




Microsoft Academic Search

SUMMARY We describe the cervical cerclage as an alternative of conservative treatment in the cervical ectopic pregnancy. Two cases of cervical ectopic pregnancy are described. Both cases corresponded to gestations smaller than seven weeks, diagnosis was done by means of transvaginal ultrasound. The cases were initially treated medically, but both patients presented severe bleeding during their evolution and cervical cerclage



Embarazo ectópico cornual. Tratamiento eficaz con dosis única de metotrexato  

Microsoft Academic Search

We describe an interstitial ectopic pregnancy in a patient with no risk factors. Diagnosis was achieved through transvaginal ultrasound. Resolution was achieved by medical treatment with a single dose of methotrexate, without complications. This type of ectopic pregnancy is particularly dangerous to the mother due to its larger size at rupture.

Á. Luengo-Tabernero; V. Zornoza-García; S. Luengo-Harto; J. Antonio Lajas-Susaño



Tratamiento conservador, laparoscópico y médico del embarazo ectópico  

Microsoft Academic Search

Background: Ectopic pregnancy is that in which implantation of fertilized zygote occurs out of the uterine cavity mucosa (fallopian tube am- pulla, isthmus, interstice, cervix, ovary or abdomen). Patients with ectopic pregnancy history have bad forecast on subsequent fertility. Objective: To describe conservative, laparoscopic and medical treatment to ectopic pregnancy (estimation of results). Material and methods: Revision of 65 files

Arturo Molina Sosa


Metotrexato sistémico o intrasacular en el tratamiento del embarazo cervical  

Microsoft Academic Search

We present a case of cervical ectopic pregnancy diagnosed in the sixth week of gestation. The speed of diagnosis and good clinical status of the patient allowed conservative treatment to be applied. Two doses of systemic methotrexate were required to decrease human chorionic gonadotrophin (?HCG) values followed by the use of intrasaccular methotrexate due to the persistence of the ultrasound

Ana Belén Partal Lorente; María del Carmen Pallarés Ayuso; Silvia Pérez López; María José Campos Pinel; Vicente Maldonado Ezequiel; Juan Torres Martí



Tratamiento del embarazo intersticial con metotrexato local y sistémico  

Microsoft Academic Search

To evaluate methotrexate treatment in an interstitial pregnancy.We report the case of a 28-year-old woman with a 9-week history of amenorrhea and a pregnancy implanted in the right uterine cornu. The ?-human chorionic gonadotropin (HCG) level was 45.617 mU\\/ml and the size of the gestational sac was 31 × 30 mm. After local methotrexate injection by laparoscopy and three systemic

Gemma Tamarit; Antonio Bolós; Antonio Pellicer



Tratamiento nutricional de los síndromes colestáticos en la infancia  

Microsoft Academic Search

ResumenLa hepatopatía colestática causa un riesgo serio de desnutrición, que incluye la desnutrición de proteína y energía y las carencias nutricionales específicas. El estado nutricional puede evaluarse basándose en mediciones antropométricas, que pueden ser equívocas a causa de la ascitis y el edema periférico. Las determinaciones bioquímicas del estado de las vitaminas liposolubles son importantes para evaluar las necesidades de

Piotr Socha



Efectos del tratamiento con Kinesio tape en el pie plano  

Microsoft Academic Search

The main purpose of this study was to investigate changes in pain in the back of leg and hindfoot valgus with Kinesio tape application over tibialis posterior muscle in subjects with flat feet.We made pre-post-intervention measurements (24hours) of perceived pain with visual analogue scale (VAS) and degrees of pronation rear foot with Perthes Ruler in 15 subjects (13 women, 2

M. Fernández Román; A. Castro Méndez; M. Albornoz Cabello


El grano y la criba de los tratamientos psicológ icos  

Microsoft Academic Search

Se presentan las conclusiones de revisar la eficacia (así como la efectividad) terapéutica par a los ca- torce tr astornos psicológ icos siguientes: Esquizofrenia, Drogadicción, Anor exia y Bulimia, Trastornos de Personalidad, Hipocondría, Trastorno Obsesivo Compulsivo, Disfunciones Se xuales, Ansiedad Ge- neralizada, Fobias Específicas, Agorafobia, Trastorno de Pánico, Trastorno por Estrés P ost-traumáti- co, Depresión unipolar y De presión bipolar

Marino Pérez



Microsoft Academic Search

A study is presented which from a historical framework refers to relationships between the foot and static and dynamic aspects of the postural whole. It is also shown how with application of different orthotics to the foot, regarded from their different concepts, the ensemble can be treated, but there are some premises to be considered as far as the more

Philippe Villenueve



Tratamiento fisioterapéutico de la fatiga en esclerosis múltiple  

Microsoft Academic Search

Multiple sclerosis (MS) is a progressive, chronic neurological disease with bigger incidence in young adults especially in female. These patients present several disabilities such as fatigue. Fatigue is one of the most frequent symptoms in the EM suffered by 75 and 95 % of the patients. This one causes limitations in the usual job, social life and in many occasions

J. Serrano Ferrer



Tratamiento de linfomas cutáneos de células T con bexaroteno  

Microsoft Academic Search

IntroductionThe choice of treatment in cutaneous T-cell lymphomas (CTCLs) depends on the clinical stage of the disease and the patient's general condition. To date, there is no curative treatment for this disease, and the objective is to control the symptoms and prevent the disease from progressing. Bexarotene is an X receptor-specific retinoid with anti-tumor activity. Its use as treatment for

Olatz Lasa; Rosa Izu; Elvira Acebo; Patricia Eguino; José L. Díaz-Pérez



Tratamiento del trastorno por déficit de atención con o sin hiperactividad en Atención Primaria: tratamiento farmacológico con metilfenidato y opciones no farmacológicas  

Microsoft Academic Search

The attention deficit disorder with or without hyperactivity (ADHD) offers a great cli- nical variability. Therefore, after a correct diagnosis and evaluation many different thera- peutic options can be considered, and reconsidered along its evolution, including precise information to families, up to complex intervention in multidisciplinary surroundings. Pharmacologic treatment is a very valid choice, alone or combined with other proce-

X. Txakartegi Etxebarria; M. Fernández Pérez


Tratamiento de la hiperfosfatemia asociada a la enfermedad renal crónica con carbonato de lantano. Nuevas evidencias  

Microsoft Academic Search

Hyperphosphatemia associated with chronic kidney disease (CKD) seems to be involved in the development of vascular calcifications and can be considered as a risk factor for cardiovascular events in addition to classical risk factors. A new phosphate-binding drug, lanthanum carbonate, has recently been marketed and has rapidly been added to the available therapeutic arsenal for hyperphosphatemia together with calcium salts

María Luisa González Casaús; Emilio González Parra; Víctor Manuel Navas Serrano; Carolina Gracia Iguacel; Pilar de Ribera Pieras; Jesús Egido de Los Ríos



Relevancia de la medicina nuclear en el diagnóstico y tratamiento del paraganglioma maligno  

Microsoft Academic Search

Summary Background: Paragangliomas are neoplasms of the chromaffin tissue characterized by the synthesis and\\/or secretion of catecholamines. Their treatment depends on the extension and functional characteristics of the tumor. In this pathology, the anatomic and functional diagnostic evaluations provided by nuclear medicine imaging studies have significant usefulness. Clinical case: A 34-year-old male was diagnosed with a paraganglioma at the aortic

Nancy Edith Aguilar-Olivos; José Rafael García-Ortiz; Guillermo Alfonso Rojas-Reyna; Juan Manuel Chaparro-González; Fred Weisser-Jacobs; Jesús Oria-Hernández



Adherencia al tratamiento en adolescentes diabéticos tipo 1 chilenos: una aproximación psicológica  

Microsoft Academic Search

Background: Treatment compliance among patients with type 1 diabetes mellitus, is low in 50% of diabetic teenagers, becoming a social and medical problem. Aim: To determine psycho-social factors associated to treatment compliance among Chilean diabetic type 1 teenagers. Patients and methods: A non experimental study of 61 diabetic teenagers (age 14.9±1.9 years, 37 male). The number of blood glucose determinations,

Manuel Ortiz P; Eugenia Ortiz P



Hacia una adaptación cultural para el tratamiento de trastornos alimentarios en latinos en Estados Unidos  

PubMed Central

Eating disorders affect all ethnic and socioeconomic groups. However, evidence based treatments for eating disorders have been developed and tested exclusively on Caucasian populations. With the purpose to develop a culturally sensitive framework for the eating disorders treatment in Latinos/as, the objectives of this work were: 1) identify and describe some of the relevant cultural elements for eating disorders in the Latino population and, 2) to draft a culturally sensitive intervention model for eating disorders in Latino population in the United States. Providing culturally sensitive treatments for Latinos with psychiatric disorders is essential to reverse public health disparities. PMID:22003472

Reyes-Rodríguez, Mae Lynn; Bulik, Cynthia M.



Validez clínica y analítica de MammaPrint ® en tratamiento del cáncer de mama  

Microsoft Academic Search

Background and objectiveMammaPrint® is a micromatrix based test and the result classifies analyzed tumors as low or high risk for recurrence of breast carcinoma. By analyzing the individual activity of these genes, MammaPrint® estimates the response to chemotherapy and\\/or predicts the outcome of the breast neoplasia. We aimed to assess the clinical and analytical validity of MammaPrint® that determines individual

Marta Cuadros; Aurora Llanos



Blanqueamiento vital domiciliario: comparación de tratamientos con peróxido de hidrógeno y peróxido de carbamida  

Microsoft Academic Search

Tray bleaching of vital teeth performed at home by the patient under the dentist's supervision, whether alone or in combina- tion with any of the in-office techniques, provides an interesting alternative to other methods employed in this type of dental treatment. This bleaching procedure applies low-concentration peroxides to the enamel by means of a custom-made mouth tray specifically designed for

Amparo Berga Caballero; Leopoldo Forner Navarro; José Amengual Lorenzo


Recursos de tratamiento en internet para conductas adictivas Treatment resources in internet for addictive behaviors  

Microsoft Academic Search

17 RESUMEN: Internet se configura como un instru- mento de utilidad en el apoyo a los procesos de tra- tamiento psicológico. El objetivo de este trabajo es la búsqueda de recursos de utilidad en el trata- miento de conductas adictivas. Dado lo extenso de este concepto se ha limitado la búsqueda a cuatro de estas conductas: adicción al propio Internet,




Tratamiento hormonal de reasignación de sexo en España: nuestra experiencia en 236 casos  

Microsoft Academic Search

IntroductionIn recent decades, demand for gender reassignment therapy (psychological, hormonal and surgical) has significantly increased. In Spain, this type of therapy has not generally been provided in public hospitals. Consequently, endocrinologists and other health professionals have insufficient experience of this treatment and transsexuals have to resort to self therapy or to private hospitals.

Antonio Becerra Fernández; María Jesús Lucio Pérez; José Luis Llopis Agelan



La hipnosis como adjunto en el tratamiento del hábito de fumar. Estudio de caso  

Microsoft Academic Search

Se presenta el caso de una paciente de 33 años con dependencia a la nicotina que lle vaba 9 años fu- mando una media de 35 cigarrillos diarios. Intentó dejarlo hace 3 años pero tuvo una recaída a los seis meses por problemas de ansiedad y continuó con su adicción. El tr atamiento tuvo como objetivo que la paciente dejara

María Elena; Mendoza Figueroa




Microsoft Academic Search

Resumen El tema de las adicciones ha sido abordado históric amente por la literatura desde múltiples puntos de vista, sin embargo en esta investigación bibliográfica nuestra intenci ón es dimensionar las teorías sobre el origen de la s adicciones, considerando la complementariedad teórica para la q ue se presta el tema, permitiendo un paralelo con l as terapias psicoanalíticas y

Alan Herzberg; Viviana Messina; Diego Moreno; Natalia Olmedo; Romina Pitronello; Francisca Roman


Hemoperitoneo masivo asociado a embarazo ectópico: revisión de su manejo diagnóstico y tratamiento quirúrgico  

Microsoft Academic Search

Global ectopic pregnancy incidence is 1-2% with an increase over the last few years. Its exact aetiology is unknown despite a high relationship with pelvic inflammatory disease. This type of pregnancy complication is associated with a greater risk of subsequent infertility.Its early diagnosis by determination of ?-hCG levels and transvaginal ultrasound is essential to prevent complications that could put maternal

V. J. Ovejero Gómez; M. V. Bermúdez García; Á. Pérez Martín; J. García Rodríguez


Tratamiento médico del embarazo ectópico instersticial: descripción de un caso clínico  

Microsoft Academic Search

Traditional management of interstitial pregnancy involves laparotomy with cornual resection. Recent advances in transvaginal ultrasonography and sensitive beta-hCG assays have led to earlier diagnosis of these cases. We report a case of interstitial pregnancy successfully treated with parenteral methotrexate. Prompt recognition of interstitial pregnancy allows conservative approachment and systemic methotrexate presents as an effective and safe option.

Begoña Adiego Burgos; María Herrera de la Muela; Felipe Ojeda Pérez; María Dolores Merinero Palomares; Manuel Víctor Albi González; Antonio López Salvá



Apoyo familiar en el apego al tratamiento de la hipertensión arterial esencial  

Microsoft Academic Search

Objective. To assess the relationship between family sup- port and drug therapy compliance in essential hyperten- sion. Material and methods. A case-control study was conducted between May and December 1999, at Mexican Institute of Social Security Regional Hospital in Durango, among 80 hypertensive subjects; 40 were cases and 40 con- trols. Cases were subjects who complied with drug therapy and

Florentina Marín-Reyes; Martha Rodríguez-Morán




Microsoft Academic Search

The purpose of the study was to determine the effectiveness of a biopsychosocial intervention program to reduce blood pressure levels and to improve adherence to treatment in patients diagnosed with Hypertension. The study was a quasi-experimental, with transversal design, and intragroup analysis for pre-post intervention. The sample was composed of 44 hypertension patients, without any other chronic illness and\\/or without




Utilidad de los fármacos modificadores de enfermedad (FAME) en el tratamiento de las espondiloartropatías  

Microsoft Academic Search

Disease-modifying antirheumatic drugs (DMARDs), a heterogeneous group of drugs, are widely used in rheumatoid arthritis management. The scientific evidence on the management of spondyloarthropathy with DMARDs is limited and the results are inconclusive. In this article, we review the role of DMARDs in the management of axial involvement in spondyloarthropathies, emphasizing its paradigm, ankylosing spondylitis. We review the data published

Alejandro Prada Ojeda; Teresa Otón Sánchez; Jesús Sanz Sanz



Nuevos retos en el tratamiento de las dislipidemias y del riesgo cardiovascular  

Microsoft Academic Search

Statin therapy reduces the incidence of cardiovascular (CV) disease by 30-40%. However, some risk of unprevented CV complications still persists. Thus, new drugs that when associated to the statins favorably modify the lipid profile and further reduce CV risk are needed. In this clinical commentary, we review the role of other lipids (HDL cholesterol and triglycerides) in CV risk and

R. López Menchaca; C. Suárez Fernández



Cmo expresar sus deseos sobre su cuidado y tratamiento 450 Brookline Ave.  

E-print Network

para cuidados de salud? Los avances de la medicina moderna han salvado vidas y mejorado la calidad Decisiones para cuidados de salud: planificación por adelantado Usted tiene derecho a tomar las decisiones para sus propios cuidados de salud. Sin embargo, una enfermedad o un accidente grave podría impedir que

Liu, Xiaole Shirley


Tratamiento quirúrgico de fístula arteriovenosa pulmonar en telangectasia hemorrágica hereditaria (Enfermedad de Rendu Osler Weber) .  

E-print Network

??Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome) is an autosomal dominant vascular disease that can be associated with pulmonary arteriovenous fistulas. We report a 16 years old… (more)

González L., Roberto




Microsoft Academic Search

The F1560 carburized steel is used in the gears manufacturing industry and high hardness values combined with good toughness are required in order to withstand wear and fatigue problems. Cryogenic treatments have been used for some time to improve the properties of different automotive devices and it could be a way to increase the gear life. However one inconvenience is

M. Preciado; M. Solaguren-Beascoa; P. M. Bravo; J. M. Alegre



Evaluación de un componente de inducción al tratamiento con adolescentes usuarios de alcohol del Distrito Federal  

Microsoft Academic Search

SUMMARY There are two main problems reported in the intervention programs addressing teenage substance users: 1) limited admission to treatment, 2) high drop out rates. Institutions in other countries working with teenage substance users report a dropout rate between 50 and 70% after the first session at early treatment stages. In Mexico, a study on dropout rates in a brief

Martha Leticia; Salazar Garza; Kalina Isela Martínez Martínez; Vania Barrientos Casarrubias




Microsoft Academic Search

In the present study, carried out in Guanare (Venezuela), in the period between November 1998 and March 1999, the application of an anaerobic digestion process in a discontinuous flow (batch) system was evaluated for the treatment of hen manure and rice hulls, with the purpose of stabilization, biogas production and pathogen control. The main biogas production (0,249 m3\\/m3d) was obtained



Micafungina en el tratamiento de la infección fúngica en modelos animales  

Microsoft Academic Search

BackgroundMicafungin is an echinocandin antifungal drug recently approved for the treatment of candidiasis. The possibility of its clinical use against other invasive mycoses, has aroused the interest of numerous investigators in evaluating its efficacy in different animal models.

Francisco Javier Pastor; Josep Guarro



Tratamiento del cáncer glótico precoz con cirugía transoral láser CO2  

Microsoft Academic Search

Objective: We present our outcome in the treat- ment of 125 patients with malignant glottic lesions between 1992 and 2003 in a retrospective study. Patient and methods: We analyze 125 cases of patients, with previously untreated carcinoma of the larynx with histological diagnosis, treated with Transoral Laser Microresection. We will pay special at- tention to those tumors involving the Anterior

J. A. González-García; A. Rodríguez Paramás; R. Souvirón Encabo; P. Ortiz García; B. Scola Yurrita



Microsoft Academic Search

Medical advances in the last decades have increased the cancer survival rate, leading to short- and long-term sequelae caused by the disease and\\/or treatment and with different de- grees of severity. Recent imaging studies have shown brain damage (white and grey matter involvement) by chemo- and radiotherapy. Pa- thology, treatments, age, sex, etc. modulate brain damage and its sequelae. Together

Jordi Bernabeu; Concepción Fournier; Esperanza García-Cuenca; María Plasencia; Olivia Prades; Mercedes Andrés Celma; Adela Cañete



Bloqueo ciático continuo con catéter estimulador guiado mediante ecografía para tratamiento del miembro fantasma doloroso  

Microsoft Academic Search

Peripheral nerve blocks can be an alternative to intravenous and epidural analgesia in the treatment of phantom limb pain. The difficulty of localizing the sciatic nerve through neurostimulation in patients with peripheral arteriopathy and neuropathy can be increased by lower limb amputation, making it impossible to observe a motor response in the foot coinciding with localization of the nerve. In

A. Martínez Navas; R. Ortiz de la Tabla González; M. Echevarría Moreno



Congenital and Developmental Abnormalities  

Microsoft Academic Search

Congenital and developmental abnormalities influencing life are rare. They mainly consist of pectus deformities, sternal fusion\\u000a abnormalities and clavicular pseudoarthrosis. The most life-threatening abnormality is cleft sternum which may leave the heart\\u000a and great vessels unprotected.

Anne Grethe Jurik


Klinefelter's syndrome presenting with leg ulcers.  


A 54-year-old man of Persian origin presented to our department with a 1-year history of ulcers on the right leg that had been unresponsive to numerous topical treatments, accompanied by lymphedema of the right leg. Medical history included hypergonadotropic hypogonadism, which had not been further investigated. He was treated for 20 years with testosterone IM once monthly, which he stopped a year before the current hospitalization for unclear reasons. The patient reported no congenital lymphedema. Physical examination revealed two deep skin ulcers (Figure 1) on the right leg measuring 10 cm in diameter with raised irregular inflammatory borders and a boggy, necrotic base discharging a purulent hemorrhagic exudate. Bilateral leg pitting edema and right lymphangitis with lymphadenitis were noted. He had low head hair implantment, sparse hair on the body and head, hyperpigmentation on both legs, onychodystrophia of the toenails (mainly the large toe and less prominent on the other toes), which was atrophic lichen-planus-like in appearance and needed no trimming (Figure 2), normal hand nails, oral thrush, and angular cheilitis. Other physical findings were gynecomastia, pectus excavatum, small and firm testicles, long extremities, asymmetrical goiter, systolic murmur 2/6 in left sternal border, and slow and inappropriate behavior. The patient's temperature on admission was 39 degrees C. Blood cultures were negative for bacterial growth. Results of laboratory investigations included hemoglobin (11.2 g/dL), hematocrit (26.8%), normal mean corpuscular volume and mean corpuscular hemoglobin volume, and red blood cell distribution width (16%). Blood smear showed spherocytes, slight hypochromia, anisocytosis, macrocytosis, and microcytosis. Blood chemistry values were taken for iron (4 micro g/dL [normal range 40-150 micro g/dL]), transferrin (193 mg/dL [normal range 220-400 mg/dL]), ferritin (1128 ng/mL [normal range 14-160 ng/mL]), transferrin saturation (1.5% [normal range 20%-55%]), serum folate (within normal limits), and vitamin B12 (within normal limits). Direct Coombs' test equaled positive 2 + IgG. All these values indicated anemia of chronic diseases combined with hemolytic anemia. Further blood work-up tested antinuclear antibody (positive <1:80 homogeneous pattern), rheumatoid factors (143 IU/mL [positive >8.5 IU/mL]), C-reactive protein (286 mg/L [normal range 0-5 mg/L]), anticardiolipin IgM antibody (9.0 monophosphoryl lipid U/mL [normal range 0-7.00 MPL U/mL]) and antithrombin III activity (135% [normal range 74%-114%]). Results of other blood tests were within normal limits or negative, including lupus anticoagulant, beta2 glycoprotein, anticardiolipin IgG Ab, anti-ss DNA Ab, C3, C4, anti-RO, anti-LA, anti-SC-70, anti-SM Ab, P-ANCA, C-ANCA, TSH, FT4, anti-T microsomal, antithyroglobulin, protein C activity, protein S free, cryoglobulins, serum immunoelectrophoresis, VDRL, hepatitis C antibodies, hepatitis B antigen, and human immunodeficiency virus. Endocrinological work-up examined luteinizing hormone (22.9 mIU/mL [normal range for adult men 0.8-6 mIU/mL]), follicle stimulating hormone (49.7 mIU/mL [normal range for adult men 1-11 mIU/mL]), testosterone (0.24 ng/mL [normal range for adult men 2.5-8.0 ng/mL]), bioavailable testosterone (0.02 ng/mL [normal range for adult men >0.6 ng/mL]), and percent bioavailable test (8.1% [normal value >20%]). These results indicate hypergonadotropic hypogonadism. Plasminogen activator inhibitor 1 was 6 U (normal value 5-20 U/mL). Karyotyping performed by G-banding technique revealed a 47 XXY karyotype, which is diagnostic of Klinefelter's syndrome. Doppler ultrasound of the leg ulcers disclosed partial thrombus in the distal right femoral vein. X-rays and bone scan displayed osteomyelitis along the right tibia. Histological examination of a 4-mm punch biopsy from the ulcer border revealed hyperkeratosis, acanthosis, hypergranulosis, and mixed inflammatory infiltrate containing eosinophils compatible with chronic ulcer. Multiple vessels were seen, compatible with a h

De Morentin, Helena Martinez; Dodiuk-Gad, Roni P; Brenner, Sarah



New evidence on a cold case: trophic transmission, distribution and host-specificity in Hedruris spinigera (Nematoda: Hedruridae).  


