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Sample records for pectus excavatum tratamiento

  1. Pectus excavatum repair - slideshow

    MedlinePlus

    ... Go to slide 4 out of 4 Normal anatomy Overview Pectus excavatum is a deformity of the ... M. is among the first to achieve this important distinction for online health information and services. Learn ...

  2. Pectus excavatum: history, hypotheses and treatment options

    PubMed Central

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

    2012-01-01

    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

  3. Thoracic outlet syndrome after corrective surgery for pectus excavatum.

    PubMed

    Donders, H P; Geelen, J A

    1988-02-01

    Two patients are described who developed a thoracic outlet syndrome (TOS) after undergoing Ravitch's operation for the correction of pectus excavatum. In one case the syndrome developed a few days after surgery, whereas in the second patient it manifested more gradually. A third patient presented with latent TOS and pectus excavatum. It is recommended that prior to the correction of pectus excavatum, the patient should be examined to detect signs of neurovascular compression due to latent thoracic outlet syndrome. After surgery the possibility of this complication should be kept in mind to avoid permanent lesions of the cervicobrachial plexus. PMID:3352940

  4. Is breast asymmetry caused by volume differences in women with pectus excavatum?

    PubMed

    Rha, Eun Young; Kim, Ji-Min; Yoo, Gyeol; Jeong, Jin Yong; Hwang, Duck Ki; Kim, Ki Jun

    2016-04-01

    This study determined the breast volumes of female patients with pectus excavatum that led to asymmetry and hypoplasia compared with normal women. This retrospective study enrolled 13 patients diagnosed with pectus excavatum and 13 normal women, randomly selected from a healthcare centre (n = 26), between January 2012 and December 2014. We measured breast volumes (n = 52) based on chest computed tomography (CT) of all patients using Image J software and divided them into four groups according to the side and presence of pectus excavatum. The mean volumes of the right and left breasts of patients with pectus excavatum were 209 ± 64 mL and 218 ± 67 mL, respectively, with no significant difference between the two groups (P = 0.736). The mean volumes of the right and left breasts of normal women were 415 ± 197 mL and 439 ± 197 mL, respectively, with no significant difference between the two groups (P = 0.754). The breasts of patients with pectus excavatum were significantly smaller than those of normal women (P < 0.001). Both breasts of patients with pectus excavatum were similar in size but were smaller than the breasts of normal women. Skeletal correction for breast asymmetry correction, followed by breast augmentation for breast hypoplasty correction, with a one- or two-step approach may be useful to improve the aesthetics of breast deformities in women with pectus excavatum. PMID:26776347

  5. CASE REPORT A Double Thoracodorsal Artery Perforator Flap Technique for the Treatment of Pectus Excavatum

    PubMed Central

    Sinna, Raphaël; Perignon, David; Qassemyar, Quentin; Benhaim, Thomas; Dodreanu, Codrin N.; Berna, Pascal; Delay, Emmanuel

    2010-01-01

    Background: Pectus excavatum is a common congenital deformity involving the anterior thoracic wall. It can be treated with several surgical approaches. Material and methods: To our best of knowledge, this is the first case of pectus excavatum repair via a 2-stage double thoracodorsal artery perforator flap procedure in a 37-year-old patient. Results: We obtained a satisfactory result in which the missing volume was correctly replaced in the absence of dorsal sequelae. The patient was very satisfied despite the dorsal scars. Conclusion: This new approach broadens the surgeon's options for the correction of thoracic deformities. PMID:20458352

  6. Management of severe asymmetric pectus excavatum complicating aortic repair in a patient with Marfan's syndrome.

    PubMed

    Yeung, Jonathan C; Marcuzzi, Danny; Peterson, Mark D; Ko, Michael A

    2016-05-01

    We describe the case of a 28-year old man with Marfan's syndrome and severe pectus excavatum who required an aortic root replacement for an ascending aortic aneurysm. There was a near-vertical angulation of the sternum that presented challenges with opening and exposure of the heart during aortic surgery. Furthermore, removal of the sternal retractor after aortic repair resulted in sudden loss of cardiac output. A Ravitch procedure was then performed to successfully close the chest without further cardiovascular compromise. We propose that patients with a severe pectus excavatum and mediastinal displacement seen on preoperative CT scanning should be considered for simultaneous, elective repair. PMID:26874148

  7. Pectus Excavatum and Pectus Carinatum: Associated Conditions, Family History, and Postoperative Patient Satisfaction

    PubMed Central

    Kuru, Pinar; Cakiroglu, Aylin; Er, Aynur; Ozbakir, Hincal; Cinel, Ali Emin; Cangut, Busra; Iris, Merve; Canbaz, Berkay; Pıçak, Ebru; Yuksel, Mustafa

    2016-01-01

    Background Pectus excavatum (PE) and pectus carinatum (PC) are the most common chest wall deformities. In this study, we aimed to characterize how patients obtained information about these deformities, as well as patients’ family history, associated medical problems, and postoperative satisfaction after the Nuss and Abramson procedures. Methods This cross-sectional retrospective study included patients who were operated by a single surgeon between 2006 and 2013. Follow-up calls were made after approval of our institution’s ethics committee. We reached 207 of the 336 PE patients (61.6%) and 73 of the 96 PC patients (76%). Results The majority of the patients were male (85% of the PE patients and 91.8% of the PC patients). The age of diagnosis of PE was 14.52±0.51 years and the age at the time of operation was 17.89±0.42 years; for PC patients, the corresponding ages were 15.23±0.55 years and 16.77±0.55 years, respectively. A total of 70% of the PE patients and 63.8% of the PC patients obtained information about pectus deformities through the Internet. In 27.1% of the PE patients with an associated anomaly, 57.1% (n=13) had scoliosis, while 41.1% of the PC patients with an associated anomaly had kyphosis (n=5). Postoperative satisfaction, as evaluated on a scale from 0 to 10, was 8.17±0.15 for PE patients and 8.37±0.26 for PC patients. The postoperative pain duration was 51.93±5.18 days for PE patients and 38.5±6.88 days for PC patients. Conclusion In this study, we found that most patients with pectus deformities were male. The Internet was an important resource for patients to learn about their deformities. Family history and associated anomalies were identified as important aspects for consideration in the clinical setting. The patients reported high levels of postoperative satisfaction, and pain management was found to be one of the most important elements of postoperative care. PMID:26889443