The life cycle of Hedruris spinigera Baylis, 1931 (Nematoda: Hedruridae) is determined here with the first formal identification of the parasite's intermediate host: the crustacean amphipod Paracorophium excavatum Thomson. Adult H. spinigera are redescribed from specimens collected from the stomach of fishes, Retropinna retropinna (Richardson) and Aldrichettaforsteri (Valenciennes), from Lake Waihola, New Zealand. Immature adults of the parasite collected from intermediate hosts (P. excavatum) are also described for the first time. The prevalence, abundance and intensity of infection of H. spinigera in several fish species are quantified along with the occurrence of P. excavatum, the parasite's intermediate host, in fish stomach contents. Although H. spinigera's transmission mode (trophic transmission) and fish diet potentially expose all fish species to infection, some level of host specificity must exist as parasite prevalence, abundance and intensity of infection vary greatly between potential definitive host species. We suggest here that the anatomy of the fish digestive tract and especially that of the stomach plays an important role in host suitability for H. spinigera. While P. excavatum is the only intermediate host in Lake Waihola, H. spinigera was found in six different fish species: Aldrichetta forsteri, Galaxias maculatus (Jenyns), Retropinna retropinna, Rhombosolea retiaria Hutton, Perca fluviatilis Linnaeus and Salmo trutta Linnaeus; although typical hedrurid attachment and mating positions were observed only in R. retropinna and A. forsteri. The limited distribution of H. spinigera is most likely due to that of its different host species (intermediate and definitive), all inhabitants of coastal fresh and brackish waters. PMID:20941914

Luque, José L; Vieira, Fabiano M; Herrmann, Kristin; King, Tania M; Poulin, Robert; Lagrue, Clément



Late Holocene benthic foraminifera and paleoenvironments of the Louisiana coast  

Microsoft Academic Search

The foraminiferal assemblages of 5 vibracores from Isles Dernieres on the Louisiana coast indicate significant environmental shifts within the past 1000 years. The cores, 2 offshore and 3 from the back barrier region, represent mainly the progradational phase of the Early Lafourche delta. Overall, Ammonia parkinsoniana and Elphidium excavatum dominate the faunas, except those of marshes and low-salinity interdistributary bays.

M. A. Eger; B. K. Sen Gupta



Evaluación económica del tratamiento médico de la hiperplasia benigna de próstata (HBP) en España en atención especializada: Aplicación al coste-efectividad de dos fármacos habitualmente utilizados en su tratamiento  

Microsoft Academic Search

ECONOMIC EVALUATION OF MEDICAL TREATMENT OF BENIGN PROSTATIC HYPERPLASIA (BPH) IN THE SPECIALISED CARE SET- TING IN SPAIN. APPLICATION TO THE COST-EFFECTIVENESS OF TWO DRUGS FREQUENTLY USED IN ITS TREATMENT Objectives: To develop a pharmacoeconomic study in order to know the average cost of BPH diagnosis and follow-up in Spain in the Urology Department setting from the perspective of the

J. Carballido; J. L. Ruiz-Cerdá; M. Unda; V. Baena; P. Campoy; J. Manasanch; J. Slof



Hipertensión endocraneana secundaria a edema cerebral y la utilización de soluciones salinas hipertónicas y manitol en su tratamiento  

Microsoft Academic Search

SUMMARY: During the last years, the intracranial hypertension and brain edema has been studied in detail. Research drives us to find new and better treatments. We have made a short review about the classic definitions that are necessary to understand the physiology, physiopathology and treatment of the brain edema. We also compare the advantage and disadvantage between the traditional and

Susan Soto Pernudi; Jorge Fernández Alpízar


Tratamiento y valoración del equilibrio mediante estabilometría en jugador de baloncesto en silla de ruedas. A propósito de un caso  

Microsoft Academic Search

This study evaluates the possible improvement on the balance of a paraplegic patient (D5 complete traumatic injury of spinal cord), who plays basketball, through training on a balance platform. One of the main purposes of this study is the improvement of balance of the patient on the wheelchair to get a better performance on his game, improve control of torso,

V. Rodríguez Pérez; A. F. López Rodríguez; C. Abecia Inchaurregui; J. Seco Calvo



Análisis de fiabilidad y estructura factorial de la versión española del TPQ - Cuestionario de Percepción del Tratamiento en Drogodependencias  

Microsoft Academic Search

SUMMARY The Treatment Perception Questionnaire' (TPQ) is a brief, self-administered scale designed to measure drug user satisfaction with the treatment programme they are following. The aim of this work is to analyse the internal consistency and reliability of the Spanish version of the TPQ, as well as the construct validity. A sample group of one hundred heroin users, diagnosed as



Diagnóstico precoz del embarazo cervical: factor más importante para la conservación de la fertilidad con tratamiento conservador  

Microsoft Academic Search

Cervical pregnancy represents less than 1% of all ectopic pregnancies. In the past, this event was associated with a high incidence of hysterectomies due to intense hemorrhage. Currently, due to early ultrasonographic diagnosis and medical treatment with metotrexate, future fertility can usually be preserved.

J. A. Sainz; R. Serrano; C. Borrero; F. Soto; A. Marín; E. Turmo; R. Garrido



Prevalencia de disfunción eyaculatoria secundaria al tratamiento con alfa-bloqueantes en pacientes con hiperplasia benigna de próstata  

Microsoft Academic Search

PREVALENCE OF EJACULATORY DYSFUNCTION SECONDARY TO ALPHA-BLOCKER THERAPY IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA Introduction: Benign prostatic hyperplasia (BPH) is characterized by lower urinary tract symptoms (LUTS) that may cause ejaculatory disorders, although they could be also a consequence of alpha-blocker treatment. Objectives: To determine the prevalence of ejaculatory dysfunction in patients with HBP undergoing alpha-blocker therapy. Secondary objectives were

A. Martín-Morales; G. Meyer; E. Ramírez



Tratamiento quirúrgico de una hiperplasia fibrosa localizada en la desembocadura del conducto de Estenon. Descripción de la técnica  

Microsoft Academic Search

The fibrous hyperplasia is an exofitic injury circumscribed and formed by dense fibrous conective weave, covered by epithelio squamous stratified. lt is located with more frequency in the buccal mucosa, gingiva, tongue and soft palate, generally zones where greater rubbing takes place, since his etiopathogenia seems to be related to chro­ nic irritatives or traumatic repeated factors. The treatment is

Camacho Alonso F; Saura Inglés A; López Jornet P; Bermejo Fenoll A


Tratamiento dietético y nutricional tras la cirugía de la obesidad en España: revisión bibliográfica (Índice Médico Español, 1975–2008)  

Microsoft Academic Search

Obesity is a disease that develops with an increase in body weight as a result of an excessive accumulation of fat in the body. When conventional treatments have failed in cases of morbid obesity, bariatric surgery is a tool that is capable of achieving significant weight losses that are maintained throughout time. The surgical procedures applied entail a situation of

Isabel Castelló Botía; Eva María Trescastro López




Microsoft Academic Search

With the purpose of increasing the useful life, and to reduce the post-harvest losses, during the commercialization and selling of the blackberry (Rubus glaucus) fruits, it was proposed to essay the post-harvest treatment, based upon the shallow application of the semperfresh wax at a 2% concentration, as a part of the Gama IV technology operations; using a packing with micro

Auris Damely; García Méndez



Efecto del tratamiento magnético del agua sobre la solubilidad de sales en sistemas binarios a 300e  

Microsoft Academic Search

This work presents the effect of magnetic treatment in water over clorures solubility of some representa- tive elements from Group I of the Periodic Table, as well as ammonia clorure which chemical behaviour is similar to those mentioned above. In this paper results related with the following are presented: .Solubility increase of all compounds under study in magnetically treated water.

Luis Bello


Valor de la microcirugía como tratamiento de la infertilidad masculina en la era de la reproducción asistida  

Microsoft Academic Search

SUMMARY The action over the epidimary tube and the deferent blocked conduct with diameter of approx. 0.1 and 0.3 mm respectively, specifies the applications of the microsurgery techniques. The microsurgery may also be needed in some varicocelectomy cases. Over all the subjects and topics related to the microsurgery, its necessary to mention that the most important factors are the practice


The distribution of Hyalomma spp. ticks from domestic ruminants in Iran.  


The distribution of Hyalomma species on domestic animals was studied in four zoogeoghraphical zones. Nine hundred and ninety-two Hyalomma ticks were collected from sheep, goats, cattle and camels. A total of seven tick species consisting of: Hyalomma anatolicum Koch, 1844 (28.93%), H. excavatum Koch, 1844 (12.5%), H. asiaticum Schulze & Schlottke, 1930 (13.5%), H. marginatum Koch, 1844 (27.01%), H. detritum Schulze, 1919 (9.67%), H. schulzei Olenev, 1931 (4.03%) and H. dromedary Koch, 1844 (4.33%) were recorded. The results indicated that H. anatolicum, H. asiaticum, H. marginatum and H. detritum were present in all zones whereas H. excavatum was absent in Zone I. The result also showed that H. dromedari was presented in Zones III and IV whereas H. schulzei was present in Zones II and III. During this study, the tick species collected are candidates for investigation as vectors of pathogenic organisms in Iran. PMID:19712158

Nabian, S; Rahbari, S; Changizi, A; Shayan, P



Molecular detection of Rickettsia africae, Rickettsia aeschlimannii, and Rickettsia sibirica mongolitimonae in camels and Hyalomma spp. ticks from Israel.  


In this study, we aimed to identify and genetically characterize spotted fever group (SFG) rickettsiae in ticks, domestic one-humped camels, and horses from farms and Bedouin communities in southern Israel. A total of 618 ixodid ticks (Hyalomma dromedarii, Hyalomma turanicum, Hyalomma excavatum, and Hyalomma impeltatum) collected from camels and horses, as well as 152 blood samples from 148 camels and four horses were included in the study. Initial screening for rickettsiae was carried out by targeting the gltA gene. Positive samples were further analyzed for rickettsial ompA, 17kDa, ompB, and 16S rRNA genes. Rickettsia aeschlimannii DNA was detected in the blood of three camels and 14 ticks (H. dromedarii, H. turanicum, and H. excavatum). Rickettsia africae was found in six ticks (H. turanicum, H. impeltatum, H. dromedarii, and H. excavatum). In addition, Rickettsia sibirica mongolitimonae was detected in one H. turanicum tick. These findings represent the first autochthonous detection of R. africae in Israel. Previous detections of R. africae in Asia were reported from the Sinai Peninsula (Egypt) and Istanbul, only. Furthermore, we report for the first time the finding of R. aeschlimannii in H. turanicum and H. excavatum ticks, as well as the first identification of R. sibirica mongolitimonae in H. turanicum ticks. The tick species identified to harbor R. africae and other SFG rickettsiae have been reported to occasionally feed on people, and, therefore, physicians should be aware of the possible exposure of local communities and travelers, especially those in contact with camels, to these tick-borne rickettsial pathogens. PMID:24107206

Kleinerman, Gabriela; Baneth, Gad; Mumcuoglu, Kosta Y; van Straten, Michael; Berlin, Dalia; Apanaskevich, Dmitry A; Abdeen, Ziad; Nasereddin, Abed; Harrus, Shimon



Un estudio de los Institutos Nacionales de la Salud indica que dos dosis de vacuna contra los VPH pueden proteger tanto como el tratamiento completo

Dos dosis de Cervarix, la vacuna contra virus del papiloma humano (VPH), fueron tan efectivas como la pauta normal actual de tres dosis después de cuatro años de seguimiento. El estudio de vacuna en Costa Rica, patrocinado por el NCI, fue diseñado para evaluar la eficacia de Cervarix en una población determinada.


Fundamentos del rechazo a la transfusión sanguínea por los Testigos de Jehová. Aspectos ético-legales y consideraciones anestésicas en su tratamiento  

Microsoft Academic Search

Summary The refusal of Jehovah's Witnesses to agree to blood or blood product transfusion based on religious beliefs is one of the most challenging conflictive issues health care givers have to face today. Such conflict is a by product of the ideological and religious diversity in society today. The perioperative care of such patients constitutes a genuine challenge for anesthesiologists

A. Pérez Ferrer; E. Gredilla; J. de Vicente; J. García Fernández; F. Reinoso Barbero


Tratamiento para el Cancer de Prostata: Guia para Hombres con Cancer Localizado de Prostata (Treating Prostate Cancer: A Guide for Men with Localized Prostate Cancer).  

National Technical Information Service (NTIS)

This guide can help you work with your doctor to treat localized prostate cancer. The information comes from a government-funded review of research about treatments for localized prostate cancer. It covers research about four common prostate cancer treatm...



Influencia del tratamiento quirúrgico de la próstata sobre la función renal en pacientes con insuficiencia renal crónica secundaria a hiperplasia prostática benigna  

Microsoft Academic Search

SUMMARY Objective: To assess the influence of the surgical treatment over the renal function in patients with Chronic Renal Failure (CRF) caused by Benign Prostatic Hyperplasia (BPH). Material and methods: This is a descrip- tive, retrospective, analytic case series study. The main result variable was the creatinine delta (postsurgery creatinine - presurgery creatinine), negative creatinine delta results were catalogued as



La decisión de entrar a un tratamiento de adicciones: motivación propia e influencia de terceros The decision to enter an addiction treatment: self motivation and others' influence  

Microsoft Academic Search

This article presents the results of a research about the importance of significant others over the decision to enter an addiction treatment, taken by an individual who has developed an addiction. Especially, it becomes interesting to understand how the participation of these significant others influence the perception of free choice of the individual who carries the addiction. From this point,

Cristián López Acosta



Del conocimiento de la etiología bacteriana al tratamiento y la prevención de las infecciones más prevalentes en la comunidad: las infecciones odontológicas  

Microsoft Academic Search

SUMMARY The prevalence of community odontological infections and their relevance to public health were reviewed. Knowledge of bacterial etiology (and the transmittability of these microbial agents) was used to study the disease (individual susceptibility to etiological agents) in order to review the effect of treatment on odontological pathogens and human microbials. The synergy between the primary care physician and the

P. Matesanz; E. Figuero; M. J. Giménez; L. Aguilar; C. Llor; J. Prieto; A. Bascones


Impacto del agua de cola de la industria pesquera: tratamientos y usos Impact of stickwater produced by the fishery industry: treatment and uses  

Microsoft Academic Search

The effluent produced by the seafood industry especially stickwater is the main source of pollution in seas where these industries have been established. Therefore, there are currently several processes for treatment, which covers physical, chemical and biological methods. Currently, efforts are being made in both: stickwater treatment as well as the recovery of solids from it that can be reinstated

C. O. García-Sifuentes; R. Pacheco-Aguilar; S. Valdez-Hurtado; E. Márquez-Rios; M. E. Lugo-Sánchez; J. M. Ezquerra-Brauer



Informe Anual a la Nación sobre el Estado del Cáncer 1975-2002 con una sección especial sobre las tendencias de tratamiento: preguntas y respuestas

Las organizaciones oncológicas principales de la nación informan que el riesgo de los estadounidenses de morir de cáncer sigue disminuyendo y que las tasas de casos nuevos de cáncer permanecen estables. El Informe Anual a la Nación sobre el Estado del Cáncer, de 1975 a 2002, señala que las tasas de mortalidad de cáncer que se observaron para todos los cánceres combinados disminuyeron 1,1 por ciento por año de 1993 a 2002.


Efectos del tratamiento con anti-TNF-?, infliximab, sobre la resistencia insulínica, adipocinas (visfatina, leptina, adiponectina, resistina y apelina) y angiopoyetina-2 en pacientes con espondilitis anquilosante.  

E-print Network

??RESUMEN: La Espondilitis Anquilosante (EA) es una enfermedad inflamatoria crónica que afecta fundamentalmente a la columna vertebral produciendo sacroileítis. Estos pacientes presentan una aterogénesis acelerada… (more)

Miranda Filloy, José Alberto



Efectos del tratamiento con anti-TNF-a, infliximab, sobre la resistencia insulínica, adipocinas (visfatina, leptina, adiponectina, resistina y apelina) y angiopoyetina-2 en pacientes con espondilitis anquilosante.  

E-print Network

??Ankylosing Spondylitis (AS) is a chronic inflammatory disease that affects the spine causing sacroiliitis. These patients have accelerated atherogenesis and insulin resistance, which promotes endothelial… (more)

Miranda Filloy, José Alberto



Cistoprostatectomía radical con preservación neurovascular para el tratamiento del cáncer vesical. Relación con la disfunción eréctil: revisión de la literatura científica  

Microsoft Academic Search

Radical cystectomy (RC) with bilateral pelvic lymph node dissection and urinary diversion remains the gold standard extirpative treatment for high risk non-invasive bladder cancer and muscleinvasive carcinoma. The endpoints after this operation have been historically focused on cure, urethral recurrence and continence. Functional outcomes in radical cystectomy patients were not considered until the middle eighties, thus the evaluation of these

F. Javier González García; Javier Angulo Cuesta



Indicaciones y resultados de la microcirugía endoscópica transanal en el tratamiento de los tumores rectales en una serie consecutiva de 52 pacientes  

Microsoft Academic Search

IntroductionThe abdominal approach for the treatment of rectal tumours is associated with considerable morbidity. Transanal endoscopic microsurgery (TEM) is a technical alternative, and less invasive than radical surgery, and thus, with a lower associated morbidity. Also, with the correct selection of patients, TEM shows similar oncological results to radical surgery. The objective of this study is to review our results

Manuel Ferrer Márquez; Ángel Reina Duarte; Francisco Rubio Gil; Ricardo Belda Lozano; Antonio Álvarez García; Isabel Blesa Sierra



Silica-coated super paramagnetic iron oxide nanoparticles (SPION) as biocompatible contrast agent in biomedical photoacoustics.  


In this study, we report for the first time the use of silica-coated superparamagnetic iron oxide nanoparticles (SPION) as contrast agents in biomedical photoacoustic imaging. Using frequency-domain photoacoustic correlation (the photoacoustic radar), we investigated the effects of nanoparticle size, concentration and biological media (e.g. serum, sheep blood) on the photoacoustic response in turbid media. Maximum detection depth and the minimum measurable SPION concentration were determined experimentally. The nanoparticle-induced optical contrast ex vivo in dense muscular tissues (avian pectus and murine quadricept) was evaluated and the strong potential of silica-coated SPION as a possible photoacoustic contrast agents was demonstrated. PMID:23082291

Alwi, Rudolf; Telenkov, Sergey; Mandelis, Andreas; Leshuk, Timothy; Gu, Frank; Oladepo, Sulayman; Michaelian, Kirk



Pulmonary non-tuberculous mycobacterial infection in congenital contractural arachnodactyly.  


Congenital contractural arachnodactyly (CCA) is caused by mutations within the fibrillin-2 gene (FBN2), which is crucial for microfibril structure. Affected individuals may have contractures, chest wall deformities, scoliosis, abnormal ear folding and elongated limbs. We describe a novel FBN2 mutation in a woman with CCA who also had pulmonary non-tuberculous mycobacteria (NTM) infection. The population with pulmonary NTM infections shares phenotypic features with CCA, such as elongated body habitus, scoliosis and pectus deformities. While it is unlikely that FBN2 defects account for susceptibility to NTM infection in the majority of cases, the overlap between these two diseases suggests some shared pathophysiology. PMID:22325249

Paulson, M L; Olivier, K N; Holland, S M



Silica-coated super paramagnetic iron oxide nanoparticles (SPION) as biocompatible contrast agent in biomedical photoacoustics  

PubMed Central

In this study, we report for the first time the use of silica-coated superparamagnetic iron oxide nanoparticles (SPION) as contrast agents in biomedical photoacoustic imaging. Using frequency-domain photoacoustic correlation (the photoacoustic radar), we investigated the effects of nanoparticle size, concentration and biological media (e.g. serum, sheep blood) on the photoacoustic response in turbid media. Maximum detection depth and the minimum measurable SPION concentration were determined experimentally. The nanoparticle-induced optical contrast ex vivo in dense muscular tissues (avian pectus and murine quadricept) was evaluated and the strong potential of silica-coated SPION as a possible photoacoustic contrast agents was demonstrated. PMID:23082291

Alwi, Rudolf; Telenkov, Sergey; Mandelis, Andreas; Leshuk, Timothy; Gu, Frank; Oladepo, Sulayman; Michaelian, Kirk



A survey of ticks on farm animals in Libya.  


Thirteen species of ixodid ticks and two species of argasid ticks were collected during a three-year survey of 58 farms in Libya. These included Boophilus annulatus, B. microplus, B. decoloratus, seven species of Hyalomma, Rhipicephalus sanguineus, Rh. evertsi, Rh. bursa, Argas persicus and Ornithodoros foleyi. This is the first recording of B. microplus, B. decoloratus and Rh. bursa in Libya. Of 20,391 animals examined by random sampling, 2020 (9.6%) had ticks; particularly common were Hy. dromedarii on camels, Hy. impeltatum on sheep and Hy. excavatum on cattle. The tick found most frequently overall was Hy. dromedarii. PMID:1288437

Gabaj, M M; Awan, M A; Beesley, W N



Bionomics of ticks collected from Sinai Peninsula: 2- abundance, attachment sites, and density estimators of ticks infesting Arabian camels.  


Ten camels were examined monthly from January to December 1999, in Beer Lehfen North Sinai Gavernorate. A total of 5468 adult ticks of 6 species and subspecies of genus Hyalomma; H. dromedrii, H. ipmeltatum, H. a. excavatum, H. a. anatolicum, H. schulzei, and H. marginatum rufipes, in addition to 115 Hyalomma nymphs' species were collected. Of these, the first 4 types represented about 96.2% of the total collection. The infestation rate was higher during the period from March to November. The average monthly infestation rate was 22.78+/-3. The large number of the adult ticks were concentrated on tail, brisket, anus, and udder which totaled 68.2%. Attachment sites of males and females were not significantly correlated in most species. Nymphs were localized in few sites, whereas 91.6% of the total nymphs were attached to hump, neck, head (ear), and side. H. dromedarii, H. impeltatum, and H. a. excavatum were found on most of the body sites, tail, brisket, udder, and anus, totaling 79.9%. Males exceeded females in all sites, and were alone on neck and legs. Females were the only stage collected from udder. Both sex of H. a. anatolicum were collected from tail. H. schulzei and H. m. rufipes were concentrated in brisket, udder, anus, and tail. PMID:11478447

Diab, F M; El-Kady, G A; Shoukry, A



TRAMOMTANA (Tratamiento Multidisciplinar de la Obesidad Mórbida: Medicamentos, Terapia de comportamiento, Apoyo Nutricional y Actividad física). De la pregunta a la realidad de un ensayo clínico investigador iniciado (II)  

Microsoft Academic Search

Implementation of an intensive, multidisciplinary weight loss program in patients with morbid obesity is reported. This program is based on behavioral changes, lifestyle intervention, medication, and group therapy sessions. Our objective is to show that the results achieved with this two-year weight loss program will be at least similar to those achieved with bariatric surgery in patients with morbid obesity.

Juan Tur; Maria Alòs; Lourdes Iglesias; Lourdes Luque; Antoni Colom; Antonio Escudero; David Martínez; Alberto Pagán; Elena Ugarriza; Marga Frontera; Gabriela Nicola; Antonio Palomero; Santiago Tofé; Juan Ramón Urgeles; María Antonia Barceló; Marta Couce; Mónica De La Peña; Miguel Fiol; Baltasar Cortés; Emma Terés; Ángela Tumbarello; Cristina Álvarez; Ramón Salinas; Vicente Pereg; Xavier González; Bartolomé Burguera



ASOCIACIÓN DE ELECTROANALGESIA (TENS) Y ULTRASONOTERAPIA EN EL TRATAMIENTO DE LESIONES INFLAMATORIAS DEL M. Longissimus dorsi EN EL EQUINO Electroanalgesia and Ultrasonotherapy Relationship on the Treatment of Inflammatory Lesions of Longissimus Dorsi Muscle in the Horse  

Microsoft Academic Search

Physical therapy has acquired in Veterinary a lot of importance Medicine in the last decades and a consistent increase has been, given to its frecuent use as a complement of pharmacol- ogical therapy; in some cases, it has come to replace it. In this paper, the authors give a way their experience in the use of of electroanalgesia and ultrasound

Mónica Cristina Mercado; José Alberto García Liñeiro; Carlos Horacio Lightowler



El Informe Anual a la Nación indica que las tasas de mortalidad por cáncer continúan declinando: los avances en el tratamiento del cáncer varían según el tipo de cáncer

Las organizaciones oncológicas principales de la nación informan que el riesgo de los estadounidenses de morir de cáncer sigue disminuyendo y que las tasas de casos nuevos de cáncer permanecen estables. El Informe Anual a la Nación sobre el Estado del Cáncer, de 1975 a 2002, señala que las tasas de mortalidad de cáncer que se observaron para todos los cánceres combinados disminuyeron 1,1 por ciento por año de 1993 a 2002.


Testing road surface treatments to reduce erosion in forest roads in Honduras [Tratamientos de la superfi cie de rodadura para reducir la erosi??n en caminos forestales en Honduras  

USGS Publications Warehouse

Testing road surface treatments to reduce erosion in forest roads in Honduras. Cien. Inv. Agr. 36(3):425-432. Using forest roads produces more erosion and sedimentation than any other forest or agricultural activity. This study evaluated soil losses from a forest road in central Honduras over two consecutive years. We divided a 400-m segment of road into 8 experimental units, each 50 m in length. Four units were treated with Best Management Practices (BMPs) and four were left untreated. The BMP treatments included reshaping the road prism, installing culverts and reshaping of road ditches, compacting 20-cm layers of the road tread, crowning the road surface (3% slope, double drainage), longitudinal sloping (less than 12%), and adding a 10-cm layer of gravel (crush size = 0.63 cm). Soil movement was measured daily during the rainy seasons. The highest soil loss occurred in the control road, around 500 m3 km-1 per year, while the road treated with BMP lost approximately 225 m3km-1 per year. These results show that road surface erosion can be reduced up to 50% with the implementation of surface treatments.

Rivera, S.; Kershner, J.L.; Keller, G.R.



Difusión de resultados iniciales del Estudio del Tamoxifeno y del Raloxifeno (STAR): el fármaco para el tratamiento de la osteoporosis, raloxifeno, es tan efectivo como el Tamoxifeno en la prevención de cáncer de seno invasor

Los resultados iniciales del Estudio del Tamoxifeno y del Raloxifeno, STAR, demuestran que el fármaco raloxifeno, actualmente utilizado para prevenir y tratar la osteoporosis en mujeres posmenopáusicas, funciona tan bien como el tamoxifeno para reducir el riesgo de cáncer de seno entre las mujeres posmenopáusicas que tienen riesgo elevado de padecer la enfermedad. Preguntas y respuestas


Modern foraminiferal facies in a subtropical estuarine channel, Bertioga, São Paulo, Brazil  

USGS Publications Warehouse

Numerical analyses of modern foraminiferal abundance and environmental data from the Bertioga Channel (Sa??o Paulo, Brazil) reveal multiple biofacies within an overall paralic setting. Despite its fisheries, mariculture and attraction to tourists, the environmental state of Bertioga Channel remains poorly studied. The present investigation is an attempt to partly fill this gap; the parameters examined include depth, salinity, temperature, organic carbon, sulfur content and bottom sediment type. Muddy sediments with high organic carbon content derived from land drainage are found in the inner parts of the channel, whereas sandy sediment dominates the areas adjacent to the Atlantic Ocean. In the eastern entrance to the channel, sandy sediment contain species of Rotaliida from Facies 1 (including Elphidium discoidale, Elphidium poeyanum, Hanzawaia boueana, Pararotalia cananeiaensis and Nonionella atlantica), reflecting normal marine salinity. Sediments with high percentages of silt and clay in polyhaline and eurybaline environments of the eastern part and Itapanhau?? River contain Facies 2, which includes Ammonia beccarii and Pararotalia cananeiaensis. In the western entrance and central, western and eastern parts, where salinities vary from 18 to 30 psu and the sediments contain both low and high organic carbon, the foraminifera from Facies 3 are dominated by Quinqueloculina milletti, Arenoparrella mexicana, Pararotalia cananeiaensis, Ammonia beccarii, Buliminella elegantissima, Elphidium sp., Elphidium excavatum, Elphidium gunteri and Elphidium poeyanum. In mesohaline and polyhaline waters of the central part, the organic-carbon-rich silt and clay contain Facies 4, which includes Ammonia beccarii, Pararotalia cananeiaensis, Elphidium excavatum and Elphidium sp. Most of organic-carbon-enriched, silty-clay substrates that are subject to the highest fresh-water discharge and high bottom temperatures support two different assemblages: one of mostly Rotaliina and the other mostly of Textulariida (Facies 5 and 6). Facies 5 includes Ammonia beecarii, Elphidium excavatum, Arenoparrella mexicana, Haplophragmoides wilberti, Siphotrochammina lobata, Trochammina inflata and Trochammina sp., all of which are typical of mesohaline sites (mainly Crumau?? and Trindade rivers), and Facies 6 includes Bolivina sp., Ammoastuta salsa, Arenoparrella mexicana, Haplophragmoides wilberti and Trochammina sp., all of which are typical of oligohaline and mesohaline mangrove fringes. The foraminiferal species from the present study are frequently found in paralic environments in Brazil, western Africa and other estuaries around the world.

Eichler, P.P.B.; Eichler, B.B.; De Miranda, L. B.; Rodrigues, A.R.



Dolor (PDQ®)

Resumen de información revisada por expertos acerca del dolor como una complicación a causa del cáncer o su tratamiento. Se discuten enfoques sobre el manejo y tratamiento del dolor relacionado con el cáncer.


Prurito (PDQ®)

Resumen de información revisada por expertos acerca del prurito (picazón de la piel) como complicación a causa del cáncer y su tratamiento. Se discuten los enfoques del manejo y tratamiento del prurito.


Platiquemos un rato...

1 La historia de Ana Y cómo ella recibió tratamiento para el cáncer 2 Ana tiene cáncer. 3 “Existen muchos tratamientos para el cáncer”, dijo su médico. 4 Le dio un folleto acerca de un estudio clínico, una opción para el tratamiento del cáncer. 5 Un estudio


Rib Cage Deformities Alter Respiratory Muscle Action and Chest Wall Function in Patients with Severe Osteogenesis Imperfecta  

PubMed Central

Background Osteogenesis imperfecta (OI) is an inherited connective tissue disorder characterized by bone fragility, multiple fractures and significant chest wall deformities. Cardiopulmonary insufficiency is the leading cause of death in these patients. Methods Seven patients with severe OI type III, 15 with moderate OI type IV and 26 healthy subjects were studied. In addition to standard spirometry, rib cage geometry, breathing pattern and regional chest wall volume changes at rest in seated and supine position were assessed by opto-electronic plethysmography to investigate if structural modifications of the rib cage in OI have consequences on ventilatory pattern. One-way or two-way analysis of variance was performed to compare the results between the three groups and the two postures. Results Both OI type III and IV patients showed reduced FVC and FEV1 compared to predicted values, on condition that updated reference equations are considered. In both positions, ventilation was lower in OI patients than control because of lower tidal volume (p<0.01). In contrast to OI type IV patients, whose chest wall geometry and function was normal, OI type III patients were characterized by reduced (p<0.01) angle at the sternum (pectus carinatum), paradoxical inspiratory inward motion of the pulmonary rib cage, significant thoraco-abdominal asynchronies and rib cage distortions in supine position (p<0.001). Conclusions In conclusion, the restrictive respiratory pattern of Osteogenesis Imperfecta is closely related to the severity of the disease and to the sternal deformities. Pectus carinatum characterizes OI type III patients and alters respiratory muscles coordination, leading to chest wall and rib cage distortions and an inefficient ventilator pattern. OI type IV is characterized by lower alterations in the respiratory function. These findings suggest that functional assessment and treatment of OI should be differentiated in these two forms of the disease. PMID:22558284

LoMauro, Antonella; Pochintesta, Simona; Romei, Marianna; D'Angelo, Maria Grazia; Pedotti, Antonio; Turconi, Anna Carla; Aliverti, Andrea



The most recent results on orchid mycorrhizal fungi in Hungary.  


Symbionts and endophytes of Hungarian orchids were studied at diverse habitats. Mycobionts of roots and in situ germinated protocorms of 15 orchid species were identified by molecular methods. Four fungal groups could be distinguished from orchids living at diversely wet treeless habitats: Ceratobasidiaceae, Epulorhiza 1, Epulorhiza 2 and Sebacinaceae. While the groups Ceratobasidiaceae and Sebacinaceae were detected only at habitats with medium water supply, members of clade Epulorhiza occurred at all of the treeless study sites. These observations suggest that fungi belonging to the genus Epulorhiza are more tolerant of water-stress than the other investigated genera. An ascomycetous fungus from the family Pezizaceae could be identified from the roots of Orchis coriophora. Further Ascomycetes were identified at forest habitats. Tuber maculatum was detected from the roots of Epipactis helleborine and Cephalanthera damasonium, and Tuber excavatum from Epipactis microphylla. PMID:21565766

Illyés, Z; Ouanphanivanh, Noémi; Rudnóy, Sz; Orczán, A K; Bratek, Z



Protozoal parasites in tick species infesting camels in Sinai Peninsula.  


A faunistic survey of ticks infesting camels was carried out in 7 localities of Sinai; El-Arish, Beer El Abd, Nakhel, Ain Mousa, St. Catherine, Wadi Hadra, and Dahab. The protozoal organisms present in the gut and haemolymph of the collected tick species were investigated. Results revealed the presence of six species of tick infesting camels, Hyalomma dromedarii, H. impeltatum, H. an. excavatum, H. an. anatolicum, H. marginatum and H. schulzei. The first 3 species were most common, whereas the latter 3 species were found in certain limited localities. Babesia sp. and Theilera sp. were recorded in both tick guts and haemolymph in most species allover the studied areas. Trypanosoma sp. was recorded in the guts of ticks collected from Beer El Abd, Nakhel and Dahab. Anaplasma sp. was found in tick guts from Beer El Abd and Dahab, however the same organism was detected in the haemolymph of ticks collected in Nakhel and Dahab. PMID:9914699

el Kady, G A



Tick paralysis: first zoonosis record in Egypt.  


Tick paralysis caused by the secretion of toxin with saliva while taking a blood meal is an important veterinary disease, but is rare in humans. Although it has certain geographical proclivities, it exists worldwide. Tick paralysis was demonstrated for the first time in Egypt among four children living in rural area at Giza Governorate. The clinical pictures were confused with rabies; myasthensia gravis; botulism; diphtheritic polyneuropathy encountered in rural areas. The recovery of tick infesting the four little children and negative clinical and laboratory data of all diseases denoted tick paralysis. The encountered ticks infesting their animals were Rhipicephalus sanguineus on dogs, Hyalomma dromedarii on camels and Hyalomma anatolicum excavatum and Haemaphysalis sp. on goats. The case was recognized as first record of tick paralysis in Egypt. PMID:22662597

Mosabah, Amira A Abd El-rahman; Morsy, Tosson A



Hard ticks on one-humped camel (Camelus dromedarius) and their seasonal population dynamics in southeast, Iran.  


The primary objective of this study was to determine the diversity and intensity of ticks found on camels (Camelus dromedarius) and their seasonal population dynamics in Kerman, southeast of Iran. For this purpose, a total of 426 tick specimens were collected from 217 infested camels in southeast of Iran during activating seasons of ticks (April 2009 to March 2010). The species collected from camel were Hyalomma dromedarii (84.7%), Hyalomma marginatum (8.7%), Hyalomma anatolicum excavatum (5.4%), and Hyalomma anatolicum anatolicum (1.2%). The highest seasonal activities occurred in summer. The ratio of male ticks was more than female ticks. H. dromedarii was the predominant tick species and accounted for 84.7% of the ticks. PMID:21720786

Fard, Saeid Reza Nourollahi; Fathi, Saeid; Asl, Ehsan Norouzi; Nazhad, Hojat Asgary; Kazeroni, Seimin Salehzadeh



Rickettsial agents in Egyptian ticks collected from domestic animals.  


To assess the presence of rickettsial pathogens in ticks from Egypt, we collected ticks from domestic and peridomestic animals between June 2002 and July 2003. DNA extracts from 1019 ticks were tested, using PCR and sequencing, for Anaplasma spp., Bartonella spp., Coxiella burnetii, Ehrlichia spp., and Rickettsia spp. Ticks included: 29 Argas persicus, 10 Hyalomma anatolicum anatolicum, 55 Hyalomma anatolicum excavatum, 174 Hyalomma dromedarii, 2 Hyalomma impeltatum, 3 Hyalomma marginatum rufipes, 55 unidentified nymphal Hyalomma, 625 Rhipicephalus (Boophilus) annulatus, 49 Rhipicephalus sanguineus, and 17 Rhipicephalus turanicus. Ticks were collected predominantly (>80%) from buffalo, cattle, and camels, with smaller numbers from chicken and rabbit sheds, sheep, foxes, a domestic dog, a hedgehog, and a black rat. We detected Anaplasma marginale, Coxiella burnetii, Rickettsia aeschlimannii, and four novel genotypes similar to: "Anaplasma platys," Ehrlichia canis, Ehrlichia spp. reported from Asian ticks, and a Rickettsiales endosymbiont of Ixodes ricinus. PMID:17004028

Loftis, Amanda D; Reeves, Will K; Szumlas, Daniel E; Abbassy, Magda M; Helmy, Ibrahim M; Moriarity, John R; Dasch, Gregory A



Benthic foraminifera and environmental changes in Long Island Sound  

USGS Publications Warehouse

Benthic foraminiferal faunas in Long Island Sound (LIS) in the 1940s and 1960s were of low diversity, and dominated by species of the genus Elphidium, mainly Elphidium excavatum clavatum, with common Buccella frigida and Eggerella advena. The distribution of these species was dominantly correlated with depth, but it was not clear which depth-related environmental variable was most important. Differences between faunas collected in 1996 and 1997, and in the 1940s and 1960s include a strong decrease in relative abundance of Eggerella advena over all LIS, an increase in relative abundance of Ammonia beccarii in western LIS, and a decrease in species diversity. The decreased diversity suggests that environmental stress caused the faunal changes. Oxygen isotope data for E. excavatum clavatum indicate that a change in salinity is not a probable cause. Carbon isotope data suggest that the supply of organic matter to the benthos increased since the early 1960s, with a stronger increase in western LIS where algal blooms have occurred since the early 1970s, possibly as a result of nutrient input by waste water treatment plants. These blooms or the resulting episodes of anoxia/hypoxia may have played a role in the increased relative abundance of A. beccarii. There is no clear explanation for the decreased abundance of E. advena, but changes in the phytoplankton composition (thus food supply) are a possible cause. Benthic foraminiferal faunal and stable isotope data have excellent potential as indicators of physicochemical environmental changes and their effects on the biota in LIS.

Thomas, E.; Gapotchenko, T.; Varekamp, J.C.; Mecray, E.I.; Buchholtz ten Brink, M. R.



Effects of high hydrostatic pressure processing and of glucose oxidase-catalase addition on the color stability and sensorial score of grape juice \\/ Efectos del tratamiento con altas presiones y de la adición de glucosa oxidasa-catalasa en la estabilidad del color y en la evaluación sensorial del zumo de uva  

Microsoft Academic Search

The effects of high hydrostatic pressure treatment (HHP) and the use of glucose oxidase-catalase enzymes on the color stability of a white grape juice were studied. The cold-prepared grape juice was stored for three weeks at 5 °C and evaluated for color and non-flavonoid phenolic content. The HHP treatments at 600 and 900 MPa slowed the degradation of non-flavonoid phenolics

M. Castellari; L. Matricardi; G. Arfelli; G. Carpi; S. Galassi



Efi cacia y seguridad de altas dosis de hierro parenteral en el tratamiento de anemia ferropénica en pacientes con enfermedad renal crónica Effi cacy and safety of hight doses of parenteral iron in the treatment of ferropenic anemia in patients with cronic renal disease  

Microsoft Academic Search

Objetive: to determine the effi cacy and safety of iron saccharose at high doese (200 to 300 ml, intravenously) compared to the classical doses (100 mgr. I.V.) in patients with chronic renal disease and ferropenic anemia.



Fármacos dirigidos activos contra el cáncer de seno HER-2 positivo: preguntas y respuestas

ALTTO fue un estudio clínico diseñado para determinar si la combinación del anticuerpo monoclonal trastuzumab (Herceptina) y el fármaco lapatinib (Tykerb) era más eficaz para el tratamiento del cáncer de seno HER2/ErbB2 positivo al combinarse con quimioterapia que el tratamiento con uno solo de los fármacos. Los resultados del estudio no indicaron que existan ventajas al combinar trastuzumab y lapatinib frente al tratamiento solo con trastuzumab.


On-Site Wastewater Treatment Systems: Aerobic Treatment Unit (Spanish)  

E-print Network

Sistemas individuales para el tratamiento de aguas negras Fosa de basura de un compartimiento Cloronizador Unidad de tratamiento aer?bico Rociadores Tanque bomba Unidad de tratamiento aer?bico Bruce Lesikar y Juan Enciso Promotores Especialistas de... Ingenier?a Agr?cola El Sistema Universitario Texas A&M L-5302S 8-00 Figura 1: Un sistema individual para el tratameinto de agua negras con una unidad de tratamiento aer?bico. L as unidades aer?bicas tratan las aguas negras para las casas y los negocios...

Lesikar, Bruce J.; Enciso, Juan



Pretreatment tecnologies to enhance solid wastes anaerobic digestion.  

E-print Network

??El principal objetivo es mejorar la digestión anaerobia mediante tecnologías de pretratamiento: hidrólisis térmica, ultrasonidos y tratamiento enzimático. Se estudian seis residuos sólidos: lodos de… (more)

Cano Herranz, Raúl



Benthic foraminiferal assemblages help to understand carbonate mound evolution  

NASA Astrophysics Data System (ADS)

On- and off-mound sediment cores from Propeller Mound (Porcupine Seabight) were analysed for their benthic foraminiferal assemblages. Benthic foraminifera from the off-mound position show three different assemblages describing the Holocene, Oxygen Isotope Stage (OIS) 2 and late OIS 3. The Holocene assemblage is dominated by Uvigerina mediterranea, Trifarina angulosa, Melonis barleeanum, Hyalinea balthica, Bulimina marginata. These species are related to a higher supply of organic material. The glacial assemblage shows high abundances of Cassidulina teretis, C. reniforme, Globocassidulina subglobosa, and Cibicidoides kullenbergi, implying cold bottom waters and a reduced productivity. The lower part of late OIS 3 is dominated by Elphidium excavatum, which is displaced continuously by very high abundances of C. teretis towards the transition of OIS3/2. E. excavatum, a shallow shelf species generally reported from above 200 m water depth, and high amounts of sediment supplied to the core site points to shelf erosion related to sea level lowering (approx. 50 m). Towards OIS 2 the system returns to normal background sedimentation pattern. We transferred the established off-mound assemblages onto the on-mound core, in which the sediment sequence is incomplete characterised by numerous hiatuses. The Holocene assemblage describes almost the complete core with relative abundances of >20%, interrupted only by three sections with slightly higher amounts of the glacial assemblage, which are not comparable to abundances of >70% of the glacial assemblage found in the off-mound core. These results are in conjunction with stable oxygen isotope data indicating only interstadial values, assuming peak glacial and interglacial sediments to be removed from the mound. Another assemblage described for the on-mound core is dominated by Discanomalina coronata, Gavelinopsis translucens, Planulina ariminensis, Cibicides lobatulus and to a lower degree by Hyrrokkin sarcophaga. These species are only found or show significantly higher relative abundances in on-mound samples and are grouped to the mound assemblage. This assemblage probably indicates a higher coral growth density on Propeller Mound in an earlier period, but is less abundant during the Holocene, which indicates a declining of the mound associated with less coral growth.

Rüggeberg, A.; Dorschel, B.; Dullo, C.; Hebbeln, D.; Freiwald, A.



Influencia de dos procedimientos sobre la generalización de la corrección de err ores articulatorios  

Microsoft Academic Search

Se presenta un estudio sistemático sobre la generalización en el tratamiento de los errores articulato- rios en el lenguaje infantil. Se experimentaro n dos procedimientos con distintos tipos de relaciones funcionales del lenguaje: el Grupo 1 recibió un tratamiento exclusivamente con ensayos de imitación, y el Grupo 2 recibió ensayos de imitación, tactos e intraverbales. Participaron 10 niños y niñas

Carmen V ives Montero; Carmen Luciano Soriano; Luis V alero Aguayo



Boletín del Instituto Nacional del Cáncer - 09-14-2010

Las mediciones ecocardiográficas del ventrículo izquierdo del corazón sirven para que los médicos monitoreen el funcionamiento cardiaco durante el tratamiento contra el cáncer. Una reducción de la fracción de eyección ventricular izquierda (LVEF) durante el tratamiento puede indicar daño cardiaco provocado por los fármacos. Haga clic para ampliar.


arco de canto multiansas (multiloop edgewise archwire: meaw) ¿por qué multiloop? a spectos clínicos y biomecánica  

Microsoft Academic Search

resumen La utilización del loop en los tratamientos con aparatolo- gía fija, usando alambres rectangulares, en el contexto de una filosofía de diagnóstico y tratamiento basada en el crecimiento dinámico del complejo maxilofacial, ha pro- vocado un creciente interés entre los clínicos y los investi- gadores. Se destacan en este campo, el profesor Youg Kim, presidente de Mea w Foundation

Ricardo Voss



Embarazo heterotópico en un ciclo de concepción natural presentado como embarazo ectópico roto. Informe de un caso  

Microsoft Academic Search

Resumen Introducción: El embarazo heterotópico se define como ges- tación intrauterina que coexiste con otra de tipo ectópico. Es una entidad rara, en particular en paciente sin antecedentes de tratamiento contra la infertilidad. El objetivo de esta comuni- cación es informar de una paciente sin antecedente de fertili- zación in vitro o de tratamiento para la fertilidad, quien presen- tó

Karla Elena Domínguez-Meléndez; Héctor Sastré-Gómez; Francisco Higuera-Hidalgo; Armando Vargas-Domínguez; Felipe Rafael Zaldívar-Ramírez



Dysregulation of FHL1 spliceforms due to an indel mutation produces an Emery-Dreifuss muscular dystrophy plus phenotype.  


Emery-Dreifuss muscular dystrophy (EDMD) is characterised by early-onset joint contractures, progressive muscular weakness and wasting and late-onset cardiac disease. The more common X-linked recessive form of EDMD is caused by mutations in either EMD (encoding emerin) or FHL1 (encoding four and a half LIM domains 1), while mutations in LMNA (encoding lamin A/C), SYNE1 (encoding nesprin-1) and SYNE2 (encoding nesprin-2) lead to autosomal dominant forms of the condition. Here, we identify a three-generation family with an extended EDMD phenotype due to a novel indel mutation in FHL1 that differentially affects the relative expression of the three known transcript isoforms produced from this locus. The additional phenotypic manifestations in this family-proportionate short stature, facial dysmorphism, pulmonary valvular stenosis, thoracic scoliosis, brachydactyly, pectus deformities and genital abnormalities-are reminiscent of phenotypes seen with dysregulated Ras-mitogen-activated protein kinase (RAS-MAPK) signalling [Noonan syndrome (NS) and related disorders]. The misexpression of FHL1 transcripts precipitated by this mutation, together with the role of FHL1 in the regulation of RAS-MAPK signalling, suggests that this mutation confers a complex phenotype through both gain- and loss-of-function mechanisms. This indel mutation in FHL1 broadens the spectrum of FHL1-related disorders and implicates it in the pathogenesis of NS spectrum disorders. PMID:23456229

Tiffin, Heather R; Jenkins, Zandra A; Gray, Mary J; Cameron-Christie, Sophia R; Eaton, Jennifer; Aftimos, Salim; Markie, David; Robertson, Stephen P



Further evidence of the importance of RIT1 in Noonan syndrome.  