  8. Nuss technique in pectus excavatum: a mono-institutional experience

    PubMed Central

    2015-01-01

    Background Pectus excavatum (PE) is the most common anomaly of the anterior chest wall. Prior PE was corrected by a modified Ravitch operation, but since Nuss published his minimal technique in 1998, most surgeons have preferred this technique. Methods Since 2001 the modified Nuss procedure has routinely been used for correction of more than 1,500 patients at Aarhus University Hospital. In the time period between January 1, 2011 and January 31, 2015, 675 patients have been corrected. The median age was 16 years (range, 11-58 years). All patients had preoperatively an epidural catheter and the operations were done in general anaesthesia. The postoperative pain treatment was planned for 4-5 weeks and the patients were routinely seen in the outpatient clinic 6 weeks after surgery and the bars removed after 3 years. Results Four hundred-and-fifty patients had one bar, 216 patients with two bars and nine patients with three bars inserted. The median length of the bar was 10 inch. The median duration of the operation was 29 minutes. The median postoperative stay was 3 days. No death, cardiac perforation or deep infection occurred and only 5% of the patients experienced a complication. Conclusions The Nuss procedure should still be considered in the treatment of PE. To my opinion, it should be the choice for correction of PE. The short bar should be used to achieve the best stability of the system, to obtain a good cosmetic result, a reduced dysfunction motion of the chest wall and an increased cardiac performance. PMID:25984364

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

    NASA Astrophysics Data System (ADS)

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

    2011-03-01

    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.

  10. Fatal reexpansion pulmonary edema in a kitten following surgical correction of pectus excavatum.

    PubMed

    Soderstrom, M J; Gilson, S D; Gulbas, N

    1995-01-01

    Fulminant, fatal pulmonary edema developed in an eight-week-old kitten following external splint correction of severe pectus excavatum. History, signalment, onset of clinical signs, and gross pathological findings were most compatible with a diagnosis of reexpansion pulmonary edema (RPE). This report presents case findings and a literature review of RPE. PMID:7773758

  11. Advancing our understanding of the inheritance and transmission of pectus excavatum

    PubMed Central

    Horth, Lisa; Stacey, Michael W.; Proud, Virginia K.; Segna, Kara; Rutherford, Chelsea; Nuss, Donald; Kelly, Robert E.

    2012-01-01

    Pectus excavatum is the most common congenital chest wall abnormality expressed in children, yet its inheritance is poorly understood. Here we present the first comprehensive assessment of the inheritance of this disorder. After evaluating 48 pedigrees and 56 clinical traits of probands and family members, we find strong evidence of autosomal recessive, genetic control for this disorder. Additionally there is likely more than one pectus disease-associated allele, as well as a relatively large number of disease allele carriers in the human population. Some clinical traits appear important and may serve as reliable indicators for predicting the likelihood of pectus excavatum in children before severe symptoms present. Quantifying sex-ratio bias in probands demonstrates a highly significant male bias associated with pectus excavatum. When combined with pedigree data, sex-bias is indicative of sex-linked, sex-limited, and/or epigenetic control such as X-inactivation, reiterating a point made with pedigrees alone, which is that more than one mutation is likely responsible for this disorder.

  12. Pectus excavatum in relief from Ancient Egypt (dating back to circa 2400 BC).

    PubMed

    Bialas, Adam J; Kaczmarski, Jacek; Kozak, Jozef; Kempinska-Miroslawska, Bogumila

    2015-04-01

    Pectus excavatum is one of the most common congenital deformities of the chest wall. The aim of the study was to analyse 621 artefacts (reliefs, sculptures, paintings) from Ancient Egypt in terms of anatomical defects of the chest. The team which analysed artefacts consisted of historians of medicine and thoracic surgeons. The researchers found a relief, depicting a man with an abnormal shape of the chest. The relief was from Niankhkhnum and Khnumhotep mastaba and dates back to circa 2400 BC. The authors think it is possible that the relief may represent a pectus excavatum deformity and believe the image will open up debate on the occurrence of this deformity in ancient times. PMID:25564580

  13. Variation of the Anthropometric Index for pectus excavatum relative to age, race, and sex

    PubMed Central

    Rebeis, Eduardo Baldassari; de Campos, Jose Ribas Milanez; Moreira, Luis Felipe Pinho; Pastorino, Antonio Carlos; Pêgo-Fernandes, Paulo Manuel; Jatene, Fabio Biscegli

    2013-01-01

    OBJECTIVES: To determine possible variations in the Anthropometric Index for pectus excavatum relative to age, race, and sex in individuals free of thoracic wall deformities. METHODS: Between 2002 and 2012, 166 individuals with morphologically normal thoracic walls consented to have their chests and the perimeter of the lower third of the thorax measured according to the Anthropometric Index for pectus excavatum. The participant characteristics are presented (114 men and 52 women; 118 Caucasians and 48 people of African descent). RESULTS: Measurements of the Anthropometric Index for pectus excavatum were statistically significantly different between men and women (11–40 years old); however, no significant difference was found between Caucasians and people of African descent. For men, the index measurements were not significantly different across all of the age groups. For women, the index measurements were significantly lower for individuals aged 3 to 10 years old than for individuals aged 11 to 20 years old and 21 to 40 years old; however, no such difference was observed between women aged 11 to 20 years old and those aged 21 to 40 years old. CONCLUSION: In the sample, significant differences were observed between women aged 11 to 40 years old and the other age groups; however, there was no difference between Caucasian and people of African descent. PMID:24141837

  14. Simultaneous aortic valve replacement and pectus excavatum correction in a 76-year-old man.

    PubMed

    Suzuki, Shigemitsu; Kiyokawa, Kensuke; Nakamura, Katsuhiko; Kashikie, Hideyuki; Akaiwa, Keiichi; Watanabe, Koichi; Hara, Shigeru

    2014-01-01

    A 76-year-old man was admitted to our department to undergo surgical treatment for aortic valve regurgitation. On physical examination, a bowl-shaped concavity was noted. Chest computed tomography revealed left-sided heart displacement by severe pectus excavatum with a Haller index of 6.40. Considering the postoperative cardiopulmonary complications that may result from mechanical compression due to uncorrected sternal deformities, we decided to perform a simultaneous aortic valve replacement and pectus excavatum correction. The operation time was long (570 min) and involved a high-volume transfusion due to excessive bleeding caused by resection of the deformed costal cartilages and sternal osteotomy under the use of heparin. The endotracheal tube was removed on the fifth postoperative day, but reintubation was required because of hypercapnea and difficulty in sputum discharge. With the aid of tube feeding for nutritional management, his cardiopulmonary function gradually ameliorated and his general condition improved. Consequently, he was weaned from mechanical ventilation on the 14th postoperative day. The patient is doing well 1 year after surgery. We report on the surgical management for pectus excavatum in adult patients. PMID:24088909

  15. Pulmonary scintigraphic findings in children with pectus excavatum by the comparison of chest radiograph indices.

    PubMed

    Kao, C H; Liao, S Q; Wang, S J; Yeh, S H

    1992-11-01

    Pulmonary scintigraphy, including Xe-133 ventilation combined with Tc-99m MAA perfusion scans, was performed in 23 children (3 girls, 20 boys, ages: 2-9 years) with pectus excavatum, and the indices from lateral chest radiography were used for comparison. The findings of pulmonary scintigraphy were analyzed as 1) ventilation fractions (VF), and 2) perfusion fractions (PF) between bilateral lungs; and 3) ventilation-perfusion ratios (V/Q ratio) of both lungs. The results showed that 6 of 23 cases had impaired VF, 11 of 23 cases had impaired PF, and 7 of 23 cases had an impaired V/Q ratio in the right and left lung, respectively. The severity of sternal depression in pectus excavatum was shown as certain indices that were obtained on routine lateral chest radiographs. However, no significant correlations existed between the differences in the fractions and the indices. Our results suggest that pulmonary scintigraphy is not necessary for children with pectus excavatum to predict the severity of sternal depression and pulmonary function, because 1) pulmonary scintigraphy is very difficult to perform in children; 2) unnecessary radiation exposure should be avoided; and 3) it is not well correlated with the severity of the depressed sternum. PMID:1424376

  16. Pectus excavatum; a clinical study with long term postoperavtive follow-up.

    PubMed

    Gyllenswärd, A; Irnell, L; Michaëlsson, M; Qvist, O; Sahlstedt, B

    1975-01-01

    There are divergent views about the harm that pectus excavatum and related chest deformities does to the respiratory and heart function. The indications for surgery and the optimal age for surgical intervention are debatable. In this study 37 operated and 38 nonoperated cases of about the same severity have been followed for more than ten years and examined after the age of 18 years. The examination included socio-economic, cosmetic and cardio-pulmonary function aspects. It could be shown that from the psychological aspect there were no significant differences between the operated and the non-operated cases. The tendency to contract bronchopneumonia is not influenced by operation. The physical working capacity was the same in the two groups. The operated cases have slightly lower pulmonary function values that the non-operated in spite of the fact that the non-operated group at the time of follow-up included the more seveee cases. Age at operation did not seem to be of any importance for the long-term results. The lower pulmonary function capacity in the operated cases is thought to be attributed to a restriction secondary to the operation. There are also indications that pectus excavatum tends to become less pronounced with increasing age. The study supports a restrictive attitude towards surgery. PMID:1058627

  17. The use of soft silicone solid implant molded intraoperatively for pectus excavatum surgical repair

    PubMed Central

    Anger, Jaime; Alcalde, Raphael Francisco Vesterman; de Campos, Jose Ribas Milanez

    2014-01-01

    ABSTRACT Objective: To describe a new surgical technique to treat pectus excavatum utilizing low hardness solid silicone block that can be carved during the intraoperative period promoting a better aesthetic result. Methods: Between May 1994 and February 2013, 34 male patients presenting pectus excavatum were submitted to surgical repair with the use of low hardness solid silicone block, 10 to 30 Shore A. A block-shaped parallelepiped was used with height and base size coinciding with those of the bone defect. The block was carved intraoperatively according to the shape of the dissected space. The patients were followed for a minimum of 120 days postoperatively. The results and the complications were recorded. Results: From the 34 patients operated on, 28 were primary surgeries and 6 were secondary treatment, using other surgical techniques, bone or implant procedures. Postoperative complications included two case of hematomas and eight of seromas. It was necessary to remove the implant in one patient due to pain, and review surgery was performed in another to check prothesis dimensions. Two patients were submitted to fat grafting to improve the chest wall contour. The result was considered satisfactory in 33 patients. Conclusion: The procedure proved to be fast and effective. The results of carved silicone block were more effective for allowing a more refined contour as compared to custom made implants. PMID:25003924

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

    NASA Astrophysics Data System (ADS)

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

    2014-03-01

    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.

  19. Descending aortic replacement after Nuss for pectus excavatum in a Marfan patient—Case report

    PubMed Central

    Jaroszewski, Dawn; Ewais, MennatAllah; DeValeria, Patrick; Gotway, Michael; Craig Miller, D.

    2016-01-01

    Introduction The Nuss procedure for pectus excavatum (PE) repair has been successfully performed in Marfan syndrome (MFS) patients however there is concern for future risk of aortic dilation/rupture and need for emergent access with support bars in place. Case presentation We present a 45 year-old male with MFS that required descending aortic replacement shortly after modified Nuss repair. Discussion The majority of MFS patients have severe PE and repair with the Nuss procedure is not uncommon. The risk for life threatening aortic dilation, dissection, or rupture in such patients is a concern when utilizing this technique. Our work has been reported in line with the CARE criteria. Conclusion Nuss repair should be considered in MFS patients with technique modifications and careful consideration of future risk of aortic dilation and rupture. PMID:26895112

  20. Minimally invasive repair of pectus excavatum (MIRPE) in adults: is it a proper choice?

    PubMed Central

    Demirkaya, Ahmet; Kılıç, Burcu; Kara, Hasan Volkan; Yakşi, Osman; Alizade, Nurlan; Demirhan, Özkan; Sayılgan, Cem; Turna, Akif; Kaynak, Kamil