Noonan syndrome (NS) is an autosomal dominant disorder consisting of short stature, short and/or webbed neck, distinctive facial features, cardiac abnormalities, cryptorchidism, and coagulation defects. NS exhibits genetic heterogeneity, associated with mutated genes that participate in RAS-mitogen-activated protein kinase signal transduction. Recently, a new gene (RIT1) was discovered as the causative gene in 17 of 180 Japanese individuals who were negative for the previously known genes for NS and were studied using exome sequencing (four patients), followed by Sanger sequencing (13 patients). The present study used the same technique in 70 Brazilian patients with NS and identified six with RIT1 missense mutations. Thus, we confirm that RIT1 is responsible for approximately 10% of the patients negative for mutations in the previously known genes. The phenotype includes a high frequency of high birth weight, relative macrocephaly, left ventricular hypertrophy, and ectodermal findings, such as curly hair, hyperpigmentation, and wrinkled palms and soles. Short stature and pectus deformity were less frequent. The majority of patients with a RIT1 mutation did not show apparent intellectual disability. Because of the relatively high frequency of mutations in RIT1 among patients with NS and its occurrence in different populations, we suggest that it should be added to the list of genes included in panels for the molecular diagnosis of NS through targeted next-generation sequencing. © 2014 Wiley Periodicals, Inc. PMID:25124994

Bertola, Débora R; Yamamoto, Guilherme L; Almeida, Tatiana F; Buscarilli, Michelle; Jorge, Alexander A L; Malaquias, Alexsandra C; Kim, Chong A; Takahashi, Vanessa N V; Passos-Bueno, Maria Rita; Pereira, Alexandre C



A Novel Nemaline Myopathy in the Amish Caused by a Mutation in Troponin T1  

PubMed Central

The nemaline myopathies are characterized by weakness and eosinophilic, rodlike (nemaline) inclusions in muscle fibers. Amish nemaline myopathy is a form of nemaline myopathy common among the Old Order Amish. In the first months of life, affected infants have tremors with hypotonia and mild contractures of the shoulders and hips. Progressive worsening of the proximal contractures, weakness, and a pectus carinatum deformity develop before the children die of respiratory insufficiency, usually in the second year. The disorder has an incidence of ?1 in 500 among the Amish, and it is inherited in an autosomal recessive pattern. Using a genealogy database, automated pedigree software, and linkage analysis of DNA samples from four sibships, we identified an ?2-cM interval on chromosome 19q13.4 that was homozygous in all affected individuals. The gene for the sarcomeric thin-filament protein, slow skeletal muscle troponin T (TNNT1), maps to this interval and was sequenced. We identified a stop codon in exon 11, predicted to truncate the protein at amino acid 179, which segregates with the disease. We conclude that Amish nemaline myopathy is a distinct, heritable, myopathic disorder caused by a mutation in TNNT1. PMID:10952871

Johnston, Jennifer J.; Kelley, Richard I.; Crawford, Thomas O.; Morton, D. Holmes; Agarwala, Richa; Koch, Thorsten; Schaffer, Alejandro A.; Francomano, Clair A.; Biesecker, Leslie G.



Benthic foraminifers on the continental shelf and upper slope, Russian River area, northern California ( USA).  

USGS Publications Warehouse

We analyzed benthic foraminifers from 71 surface samples collected from the sea floor of the continental margin. One hundred and six different taxa were identified, and Q-mode factor analysis was used to identify assemblages. Six foraminiferal assemblage factors explain 94% of the variation in the data matrix. The Inner Shelf Assemblage is characterized by Trichohyalus ornatissima, Rotalia columbiensis, Cassidulina limbata, Cibicides fletcheri, Elphidiella hannai and Elphidium sp. 1 and occupies water depths less than 50 m. The Middle Shelf Assemblage is characterized by Nonionella basispinata, Elphidium excavatum and Florilus labradoricus and occupies water depths between 50 and 90 m. A Middle Shelf to Upper Bathyal Assemblage is characterized by Uvigerina juncea, Globobulimina spp. and Nonionella basispinata and occupies depths between about 90 and 450 m. Two overlapping assemblages make up the Upper Middle Bathyal Assemblage and are most abundant between water depths of 500 and 1300 m. They are associated with low- oxygen conditions. The Mid-Bathyal Assemblage is dominated by Uvigerina proboscidea and occurs on the slope at water depths ranging from 1200 to 2500 m. -from Authors

Quinterno, P. J.; Gardner, J. V.



Dinoflagellate resting cysts as factors in phytoplankton ecology of the North Sea  

NASA Astrophysics Data System (ADS)

The occurrence and distribution of dinoflagellate resting cysts were investigated at 11 locations in the south-eastern part of the North Sea. Twenty-six known cyst species and 7 unknown cyst types, which may act as seed population for planktonic dinoflagellate blooms, have been recorded for the first time in the area. The most common cysts in recent sediments were those of Scrippsiella trochoidea, Zygabikodinium lenticulatum, Peridinium dalei, Scrippsiella lachrymosa, Protoceratium reticulatum, Protoperidinium denticulatum, and P. conicum. At all stations, S. trochoidea dominated the cyst assemblages with a maximal abundance of 1303 living cysts/cm3 in the uppermost half centimetre. Cysts of the potentially toxic dinoflagellates Alexandrium cf. excavatum and A. cf. tamarense were scarce. In the upper 2-cm layer of sediment, dinoflagellate cysts were found in concentrations of 1.8 up to 682 living cysts/cm3. Empty cysts constituted 22 56% of total cyst abundance. The comparative distribution of the cysts showed a general increase in abundance from inshore sites to the offshore area, whereby sandy stations exhibited the lowest cyst abundance and diversity. The wide distribution of living and empty cysts of Scrippsiella lachrymosa suggests that its motile form, which has not been officially recorded in the area until now, is a common plankton organism in German coastal waters. The relatively high abundance of cysts in recent sediments demonstrates the potential importance of benthic resting stages for the initiation of dinoflagellate blooms in the study area.

Nehring, S.



An outbreak of Crimean-Congo hemorrhagic fever in the United Arab Emirates, 1994-1995.  


A multi-faceted investigation was conducted in the United Arab Emirates to characterize the epidemiologic and ecologic factors underlying an outbreak of Crimean-Congo hemorrhagic fever (CCHF) noted in November 1994 among abattoir workers. A chart review was conducted among hospitalized suspected cases of viral hemorrhagic fever with onset between January 1994 and March 1995 coupled with serologic testing of available specimens for the presence of virus antigen and IgG and IgM antibodies by ELISA. Livestock handlers and animal skin processors were interviewed and tested for the presence of IgG antibody. Sera from imported and domestic ruminants were examined for antibody for CCHF virus, and ticks collected from these animals were tested with an antigen-capture ELISA. Thirty-five suspected cases of CCHF were identified (case fatality = 62%). Livestock market employees, abattoir workers, and animal skin processors accounted for 16 (57%) of 28 cases with known occupational status. Serologic evidence of past asymptomatic infection was noted in 12 (4%) of 291 livestock and abattoir workers but in none of the controls. Nineteen (7%) of 268 animals were positive for CCHF virus antibodies by ELISA including 12 ruminants from Somalia and Iran and five indigenous camels. One Hyalomma impeltatum and two H. excavatum from Somali cattle and one H. anatolicum from a Somali goat were positive for CCHF virus antigen. PMID:9392589

Khan, A S; Maupin, G O; Rollin, P E; Noor, A M; Shurie, H H; Shalabi, A G; Wasef, S; Haddad, Y M; Sadek, R; Ijaz, K; Peters, C J; Ksiazek, T G



Ticks (Acari: Ixodidae) infesting the Arabian camel (Camelus dromedarius) in the Sinai, Egypt with a note on the acaricidal efficacy of ivermectin.  


In this study, tick burdens on camels (Camelus dromedarius) were determined in the vicinity of the St. Catherine monastery, Sinai, Egypt. In total 2,545 ticks (1,491 adults and 1,054 nymphs) were collected and identified. Mean tick burdens were relatively heavy and the range in number of ticks per camel was very broad (6-173). Hyalomma dromedarii was the predominant tick species and accounted for 95.6% of the adult ticks. Other ticks found were H. marginatum subspp. and H. anatolicum excavatum. All nymphs collected were Hyalomma spp. In addition, the effect of ivermectin (Ivomec MSD AGVET) on tick burdens, when given subcutaneously at 0.2 mg/kg-1, was evaluated in nine camels in the date-palm plantation of Kibbutz Yahel in the Arava valley, Israel. Initial tick burdens on these camels (half-body tick counts) ranged from 20-105 ticks per camel. Seven camels from the same herd with half-body tick counts ranging from 40-107 ticks per camel were not treated and served as a control group. Ivermectin was not effective against Hyalomma tick infestation in camels under these conditions. PMID:7628237

van Straten, M; Jongejan, F



Investigation of blood parasites in livestock infested with argasid and ixodid ticks in Egypt.  


Nineteen species and subspecies of ixodid and argasid ticks, Hyalomma dromedarii, H. impeltatum, H. anatolicum excavatum, H. a. anatolicum, H. truncatum, H. m. marginatum, H. m. rufipes, H. m. turanicum, Boophilus annulatus, Rhipicephalus sanguineus, R. turanicus, R. guilhoni, R. camicasi, Amblyomma lipidum, A. marmoreum, A. vareigatum, Argas persicus, A. hermanii and A. arboreus were collected from different localities in five governorates, Giza, Sharkia, Ismailia, El Beheira and Sinai. Hyalomma species were found on camels (98.6%) and cows (1.4%). B. annulatus was found only on cows (100%), Rhipicephalus species on dogs (89.8%), camels (8.2%) and sheep (2.0%), Amblyomma species were found on imported camels (100%), and Argas species on chickens (70.6%), herons (18.8%) and pigeons (10.6%). Examination of camels, cows, sheep, and chickens infested with ticks showed Theileria annulata (rod and ovoid), Babesia bigemmina (ring), B. ovis (ovoid), and Babesiosoma gallinarum (dot-like), respectively. Haemoproteus columbae were found in pigeons. These parasites were determined by microscope imaged. PMID:11478436

El Kammah, K M; Oyoun, L M; El Kady, G A; Shafy, S A



Studies on theileria and babesia infecting live and slaughtered animals in Al Arish and El Hasanah, North Sinai Governorate, Egypt.  


During the year 2001, a total of 475 sheep, 200 goats, 135 cattle and 190 camels in El Arich city and El Hassanah center were examined for Babesia ovis and Theileria ovis. Blood films were taken from the vein of the ear. Meanwhile, the animals were examined for tick infestations. B. ovis and Th. ovis were detected in 13 (2.7%), and 14 (2.9%) sheep, 14 (7.0%), and 15 (7.5%) goats, 13 (9.6%), and 11 (8.1%) cattle and 18 (9.5%), and 24 (12.6%) camels respectively. On the other hand, double infection was found in 114 (24%) sheep, 51 (25%) goats, 27 (20%) cattle and 66 (34.7%) camels. Adult ticks were identified as Rhipicephalus appendiculatus, R. bursa, R. turanicus and Haemaphysalis parva on sheep, Hyalomma anatolicum excavatum and Haemaphysalis sulcata on goats, Hyalomma lusitanicum on cattle and Hyalomma dromedarii, H. impeltatum, H. marginitum and H. a. anatolicum on camels. Babesia ovis and/or Theileria ovis were recorded in ticks gut and/or salivary glands in R. appendiculatus (20.%), R. bursa (16.7%), R. turanicus (10%), Haemaphysalis parva (10%), H. a. excavaium (30.%), H. dromedarii (18%), and H. a. anatolicum (6.7%). PMID:12214937

Mazyad, Said A M; Khalaf, Samy A A



Population dynamics of ticks infesting the one-humped camel (Camelus dromedarius) in central Tunisia.  


A tick population was monitored on 30 camels (Camelus dromedarius) over one year in Kairouan region, Central Tunisia. A total of 1630 ticks was collected and identified resulting in an estimate of different parasitological indicators. The ticks belonged to 2 genera and 5 species: Hyalomma impeltatum (53%) and Hyalomma dromedarii (45%) were the dominant species followed by Hyalomma excavatum (1%), Hyalomma marginatum (0.5%), and Rhipicephalus turanicus (0.5%) (p<0.001). Mean infestation prevalence was 90.6%; all the animals were infested by at least one tick from May to September. The highest mean prevalence was observed in H. impeltatum (60%), the lowest was reported in R. turanicus (0.03%) (p<0.05). Mean overall intensity of infestation was 4.4 ticks/animal. The highest mean intensity was observed in H. impeltatum (2.7 ticks/animal). Overall mean abundance of ticks was 4.4 ticks/animal. Different abiotic factors, namely monthly mean minimum and monthly mean maximum temperatures and the number of sunny days were positively correlated with overall monthly tick burdens which were in turn negatively correlated with the monthly mean relative humidity. This is the first study on camel tick dynamics in Tunisia. PMID:23999226

Gharbi, Mohamed; Moussi, Nawfel; Jedidi, Mohamed; Mhadhbi, Moez; Sassi, Limam; Darghouth, Mohamed Aziz



Ticks (Ixodidae) on migrating birds in Egypt, spring and fall 1962*  

PubMed Central

Over a number of years studies have been carried out in Egypt on the transport by migrating birds of ticks that may transmit pathogens of man and animals. In continuation of these investigations 11 036 birds migrating southwards through Egypt were examined for ticks during the fall of 1962. The 881 infested birds (comprising 24 species and sub-species represented by 10 612 individuals) yielded 1442 ticks. Tick-host relationships were similar to those of previous years except that in 1962 the prevalence of infestation was almost invariably much higher than the averages for 1959-61. Five species of birds were added to the previous list of 40 infested forms. Previously unrecorded tick species taken during 1962 were Ixodes redikorzevi (a species from Asia very occasionally found in rodent burrows in Egypt), the rare Haemaphysalis inermis, and Hyalomma a. anatolicum, H. anatolicum excavatum and H. dromedarii, which may have been carried from Asia or have attached themselves to the birds at the time of netting. During the spring of 1962, altogether 1774 birds migrating northwards through Egypt were also examined. The 56 tick-infested birds (comprising 13 species represented by 867 individuals) yielded 186 ticks. As in previous years, Hyalomma marginatum rufipes was the chief species (89.25%) parasitizing spring migrants. A single specimen of Amblyomma variegatum was taken on Anthus cervinus and 19 specimens of Ixodes?sp. nov. were collected from Sylvia c. communis and Motacilla a. alba. PMID:14163959

Hoogstraal, Harry; Traylor, Melvin A.; Gaber, Sobhy; Malakatis, George; Guindy, Ezzat; Helmy, Ibrahim



Prevalence and genetic diversity of piroplasm species in horses and ticks from Tunisia.  


The genetic diversity and prevalence of Babesia and Theileria species in the equine population of Tunisia were studied using reverse line blot (RLB) hybridization on blood samples and unfed adult ticks collected from apparently healthy horses from three bioclimatic zones in Tunisia. Piroplasms were identified in 13 of 104 of the horse blood samples analyzed (12.5%) and five genotype groups were identified: Theileria equi group A (nine animals, 8.7%), group C (one animal, 1.0%) and group D (three animals, 2.9%), and Babesia caballi groups A and B (one animal each). All horses from the semi-arid zone were negative and prevalence in the humid and sub-humid zones were 12.9% and 20.0%, respectively. Three Ixodid tick species (Hyalomma marginatum, Hyalomma excavatum and Rhipicephalus bursa) were collected from examined horses and equine piroplasms were detected in 10.8% of them. T. equi groups A and D (9.2%), and B. caballi group B (1.6%) were identified in ticks. This work represents the first epidemiological report of equine piroplasmosis in Tunisia. Results showed a high level of diversity within the 18S rRNA gene of equine piroplasm species, and confirmed the presence in Tunisia of two T. equi genetic groups, C and D, only reported before in South Africa and Sudan. PMID:23542456

Ros-García, Amaia; M'ghirbi, Youmna; Hurtado, Ana; Bouattour, Ali



Selection of a set of specific primers for the identification of Tuber rufum: a truffle species with high genetic variability.  


Tuber rufum is a truffle widely distributed throughout Europe, which forms mycorrhizal associations with numerous species of broadleaf and coniferous trees. The possibility of T. rufum contamination in commercial truffle-infected plants makes its detection important. To facilitate the identification of T. rufum from mycorrhiza and fruitbodies, species-specific primers were designed and tested. To overcome the high intraspecific genetic variability within the internal transcribed spacer (ITS) regions of T. rufum, as demonstrated by phylogenetic analysis, two forward primers, Ru1f and Ru2f, located on the ITS1 region were designed to be used in concert with the reverse primer ITS4. Only T. rufum was amplified with this primer combination, while DNA of Tuber magnatum, Tuber brumale, Tuber maculatum, Tuber borchii, Tuber excavatum and Tuber melanosporum was not. These primers give a specific amplicon ranging between 566 and 572 bp and are able to discriminate between T. rufum, T. borchii and T. magnatum in multiplex PCR. In addition, T. rufum-specific amplicons were obtained from both spore suspensions and mycorrhiza by direct PCR. Tuber rufum mycorrhiza obtained in the greenhouse using mycelial inoculation techniques had morphological features similar to those of other species of Tuber, stressing the importance of molecular tools for their identification. PMID:18031344

Iotti, Mirco; Amicucci, Antonella; Bonito, Gregory; Bonuso, Enrico; Stocchi, Vilberto; Zambonelli, Alessandra



Improved resolution of major clades within Tuber and taxonomy of species within the Tuber gibbosum complex.  


Tuber gibbosum Harkn., described from northern California, originally was thought to be a single, variable species that fruited from autumn through winter to spring. It has become popular as a culinary truffle in northwestern USA, where it is commercially harvested. Morphological studies suggested it might be a complex that includes at least two species. We conducted morphological and phylogenetic studies of the complex to determine how many species it might contain and how they differed morphologically, geographically and seasonally. We also provide the first LSU phylogeny for the genus Tuber. Phylogenetic analyses resolve nine major clades in the genus with high bootstrap support and distinguish the Gibbosum clade from the Aestivum, Excavatum, Macrosporum, Magnatum, Melanosporum, Puberulum, Rufum and Spinoreticulatum clades. Further analyses of ITS and LSU regions revealed four distinct species in the Gibbosum complex. Although morphologically similar the four species differ in spore size and shape and in peridial anatomy. These species share the synapomorphy of having suprapellis hyphae with distinctive, irregular wall swellings at maturity; we have not seen this hyphal type in any other Tuber spp. worldwide. The three new species are named and described as T. bellisporum Bonito & Trappe, T. castellanoi Bonito & Trappe and T. oregonense Trappe, Bonito & Rawlinson. PMID:20943504

Bonito, Gregory; Trappe, James M; Rawlinson, Pat; Vilgalys, Rytas



La radioterapia y usted: Apoyo para las personas con cáncer

Publicación para personas que van a recibir o que ya están recibiendo radioterapia contra el cáncer. Contiene información sobre la radioterapia y sus efectos secundarios y describe cómo puede cuidarse durante y después del tratamiento.


Boletín del Instituto Nacional del Cáncer - 19 de julio de 2011

Le invitamos a que comparta esta publicación con sus amigos, familiares y colegas y nos ayude a continuar nuestra misión de difundir las investigaciones más recientes sobre la prevención, el tratamiento y la información del cáncer.


Boletín del Instituto Nacional del Cáncer - 24 de abril de 2012

Le invitamos a que comparta esta publicación con sus amigos, familiares y colegas y nos ayude a continuar nuestra misión de difundir las investigaciones más recientes sobre la prevención, el tratamiento y la información del cáncer.


Boletín del Instituto Nacional del Cáncer - 11 de octubre de 2011

Le invitamos a que comparta esta publicación con sus amigos, familiares y colegas y nos ayude a continuar nuestra misión de difundir las investigaciones más recientes sobre la prevención, el tratamiento y la información del cáncer.


Ttulos Propios de la UAM (curso acadmico 2012/ 2013) TTULOS PROPIOS DE LA UAM  

E-print Network


Autonoma de Madrid, Universidad


Lo que usted necesita saber sobre™ el cáncer de cérvix

Contiene información sobre las opciones de tratamiento, la obtención de una segunda opinión, los cuidados de seguimiento y las fuentes de apoyo para alguien que ha sido diagnosticado recientemente con cáncer de cérvix o cuello uterino.


Trastorno de tensión postraumática (PDQ®)

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Cánceres de la A a la Z: B

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Boletín del Instituto Nacional del Cáncer - 8 de noviembre de 2011

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Boletín del Instituto Nacional del Cáncer - 27 de marzo de 2012

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Consejos para cuando le duelan la boca o la garganta

Información para personas que están recibiendo radioterapia y consejos sobre cómo controlar las molestias en la boca y garganta, sentirse mejor durante el tratamiento y comunicarse con su doctor o enfermera.


La radioterapia y usted: Apoyo para las personas con cáncer

E-book para personas que van a recibir o que ya están recibiendo radioterapia contra el cáncer. Contiene información sobre la radioterapia y sus efectos secundarios y describe cómo puede cuidarse durante y después del tratamiento.


Aspectos relacionados con la sexualidad y la reproducción (PDQ®)

Resumen de información revisada por expertos acerca de los factores que pueden afectar el funcionamiento sexual de las personas con cáncer. Se discuten además temas sobre la fecundidad relacionados con el tratamiento del cáncer.


Linfedema (PDQ®)

Resumen de información revisada por expertos sobre la anatomía, la patofisiología, las manifestaciones clínicas, el diagnóstico y el tratamiento del linfedema relacionado con el cáncer, una afección en la que se acumula líquido linfático en los tejidos y causa inflamación..


Terapia hormonal para el cáncer de próstata

Hoja informativa que describe la terapia hormonal y su función en el tratamiento del cáncer de próstata. Incluye información acerca de los tipos diferentes de terapia hormonal, cómo se usan y los efectos secundarios posibles.


La quimioterapia y usted: Apoyo para las personas con cáncer

Publicación para personas que van a recibir o que ya están recibiendo quimioterapia contra el cáncer. Contiene información sobre la quimioterapia y sus efectos secundarios y describe cómo puede cuidarse durante y después del tratamiento.


Cánceres poco comunes en la niñez (PDQ®)

Resumen de información revisada por expertos acerca del tratamiento de los cánceres poco comunes en la niñez como los cánceres de la cabeza y el cuello, el tórax, el abdomen, el aparato reproductor, la piel y otros.


Boletín del Instituto Nacional del Cáncer - 22 de mayo de 2012

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Consejos para pacientes que reciben radioterapia

Serie de nueve (9) hojas sobre los efectos secundarios de la radioterapia. Cada hoja contiene recomendaciones y sugerencias prácticas para ayudarle a controlar los efectos secundarios durante la radioterapia, y a que se sienta mejor durante el tratamiento.


Consejos para pacientes que reciben quimioterapia

Serie de dieciocho (18) hojas sobre los efectos secundarios de la quimioterapia. Cada hoja contiene recomendaciones y sugerencias prácticas para ayudarle a controlar los efectos secundarios durante la quimioterapia, y a que se sienta mejor durante el tratamiento.



E-print Network

tratamiento automatizado. La responsabilidad del fichero automatizado corresponde al Consejo de Universidades ESPECIALIDADES No existen datos RAMA ISCED 1 ISCED 2 Ingenier�a y Arquitectura Construcci�n e ingenier�a civil

Fraguela, Basilio B.


E S P A O L V A L E N C I E N G L I S H Instituto Universitario de Investigacin Informtica  

E-print Network

Automática y robótica Tratamiento de señal y telecomunicaciones POSIBLES PROYECTOS DE TESIS En este apartado Romero Estela Saquete Boro Antonio Soriano Paya Armando Suarez Cueto David Tomas Diaz Fernando Torres

Escolano, Francisco


Cómo cuidarse mientras usted cuida a su ser querido: Apoyo para personas que cuidan a un ser querido con cáncer

Un folleto para las personas responsables del cuidado de un ser querido que recibe tratamiento para el cáncer. Ofrece información práctica y apoyo para ayudarlas a sobrellevar este período difícil y estresante.