    2016-01-01

    Introduction The Nuss procedure is suitable for prepubertal and early pubertal patients but can also be used in adult patients. Aim To determine whether the minimally invasive technique (MIRPE) can also be performed successfully in adults. Material and methods Between July 2006 and January 2016, 836 patients (744 male, 92 female) underwent correction of pectus excavatum with the MIRPE technique at our institution. The mean age was 16.8 years (2–45 years). There were 236 adult patients (28.2%) (> 18 years) – 20 female, 216 male. The mean age among the adult patients was 23.2 years (18–45 years). The recorded data included length of hospital stay, postoperative complications, number of bars used, duration of the surgical procedure and signs of pneumothorax on the postoperative chest X-ray. Results The MIRPE was performed in 236 adult patients. The average operative time was 44.4 min (25–90 min). The median postoperative stay was 4.92 ±2.81 days (3–21 days) in adults and 4.64 ±1.58 (2–13) in younger patients. The difference was not statistically significant (p = 0.637). Two or more bars were used in 36 (15.8%) adult patients and in 44 (7.5%) younger patients. The difference was not statistically significant either (p = 0.068). Regarding the overall complications, complication rates among the adult patients and younger patients were 26.2% and 11.8% respectively. The difference was statistically significant (p = 0.007). Conclusions MIRPE is a feasible procedure that produces good long-term results in the treatment of pectus excavatum in adults. PMID:27458490

  1. Off-pump minimally invasive direct coronary artery bypass in patients with cosmetic prosthesis for pectus excavatum.

    PubMed

    Massi, Francesco; Manca, Mario; Muretti, Mirko; Portoghese, Michele

    2016-08-01

    Pectus excavatum can be associated with coronary artery diseases that can become difficult to manage in urgent situations. We describe the use of an off-pump minimally invasive direct coronary artery bypass (MIDCAB) through the fourth intercostal space incision in a patient with pectus excavatum and acute coronary syndrome who previously underwent a cosmetic prosthesis implantation. The patient refused any surgical procedure that could compromise the integrity of his cosmetic prosthesis and a left mini-thoracotomy was a good option to avoid the removal of the prosthesis. The preservation of the integrity of the thoracic cage enhanced chest wall stability and pulmonary function and permitted avoidance of inadvertent cardiac structure iatrogenic injuries. MIDCAB was optimal for the exposure of the left internal thoracic artery and the left anterior descending artery. The deformity of the chest should not be considered as an absolute contraindication to off-pump MIDCAB when other surgical options are not viable, even in emergency situations. PMID:27170745

  2. Early complications of the Nuss procedure for pectus excavatum: a prospective study.

    PubMed

    Castellani, Christoph; Schalamon, Johannes; Saxena, Amulya K; Höellwarth, Michael E

    2008-06-01

    The Nuss procedure is a minimally invasive method for the correction of pectus excavatum, with several centers reporting its successful application. Complications related to the Nuss procedure are not uncommon and life-threatening complications have been reported. This study focuses on the incidence and management of complications in a series of 167 children and adults with funnel chest corrected by Nuss procedure. Guidelines and strategies to avoid the most common and typical complications are proposed. All patients with funnel chest, operated between April 2000 and 2006 were evaluated prospectively. Our surgical approach involved the submuscular insertion of the pectus bar under right-sided thoracoscopic control. The bar was secured in most cases with one stabilizer on the right side on the underlying rib to prevent bar displacement. Postoperative pain was primarily managed by epidural catheters. All data in the patient report forms was prospectively entered in a database. All complications were documented and classified into major or minor complication. A major complication was noted, if an organ injury occurred or if a significant surgical intervention became necessary. A minor complication was documented, if either an endoscopy or an evacuation of fluid or gas from the thorax by puncture were necessary. One hundred and sixty seven patients (136 males and 31 females) with a mean age of 16.3 (range 5-40 years) were included in this study. Major complications occurred in seven patients (4.2%) and consisted of one intraoperative heart perforation, one piercing of the liver with the trocar, bar infections (n = 2) and significant bar displacement (n = 3). Minor complications were seen in 122 patients (73.1%) and consisted of breakage of wires used to secure the lateral stabilizer plate (n = 48), pleural effusions (n = 28), intraoperative rupture of the intercostal muscle (n = 15), pericardial tears without clinical significance (n = 7) and lung atelectasia (n = 4

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

    PubMed Central

    2014-01-01

    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

  4. Semi-automatic 3D segmentation of costal cartilage in CT data from Pectus Excavatum patients

    NASA Astrophysics Data System (ADS)

    Barbosa, Daniel; Queirós, Sandro; Rodrigues, Nuno; Correia-Pinto, Jorge; Vilaça, J.

    2015-03-01

    One of the current frontiers in the clinical management of Pectus Excavatum (PE) patients is the prediction of the surgical outcome prior to the intervention. This can be done through computerized simulation of the Nuss procedure, which requires an anatomically correct representation of the costal cartilage. To this end, we take advantage of the costal cartilage tubular structure to detect it through multi-scale vesselness filtering. This information is then used in an interactive 2D initialization procedure which uses anatomical maximum intensity projections of 3D vesselness feature images to efficiently initialize the 3D segmentation process. We identify the cartilage tissue centerlines in these projected 2D images using a livewire approach. We finally refine the 3D cartilage surface through region-based sparse field level-sets. We have tested the proposed algorithm in 6 noncontrast CT datasets from PE patients. A good segmentation performance was found against reference manual contouring, with an average Dice coefficient of 0.75±0.04 and an average mean surface distance of 1.69+/-0.30mm. The proposed method requires roughly 1 minute for the interactive initialization step, which can positively contribute to an extended use of this tool in clinical practice, since current manual delineation of the costal cartilage can take up to an hour.

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

    PubMed Central

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

    2014-01-01

    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

  6. Nuss procedure for repair of pectus excavatum after failed Ravitch procedure in adults: indications and caveats

    PubMed Central

    Kocher, Gregor J.; Gstrein, Nathalie; Jaroszewski, Dawn E.; Ewais, Mennatallah M.

    2016-01-01

    Background Recurrence of pectus excavatum (PE) is not an uncommon problem after open repair using the Ravitch technique. The optimal approach for redo surgery is still under debate, especially in adults with less chest wall pliability. Aim of this study was to investigate the usefulness and efficacy of the minimally invasive Nuss technique for repair of recurrent PE after conventional open repair. Methods We performed a retrospective multicentre review of 20 adult patients from University Hospital Bern (n=6) and the US Mayo Clinic (n=14) who underwent minimally invasive repair of recurrent PE after unsuccessful prior Ravitch procedure. Results Mean patient age at primary open correction was 21 years, with recurrence being evident after a mean duration of 10.5 years (range, 0.25–47 years). Mean age at redo surgery using the Nuss technique was 31 years, with a mean Haller index of 4.7 before and 2.5 after final correction. Main reason for redo surgery was recurrent or persistent deformity (100%), followed by chest pain (75%) and exercise intolerance (75%). No major intraoperative or postoperative complications occurred and successful correction was possible in all patients. Conclusions Although the procedure itself is more challenging, the minimally invasive Nuss technique can be safely and successfully used for repair of recurrent PE after failed open surgery. In our series final results were good to excellent in the majority of patients without major complications or recurrence.

  7. Open surgical correction combined with an external splint for correction of a non-compliant pectus excavatum in a cat.

    PubMed

    Mestrinho, Lisa A; Ferreira, Carina A; Lopes, António M; Niza, Maria Mre; Hamaide, Annick J

    2012-02-01

    A 4-month-old domestic shorthair female cat weighing 1.3 kg was presented for evaluation of respiratory distress. The animal showed evident dyspnoea with exercise intolerance and a marked concave deformation of the sternum. After measurements of the fronto-sagittal and vertebral indexes, the pectus was classified as moderate and surgery was elected. Surgical correction was performed using an open approach to the sternum with osteotomy of the last sternebra and costochondral junctions of the eighth and ninth ribs bilaterally. A silicone based, U-shape external splint was manufactured and used to stabilise the sternum. Immediate and 5-week postsurgical radiographs revealed a decreased concavity of the sternum and an increase thoracic height at the level of the last sternebra. Postoperative results suggest that this technique could be an effective and economical option for cats with pectus excavatum with a non-compliant sternum. PMID:22314092

  8. Pectus excavatum postsurgical outcome based on preoperative soft body dynamics simulation

    NASA Astrophysics Data System (ADS)

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

    2012-02-01

    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.

  9. Genetic Linkage Localizes an Adolescent Idiopathic Scoliosis and Pectus Excavatum Gene to the 18q Chromosome

    PubMed Central

    Gurnett, Christina A; Alaee, Farhang; Bowcock, Anne; Kruse, Lisa; Lenke, Lawrence G.; Bridwell, Keith H.; Kuklo, Timothy; Luhmann, Scott J.; Dobbs, Matthew B.

    2009-01-01

    Study Design A single large family, in which adolescent idiopathic scoliosis (AIS) and pectus excavatum (PE) segregate as an autosomal dominant condition, was evaluated. Genome-wide linkage analysis and candidate gene sequencing were performed. Objective To map the disease-causing locus in a large Caucasian family in which AIS and PE co-segregate. Summary of Background Data AIS and PE are common musculoskeletal conditions known to have a genetic component, though few genes have been identified for either. Genetic studies have been confounded by a lack of large families in which the disorders segregate. Methods Clinical examinations were performed on the proband, who underwent posterior spinal fusion, and twelve additional affected family members. To map a gene causing AIS and PE, a genome-wide linkage analysis was performed with the Affymetrix Mapping 10K XbaI array on thirteen affected and ten unaffected family members. Candidate genes were sequenced. Results AIS was present in thirteen female family members and PE was present in three males and one female. Genome-wide linkage analysis resulted in a linkage peak on chromosome 18q with a maximum parametric multipoint logarithm of the odds (LOD) score of 3.86. Recombinants delineated the critical genetic region to an interval of 6.4 cM between SNP_A-1519369 and SNP_A-1507702, corresponding to a 7.06 Mb region (hg18: chr18:26342508-34395660). The chromosome 18q linkage region contains more than 30 genes. Re-sequencing of the coding regions of 21 candidate genes in the region did not reveal any causative mutation. Conclusion Linkage analysis in this large family demonstrated a novel locus for AIS and PE on chromosome 18q. Because of the increased frequency of PE in family members of AIS patients, consideration of family members with PE as affected may increase the power of AIS genetic linkage studies. PMID:19139660

  10. Surgical correction of 639 pectus excavatum cases via the Nuss procedure

    PubMed Central

    Zhang, Dong-Kun; Tang, Ji-Ming; Ben, Xiao-Song; Xie, Liang; Zhou, Hai-Yu; Ye, Xiong; Zhou, Zi-Hao; Shi, Rui-Qing; Xiao, Pu

    2015-01-01

    Background To review the clinical experience and short- to middle-term effects of the Nuss procedure for correction of pectus excavatum (PE). Methods From September 2006 to August 2014, 639 patients with PE were treated using the Nuss procedure. Of these, 546 were male and 93 were female. The mean age was 15.3±5.8 years (2.5-49 years). Preoperative chest CT scans Haller index (HI) was 4.3±1.7 (2.9-17.4), with 75 cases of mild PE (HI <3.2), 114 cases of moderate PE (HI 3.2-3.5), 393 cases of severe PE (HI 3.6-6.0), and 57 cases of extremely severe PE (HI >6.0). Results A total of 638 patients successfully completed the surgery, an 11-year-old male patient who died after the surgery had undergone ventricular septal defect closure surgery through a sternal incision 7 years ago. The mean operative time was 64.3±41.7 min (40-310 min). Excluding the patient who died, the average blood loss was 24.5±17.8 mL (10-160 mL). The average length of postoperative hospital stay was 5.2±2.9 days (4-36 days). A total of 484 cases (75.7%) required 1 steel bar insertion, 153 cases (24.0%) required 2 steel bars, and 2 cases (0.3%) required 3 bars. Postoperative evaluation of the surgery outcomes revealed the following: excellent in 504 cases, good in 105, fair in 28 and poor in 2, good quality rate was 95.3%. Conclusions Correction of PE via the Nuss procedure is minimally invasive and simple to perform with good short and mid-term effects, while long-term efficacy remains to be determined. PMID:26543607

  11. Combined mitral valve replacement associated with the Bentall procedure, diaphragmatic hernia repair and reconstruction of the pectus excavatum in a 26-year-old patient with Marfan syndrome

    PubMed Central

    Stępiński, Piotr; Aboul-Hassan, Sleiman Sebastian; Szymańska, Anna; Marczak, Jakub; Cichoń, Romuald

    2016-01-01

    A 26-year-old man with Marfan syndrome was admitted as an emergency patient with ascending aorta aneurysm, severe mitral and aortic regurgitation, diaphragmatic hernia and pectus excavatum. After completion of diagnostics a combined surgical procedure was performed. PMID:27516786

  12. The study of physicochemical properties of stabilizing plates removed from the body after treatment of pectus excavatum.