Fatiga (PDQ®)

Resumen de información revisada por expertos acerca de la fatiga, una afección caracterizada por extremo cansancio e incapacidad para funcionar por la falta de energía, que a menudo se observa como una complicación del cáncer y su tratamiento.


El NCI inicia un estudio para evaluar la utilidad de la secuenciación genética para mejorar los resultados en los pacientes

El Instituto Nacional del Cáncer (NCI) lanzará este mes un estudio clínico piloto denominado M-PACT con la finalidad de evaluar si el tratamiento asignado según mutaciones genéticas específicas puede brindar beneficios a pacientes con tumores sólidos metastásicos.


El cáncer

Información para mejorar sus conocimientos sobre el cáncer, que incluye las formas de prevenir el cáncer, la importancia de visitar al médico regularmente y hacerse exámenes de detección, y las diferentes opciones de tratamiento disponibles.


Preguntas para el doctor si tiene un cáncer avanzado

Serie de preguntas que los pacientes con cáncer pueden hacerle al médico sobre las opciones de tratamiento si el cáncer es avanzado, las formas de controlar los síntomas y cómo prepararse para la etapa final de la vida.


Náuseas y vómitos (PDQ®)

Resumen de información revisada por expertos acerca de las náuseas y los vómitos como complicaciones a causa del cáncer o su tratamiento. Se discuten enfoques sobre el manejo de las náuseas y los vómitos.


Aspectos relacionados con la sexualidad y la reproducción (PDQ®)

Resumen de información revisada por expertos acerca de los factores que podrían afectar el funcionamiento sexual de las personas con cáncer. Se discuten además temás sobre la fertilidad relacionados con el tratamiento del cáncer.


Tomografía computarizada (TC) y exploraciones para cáncer

Hoja informativa que describe el procedimiento y la tecnología de exploraciones con tomografía computarizada así como sus usos para el diagnóstico, para exámenes de detección y para tratamiento del cáncer.


BioViewMed, una herramienta visual de ayuda a la expansin de la cadena de bsqueda usando conocimiento semntico*  

E-print Network

a Freebase: Utilizamos la API que nos proporciona Freebase, en concreto, una consulta MQL de la información que necesitamos, en concreto obtenemos: Tratamientos, Causas, Factores de Riesgos, Síntomas y Personas

Escolano, Francisco


Complicaciones gastrointestinales (PDQ®)

Resumen de información revisada por expertos acerca del estreñimiento, la retención fecal, la obstrucción intestinal y la diarrea como complicaciones del cáncer o su tratamiento. Se discute el manejo de estos problemas.


Delirio (PDQ®)

Resumen de información revisada por expertos acerca del delirio como una complicación a causa del cáncer o su tratamiento. Se discuten los enfoques de los cuidados médicos de apoyo, asi como farmacológicos para el manejo del delirio.


Terapia hormonal para el cáncer de seno

Hoja informativa que describe la terapia hormonal y su función en la prevención y tratamiento del cáncer de seno. Incluye información acerca de los efectos secundarios posibles y de los fármacos que pueden interferir con la terapia hormonal.


Un estudio financiado por los Institutos Nacionales de la Salud (NIH) muestra reducción en la mortalidad entre hombres con cáncer de próstata en grado intermedio:

Terapia hormonal por corto tiempo administrada en combinación con radioterapia a hombres con cáncer de próstata en estadio inicial aumentó sus posibilidades de vivir más en comparación con tratamiento de radioterapia sola, según un estudio clínico patrocinado por el NCI. Los beneficios del tratamiento combinado se limitaron principalmente a pacientes con enfermedad de riesgo intermedio y no se observaron en hombres con cáncer de próstata de riesgo bajo, indican los investigadores.


A kindred exhibiting cosegregation of an overlap connective tissue disorder and the chromosome 16 linked form of autosomal dominant polycystic kidney disease.  


Autosomal dominant polycystic kidney disease (ADPKD) is a disorder of adult onset manifested by bilaterally enlarged cystic kidneys frequently associated with progressive renal failure. The mutated gene (PKD1) responsible for 85 to 95% of cases has been localized to a small segment on the distal tip of the short arm of chromosome 16. A clinical spectrum of heritable connective tissue disorders that remain unclassifiable under the present nosology but that contain elements of the Marfan's syndrome have previously been described. The genetic localization and molecular basis of such overlap connective tissue disorders (OCTD) have not been elucidated. In this report, a kindred in which ADPKD and OCTD appear to cosegregate is described. The connective tissue phenotype in this family includes aortic root dilation, aortic and vertebral artery aneurysms with dissection, and aortic valve incompetence, as well as pectus abnormalities, pes planus, joint laxity, arachnodactyly, scoliosis, dolichostenomelia, and high arched palate. ADPKD was manifest primarily as bilateral renal cysts with or without renal failure. The DNA of all living family members was studied with markers recognizing polymorphic loci flanking the PKD1 region (3'HVR and O90a), as well as markers from the loci of chromosomes 15 and 5, associated with fibrillin genes FBN1 and FBN2, respectively. In this kindred of 20 family members traced through five generations, cosegregation of ADPKD and the OCTD phenotype was observed in 12 of 12 meioses and 3 of 3 phase known. Both markers for PKD1 were tightly linked to both ADPKD and OCTD, whereas there was no evidence for linkage with either fibrillin locus. In this family, the ADPKD and OCTD mutations are genetically linked. The presence of OCTD with ADPKD identifies a group of patients at significantly greater risk for sudden death from aortic root and other vascular aneurysmal dissection and rupture. PMID:8130364

Somlo, S; Rutecki, G; Giuffra, L A; Reeders, S T; Cugino, A; Whittier, F C



Identifying heritable connective tissue disorders in childhood.  


Heritable connective tissue diseases are rare. Each disorder estimated at 1-10 per 100,000. However, as a group they are prevalent enough to constitute an important diagnostic challenge. Connective tissue disorders most significantly affect three systems: musculoskeletal, ocular and cardiovascular. The cardinal feature of the majority of these disorders is ligamentous laxity, or joint hypermobility. The joints show an increased range of movement, and the child may present with arthralgias, effusions and an increased risk of joint or soft tissue injury. Marfan syndrome is the most common heritable connective tissue disorder. It is an autosomal dominant condition with high penetrance but with striking pleiomorphism. In 25% of individuals there is no family history. The diagnosis is often not made until late childhood. Individuals are tall with a low upper: lower segment ratio and an arm span greater than height. Other skeletal characteristics include pectus deformity and scoliosis. Myopia and astigmatism are common. Cardiac abnormalities include mitral valve prolapse, mitral regurgitation and arrhythmias. Early diagnosis, meticulous echocardiographic follow-up and multidisciplinary assessment are essential. The Ehlers-Danlos syndromes share a triad of features: skin hyperextensibility, articular hypermobility, and tissue fragility. The abnormalities are caused by genetic defects resulting in the faulty synthesis or structure of collagen. There is a wide variety of phenotypes and mode of inheritance. Symptom management and joint protection are important to improve quality of life and prevent secondary complications. Osteogenesis imperfecta encompasses a group of rare heritable disorders associated with low bone mass and increased susceptibility to fractures. Increased bone fractures after minimal trauma is the cardinal feature. Other features include blue sclera, hearing loss, scoliosis, deafness, and hypermobility. PMID:22916581

Armon, Kate; Bale, Peter



[Natural history of Morquio A disease].  


Type IV mucopolysaccharidosis (Morquio A syndrome; MPS IVA; OMIM 253000), is a multisystemic, severe and very disabling disease, also life-threatening; MPS IVA is due to a deficiency of the enzyme N-acetylgalactosamine-6-sulfate sulfatase (GALNS), a lysosomal enzyme responsible for the degradation of keratan sulfate (KS) and chondroitin-6-sulfate (C6S). The disease is characterized by respiratory, pulmonary manifestations and also causes bone involvement with progressive spondyloepimetaphyseal degradation and mild and late-onset ophthalmologic, hearing and cardiac complications. These manifestations progressively impair the patients' physical mobility. Severe forms of the disease, diagnosed before the age of 1 year, can be distinguished from intermediary (diagnosed between 1 and 5 years old) and attenuated disease, diagnosed after the age of 5 years (occasionally far later). The main signs are bone deformities namely pectus carinatum, kyphoscoliosis and genu valgum, with early flattening of the growth curve, leading rapidly to almost complete growth arrest. Patients have normal cognitive development. The radiological signs are relatively specific with, in particular, platyspondyly, shortening of the long bones and characteristic pelvic changes. The diagnosis is suggested by elevated urinary GAGs level and profile, and is confirmed by GALNS enzymatic studies on molecular testing. Genetic counseling is important in this autosomal recessive disorder and enzymatic and/or molecular testing can be offered for prenatal diagnosis. Management is mostly symptomatic, based on early detection and orthopedic correction of spine and lower limb deformities, ENT and respiratory management and psychological, social and educational support for the child and his/her family. PMID:25063382

Baujat, G; Valayannopoulos, V



Safety and cardiovascular behavior during pulmonary function in patients with marfan syndrome.  


Background: Marfan syndrome (MS) is a dominant autosomal connective tissue disease that impacts multiple systems, such as the cardiovascular system, tissue viscoelastic properties, bone calcification matrix and, most specific to the present investigation, pulmonary parenchyma. The aim of the present study was evaluate pulmonary function (PF) in patients with MS and relate it to thoracic cage abnormalities (TCA) and the occurrence of cardiac arrhythmias during the spirometric exam (SE). Method: A sample of 75 subjects (46 with MS) underwent clinical, anthropometric, echocardiographic, radiographic and PF evaluation; 51 subjects (33 with MS) had their ECG information evaluated during PF. These individuals were matched and compared to a healthy control group (CG) Results: Forced vital capacity (FVC) and forced expiratory volume in the first second (FEV(1) ) in the patients with MS were significantly lower in comparison to the CG (p=0.012 and p=0.0006) and predicted values (p=0.04 and p=0.003). Subgroup analysis based on TCA revealed differences between patients with MS with two combined abnormalities (scoliosis + pectus) in comparison to both the CG (p=0.012 and p=0.002) and patients without abnormalities (p=0.05 and p=0.006). There were no differences regarding the occurrence of arrhythmia during exertion on the SE. There was some correlation between clinical history and cardiovascular behavior and PF. Conclusion: PF is reduced in patients with MS and deformities in the thoracic cage appear to contribute to this reduction. Despite the apparent structural alterations in the cardiovascular system in this population, exertion during the spirometric exam appears to be safe. PMID:21204789

Cipriano, Graziella França Bernardelli; Peres, Paulo Alberto Tayar; Junior, Gerson Cipriano; Arena, Ross; Carvalho, Antonio Carlos



Safety and cardiovascular behavior during pulmonary function in patients with Marfan syndrome.  


Marfan syndrome (MS) is a dominant autosomal connective tissue disease that impacts multiple systems, such as the cardiovascular system, tissue viscoelastic properties, bone calcification matrix and, most specific to the present investigation, pulmonary parenchyma. The aim of the present study was to evaluate pulmonary function (PF) in patients with MS and relate it to thoracic cage abnormalities (TCA) and the occurrence of cardiac arrhythmias during the spirometric exam (SE). A sample of 75 subjects (46 with MS) underwent clinical, anthropometric, echocardiographic, radiographic and PF evaluation; 51 subjects (33 with MS) had their electrocardiogram (ECG) information evaluated during PF. These individuals were matched and compared with a healthy control group (CG). Forced vital capacity (FVC) and forced expiratory volume (FEV) in the first second (FEV(1)) in the patients with MS were significantly lower in comparison with the CG (p = 0.012 and 0.0006) and predicted values (p = 0.04 and 0.003). Subgroup analysis based on TCA revealed differences between patients with MS with two combined abnormalities (scoliosis + pectus) in comparison with both the CG (p = 0.012 and 0.002) and patients without abnormalities (p = 0.05 and 0.006). There were no differences regarding the occurrence of arrhythmia during exertion on the SE. There was a correlation between clinical history, cardiovascular behavior and PF. PF is reduced in patients with MS, and deformities in the thoracic cage appear to contribute to this reduction. Despite the apparent structural alterations in the cardiovascular system in this population, exertion during the SE appears to be safe. PMID:20370798

Cipriano, G F B; Peres, P A T; Cipriano, G; Arena, R; Carvalho, A C



Tracing latitudinal gradient, river discharge and water masses along the subtropical South American coast using benthic Foraminifera assemblages.  


More than 30% of Buccella peruviana (D'Orbigny), Globocassidulina crassa porrecta (Earland & Heron-Allen), Cibicides mackannai (Galloway & Wissler) and C. refulgens (Montfort) indicate the presence of cold Sub Antarctic Shelf Water in winter, from 33.5 to 38.3º S, deeper than 100 m, in the southern part of the study area. In summer, the abundance of this association decreases to less than 15% around 37.5-38.9º S where two species (Globocassidulina subglobosa (Brady), Uvigerina peregrina (Cushman) take over. G. subglobosa, U. peregrina, and Hanzawaia boueana (D'Orbigny) are found at 27-33º S in both seasons in less than 55 m deep in the northern part, and are linked with warm Subtropical Shelf Water and Tropical Water. Freshwater influence was signalized by high silicate concentration and by the presence of Pseudononion atlanticum (Cushman), Bolivina striatula (Cushman), Buliminella elegantissima (D'Orbigny), Bulimina elongata (D'Orbigny), Elphidium excavatum (Terquem), E. poeyanum (D'Orbigny), Ammobaculites exiguus (Cushman & Brönnimann), Arenoparrella mexicana (Kornfeld), Gaudryina exillis (Cushman & Brönnimann), Textularia earlandi (Parker) and thecamoebians in four sectors of the shelf. The presence of Bulimina marginata (D'Orbigny) between 34.1-32.8º S in the winter and 34.2-32.7º S in the summer indicates that the influence of the Subtropical Shelf Front on the sediment does not change seasonally, otherwise, the presence of Angulogerina angulosa (Williamson) in the winter, only in Mar del Plata (38.9º S), show that Malvinas currents are not influencing the sediment in the summer. PMID:23011301

Eichler, P P B; Rodrigues, A R; Eichler, B B; Braga, E S; Campos, E J D



Flea Control (Spanish)  

E-print Network

E-149S 5-02 Mike Merchant Extension Entomologist Texas Cooperative Extension The Texas A&M University System Como Controlar las Pulgas N uevos tratamientos disponibles de los vet- erinarios y los distribuidores de productos para las mascotas hacen... que el control de las pulgas sea m?s f?cil que nunca. Estos tratamientos constan de reguladores de crecimien- to de insectos de acci?n lenta o plaguicidas resid- uales (aerosoles). Es importante entender la difer- encia entre estos dos tipos de...

Merchant, Michael E.



The Texas Two-Step Method: Do-It-Yourself Fire Ant Control for Homes and Neighborhoods (Spanish)  

E-print Network

cebo est? fresco, las hormigas comenzar?n a recogerlo dentro de los 30 minutos. ? Aplique el cebo cuando no se espere lluvia por lo menos dentro de 8 horas. Esto reduce el riesgo de que el agua arrase con el cebo. La mayor?a de los productos granulares... contiene un insecticida que se libera al suelo cuando se empapa con agua. 2 Trate los hormigueros El segundo paso es tratar las colonias de hormigas problem?ticas (las que exigen atenci?n inmediata) usando un tratamiento para los hormigueros. El tratamiento...

Drees, Bastiaan M.; Merchant, Michael E.



Controlling Mold Growth after the Storm (Spanish)  

E-print Network

tormentas que traen aparejados da?os provocados por el agua. Los da?os pueden ser causados por vientos y r?fagas de lluvia o inundaciones. El moho puede da?ar su hogar, sus bienes y su salud. Cuanto m?s permita que crezca el moho, mayor ser? el riesgo y m... experiencia en el tratamiento de da?os provocados por el agua y el tratamiento del moho. Sin embargo, esto puede resultar dif?cil luego de un desastre. Es probable que usted mismo tenga que limpiar. En ese caso, siga los pasos que se indican a continuaci...

Harris, Janie



Estudio de terapias dirigidas para el cáncer de seno estableció un modelo de estudios clínicos a nivel mundial

Dos medicamentos de acción dirigida, diseñados para tratar una forma agresiva de cáncer de seno (mama), se pusieron a prueba en un estudio que incluyó a 8 000 participantes en 44 países. Si bien la finalidad del estudio fue ayudar a que los investigadores determinaran si el tratamiento combinado con trastuzumab y lapatinib para el tratamiento del cáncer de seno HER2 positivo en estado inicial era mejor que la terapia solo con trastuzumab, los resultados del estudio no indicaron que existan ventajas para las mujeres al recibir la combinación de fármacos de trastuzumab o lapatinib.


Foraminiferal Distributions, Sedimentation Rates and Patterns in the Albemarle Estuarine System, North Carolina  

NASA Astrophysics Data System (ADS)

The modern distribution of benthic foraminifera of the Albemarle Estuarine System (AES) has been characterized by studying 50 strategically chosen sites to provide a model for paleoenvironmental interpretations of short sediment cores (15-75 cm). Water bodies studied within the AES include Albemarle Sound, Currituck Sound, Roanoke Sound, Croatan Sound, northern Pamlico Sound, North River, Pasquotank River, Alligator River, as well as Oregon Inlet and the adjacent foreshore and shoreface of the Atlantic Ocean. Sedimentation rates in the study area have been addressed using 210Pb and 137Cs dating methods. Five foraminiferal assemblages are present: an inner estuary biofacies characterized by two dominant genera, Ammobaculites and Ammotium, with moderate percentages of Miliammina fusca and minor percentages of Ammoastuta salsa; an outer estuary biofacies characterized again by Ammobaculites and Ammotium, but with lower percentages of Miliammina fusca; a marsh shoreline biofacies characterized by a mixed assemblage dominated by Ammobaculites and Ammotium with minor to moderate percentages of adjacent marsh foraminifera; a marsh biofacies characterized by varying abundances of Ammoastuta inepta, Arenoparella mexicana, Haplophragmoides wilberti, Jadammina macrescens, Miliammina earlandi, Miliammina fusca, Tiphotrocha comprimata, Trochammina inflata, as well as the genera Ammobaculites and Ammotium; and a marine (normal salinity) biofacies characterized mainly by Elphidium excavatum and minor percentages of other elphidiids. Sedimentation rates were studied from 28 short cores taken along transects in all the major water bodies. Rates were as high as 0.45 cm/yr at the head of Albemarle Sound and as little as 0.05 cm/yr 60 km away in the eastern part of the Albemarle. The embayed tributaries exhibited sedimentation rates on the order of 0.25 cm/yr. Limited information on sedimentation rates was provided by cores in eastern sounds, which had only a few centimeters of recent sediment possessing excess 210Pb over sediments out of range of 210Pb dating. Based on 210Pb and 137Cs trends, as well as variations in different physio-chemical conditions present at each site, notably salinity, two short cores from the Albemarle Sound, one located at the head of the sound and the second 60 km away in the eastern part of the sound, were chosen for down core paleoenvironmental reconstruction using foraminiferal assemblages as environmental indicators. Analysis of these cores has enabled an historic reconstruction of environmental conditions within the AES, as well as an understanding of the taphonomic processes that affect estuarine foraminiferal assemblages.

Vance, D. J.; Corbett, D. R.; Culver, S. J.



Identification of Tick-Borne Pathogens in Ticks Feeding on Humans in Turkey  

PubMed Central

Background The importance of tick-borne diseases is increasing all over the world, including Turkey. The tick-borne disease outbreaks reported in recent years and the abundance of tick species and the existence of suitable habitats increase the importance of studies related to the epidemiology of ticks and tick-borne pathogens in Turkey. The aim of this study was to investigate the presence of and to determine the infection rates of some tick-borne pathogens, including Babesia spp., Borrelia burgdorferi sensu lato and spotted fever group rickettsiae in the ticks removed from humans in different parts of Ankara. Methodology/Principal Findings A total of 169 ticks belonging to the genus Haemaphysalis, Hyalomma, Ixodes and Rhipicephalus were collected by removing from humans in different parts of Ankara. Ticks were molecularly screened for Babesia spp., Borrelia burgdorferi sensu lato and spotted fever group rickettsiae by PCR and sequencing analysis. We detected 4 Babesia spp.; B. crassa, B. major, B. occultans and B. rossi, one Borrelia spp.; B. burgdorferi sensu stricto and 3 spotted fever group rickettsiae; R. aeschlimannii, R. slovaca and R. hoogstraalii in the tick specimens analyzed. This is the report showing the presence of B. rossi in a region that is out of Africa and in the host species Ha. parva. In addition, B. crassa, for which limited information is available on its distribution and vector species, and B. occultans, for which no conclusive information is available on its presence in Turkey, were identified in Ha. parva and H. marginatum, respectively. Two human pathogenic rickettsia species (R. aeschlimannii and R. slovaca) were detected with a high prevalence in ticks. Additionally, B. burgdorferi sensu stricto was detected in unusual tick species (H. marginatum, H. excavatum, Hyalomma spp. (nymph) and Ha. parva). Conclusions/Significance This study investigates both the distribution of several tick-borne pathogens affecting humans and animals, and the presence of new tick-borne pathogens in Turkey. More epidemiological studies are warranted for B. rossi, which is very pathogenic for dogs, because the presented results suggest that B. rossi might have a wide distribution in Turkey. Furthermore, we recommend that tick-borne pathogens, especially R. aeschlimannii, R. slovaca, and B. burgdorferi sensu stricto, should be taken into consideration in patients who had a tick bite in Turkey. PMID:25101999

Orkun, Omer; Karaer, Zafer; Cakmak, Ayse; Nalbantoglu, Serpil



Molecular detection of spotted fever group rickettsiae associated with ixodid ticks in Egypt.  


Tick-borne diseases comprise a complex epidemiological and ecological network that connects the vectors, pathogens, and a group of host species. The aim of this study was to identify bacteria from the genus Rickettsia associated with ixodid ticks infesting camels and cows in Egypt. Ticks were collected from 6 different localities: Qina, Giza, Qalet El Nakhl, New Valley, El Arish, and Minufia, from July to October 2008. Species were identified using PCR, followed by sequencing. The gltA and rOmpA genes were used for the initial detection of Rickettsia spp. Further characterization of positive samples utilized primers targeting rOmpB, sca4, and intergenic spacers (mppA-purC, dksA-xerC, and rpmE-tRNA(fMet)). Cows were infested with Hyalomma anatolicum excavatum and Boophilus annulatus. Camels were infested with Hyalomma dromedarii, H. impeltatum, and H. marginatum marginatum. Approximately 57.1% of H. dromedarii ticks collected from Qalet El Nakhl were infected with Rickettsia africae, exhibiting 99.1-100% identity to reference strains. Within H. impeltatum, 26.7% and 73.3% of ticks from El Arish were infected with R. africae and R. aeschlimannii, with 98.3-100% and 97.9-100% identity, respectively. Furthermore, 33.3% of H. marginatum marginatum ticks in Qalet El Nakhl were infected with the same two species as H. impeltatum, demonstrating 99.1-100% and 99.3-100% identity, respectively. By comparing percent identities and phylogenetic relationships, R. africae is identified for the first time in Egypt, in addition to R. aeschlimannii, which exhibits 100% identity with the Stavropol strain in GenBank. In conclusion, the obtained data underscore the medical and veterinary importance of tick-borne rickettsioses, which necessitate further investigation by authorities in Egypt. Moreover, additional characterization of these rickettsial isolates should be performed to designate their strains, using a polyphasic strategy combining genotypic and phenotypic tests, to facilitate their deposition in the rickettsial collection of the WHO and/or ATCC. PMID:22217182

Abdel-Shafy, Sobhy; Allam, Nesreen A T; Mediannikov, Oleg; Parola, Philippe; Raoult, Didier



Si tiene cáncer

Más información Los estudios clínicos de tratamiento para cáncer son estudios de investigación para encontrar mejores formas de tratar el cáncer. Es importante que mujeres y hombres de todas las edades y antecedentes étnicos participen en los estudios clínicos, para que lo que se aprenda en ellos ayude a todos los pacientes de cáncer ahora y en el futuro.


Boletín del Instituto Nacional del Cáncer - 6 de noviembre de 2012

Nuevos resultados de tres estudios clínicos resaltan la evolución de opciones de tratamiento para mujeres con cáncer de mama HER2 positivo. Estos cánceres, los cuales producen demasiada proteína HER2, constituyen una forma maligna de la enfermedad y representan aproximadamente 20 por ciento de todos los casos de cáncer de mama diagnosticados.


Boletín del Instituto Nacional del Cáncer - 4 de enero de 2011

En esta edición especial del Boletín del Instituto Nacional del Cáncer, usted conocerá las diversas formas en que el NCI está apoyando los esfuerzos de colaboración internacional en las áreas de investigación, capacitación, comunicación y demás actividades relacionadas con una mejor comprensión del cáncer y el tratamiento de pacientes con esta enfermedad.



E-print Network


Autonoma de Madrid, Universidad


Ttulos Propios de la UAM (curso acadmico 2008/ 2009) TTULOS PROPIOS DE LA UAM  

E-print Network

Protegidos Máster en Gestión y Tratamiento de Residuos Máster en Ingeniería Nuclear y Aplicaciónes Educativos en el Nuevo Entorno Digital MEDICINA Diploma de Formación Superior en Cuidados Paliativos y

Autonoma de Madrid, Universidad


Ttulos Propios de la UAM (curso acadmico 2011/ 2012) TTULOS PROPIOS DE LA UAM  

E-print Network


Autonoma de Madrid, Universidad


Ttulos Propios de la UAM (curso acadmico 2010/ 2011) TTULOS PROPIOS DE LA UAM  

E-print Network


Autonoma de Madrid, Universidad


Pruebas de seguimiento

Ofrece información sobre las posibles pruebas de seguimiento; los posibles tratamientos y pasos a seguir para las mujeres con un resultado anormal en una prueba de detección del cáncer de cuello uterino, entre ellos, la crema de estrógeno, la colposcopia, la biopsia por legrado endocervical, la biopsia con sacabocados y la biopsia de cono.


Los Derechos de los Pacientes del Centro Clnico  

E-print Network

Los Derechos de los Pacientes del Centro Clínico Los Derechos de los Pacientes del Centro Clínico medir las respuestas de los pacientes al tratamiento. Existen procesos que protegen los derechos de paciente que se observen los derechos fundamentales de la dignidad humana. Esta Declaración de Derechos


Conoces tu Agua Arizona?  

E-print Network

¿Conoces tu Agua Arizona? Una Guía para el Consumidor sobre las Fuentes de Agua, la Calidad del Agua, las Reglamentaciones y las Opciones de Tratamiento del Agua en los Hogares. #12;Mapa de Arizona. Fuente: Cartel del mapa de las fuentes de agua en Arizona, 2002, Centro de Investigatciones de los

Fay, Noah


Emergency Factsheet for Tratando Agua Almacenada con Cloro  

E-print Network

Emergency Factsheet for Tratando Agua Almacenada con Cloro Monty C. Dozier, Profesor Asistente y Fertilidad de Suelos El Sistema Universitario Texas A&M Al tratamiento del agua potable para mejorar su contaminaciónbacteriológica del agua. Este método tambiénpuede ser usado por los propietarios de pozos de agua particulares


Campus de Excelencia Internacional Sensores y robtica para aplicaciones avanzadas Ingeniera del agua  

E-print Network

agua · Communications for smart environments · Nanoingeniería · Ciencias · Tecnología de polímeros mejora · Ingeniería de las TIC · Urbanismo y ordenación del territorio · Tratamiento de aguas y gestión

Politècnica de Catalunya, Universitat


Lo que usted necesita saber sobre™ el cáncer de seno

E-book que describe las opciones de tratamiento, los diferentes médicos que tratan el cáncer de seno, la obtención de una segunda opinión, los cuidados de seguimiento y las fuentes de apoyo para alguien que ha sido diagnosticado recientemente con cáncer de seno.



Microsoft Academic Search

con cuatro repeticiones. La unidad experimental net a fue 20m 2 (20mx1m). Las variables evaluadas fueron: Incremento de altura y diámetro, número de brotes, producción de tallos, peso de tallos en verde, determinación de m ateria seca, peso de tallos en blanca, número de días de apertura de flor, número de días en florero y análisis económico. El tratamiento que



E-print Network

OF BLACK-TAILED PRAIRIE DOGS (CYNOMYS LUDOVICIANUS) RACHEL E. MCCAFFREY,* MARK C. WALLACE, AND JAMES D. RAY (Cynomys ludovicianus), PhostoxinH-treated colonies, and non- colonized short-grass prairie to assess de las praderas de cola negra (Cynomys ludovicianus), en colonias con tratamiento de PhostoxinH, y en

Wallace, Mark C.


Comienza la construcción de instalación patrocinada por el NCI en Puerto Rico para realizar estudios clínicos sobre el cáncer

El gobierno de Puerto Rico ha destinado $196 millones de dólares para construir un hospital oncológico de 287 000 pies cuadrados en San Juan, que contará con 96 camas. El nuevo hospital es el primero en su clase en la región caribeña y en él se llevarán a cabo tratamientos para el cáncer y estudios clínicos.


PasivacindecalcitaentratamientodeAMD Pasivacin de calcita en el  

E-print Network

PasivacióndecalcitaentratamientodeAMD Pasivación de calcita en el tratamiento de AMD (Acid Mine ID�A #12;PasivacióndecalcitaentratamientodeAMD Acid Mine Dranaige (AMD) Oxidación de pirita / minerales Drainage) Experimentos de Laboratorio Francesco Offeddu Supervisores: Carlos Ayora Josep Soler Jordi Cama

Politècnica de Catalunya, Universitat



E-print Network

tratamiento de la hipertensi´on arterial. De dos poblaciones independientes se extraen dos muestras aleatorias segundos con enalapril. Posteriormente, se les mide el grado de disminuci´on de la tensi´on arterial (en mg´on arterial, del 90% de confianza. Se suponen distribuciones normales independientes para las variables. b


Guías de práctica clínica de la Sociedad Española de Cardiología en hipertensión arterial  

Microsoft Academic Search

La hipertensión arterial es un factor de riesgo cardio- vascular reconocido, responsable de una morbimortali- dad cardiovascular elevada. Sin embargo, a pesar de disponer de fármacos eficaces para su tratamiento y de numerosos programas científicos de formación y actuali- zación realizados, la realidad es que sólo se controla a un porcentaje bajo de pacientes de acuerdo con las ci- fras

Federico Lombera Romero; Vivencio Barrios Alonso; Federico Soria Arcos; Luis Placer Peralta; Luis Tomás Abadal; Luis Rodríguez Padial; José R. González Juanatey



Terapias adyuvantes y neoadyuvantes para el cáncer de seno

Hoja informativa que explica las terapias adyuvantes (tratamiento que se administra además de la terapia primaria para aumentar la posibilidad de supervivencia a largo plazo) y las neoadyuvantes (terapia que se administra antes de la terapia principal). Contiene información sobre los efectos secundarios y sobre los riesgos y beneficios de estas terapias.


Bronchopulmonary dysplasia (pulmonologist's point of view)  

Microsoft Academic Search

RESUMEN La displasia broncopulmonar describe los trastornos respiratorios crónicos asociados primariamente con el nacimiento prematuro y sus tratamientos. Su definición, factores de riesgo, características radiológicas y patológicas han evolucionado con el tiempo, debido a los cambios en los cuidados de los recién nacidos prematuros. Sus características clínicas involucran no sólo al sistema respiratorio sino también al cardiovascular, gastrointestinal y al

Carlos E. Sabogal Rosas; Isaac Talmaciu




E-print Network

Facultades de Medicina, Enfermería, Profesiones de la Salud, Dentistería y Farmacia y otros proveedores de salud afiliados, incluyendo todos los empleados, voluntarios, y el personal de servicios de salud de la relativa a su salud entre ellos para fines de tratamiento, pagos o el buen funcionamiento de las

Príncipe, José Carlos


Lo que usted necesita saber sobre™ el cáncer de pulmón

E-book que describe las opciones de tratamiento, los diferentes médicos que tratan el cáncer de pulmón, la obtención de una segunda opinión, los cuidados de seguimiento y las fuentes de apoyo para alguien que ha sido diagnosticado recientemente con cáncer de pulmón.


Lo que usted necesita saber sobre™ el cáncer de pulmón

Folleto que describe las opciones de tratamiento, los diferentes médicos que tratan el cáncer de pulmón, la obtención de una segunda opinión, los cuidados de seguimiento y las fuentes de apoyo para alguien que ha sido diagnosticado recientemente con cáncer de pulmón.



E-print Network

y de acreci'on) --- Chorros bipolares --- Estelas (planetas en viento solar; globulas cometarias energia cin'etica De cara al cliente: Requerimientos al tratamiento de la convecci'on Evoluci'on estelar ecu -- amplitudes y correlaciones de fluctuaciones Atm'osferas estelares / solar Simulaciones num

Petrovay, Kristóf


La malnutrición en los países en vías de desarrollo: un cambio de apariencia  

Microsoft Academic Search

ResumenLa malnutrición implica anomalías de sobrenutrición y subnutrición. Los países en vías de desarrollo se caracterizan por la pobreza generalizada, debida a la escasez de recursos económicos o la distribución injusta de la riqueza en la sociedad. Aunque la subnutrición se manifiesta como la insuficiencia ponderal, emaciación y retraso del crecimiento en la población, y el tratamiento hospitalario de la

Noel W. Solomons



Significado de los cambios en el cuello uterino: Guía para la salud de la mujer

Conozca qué significan los resultados de una prueba de detección como la prueba de Pap (Papanicolaou), entérese si los resultados mostraron cambios en las células del cuello uterino o si la prueba del VPH dio positiva. No todos los cambios cervicouterinos son cáncer. Infórmese sobre la importancia de los cuidados de seguimiento y el tratamiento para los resultados anormales.


Los NIH anuncian el lanzamiento de 3 estudios integrados de medicina de precisión; ALCHEMIST es para pacientes con ciertos tipos de cáncer de pulmón en estadio inicial

Los Estudios sobre la Secuenciación e Identificación de Marcadores para el Mejoramiento de la Terapia Adjuvante para el Cáncer de Pulmón, conocidos con el nombre de ALCHEMIST, identificarán a pacientes con cáncer de pulmón en estadio inicial cuyos tumores albergan ciertos cambios genéticos, y evaluarán si los tratamientos con medicamentos que actúan sobre esos cambios pueden mejorar la supervivencia.


Añadir quimioterapia después de la radioterapia mejora la supervivencia de adultos con un tipo de tumor cerebral de crecimiento lento

Adultos con gliomas de grado bajo, una forma de tumor cerebral, que recibieron tratamiento con quimioterapia después de la radioterapia vivieron más tiempo que pacientes que recibieron solo radioterapia, según los resultados de seguimiento a largo plazo de un estudio clínico aleatorizado y controlado, subvencionado por los NIH.



E-print Network

podrán ser objeto de tratamiento automatizado. La responsabilidad del fichero automatizado corresponde al ISCED 2 Ingeniería y Arquitectura Construcción e ingeniería civil Construcción e ingeniería civil

Casanellas, Marta


El contrato de seguro Ley 389 de 1997 y otros estudios  

Microsoft Academic Search

El texto incluye cuatro estudios: “Carácter consensual del contrato de seguros” donde se analiza la conveniencia o no de dicho tratamiento; “La responsabilidad civil y el seguro obligatorio de automóviles” el cual se ocupa de la problemática que genera la simbiosis entre el seguro obligatorio y la responsabilidad civil; “El seguro de responsabilidad civil y la admisión de las cláusulas

Andrés E. Ordóñez Ordóñez


El análisis de un estudio clínico indica que una combinación de fármacos puede ser de gran eficacia contra el cáncer de ovario recidivante

El uso de un tratamiento farmacológico combinado para el cáncer de ovario recidivante mostró mejorías significativas, según se informó el día de hoy en el congreso anual de la Sociedad Americana de Oncología Clínica (ASCO). La combinación farmacológica se evaluó en un estudio de fase I y posteriormente en un estudio clínico aleatorizado de fase II patrocinado por el Instituto Nacional del Cáncer (NCI).


Cómo hacer frente al cáncer: cuidados médicos de apoyo y cuidados paliativos

Formas de controlar los efectos físicos y psicológicos del cáncer y del tratamiento en los pacientes y sus familias, así como los efectos en la calidad de vida. También se incluye información sobre servicios de salud, ayuda económica y seguro médico.


Iniciativa de Respuestas Excepcionales: Preguntas y respuestas

El Instituto Nacional del Cáncer (NCI) emprendió la Iniciativa de Respuestas Excepcionales (Exceptional Responders Initiative) a fin de entender la base molecular de los tumores en pacientes de cáncer que responden en forma excepcional al tratamiento, principalmente el administrado por quimioterapia.


Etapa final de la vida (PDQ®)

Sumario informativo revisado por expertos sobre el tratamiento y la atención del paciente de cáncer desde los últimos días hasta las últimas horas de vida; esto incluye los síntomas comunes, los dilemas éticos que pueden surgir y la función que desempeña el oncólogo en proveer cuidados al paciente y su familia durante este período.


EFECTO DEL CONSUMO DE CULTIVO DE LEVADURAS Saccharomyces cerevisiae Y\\/O SELENIO EN POLLOS DE ENGORDE EXPUESTOS A BAJOS NIVELES DE AFLATOXINA B1 EN LA DIETA. 2: MORFOLOGÍA HEPÁTICA. Effect of Saccharomyces cerevisiae Culture and\\/or Selenium Intake on Broiler Exposed to Low Levels of Aflatoxin B1 in the Ration. 2: Hepatic Morphology  

Microsoft Academic Search

con 4 replicas de 15 pollos, estas correspondieron a los siguien- tes tratamientos (T) T : grupo control que consiste en alimento comercial (AC) sin niveles detectables de aflatoxina; T :A C + AFB ;T :A C +S c; T :A C +A FB + Sc; T :A C +Se ;T :A C + AFB + Se ;T :A C

Darwuin Arrieta; María L. Pérez; Juan Hernández-Fonseca; María G. Oviedo; Silvio Miranda; Amelia Luengo


El suicidio y algunos de sus correlatos neurobiológicos. Segunda parte  

Microsoft Academic Search

La inducción al suicidio por tratamientos farmacológicos que buscan precisamente lo contrario es un punto de álgi- do debate. Los datos son concluyentes. Un estudio sueco comparó la presencia o ausencia de antidepresivos inhibidores selectivos de recaptura de serotonina (ISRSs) en el plasma de suicidas, que lo habían consumado o no de manera violenta. Se encontró que entre los más

Ana G. Gutiérrez-García; Carlos M. Contreras



Caracterización de tintas de titanio dopadas con óxidos metálicos  

Microsoft Academic Search

Se prepararon tintas de Diisopropoxido de titanio bis(acetilacetonato) por el método sol-gel para aplicar en la elaboración de nanoestructuras mediante la técnica de escritura directa. Esta técnica permite estructurar materiales con alto índice de refracción a escala micro y nanométrica en tres dimensiones mediante extrusión, para elaborar cristales fotónicos. El tratamiento de las nanoestructuras extruidas a temperaturas elevadas para transformarlas



Drug Facts  

MedlinePLUS Videos and Cool Tools

... who wants to talk to her daughter about drugs. Take a quiz : What do you know about drugs? Haga clic aquí para información sobre el abuso ... y tratamiento. VIDEO: Anyone Can Become Addicted to Drugs VIDEO: Why Are Drugs So Hard to Quit? ...


Lo que usted necesita saber sobre? el cáncer

La serie de folletos Lo que usted necesita saber sobre? está diseñada para pacientes con cáncer y proporciona información sobre muchos tipos de cáncer. Cada folleto incluye información acerca de los síntomas, diagnóstico y tratamiento del cáncer. En todos los títulos de la serie, se ofrece también información adicional acerca de los problemas emocionales y preguntas para hacer al doctor.



E-print Network


Autonoma de Madrid, Universidad



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Autonoma de Madrid, Universidad


Clausura de curso del Mster en Gestin Sostenible y Tecnologas del Agua de la Universidad de Alicante  

E-print Network

Clausura de curso del Máster en Gestión Sostenible y Tecnologías del Agua de la Universidad de el Tratamiento del Agua (ATTA) pronunciará la ponencia de clausura Finaliza el curso de los estudios oficiales del Máster en Gestión Sostenible y Tecnologías del Agua de la UA que imparte el Instituto del Agua

Escolano, Francisco


Atlas del Genoma del Cáncer

Es posible que haya más de 200 tipos diferentes de cáncer y muchos subtipos más, cada uno de estos causado por errores en el ADN que desencadenan el crecimiento descontrolado de las células. La identificación de los cambios en el conjunto completo de ADN de cada tipo de cáncer, su genoma, y el entendimiento de cómo interactúan dichos cambios para impulsar el proceso de la enfermedad sentarán las bases de una era individualizada de tratamiento del cáncer.


PANTONE 201 PANTONE black tiro Universidad  

E-print Network

objetivo formar profesionales universitarios de la Medicina y Licenciados en Nutrición y Dietética en el investigadores del área. ¿A quién está dirigido? A Licenciados en nutrición, medicina, dietética o carreras serán capaces de: Desempeñarse en actividades del área de la salud que requieran un tratamiento

Vásquez, Carlos


Exámenes selectivos de detección para cáncer colorrectal: para los hispanos, se trata de prevención, no solo de detección

Todos los exámenes de detección de cáncer que se usan extensamente tienen el objetivo de detectar el cáncer a tiempo, cuando el tratamiento puede tener más éxito. Pero varias pruebas de detección pueden también ayudar a encontrar células anormales que no se han convertido todavía en cancerosas, lo que permite que se extirpen antes de que causen problemas. Las pruebas de detección de cáncer colorrectal, es decir, en el colon y recto, pueden ayudar a detectar formaciones precancerosas que se llaman pólipos.


Observaciones clínicas sobre ochenta casos tratados con prazosin solo y asociado a otros antihipertensores  

Microsoft Academic Search

ResumenFueron estudiados ochenta pacientes hipertensos, a los que se les administr? prazosin, ya sea solo o asociado a beta-bloqueadores, metildopa, diur?ticos, o una combinacion de varias de estas drogas en las hipertensiones severas. El 72,5% respondi? positivamente al tratamiento, mientras que el 27,5% o bien no respondi? a la?medicacion, o present? efectos secundarios que obligaron a suspender el uso de

E. Benzecry



Biostratigraphy and paleoceanography of the Japan Sea in Joetsu Basin since 120 cal. kyr BP  

NASA Astrophysics Data System (ADS)

In the Japan Sea, the Quaternary sediments are characterized by alternating dark and light layers that demonstrate different bottom water oxygenation. Biostratigraphy and paleoceanography of the Japan Sea around Joetsu Basin has been reconstructed in core MD179-3312 since 120 cal. kyr BP. Based on both benthic and planktonic foraminifera assemblages, the sequence of this core is divided into 7 biozones, Biozone 7 to 1, in stratigraphic ascending order. The Biozone 7 (120-115 cal. kyr BP) is characterized by occurrence of Globigerinoides ruber, a marker species of warm surface water, and can be correlated with MIS 5.5. The Biozone 6 (115 to 25 cal. kyr BP) is divided into 5 subzone, Subzone 6-5 to 6-1, The Subzones 6-5, 6-3 and 6-1 are characterized by appearance of both suboxic and oxic species. It seems that during these periods the water oxygenation fluctuated between suboxic and oxic conditions from time to time corresponding to increase and decrease of nutrients supplied by low saline East China Sea Coastal Water through the Tsushima Strait. The Subzones 6-4 and 6-2 characterized by abundant occurence of suboxic to euxinic species such as Brizalina pacifica, Stainforthia loeblichi and Nonionella globosa. During these periods the deep-water oxygenation reduced by high productivity and low vertical mixing which is caused suboxic to euxinic conditions. The Biozone 5 (25 to 15 cal. kyr BP) characterized by the thin-laminated dark layers (TL-2), with high abundant of Globigerina umblicata and low or absent benthic foraminifera, corresponding to the sea-level drop below the sill depth of Tsushima Strait. The TL layers during this period represent euxinic bottom-water and the Japan Sea was nearly isolated from the open ocean. The Biozone 4 (15-11.5 cal. kyr BP) characterized by appearance of Elphidium excavatum which is a cool shallow-water species and shows the inflow of Oyashio Cold Water. The Biozon 3 (11.5-11 cal. kyr BP) is lithologically correlated with TL1 and characterized by high amount of Brizalina pacifica which is demonstrates suboxic to euxinic bottom water condition. The Biozone 2 (11-7 cal. kyr BP) is characterized by appearance of Pullenia aperture, low or absent of both benthic and planktonic foraminifera and indicates low saline condition. In the Biozone 1 (7 cal. kyr BP to recent) a warm-water species, Globigerinoides ruber, is found as in the Biozone 7. A drastic change of dominant species from Globigerina bulloides to Neogloboquadrina incompta in planktonic assemblage suggests the invasion of the Tsushima Warm Current (TWC) into the Japan Sea. The regeneration of deep water followed the initiation of the TWC inflow into the Japan Sea, and the modern Japan Sea Proper Water with high oxygen has been generated.

Saeidi Ortakand, M.; Hasegawa, S.



The Late Holocene Stratigraphy of an Inlet-Dominated Barrier Island, Pea Island, North Carolina.  

NASA Astrophysics Data System (ADS)

Sedimentological, foraminiferal, geochemical, and geophysical data sets as well as aerial photographs have been used to investigate the natural processes (inlet dynamics, ocean/estuarine washover, and sea-level change) responsible for the late Holocene units preserved in the barrier island subsurface at Pea Island National Wildlife Refuge. Historic nautical charts indicate that three inlets characterized Pea Island between early European exploration (1590) and the late 19th century; aerial photographs show New Inlet open in 1932 and 1940. Vibracores (up to 5.5 m) collected along three transects across Pea Island extend our knowledge of the geological evolution of this region to pre-historic times. The section in the longest core (PI01S6) consists of four fining-upwards depositional sequences. The basal unit of each sequence is a bedded, medium to fine, clean quartz sand with increasing concentrations of organic matter (3-4 % detrital and 5-7 % in situ Spartina alterniflora roots) or irregular mud clasts (2-5 cm) to spherical mud balls (1-2 cm) up core. The clean sand units have so far proven to be barren of foraminifera except for a shelly unit at ca. 220 cm below MSL. The foraminiferal assemblage in this unit is of open shelf character (Elphidium excavatum, Hanzawaia strattoni, and Buccella inusitata). A 14C age on a disarticulated Chione cancellata valve from this unit is cal. 930+/-60 BP. The sand grades into a gray, tight mud in the first two sequences and into an inter-laminated mud and in situ peat in the third sequence. The peat contains leaf fragments and rhizomes of the marsh plants Juncus roemarianus, Spartina cynosuroides, and/or Phragmites spp. The peat and muddy sand units contain marsh foraminifera (Trochammina spp., Miliammina fusca, Arenoparrella mexicana), which are also found in modern marsh deposits. A peat sample from the third fining upward sequence (the only one to grade into a true peat) has a 14C age of cal. 395+/-35 BP, cal. 295+/-35 BP, or cal 180+/-40 BP. The four fining-upwards sequences have sharp erosional basal contacts. These deposits appear to reflect back-barrier processes including sequential deposition of flood-tide delta sands and/or sound sands adjacent to marshes. The shelly sands, containing open shelf foraminiferal assemblages, represent oceanic overwash, inlet deposits, or open embayment sands deposited behind a laterally extensive breach in the barrier island. The sequences are capped by the deposits of modern environments that include algal flats, tidal creeks, high and low marshes, back-barrier berms, overwash fans, and aeolian dunes. Several of the modern environments became covered with marsh vegetation after the construction of barrier dune ridges in the late 1930?s.