    PubMed

    Kajzer, Anita; Kajzer, Wojciech; Dzielicki, Józef; Matejczyk, Dawid

    2015-01-01

    This paper presents the results of a physicochemical surface study and clinical observation of a new generation of plates for the treatment of pectus excavatum. Analysis of the data allowed us to investigate the effect of implant design and condition of their surface on the results of treatment of pectus excavatum. In the study, we performed an analysis of clinical data, obtained after a suitable period of treatment with the use of implants, as well as a study of physicochemical properties of stabilizing plates after their removal from the body. Surface roughness, the surface wettability and corrosion resistance were measured, and the results were compared with clinical observations. When removing the plates we found only slight inflammatory-periosteal reactions around the wire fixing transverse stabilizing plates to the ribs and locking the base plate correcting the distortion. The corrective plates did not shift or rotate during the entire treatment period, giving an optimal, oval and natural shape of the chest. The obtained values of the parameters investigated indicate that the reduction in resistance to pitting corrosion occurred in the areas where laser marking was made to identify the plate. The remaining plates, in spite of mechanical damage of the surface, were characterized by good corrosion resistance, a fact which is confirmed by the results of clinical evaluation. PMID:26400194

  13. Revision breast and chest wall reconstruction in Poland and pectus excavatum following implant complication using free deep inferior epigastric perforator flap

    PubMed Central

    Dionyssiou, Dimitrios; Demiri, Efterpi; Batsis, Georgios; Pavlidis, Leonidas

    2015-01-01

    This study aims to present the case of a female patient with Poland's syndrome and pectus excavatum deformity who underwent breast and chest wall reconstruction with a pre-shaped free deep inferior epigastric perforator flap. A 57-year-old female patient with Poland's syndrome and pectus excavatum presented with a Baker III capsular contracture following a previously performed implant-based right breast reconstruction. After a chest and abdominal CT angiography, she was staged as 2A1 chest wall deformity according to Park's classification and underwent implant removal and capsulectomy, followed by a pre-shaped free abdominal flap transfer, providing both breast reconstruction and chest wall deformity correction in a single stage operation. Post-operative course was uneventful, and the aesthetic result remains highly satisfactory 24 months after surgery. Deep inferior epigastric free flap represents an interesting reconstructive solution when treating Poland's syndrome female patients with chest wall and breast deformities. PMID:25991894

  14. Postoperative epidural analgesia for patients undergoing pectus excavatum corrective surgery: a 10-year retrospective analysis

    PubMed Central

    Siddiqui, Asad; Tse, Andrew; Paul, James E; Fitzgerald, Peter; Teh, Bernice

    2016-01-01

    Introduction Managing postoperative pain in patients undergoing minimally invasive pectus excavatum repair (Nuss procedure) is challenging but essential in facilitating ambulation and minimizing the length of stay. Although multiple epidural regimens with varying opioids are presently used for pain management, there is currently no clinical consensus regarding which epidural regimen provides the best analgesia outcomes with the fewest side effects. This 10-year retrospective cohort study was performed to compare the quality of analgesia and the incidence of side effects associated with the three most common epidural regimens used at a tertiary care children’s hospital, in patients undergoing the Nuss procedure. Methods Seventy-two pediatric patients were identified as having been treated with one of three epidural regimens for postoperative pain management following the Nuss procedure: Group A (n=12) received 0.125% bupivacaine and 5 µg/mL fentanyl, Group B (n=21) received 0.125% bupivacaine and 10 µg/mL hydromorphone, and Group C (n=39) received 0.1% ropivacaine and 20 µg/mL hydromorphone. Our primary outcome was maximal daily pain scores (numerical rating scale 0–10), with an analytical focus on postoperative day 1 scores. The primary outcome was analyzed using linear regression. The secondary outcomes included the length of stay, side-effect profiles as reflected by the number of treatments for nausea and pruritus, pain scores according to epidural site insertion, occurrence of breakthrough pain, and presence of severe pain throughout their hospital stay. Secondary outcomes were analyzed using linear or logistic regression adjusted for pain scores at baseline. The criterion for statistical significance was set a priori at alpha =0.05. Results Group A had significantly higher day-1 pain scores (score 5.42/10) than Group B (4.52/10; P=0.030) and Group C (4.49/10; P=0.015) after adjusting for baseline pain and age. No significant difference in maximum daily

  15. Use of laryngeal mask airway for non-endotracheal intubated anesthesia for patients with pectus excavatum undergoing thoracoscopic Nuss procedure

    PubMed Central

    Du, Xiaojun; Mao, Songsong; Cui, Jianxiu; Ma, Jue; Zhang, Guangyan; Zheng, Yong; Zhou, Haiyu; Xie, Liang; Zhang, Dongkun; Shi, Ruiqing

    2016-01-01

    Background The aim of the present study was to determine the safety and feasibility of the use of laryngeal mask airway (LMA) for non-endotracheal intubated anesthesia for patients with pectus excavatum (PE) undergoing thoracoscopic Nuss procedure. Methods Between July 2015 and December 2015, 30 selected patients with PE were planned to undergo a thoracoscopic Nuss procedure using LMA for non-endotracheal intubated anesthesia in the Guangdong General Hospital. The clinical data were analyzed to evaluate the safety and feasibility of this technique. Results Of the 30 selected patients, two were female, the mean age was 16.04±5.09 years and the average Haller index was 3.37±0.88. A total of 27 cases (90%) succeeded at the first attempt, one patient required conversion to an endotracheal tube (ETT) because of continuous air leak. The peripheral O2 saturation (SpO2), end-tidal carbon dioxide (EtCO2) values, heart rate (HR), and mean arterial blood pressure (MAP) remained stable throughout the procedure in all cases. All of the 30 patients were successfully corrected without requiring conversion to an open surgery. Two patients experienced postoperative nausea and one reported a sore throat. Neither gastro-esophageal reflux nor in-hospital mortality occurred. Conclusions The use of LMA for non-endotracheal intubated anesthesia for selected patients with PE undergoing thoracoscopic Nuss procedure is clinically safe and technically feasible. PMID:27621860

  16. Sternal Cleft and Pectus Excavatum: A Combined Approach for the Correction of a Complex Anterior Chest Wall Malformation in a Teenager.

    PubMed

    Tocchioni, Francesca; Ghionzoli, Marco; Lo Piccolo, Roberto; Deaconu, Diana E; Facchini, Flavio; Milanez De Campos, Jose R; Messineo, Antonio

    2015-06-01

    Congenital sternal cleft is a rare chest wall malformation. Because of the flexibility of the chest in infants, surgical repair should be performed by primary closure in the neonatal period. In adolescents and adults, different techniques have been suggested to overcome the lack of sternal bone tissue. We describe a very rare case of an 18-year-old woman with a complete bifid sternum associated with pectus excavatum for whom a satisfactory cosmetic and functional result was obtained by adequate surgical planning, which entailed a combination of two standardized surgical techniques. PMID:26046903

  17. Pectus excavatum repair

    MedlinePlus

    ... surgery to repair this condition -- open surgery and closed (minimally invasive) surgery. Either surgery is done while ... At the end of surgery, the incision is closed. The metal struts are removed in 6 to ...

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

    PubMed

    Haje, S A; Haje, D P

    2006-08-01

    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

  19. ORTHOPEDIC APPROACH TO PECTUS DEFORMITIES: 32 YEARS OF STUDIES

    PubMed Central

    Haje, Sydney Abrão; de Podestá Haje, Davi

    2015-01-01

    The authors summarize a 32-year experience in the study and in the non-operative approach of pectus carinatum and pectus excavatum. Data of 4,012 patients with pectus deformities were collected from 1977 to January 2009, allowing evaluation on the etiology, pathogenesis and treatment of these deformities. Growth disturbances of anterior chest wall bones and cartilages were detected in imaging studies. Heredity, and biomechanical factors, like respiratory disturbances and scoliosis were noticed in more than 40% of the patients. The method of dynamic remodeling of the thorax – compressive orthoses simultaneously to exercises practice – was indicated in 2453 patients. Concomitant treatment with bending brace was provided in patients with 20° to 52° scoliosis. Of pectus patients with treatment indication, 1717 returned for re-evaluation: 1632 children and adolescents and 85 adults. Good results were seen in 60.6% of children and adolescents and in 27% of adults treated. No scoliosis patient presented curve worsening, and a case of 52° presented an improvement of 20° in the scoliosis with the treatment. Disturbances in the growth of the sternum and costal arches, as well as biomechanical factors related to the pathogenesis of pectus deformities, demonstrate how these deformities are correlated to orthopaedics. Appropriate evaluation of the anterior chest wall and concomitant treatment with bending brace are recommended in the presence of scoliosis. The dynamic remodeling method of the thorax requires a protocol of medical actions for a successful treatment. PMID:27004171

  20. [Children severe OSAHS with pectus excavatum: a case report].

    PubMed

    Ma, Wei; Wang, Jinfeng; Xie, Yuping

    2016-03-01

    The primary etiopathology of pediatric OSAHS includes tonsil or adenoid hypertrophy. Severe OSAHS contributes to or aggravates thoracic deformity, which is rarely reported. In the current report, This children sleep snoring more than 4 years, increasing with thoracic severe depression during sleep 2 days. Clinical examination indicated tonsil and adenoid hypertrophy, and polysomnography revealed OSAHS . The symptoms of OSAHS and severe inhalation-related sternum depression disappeared rapidly after tonsillectomy. Our findings indicated that OSAHS were the major causes underlying funnel chest in children. The rarity of the incidence may result in missed diagnosis or misdiagnosis. Polysomnography was recommended for the child diagnosed with funnel chest accompanied by upper airway stenosis. PMID:27382691

  1. Excavatoids E and F: Discovery of Two New Briaranes from the Cultured Octocoral Briareum excavatum

    PubMed Central

    Sung, Ping-Jyun; Chen, Bo-Yuan; Lin, Mei-Ru; Hwang, Tsong-Long; Wang, Wei-Hsien; Sheu, Jyh-Horng; Wu, Yang-Chang

    2009-01-01

    Two new briarane-related diterpenoids, designated as excavatoids E (1) and F (2), were isolated from the cultured octocoral Briareum excavatum. The structures of compounds 1 and 2 were established on the basis of extensive spectral data analysis. Briaranes 1 and 2 were found to exhibit moderate inhibitory effects on elastase release by human neutrophils. PMID:19841727

  2. Minimally Invasive Repair of Pectus Carinatum in Patients Unsuited to Bracing Therapy

    PubMed Central

    Suh, Jee-Won; Joo, Seok; Lee, Geun Dong; Haam, Seok Jin; Lee, Sungsoo

    2016-01-01

    Background We used an Abramson technique for minimally invasive repair of pectus carinatum in patients who preferred surgery to brace therapy, had been unsuccessfully treated via brace therapy, or were unsuitable for brace therapy because of a rigid chest wall. Methods Between July 2011 and May 2015, 16 patients with pectus carinatum underwent minimally invasive surgery. Results The mean age of the patients was 24.35±13.20 years (range, 14–57 years), and all patients were male. The percentage of excellent aesthetic results, as rated by the patients, was 37.5%, and the percentage of good results was 56.25%. The preoperative and postoperative Haller Index values were 2.01±0.19 (range, 1.60–2.31), and 2.22±0.19 (range, 1.87–2.50), respectively (p-value=0.01), and the median hospital stay was 7.09±2.91 days (range, 5–15 days). Only one patient experienced postoperative complications. Conclusion Minimally invasive repair is effective for the treatment of pectus carinatum, even in adult patients. PMID:27066432

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

    PubMed Central

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

    2012-01-01

    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

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

    PubMed Central

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

    2012-01-01

    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

  5. A Case of Successful Surgical Repair for Pectus Arcuatum Using Chondrosternoplasty

    PubMed Central

    Kim, Sang Yoon; Park, Samina; Kim, Eung Rae; Park, In Kyu; Kim, Young Tae; Kang, Chang Hyun

    2016-01-01

    Pectus arcuatum is a rare complex chest wall deformity. A 31-year-old female presented with a severely protruding upper sternum combined with a concave lower sternum. We planned a modified Ravitch-type operation. Through vertical mid-sternal incision, chondrectomies were performed from the second to fifth costal cartilages, saving the perichondrium. Horizontal osteotomy was performed in a wedge shape on the most protruding point, and followed by an additional partial osteotomy at the most concaved point. The harvested wedge-shape bone fragments were minced and re-implanted to the latter osteotomy site. The osteotomized sternum was fixed with multiple wirings. With chondrosternoplasty, a complex chest wall deformity can be corrected successfully. PMID:27298803