Smith, C. G.; Ames, D.; Corbett, D. R.; Culver, S.; Mallinson, D.; Riggs, S. R.; Vance, D.



Part 9, Authors: L To Lyutkevich  

E-print Network

. [W?.] L., H. [Dr., Mannheim] 1931 a.?Neuer Parasit au Daphnien im Aquarium beobachtet Tratamiento de los oxiuros en el adulto

Segal, Dorothy B.; Ray, Doris H.; Hassall, Albert; Doss, Mildred A.



Shock Chlorination of Stored Water Supplies (Spanish)  

E-print Network

A l tratamiento del agua potable para mejo- rar su sanidad o calidad bacteriol?gica se le refiere como desinfecci?n. La clo- raci?n por choque (o cloraci?n por shock) es uno de los m?todos de desinfecci?n usado por los proveedores locales para... disminuir la contami- naci?n bacteriol?gica del agua. Este m?todo tam- bi?n puede ser usado por los propietarios de pozos de agua particulares. Pozos de agua Los pozos de agua contaminados con bacterias pueden ser clorados por choque por medio de la...

Dozier, Monty; McFarland, Mark L.



On-Site Wastewater Treatment Systems: Tablet Chlorination (Spanish)  

E-print Network

L-5344S 01-06 Figura 1: La manera m?s com?n de desinfectar los sistemas individuales es la cloraci?n con pastilla. Sistemas individuales para el tratamiento de aguas negras Cloraci?n con pastilla Richard Weaver, Bruce Lesikar y Juan Enciso Profesor... de Microbiolog?a del Medio Ambiente y del Suelo, Promotores Especialistas de Ingenier?a Agr?cola El Sistema Universitario Texas A&M L as aguas negras rociadas al c?sped deben desinfectarse primero para evitar malos olores y eliminar microorganismos...

Weaver, Richard; Lesikar, Bruce J.; Enciso, Juan



On-Site Wastewater Treatment Systems: Gravel-less Pipe (Spanish)  

E-print Network

tratamiento de aguas negras Tuber?a sin grava Bruce Lesikar, Juan Enciso y Russell Persyn Promotores Especialistas de Ingenier?a Agr?cola, Promotor Adjunto de Conservaci?n de Agua El Sistema Universitario Texas A&M L os sistemas de tuber?a sin grava... distribuyen aguas negras tratadas sobre el suelo. Son como los sistemas convencionales de zanjas llenas de grava, excepto que la tuber?a sin grava est? rodeada de una tela geotextil en lugar de la grava. Un sistema de tuber?a sin grava consiste en: 3 Un...

Lesikar, Bruce J.; Enciso, Juan



On-Site Wastewater Treatment Systems: Evapotranspiration Bed (Spanish)  

E-print Network

Fosa s?ptica de dos compartimentos Suelo arcilloso Piedra quebrada Cama de evapotranspiraci?n Mecha de absorci?n Sistemas individuales para el tratamiento de aguas negras Cama de evapotranspiraci?n Bruce Lesikar y Juan Enciso Promotores... Especialistas en Ingenier?a Agr?cola El Sistema Universitario Texas A&M L-5228S 4-02 Figure 1: Un sistema de lecho de evapotranspiraci?n. U na cama de evapotranspiraci?n (ET) trata las aguas negras usando la evapotranspiraci?n, la p?rdida de agua del suelo por...

Lesikar, Bruce J.; Enciso, Juan



Shock Chlorination of Wells (Spanish)  

E-print Network

E l tratamiento con cloro es un m?todo para desinfectar un pozo de agua. Se recomien- da cuando un sistema de agua est? contam- inado con bacterias. La contaminaci?n puede ocurrir en la instalaci?n del pozo, cuando se hacen repara- ciones a la bomba... o a la tuber?a, o cuando los escur- rimientos por exceso de lluvia entran en el pozo. Si el agua subterr?nea constituye en s? la fuente de bacterias, el sistema se contaminar? de nuevo cada vez que el agua sea bombeada por las tuber?as. En ese caso...

McFarland, Mark L.; Dozier, Monty



On-Site Wastewater Treatment Systems: Leaching Chambers (Spanish)  

E-print Network

tratamiento de aguas negras C?maras de percolaci?n Bruce Lesikar, Juan Enciso y Russell Persyn Promotores Especialistas de Ingenier?a Agr?cola, Promotor Adjunto de Conservaci?n del Agua El Sistema Universitario Texas A&M Un sistema de c?mara de percola- ci... superior de la c?mara es maciza para que pueda soste- ner la tierra de encima, las paredes son tipo persiana y el fondo est? abierto para permitir que el agua salga. El ancho de la c?mara var?a entre 15 y 36 pulgadas. 3 Las zanjas de la c?mara de percolaci...

Lesikar, Bruce J.; Enciso, Juan



On-Site Wastewater Treatment Systems: Constructed Wetlands (Spanish)  

E-print Network

tejido duro o suave, algunos, expertos creen que las plantas de tejido duro son mejores porque pueden ofrecer una v?a para que el ox?geno entre al humedal durante el invierno y reducir la necesidad del mantenimiento de plantas. Sin embargo, los residentes... prefieren plantas de tejido suave porque por lo general tienen flores y son llamativas. Recuerde que si usa plantas de tejido suave, el sistema puede necesitar m?s mantenimiento. Tratamiento Primero, el tanque s?ptico trata las aguas negras. El tanque, que...

Lesikar, Bruce J.; Enciso, Juan



Información sobre el cáncer para hispanos y latinos

Cada vez más estadounidenses sobreviven al cáncer y continúan llevando vidas productivas. Sin embargo, muchos hispanos y latinos en los Estados Unidos no han escuchado este mensaje, y no se han beneficiado de los adelantos en los campos de la detección temprana y el tratamiento. El nuevo sitio web del Instituto Nacional del Cáncer,, lanzado el día 2 de abril de 2007, comunica enérgicamente el mensaje de que el cáncer puede prevenirse y tratarse, y ofrece, además, información sobre todos los aspectos de la enfermedad.


Grupos españoles de cálculos ab initio de moléculas de interés astrofísico  

NASA Astrophysics Data System (ADS)

Pocos campos de la química están tan bien adaptados a la modelización por medio de los métodos teóricos de la Química Cuántica como la Astroquímica y la Química de la Atmósfera, donde las interacciones moleculares son, generalmente, lo suficientemente pequeñas para que el modelo de molécula aislada funcione muy bien. En España son varios los grupos teóricos que dedican su esfuerzo de investigación, o parte de él, al estudio de moléculas o procesos de interés en Astrofísica o en atmósferas planetarias. Presentaremos diferentes ejemplos paradigmáticos de esta actividad en la que se exploran desde aspectos estructurales, hasta aspectos espectroscópicos y dinámicos. Entre los últimos, cabe destacar estudios en los que se demuestra la importancia de procesos a dos estados, prohibidos por espín, en la formación astrofísica de diversos derivados de interés. En el tratamiento espectroscópico se han hecho esfuerzos interesantes, que han aunado teoría y experimento, en el estudio de sistemas relevantes desde el punto de vista atmosférico, como los hidratos de ácido nítrico, o el tratamiento espectroscópico de moléculas no rígidas. No menos interesantes son los estudios de fotoabsorción de radicales o de procesos multifotónicos. Son particularmente abundantes los estudios dedicados a la reactividad específica de sistemas de interés astrofísico o atmosférico, con el objetivo de esclarecer vías de formación de determinados compuestos o de proporcionar mecanismos que permitan identificar las etapas reactivas limitantes de reacciones de interés en esos medios y sobre los que no existía información previa. Así, por ejemplo, se han publicado interesantes estudios sobre la formación o propiedades de compuestos de fósforo, de silico o de azufre o sobre mecanismos de reacción en los que intervienen el ozono, el radical nitrato, el radical OH u otras especies. Finalmente, son también particularmente relevantes los estudios que varios grupos españoles han llevado, y siguen llevando a cabo, sobre sistemas débilmente enlazados, como complejos de Van der Waals o complejos por enlace de hidrógeno, que sin duda juegan un papel importante tanto en medios atmosféricos como interestelares.

Yáñez, M.



PubMed Central

Introduccion La diabetes mellitus y las demencias constituyen dos problemas crecientes de salud entre la población adulta mayor del mundo y en particular de los paises en desarrollo. Hacen falta estudios longitudinales sobre el papel de la diabetes como factor de riesgo para demencia. Objetivo Determinar el riesgo de demencia en sujetos Mexicanos con diabetes mellitus tipo 2. Materiales y Metodos Los sujetos diabéticos libres de demencia pertenecientes al Estudio Nacional de Salud y Envejecimiento en México fueron evaluados a los dos años de la línea de base. Se estudió el papel de los factores sociodemográficos, de otras comorbilidades y del tipo de tratamiento en la conversión a demencia. Resultados Durante la línea de base 749 sujetos (13.8%) tuvieron diabetes. El riesgo de desarrollar demencia en estos individuos fue el doble (RR, 2.08 IC 95%, 1.59–2.73). Se encontró un riesgo mayor en individuos de 80 años y más (RR 2.44 IC 95%, 1.46–4.08), en los hombres (RR, 2.25 IC 95%, 1.46–3.49) y en sujetos con nivel educativo menor de 7 años. El estar bajo tratamiento con insulina incrementó el riesgo de demencia (RR, 2.83, IC 95%, 1.58–5.06). Las otras comorbilidades que aumentaron el riesgo de demencia en los pacientes diabéticos fueron la hipertensión (RR, 2.75, IC 95%, 1.86–4.06) y la depresión (RR, 3.78, 95% IC 2.37–6.04). Conclusión Los sujetos con diabetes mellitus tienen un riesgo mayor de desarrollar demencia, La baja escolaridad y otras comorbilidades altamente prevalentes en la población Mexicana contribuyen a la asociación diabetes-demencia. PMID:21948010

Silvia, Mejia-Arango; Clemente, y Zuniga-Gil



The residual and direct effects of reduced-risk and conventional miticides on twospotted spider mites, Tetranychus urticae (Acari: Tetranychidae) and predatory mites (Acari: Phytoseiidae)  

SciTech Connect

The residual effects of several reduced-risk and conventional miticides were evaluated in strawberries (Fragaria z ananassa Duchesne) on the twospotted spider mite (TSSM), Tetranychus urticae Koch (Acari: Tetranychidae) and on 2 predatory mites, Neoseiulus californicus McGregor and Phytoseiulus persimilis Athias-Henriot (Acari: Phytoseiidae). Experiments were conducted in the laboratory and greenhouse. The greenhouse experiments also tested the direct effects of the miticides on TSSM. The efficacy of conventional and reduced-risk miticides was evaluated on strawberry leaf discs and on whole plants for control of TSSM. Furthermore, the residual effects of these miticides were evaluated on whole strawberry plants against selective predatory mites. For TSSM, 5 treatments were evaluated: a conventional miticide; fenbutatin-oxide (Vendex[reg]) and 3 reduced-risk miticides; binfenazate (Acramite 50WP[reg]), activated garlic extract (Repel[reg]), sesame seed and castor oil (Wipeout[reg]), and a water-treated control. For predatory mites, the residual effects of only Acramite[reg] and Vendex[reg] were evaluated. Acramite[reg] was the most effective acaricide in reducing TSSM populations in both the laboratory and greenhouse experiments. Vendex[reg] and Wipeout[reg] were also effective in the laboratory, but did not cause significant reduction of TSSM in the greenhouse. Repel[reg] was the least effective of the 4 pesticides evaluated. Neither Acramite[reg] nor Vendex[reg] had a significant effect on either predatory mite species. However, there appeared to be more predatory mites on the Vendex[reg]-treated plants than on the Acramite[reg]-treated plants. There were significantly more predatory mites of both species on the cue plants, which were inoculated with TSSM versus the non-cue plants, which were not inoculated. (author) [Spanish] Los efectos residuales en poblaciones de la 'arana roja', Tetranychus urticae Koch (Acari: Tetranichidae) y de los acaros predadores Neoseiulus californicus McGregor y Phytoseilus persimilis Athias-Henriot (Acari: Phytoseiidae) causados por varios acaricidas convencionales y de riesgo-reducido fueron evaluados en fresas (Fragaria x ananassa Duchense). Los experimentos fueron realizados en laboratorio e invernadero. Los experimentos en el invernadero evaluaron tambien el efecto directo de los acaricidas en la 'arana roja'. La eficacia para controlar la 'arana roja' de los acaricidas convencionales y de riesgo-reducido fue evaluada en discos de las hojas y en plantas de fresa, y los efectos residuales de los acaricidas en los acaros predadores fueron evaluados en plantas completas. Para la 'arana roja' se evaluaron cinco tratamientos: el acaricida convencional fenbutatin-oxido (Vendex[reg]), 3 acaricidas de riesgo-reducido binfenazate (Acaramite 50WP[reg]), extracto de ajo activado (Repel[reg]), aceite de semillas de ajonjoli y ricino (Wipeout[reg]) y un control tratado con agua. Para los acaros predadores solamente los efectos de Acaramite[reg] y Vendex[reg] fueron evaluados. Acaramite[reg] fue el tratamiento mas efectivo para la 'arana roja' en el laboratorio y el invernadero. Vendex[reg] y Wipeout[reg] fueron tambien efectivos en el laboratorio, pero no causaron una reduccion significativa de 'aranas rojas' en el invernadero. Repel[reg] fue el tratamiento evaluado menos eficaz. Ni Acaramite[reg] ni Vendex[reg] redujeron significativamente las poblaciones de acaros predadores. Sin embargo, aparentemente hay mas acaros predadores en Vendex[reg] que en Acaramite[reg]. Tambien se encontraron significativamente mas acaros predadores en plantas inoculadas que en plantas no inoculadas. (author)

Liburd, O.E.; White, J.C.; Rhodes, E.M. [Department of Entomology and Nematology, University of Florida, Gainesville, FL 32611 (United States); Browdy, A.A. [Department of Food Science and Human Nutrition, University of Florida, Gainesville, FL 32611 (United States)



Use of black vulture (Coragyps atratus) in complementary and alternative therapies for cancer in Colombia: A qualitative study  

PubMed Central

Background Although Coragyps atratus has been used as a traditional therapy for patients with cancer, the scientific literature does not contain enough information on how this therapy is used or the mechanisms that explain this therapeutic practice. Objectives To understand the methods of use and the reasons given by patients and caregivers for the use of Coragyps atratus in cancer treatment. Methods This study used a qualitative design based on twenty in-depth interviews of patients with cancer or caregivers of patients with the disease. The analysis of the text was based on an inductive thematic approach. Results Resistance to disease and immune enhancement are properties attributed to Coragyps atratus when used for cancer treatment. The most recommended method of use is fresh blood ingestion, and the associated mechanism of action is transfer of immune factors to the individual who consumes it. Conclusions Use of Coragyps atratus as a treatment for cancer is a popular alternative therapy in Colombia. More studies are needed to understand the clinical effects of this intervention in cancer patients. Spanish abstract Introducción Aunque Coragyps atratus se usa tradicionalmente como terapia para pacientes con cáncer, no existe suficiente información en la literatura científica sobre su forma de utilización ni sobre los mecanismos explicativos que subyacen a esta práctica terapéutica. Objetivos Conocer métodos de utilización y mecanismos explicativos dados por los pacientes y cuidadores de pacientes sobre el uso de Coragyps atratus en el tratamiento del cáncer. Materiales y métodos Diseño cualitativo basado en veinte entrevistas en profundidad de pacientes con cáncer o cuidadores de pacientes con esta enfermedad. Análisis de texto basado en enfoque temático inductivo. Resultados Al Coragyps atratus se le atribuyen propiedades de resistencia y fortalecimiento del sistema inmune de personas enfermas de cáncer. La forma de utilización mas común es la ingesta de la sangre fresca y el mecanismo de acción asociado es la transferencia de defensas a quien lo consume. Conclusiones La utilización del Coragyps atratus como tratamiento para el cáncer es una terapia alternativa usada popularmente en Colombia. El uso de este animal debe estudiarse más a fondo para conocer los efectos clínicos en los pacientes con cáncer. PMID:22651097



Cirug?a de los trastornos del comportamiento: el estado del arte  

PubMed Central

Introducción: La cirugía de los trastornos del comportamiento (CTC) se está convirtiendo en un tratamiento más común desde el desarrollo de la neuromodulación. Métodos: Este artículo es una revisión no sistemática de la historia, indicaciones actuales, técnicas y blancos quirúrgicos de la CTC. Dividimos su historia en 3 eras: la primera comienza en los inicios de la psicocirugía y termina con el desarrollo de las tícnicas estereotácticas, cuando comienza la segunda era. Ésta se caracteriza por la realización de lesiones estereotácticas. Nos encontramos transitando la tercera era, que comienza cuando la estimulación cerebral profunda (ECP) comienza a ser usada en CTC. Resultados: A pesar de los errores graves cometidos en el pasado, hoy en día, la CTC está renaciendo. Los trastornos psiquiátricos que se más frecuentemente se tratan con cirugía son: depresión refractaria, trastorno obsesivo-compulsivo y síndrome de Tourette. Además, algunos pacientes con agresividad fueron tratados quirúrgicamente. Hay varios blancos estereotácticos descriptos para estos trastornos. La estimulación vagal puede ser usada también para depresión. Conclusión: Los resultados de la ECP en estos trastornos parecen alentadores. Sin embargo, se necesitan más estudios randomizados para establecer la efectividad de la CTC. Debe tenerse en cuenta que una apropiada selección de pacientes nos ayudará a realizar un procedimiento más seguro así como también a lograr mejores resultados quirúrgicos, conduciendo a la CTC a ser más aceptada por psiquiatras, pacientes y sus familias. Se necesita mayor investigación en varios temas como: fisiopatología de los trastornos del comportamiento, indicaciones de CTC y nuevos blancos quirúrgicos. PMID:25165612

Yampolsky, Claudio; Bendersky, Damian





El objetivo del trabajo es conocer las disyuntivas entre los principios de beneficencia y autonomía, que se presentan en la relación médico-paciente, durante la terapéutica del intento de suicidio.La investigación se realizó en dos hospitales psiquiátricos de la Ciudad de México. La muestra incluyó a tres sujetos con intento de suicidio, mayores de 18 años, que eran atendidos en consulta externa a causa de una lesión autoinfligida en el último año, y a tres psiquiatras que trataban a estos pacientes. La información se obtuvo previo consentimiento informado en entrevistas individuales. Se llevó a cabo un análisis de discurso argumentado para encontrar los significados que los participantes otorgaron a los principios bioéticos y las posibles disyuntivas entre éstos.Las discordancias entre la beneficencia y la autonomía estuvieron relacionadas con el beneficio del tratamiento, el respeto por los valores y las creencias de los pacientes, entre otros. Este trabajo presenta consideraciones éticas relevantes en el escenario clínico, al ofrecer al psiquiatra un análisis bioético que le permita actuar de acuerdo con la beneficencia y respetando la autonomía del paciente frente a casos de intento de suicidio y, de esta forma procurar una mejor atención para ellos. PMID:20830214

Mondragón, Liliana; Monroy, Zuraya; Ito, Ma Emily; Medina-Mora, Dra Ma Elena




PubMed Central

El objetivo del trabajo es conocer las disyuntivas entre los principios de beneficencia y autonomía, que se presentan en la relación médico-paciente, durante la terapéutica del intento de suicidio. La investigación se realizó en dos hospitales psiquiátricos de la Ciudad de México. La muestra incluyó a tres sujetos con intento de suicidio, mayores de 18 años, que eran atendidos en consulta externa a causa de una lesión autoinfligida en el último año, y a tres psiquiatras que trataban a estos pacientes. La información se obtuvo previo consentimiento informado en entrevistas individuales. Se llevó a cabo un análisis de discurso argumentado para encontrar los significados que los participantes otorgaron a los principios bioéticos y las posibles disyuntivas entre éstos. Las discordancias entre la beneficencia y la autonomía estuvieron relacionadas con el beneficio del tratamiento, el respeto por los valores y las creencias de los pacientes, entre otros. Este trabajo presenta consideraciones éticas relevantes en el escenario clínico, al ofrecer al psiquiatra un análisis bioético que le permita actuar de acuerdo con la beneficencia y respetando la autonomía del paciente frente a casos de intento de suicidio y, de esta forma procurar una mejor atención para ellos. PMID:20830214

Mondragon, Liliana; Monroy, Zuraya; Ito, Ma. Emily; Medina-Mora, Dra. Ma. Elena



Life Course Experiences, Pain and Suffering: A Case Study of an Older Mexican American Woman with Mobility Impairment  

PubMed Central

There is a dearth of literature examining how adversity shapes the experiences of pain and/or suffering in a middle aged Mexican American women. The purpose of this qualitative descriptive study was to understand pain and suffering from a life course perspective as described by a Mexican American woman aging with early onset mobility impairment. This Hispanic woman experienced episodes of abuse and rejection over the life course, which may have significantly influenced her pain and suffering experience in adulthood. This adds to the literature on how adversity influences later life pain experience and provides insight on why pharmacological treatment alone may not be as successful as a holistic intervention. Hay escasez de literatura que examine cómo la adversidad da forma a las experiencias de dolor y / o sufrimiento en mujeres mexicana-americana mayores de edad. El propósito de este estudio descriptivo cualitativo fue comprender el dolor y el sufrimiento desde una perspectiva de ciclo de vida como descrito por una mujer mexicana-americana envejeciendo con inicio temprano de deterioro de movilidad. Esta Latina experimentó episodios de maltrato y rechazo, que se percibió haber afectado su experiencia de dolor y sufrimiento luego como adulta. Este estudio aumenta la literatura sobre cómo la adversidad influya la experiencia de dolor más tarde en la vida, y nos permite comprender mejor como el tratamiento farmacológico por sí solo no es tan exitoso como pueda ser una intervención integral. PMID:24830728

Walker, Janiece L.; Harrison, Tracie C.; Hendrickson, Sherry G.



Descompresión microvascular en neuralgia del trigémino: Reporte de 36 casos y revisión de la literatura  

PubMed Central

Objetivo: El propósito del presente trabajo es presentar los resultados de 36 pacientes con diagnóstico de neuralgia del trigémino (NT), en los cuales se realizó una descompresión microvascular (DMV). Material y Método: Desde junio de 2005 a mayo de 2012, 36 pacientes con diagnóstico de NT fueron operados por el primer autor (AC), realizando una DMV. Se evaluó: Edad, sexo, tiempo de sintomatología previo a la cirugía, hallazgos intraoperatorios (a través de los videos quirúrgicos), y resultados postoperatorios. Resultados: De los 36 pacientes operados, 25 fueron mujeres y 11 varones. El promedio de edad fue de 48 años. El seguimiento postoperatorio fue en promedio de 38 meses. De los 36 pacientes, 32 (88%) evolucionaron sin dolor hasta la fecha. De los 4 casos con recurrencia de dolor, en dos pacientes se observó como hallazgo intraoperatorio un conflicto venoso. Conclusión: La DMV como tratamiento de la NT es un procedimiento efectivo y seguro. El hallazgo intraoperatorio de una “compresión” venosa podría indicar una evolución postoperatoria desfavorable. PMID:25379343

Campero, Alvaro; Ajler, Pablo; Campero, Abraham Agustín



Cirug?a transnasal endosc?pica para tumores de hip?fisis  

PubMed Central

Introducción: Exponer la técnica utilizada y los resultados obtenidos en los primeros 52 pacientes portadores de tumores hipofisarios tratados por la vía endoscópica transnasal en el Hospital Italiano de Buenos Aires Métodos: Se llevó a cabo un análisis retrospectivo de 52 cirugías endoscópicas transnasales utilizadas en el tratamiento de tumores hipofisários. Las mismas fueron realizadas en el Hospital Italiano de Buenos Aires durante el período junio del 2011 a junio del 2012. Se analizaron las características demográficas de los pacientes, la patología de base y la morbimortalidad asociada a la cirugía. Resultados: La edad media de los pacientes fue de 41,52 años con un rango de 18-79. La distribución fue similar entre hombres y mujeres. Las patologías más frecuentes fueron: adenomas no funcionantes (40.4%), tumores productores de GH/Acromegalia (25%) y tumores productores de ACTH/Enfermedad de Cushing (23.1%). Aproximadamente el 70 % correspondieron a macroadenomas. Sólo un paciente presentó complicaciones. No se registro ningún óbito. Conclusión: Si bien podremos objetivar fehacientemente resultados más concluyentes en futuros trabajos, podemos decir a priori que, en la endoscopía el detalle anatómico es claramente superior al microscópico y que la posibilidad de la introducción del endoscopio en la silla turca permite la visualización directa de remanentes tumorales, de sitios de fístula y como así también de la glándula normal, ventajas que potencialmente podrían permitir obtener mejores resultados quirúrgicos, en términos de control de la enfermedad y tasa de complicaciones. PMID:23596553

Ajler, Pablo; Hem, Santiago; Goldschmidt, Ezequiel; Landriel, Federico; Campero, Alvaro; Yampolsky, Claudio; Carrizo, Antonio



Promoting cultural humility during labor and birth: putting theory into action during PRONTO obstetric and neonatal emergency training.  


Maternal and neonatal mortality in Northern Guatemala, a region with a high percentage of indigenous people, is disproportionately high. Initiatives to improve quality of care at local health facilities equipped for births, and increasing the number of births attended at these facilities will help address this problem. PRONTO (Programa de Rescate Obstétrico y Neonatal: Tratamiento Óptimo y Oportuno) is a low-tech, high-fidelity, simulation-based, provider-to-provider training in the management of obstetric and neonatal emergencies. This program has been successfully tested and implemented in Mexico. PRONTO will now be implemented in Guatemala as part of an initiative to decrease maternal and perinatal mortality. Guatemalan health authorities have requested that the training include training on cultural humility and humanized birth. This article describes the process of curricular adaptation to satisfy this request. The PRONTO team adapted the existing program through 4 steps: (a) analysis of the problem and context through a review of qualitative data and stakeholder interviews, (b) literature review and adoption of a theoretical framework regarding cultural humility and adult learning, (c) adaptation of the curriculum and design of new activities and simulations, and (d) implementation of adapted and expanded curriculum and further refinement in response to participant response. PMID:23360940

Fahey, Jenifer O; Cohen, Susanna R; Holme, Francesca; Buttrick, Elizabeth S; Dettinger, Julia C; Kestler, Edgar; Walker, Dilys M



Medicinal ethnobotany in Huacareta (Chuquisaca, Bolivia)  

PubMed Central

Background The aim of this study was to document the types of diseases treated by the use of medicinal plants, their main applications and also to have a report of the major diseases treated at the Hospital of San Pablo de Huacareta (Chuquisaca Bolivia). Methods We conducted semi-structured interviews on the use medicinal plants with 10 local informants, and categorized the kinds of diseases treated by traditional medicine. We obtained reports of cases treated at the Hospital of Huacareta in order to compare the use frequency of traditional medicine and allopathic medicine for the treatment of recurrent diseases in the area. Results Our survey identified 258 traditional medicine uses, spanning a total of 13 diseases categories and including 91 native and exotic plant species and one unidentified sample plant type. Gastrointestinal disorders (55%) were most frequently treated with medicinal plants, followed by afflictions of the musculoskeletal system (25%) and dermatological disorders (24%). Hospital information indicates that the most common diseases are acute respiratory infections (47%) and acute diarrheal diseases (37%). The herbal remedies were mostly used in the form of teas and decoctions. The informants used mainly native plant species, although exotic species has been introduced to the pharmacopoeia. Conclusions The treatment of gastrointestinal disorders is the primary objective of the medical ethnobotany of the inhabitants of Huacareta, while respiratory system diseases are mostly treated in the hospital. Looking at the data from the Hospital records we can infer that gastrointestinal disorders are among the most common diseases in the study area. For most respondents, traditional medicine is a reliable choice for the care of their illnesses. However, the preference of the population for either traditional medicine or allopathic medicine needs to be clarified in future comparative studies to obtain more convincing results. The results presented can be used as a base for subsequent work related to traditional medicine and its contribution to allopathic medicine in San Pablo de Huacareta. Resumen Introducción El objetivo del presente estudio fue documentar los tipos de enfermedades tratadas mediante el uso de plantas medicinales, sus aplicaciones principales y también tener un reporte de las enfermedades mayormente atendidas en el Hospital de San Pablo de Huacareta (Chuquisaca, Bolivia). Métodos Se realizaron encuestas semiestructuradas a 10 informantes locales anotando los usos atribuidos a sus plantas medicinales, se agruparon las plantas por categorías de enfermedades tratadas en la medicina tradicional. Se obtuvieron reportes de casos tratados en el Hospital de Huacareta para poder relacionar el tratamiento de enfermedades recurrentes en la zona entre la medicina tradicional y la medicina occidental. Resultados Se reportaron 91 especies nativas y exóticas, además de un espécimen indeterminado exótico que intervienen en un total de 258 aplicaciones medicinales, las cuales son empleadas en un total de 13 categorías de enfermedades. Los desórdenes gastrointestinales (55%) son mayormente tratados mediante plantas medicinales, seguidas de las afecciones al sistema esqueleto-muscular (25%) y enfermedades dermatológicas (24%). La información del Hospital indica que las enfermedades más frecuentes son Infecciones Respiratorias Agudas (47%) y Enfermedades Diarreicas Agudas (37%). Los remedios vegetales se emplean en forma de infusiones y cocciones principalmente. Se emplean mayormente plantas nativas, también se introdujo en la farmacopea médica el uso de plantas exóticas al lugar. Conclusiones El tratamiento de trastornos gastrointestinales constituye el objetivo primordial de la etnobotánica médica de los habitantes de Huacareta, las enfermedades del sistema respiratorio, son mayormente tratadas en el Hospital. Observando los datos del libro de consultas del Hospital, se puede inferir que los desórdenes gastrointestinales



Reacciones de intercambio de carga  

NASA Astrophysics Data System (ADS)

Se discute la validez de diversas metodologías y su aplicación al estudio de procesos de intercambio de carga electrónico entre iones y blancos atómicos y moleculares. Para energías de impacto entre 0.05 y 5 eV / amu se emplea el método cuántico de la Coordenada de Reacción Común (CRC). A mayores energías, se utiliza el método semiclásico iconal con un desarrollo de la función de onda dinámica en estados moleculares adiabáticos, modificados con un factor de traslación común (FTC). Estos estados pueden obtenerse con cálculos ab initio o empleando potenciales modelo. Cuando la ionización compite con la transferencia de carga, la inclusión de pseudoestados en estos desarrollos permite calcular simultáneamente las secciones eficaces de ambos procesos. Otra técnica utilizada es el método estadístico CTMC. En el tratamiento de colisiones ión-molécula (diatómica) contrastamos la aplicabilidad de distintos métodos, desde la llamada aproximación Franck-Condon hasta un desarrollo en estados vibrónicos, pasando por la aproximación súbita vibro-rotacional, obteniéndose secciones eficaces de captura electrónica total y a estados individuales, así como secciones de excitación vibracional a estados ligados y del continuo (disociación). En todos los casos es necesario calcular superficies de energía y los correspondientes acoplamientos dinámicos entre los estados. La aplicación de estos métodos permite determinar el grado de contaminación de los haces por estados metaestables en un experimento dado, el cambio en los resultados con diferentes isótopos, la importancia de procesos de doble captura, seguida de explosión culombiana, todo ello con precisión comparable a la de medidas experimentales, para sistemas de interés en distintos tipos de plasmas.

Errea, L. F.


Regulando la Enfermedad a trav?s de la Definici?n y la Restricci?n: Profesionales de la Salud Hablan sobre el VIH/SIDA1  

PubMed Central

Resumen Las profesiones de la salud tienen un papel social dual. Por un lado, velan por el mantenimiento de la salud de la población protegiendo el bien común. Por el otro, dictaminan las formas saludables, y por lo tanto socialmente apropiadas, de ser, actuar y pensar. Este último papel, está más ligado al control social de la población que a una preocupación altruista hacia la misma. A través de esta supervisión y control, se construyen los sujetos a los cuales todos/as debemos aspirar a ser para gozar de aceptación social. Los/as profesionales de la salud han jugado un rol protagónico en dicho proceso, siendo los agentes que delimitan y definen lo que es enfermo vs. saludable, útil vs. inútil, apropiado vs. inapropiado. En el caso de la epidemia del VIH, este esfuerzo se ha hecho cada vez más vigente ya que estos/as profesionales juegan un papel importante en el tratamiento de las personas que viven con VIH/SIDA (PVVS). Sin embargo, su función está plasmada de definiciones que sirven para criminalizar a las PVVS. El objetivo de este estudio fue explorar la manera en que una muestra de profesionales de la salud en Puerto Rico construyen a las PVVS. Con este propósito, entrevistamos 80 profesionales de la salud y estudiantes de estas profesiones. Estas entrevistas fueron grabadas, transcritas y sometidas a un análisis de discurso. Los resultados reflejaron que según las personas participantes: 1) la PVVS no es una persona “normal” o funcional bajo los estándares sociales debido a que su salud no se los permite, 2) representa una carga para la sociedad incluyendo familiares, amigos/as, el mundo del trabajo, e incluso para el gobierno, 3) debe ser vigilada porque representa un riesgo para la persona seronegativa que es descrita como saludable y productiva, y 4) necesita que su salud y conducta sexual sean controladas por vía legal y/o por las personas que representan las instituciones sociales, como lo son los/as profesionales de la salud. En este artículo abordamos el potencial rol de la psicología para servir como vehículo de reconstrucción de dichas nociones, tomando en consideración su propio rol en la formación y mantenimiento de dicho sujeto socialmente deseable. PMID:22025907

Rivera, Souhail Malave; Diaz, Nelson Varas



Progress in the prognosis of adult Hodgkin's lymphoma in the past 35 years through clinical trials in Argentina: a GATLA experience.  


The purpose of this study was to evaluate the trends in complete remission (CR) rate, disease-free survival (DFS), and overall survival (OS) through 35 years of Grupo Argentino de Tratamiento de la Leucemia Aguda (GATLA) clinical trials. A total of 1,254 adult patients with Hodgkin's Lymphoma were evaluated according to seven consecutive protocols. This 35-year study was divided into three phases. The patients in the first phase (1968-1985) were treated with CVPP (cyclophosphamide/vinblastine/procarbazine/prednisone) plus involved-field radiotherapy (IFRT). In the CVPP regimen, cyclophosphamide and vinblastine were administered intravenously on day 1 and prednisone and procarbazine were administered orally on days 1-14 every 28 days. The second phase (1986-1996) used mainly reinforced CVPP with cyclophosphamide and vinblastine on days 1-8 plus IFRT. The third phase (1997-2003) used ABVD(doxorubicin/bleomycin/vinblastine/dacarbazine) plus IFRT. In clinical stage I/II, the CR rate was 86% in 252 patients treated in the first phase and DFS and OS were 57% and 78% at 5 years and 50% and 71% at 10 years. The second phase had 148 patients with clinical stage I/II disease, and the CR rate was 91%, 5-year DFS and OS were 78% and 90%, and 10-year DFS and OS were 70% and 83%. The third phase had 182 patients with clinical stage I/II disease, and the CR rate was 95%, 5-year DFS and OS were 87% and 96%, and 10-year DFS and OS were not reached. The statistical difference was P = 0.016 in terms of CR and P < 0.001 in terms of DFS and OS. In the first phase of 394 patients with clinical stage III/IV disease, the CR rate was 71%, DFS and OS at 5 years were 37% and 62%, and DFS and OS at 10 years were 32% and 53%. In the second phase of 164 patients with clinical stage III/IV disease, the CR rate was 84%, DFS and OS at 5 years were 66% and 80%, and DFS and OS at 10 years were 60% and 75%. In the third phase of 114 patients with clinical stage III/IV disease, the CR rate was 88% and DFS and OS at 5 years were 60% and 90%. The DFS and OS were not reached at 10 years. The differences among the 3 phases in CR, DFS and OS were highly significant (P < 0.001). PMID:15453925

Pavlovsky, Santiago; Lastiri, Francisco



Modelizacion, control e implementacion de un procesador energetico paralelo para aplicacion en sistemas multisalida  

NASA Astrophysics Data System (ADS)

Cualquier sistema electronico que incluya un procesado o tratamiento de la senal, y ademas, algun tipo de actuador mecanico generalmente necesita, como minimo, dos tensiones diferentes de alimentacion. Excluyendo los sistemas de alimentacion distribuida, la solucion tecnica mas utilizada para proporcionar dos o mas tensiones consiste en las fuentes de alimentacion multisalida. En una fuente de alimentacion multisalida los diferentes circuitos que conforman cada salida comparten un mismo transformador de potencia optimizando coste, masa, y volumen. Las ventajas obtenidas con este procedimiento tienen en su contra el efecto que sobre cada salida individual provocan las demas en su conjunto debido, principalmente, a los efectos de los elementos parasitos de los componentes. Un cambio de carga en una de las salidas produce un transitorio que es visto por todas las demas como un efecto de impedancia cruzada, y al final del transitorio, la tension de cada salida es diferente respecto a la que tenian antes del transitorio. Este ultimo resultado se conoce como regulacion cruzada. La disminucion de los efectos de la regulacion cruzada ha sido objeto de estudio durante los ultimos anos. El objetivo ha sido el desarrollo de distintas estrategias que permiten, desde disminuir los efectos de la regulacion cruzada hasta los niveles deseables, a eliminarla completamente. El resultado final suele suponer una penalizacion sobre el diseno del sistema directamente proporcional al grado de regulacion a conseguir en las distintas salidas. Entre las soluciones propuestas para eliminar la regulacion cruzada las tecnicas de post-regulacion se han consolidado como la opcion mas aceptada ya que, pueden aplicarse a cualquier convertidor y no suponen ninguna complejidad adicional a la hora de plantear el diseno. En esta Tesis Doctoral se abordara el estudio de la tecnica conocida como postregulacion mediante transformador controlado, que si bien se ha empleado en convertidores resonantes, su modelizacion, y aplicacion en convertidores PWM, esta aun por estudiar y valorar. El primer Capitulo consiste en una breve introduccion al problema de la regulacion cruzada y la impedancia cruzada para posteriormente describir las tecnicas de post-regulacion actualmente mas empleadas, con especial atencion al post-regulador con transformador controlado. El Capitulo segundo trata del estudio de las caracteristicas estaticas del postregulador con transformador controlado. Partiendo de los estudios disponibles sobre el postregulador se plantean mejoras en su modo de actuacion y se discuten tres alternativas diferentes para controlar el transformador. Las dos primeras consisten en emplear un convertidor auxiliar Boost en sus dos modos de funcionamiento, continuo y discontinuo. La tercera consiste en controlar el transformador con una tension PWM directamente, sin filtrado. Finalmente se comprueba experimentalmente, para el estado estacionario, el funcionamiento del post-regulador para cada uno de los tres metodos de control. El Capitulo tercero trata de la dinamica de la salida controlada con el post-regulador cuando este emplea un convertidor auxiliar tipo Boost. Mediante la tecnica de promediado de variables de estado se propone el modelo de pequena senal, tanto para el modo continuo como para el modo discontinuo de funcionamiento del convertidor auxiliar. Los resultados mas significativos de esta seccion son las expresiones analiticas de las impedancias cruzadas y de la impedancia de la salida post-regulada. Como complemento al modelo de pequena senal se plantea un modelo de gran senal implementado sobre el simulador Pspice. Con este nuevo modelo se reproducen los resultados obtenidos con el modelo de pequena senal y ademas es posible simular los transitorios en las tensiones de salida ante cambios de carga. La modelizacion del convertidor cuando el transformador se controla con una tension PWM sin filtrar es el objetivo del Capitulo 4. En las secciones siguientes del Capitulo se plantea el correspondiente modelo de gran senal aplicado a un nuevo prototipo exper

Ferreres Sabater, Agustin


The effects of training in time-limited dynamic psychotherapy: changes in therapeutic outcome.  


The present study explored the effects on therapeutic outcomes of training therapists in brief manualized therapy. As part of the Vanderbilt II project, each of 16 therapists (8 psychiatrists and 8 clinical psychologists) treated 2 moderately disturbed adult patients using his or her customary short-term treatment methods; they then received a year of training in a manualized form of brief dynamic therapy, Time-Limited Dynamic Psychotherapy (TLDP); finally, they administered TLDP to 2 additional patients. It was hypothesized that training would result in improved outcomes generally and that differentially greater improvement would be seen in patients commonly considered less suitable for brief dynamic therapy. Outcome data obtained at termination failed to support either hypothesis. Measurements of interpersonal dependency obtained at a one-year follow-up were consistent with the first hypothesis, but the follow-up data were inconsistent with the second. A systematic review of the 32 posttraining cases suggested that the majority of the therapists had not achieved basic competence at TLDP. Die hier beschriebene Studie untersucht die Wirkungen eines Trainings in manualisierter Kurzzeitherapie auf das Therapierergebnis. Als Teil des Vanderbilt II Projektes behandelten jeweils 16 Therapeuten (8 Psychiater und 8 klinische Psychologen) zwei mittelgradig beeinrächtigte erwachsene Patienten mit den ihnen vertrauten Kurzzeitbehandlungsmethoden. Danach wurden sie über ein Jahr in einer manualisierten Form psychodynamischer Kurzzeittherapie ausgebildet und wandten diese Therapie auf zwei weitere Patienten an. Es wurde angenommen, dass die Ausbildung in besseren Ergebnisdaten, die bei Ende der Therapie erhoben wurden, konnten diese Hypothese nicht bestätigen. Maße für die interpersonale Abhängigkeit zu einem Einjahreskatamnesezeitpunkt waren mit der ersten Hypothese konform, aber inkonsistent mit der zweiten. Eine systematische Untersuchung der 32 nach der Ausbildung behandelten Fälle legt nahe, dass die Mehrzahl der Therapeuten keine grundlegende Kompetenz in zeitlich limitierter dynamischer Psychotherapie erworben hatte. Cette éude explore les effets sur les résultats thérapeutiques de la formation des thérapeutes dans une thérapie brève, manualissée. Dans le cadre du projet Vanderbilt II, chacun des 16 thérapeutes (8 psychiatrs et 8 psychologues cliniciens) a traité deux patients adultes modérément perturbés, chacun par sa méthode habituelle de thérapie brève; ensuite ils ont reçu une formation d'une année dans une méthode manualisée de thérapie brève, la Psychothérapie Dynamique Limitée dans le Temps (TLDP); pour finir, ils ont appliqué la TLDP à de meilleurs résultats en général, et qu'une amélioration comparativement plus importante sera observée chez des patients habituellement considérés comme moins adaptés à une thérapie dynamique brè. Les résultats obtenus à la terminaison n'ont pu confirmer aucune de ces hypothèses. Des mesures de la dépendance interpersonnelle une année après étaient consistantes avec la première hypothèse, mais les données catamnestiques étaient inconsistantes avec la deuxième. Une revue systématique des 32 cas après formation a suggéré que la majorité des thérapeutes n'avait pas acquis une compétence de base en TLDP. Este estudio exploró la efectividad del entrenamiento de terapeutas en una terapia breve manualizada. Como parte del proyecto Vanderbilt II, dieciséis terapeutas (ocho psiquiatras y ocho psicólogos clínicos) trataron dos pacientes adultos mooderadamente perturbados con sus métodos habituales de tratamiento a corto plazo. Estos terapeutas recibieron luego un año de entrenamiento en terapia dinámica breve manualizada que se Ilamó Psicoterapia Dinámica de Tiempo limitado (TLDP). Finalmente, administraron esta TLDP a dos pacientes más. La hipótesis fue que el entrenamiento ilevaría, en general, a resultados mejores y que habría mayor mejoramiento en pacientes menos aptos para una terapia dinámica breve. Los resultados

Bein, E; Anderson, T; Strupp, H; Henry, W; Schacht, T; Binder, J; Butler, S



Impact of Chloroquine on Viral Load in Breast Milk  

PubMed Central

Summary The anti-malarial agent chloroquine has activity against HIV. We compared the effect of chloroquine (n = 18) to an anti-malarial agent without known anti-HIV-activity, sulfadoxine-pyrimethamine (n = 12), on breast milk HIV RNA levels among HIV-infected breastfeeding women in Zambia. After adjusting for CD4 count and plasma viral load, chloroquine was associated with a trend towards lower levels of HIV RNA in breast milk compared with sulfadoxine-pyrimethamine (P 0.05). Higher breastmilk viral load was also observed among women receiving presumptive treatment = for symptomatic malaria compared with asymptomatic controls and among controls reporting fever in the prior week. Further research is needed to determine the potential role of chloroquine in prevention of HIV transmission through breastfeeding. Impacte de la chloroquine sur la charge virale dans le lait maternelle La chloroquine, agent antimalarique, a une activité contre le VIH. Nous avons comparé l’effet de la chloroquine à celui d’un autre agent antimalarique, la sulfadoxine-pyrimethamine, dont l’activité sur le VIH n’est pas connue, en mesurant les taux d’ARN de VIH dans le lait maternel de femmes allaitantes infectées par le VIH en Zambie. Après ajustement pour les taux de CD4 et la charge virale dans le plasma, la chloroquine comparée à la sulfadoxine pyrimethamine était associée à une tendance vers des teneurs plus bas en ARN de VIH dans le lait maternel (P = 0,05). Des charges virales plus élevées dans le lait maternel étaient aussi observées chez des femmes recevant un traitement présomptif pour des symptômes de malaria par rapport aux contrôles asymptomatiques et par rapport à des contrôles rapportant de la fièvre durant la première semaine. Des études supplémentaires sont nécessaires pour déterminer le rôle potentiel de la chloroquine dans la prévention de la transmission du VIH par l’allaitement maternel. mots clésVIH, malaria, allaitement maternel, chloroquine, sulfadoxine-pyrimethamine, charge virale du lait maternel, fièvre Impacto de la cloroquina en la carga viral de la leche materna El antimalárico cloroquina tiene actividad frente al VIH. Comparamos el efecto de la cloroquina (n = 18) frente a un antimalárico sin actividad anti-VIH conocida, la sulfadoxina-pirimetamina (n = 12), en los niveles de ARN en la leche materna de mujeres infectadas con VIH, en Zambia. Después de ajustar para recuento de CD4 y la carga viral en plasma, se asoció a la cloroquina con una tendencia hacia menores niveles de ARN del VIH en leche materna, comparado con la sulfadoxina pirimetamina (P = 0.05). También se observó una mayor carga viral en la leche materna de mujeres recibiendo tratamiento presuntivo para malaria sintomática, que en los controles asintomáticos y controles que habáan reportado fiebre la semana anterior. Es necesario realizar más estudios para determinar el papel potencial de la cloroquina en la prevención de la trasmisión de VIH a través de la lactancia materna. palabras claveVIH, malaria, lactancia materna, cloroquina, sulfadoxina pirimetamina, transmisión vertical, leche materna, carga viral, fiebre PMID:16772000

Semrau, Katherine; Kuhn, Louise; Kasonde, Prisca; Sinkala, Moses; Kankasa, Chipepo; Shutes, Erin; Vwalika, Cheswa; Ghosh, Mrinal; Aldrovandi, Grace; Thea, Donald M.