  6. Efficacy of Hyalomma scupense (Hd86) antigen against Hyalomma excavatum and H. scupense tick infestations in cattle.

    PubMed

    Galaï, Yousr; Canales, Mario; Ben Saïd, Mourad; Gharbi, Mohamed; Mhadhbi, Moez; Jedidi, Mohamed; de La Fuente, José; Darghouth, Mohamed-Aziz

    2012-11-19

    The Rhipicephalus microplus recombinant Bm86-based tick vaccines have shown their efficacy for the control of several Hyalomma cattle ticks genera, namely H. dromedarii and H. anatolicum. However, H. scupense species, the most important tick in North Africa has never been studied. Vaccination trials using either a recombinant Bm86-based vaccine or a recombinant Hd86-based vaccine (the Bm86 ortholog in H. scupense) were conducted in cattle against immature and adult H. scupense ticks and adult H. excavatum ticks. The results showed a 59.19% reduction in the number of scupense nymphs engorging on Hd86 vaccinated cattle. However, cattle vaccination with Bm86 or Hd86 did not have an effect on H. scupense or H. excavatum adult ticks infestations. These results showed that Hd86 vaccines are selectively effective against H. scupense immature instars and emphasize on an integrated anti-tick vaccine control in North Africa. PMID:23036501

  7. Pectus carinatum

    MedlinePlus

    ... carinatum may occur alone or along with other genetic disorders or syndromes. The condition causes the sternum to protrude. There is a narrow depression along the sides of the chest. This gives ...

  8. Anaesthetic Management of Laparoscopic Morgagni Hernia Repair in a Patient with Coexisting Down Syndrome, Patent Foramen Ovale and Pectus Carinatum

    PubMed Central

    Kozanhan, Betül; Başaran, Betül; Aygın, Feride; Akkoyun, İbrahim; Özmen, Sadık

    2016-01-01

    Laparoscopic repair has several advantages with a minimally invasive surgical option for children with Morgagni hernias; however, a number of physiological sequelae results from pneumoperitoneum and insufflation. These physiological changes may be more significant in patients with a congenital heart disease. Perioperative detailed evaluation, meticulous monitorization and cooperation with a surgical team are important in cases with patent foramen ovale for the possible risk of the paradoxical gas embolism. We present the anaesthetic management of a patient with patent foramen ovale, Down syndrome and pectus carinatus who successfully underwent laparoscopic Morgagni hernia repair. Under a well-managed anaesthesia that prevented complications because of pneumoperitoneum, laparoscopic surgery would be safe enough for patients with Morgagni hernia having an associated congenital heart disease. PMID:27366555

  9. Anaesthetic Management of Laparoscopic Morgagni Hernia Repair in a Patient with Coexisting Down Syndrome, Patent Foramen Ovale and Pectus Carinatum.

    PubMed

    Kozanhan, Betül; Başaran, Betül; Aygın, Feride; Akkoyun, İbrahim; Özmen, Sadık

    2016-02-01

    Laparoscopic repair has several advantages with a minimally invasive surgical option for children with Morgagni hernias; however, a number of physiological sequelae results from pneumoperitoneum and insufflation. These physiological changes may be more significant in patients with a congenital heart disease. Perioperative detailed evaluation, meticulous monitorization and cooperation with a surgical team are important in cases with patent foramen ovale for the possible risk of the paradoxical gas embolism. We present the anaesthetic management of a patient with patent foramen ovale, Down syndrome and pectus carinatus who successfully underwent laparoscopic Morgagni hernia repair. Under a well-managed anaesthesia that prevented complications because of pneumoperitoneum, laparoscopic surgery would be safe enough for patients with Morgagni hernia having an associated congenital heart disease. PMID:27366555

  10. Anti-Inflammatory and Analgesic Effects of the Marine-Derived Compound Excavatolide B Isolated from the Culture-Type Formosan Gorgonian Briareum excavatum.

    PubMed

    Lin, Yen-You; Lin, Sung-Chun; Feng, Chien-Wei; Chen, Pei-Chin; Su, Yin-Di; Li, Chi-Min; Yang, San-Nan; Jean, Yen-Hsuan; Sung, Ping-Jyun; Duh, Chang-Yih; Wen, Zhi-Hong

    2015-05-01

    In recent years, several marine-derived compounds have been clinically evaluated. Diterpenes are secondary metabolites from soft coral that exhibit anti-inflammatory, anti-tumor and cytotoxic activities. In the present study, we isolated a natural diterpene product, excavatolide B, from cultured Formosan gorgonian Briareum excavatum and investigated its anti-inflammatory activities. We found that excavatolide B significantly inhibited the mRNA expression of the proinflammatory mediators, inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2), in lipopolysaccharide (LPS)-challenged murine macrophages (RAW 264.7). We also examined the anti-inflammatory and anti-nociceptive effects of excavatolide B on intraplantar carrageenan-induced inflammatory responses. Excavatolide B was found to significantly attenuate carrageenan-induced nociceptive behaviors, mechanical allodynia, thermal hyperalgesia, weight bearing deficits and paw edema. In addition, excavatolide B inhibited iNOS, as well as the infiltration of immune cells in carrageenan-induced inflammatory paw tissue. PMID:25923315

  11. Anti-Inflammatory and Analgesic Effects of the Marine-Derived Compound Excavatolide B Isolated from the Culture-Type Formosan Gorgonian Briareum excavatum

    PubMed Central

    Lin, Yen-You; Lin, Sung-Chun; Feng, Chien-Wei; Chen, Pei-Chin; Su, Yin-Di; Li, Chi-Min; Yang, San-Nan; Jean, Yen-Hsuan; Sung, Ping-Jyun; Duh, Chang-Yih; Wen, Zhi-Hong

    2015-01-01

    In recent years, several marine-derived compounds have been clinically evaluated. Diterpenes are secondary metabolites from soft coral that exhibit anti-inflammatory, anti-tumor and cytotoxic activities. In the present study, we isolated a natural diterpene product, excavatolide B, from cultured Formosan gorgonian Briareum excavatum and investigated its anti-inflammatory activities. We found that excavatolide B significantly inhibited the mRNA expression of the proinflammatory mediators, inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2), in lipopolysaccharide (LPS)-challenged murine macrophages (RAW 264.7). We also examined the anti-inflammatory and anti-nociceptive effects of excavatolide B on intraplantar carrageenan-induced inflammatory responses. Excavatolide B was found to significantly attenuate carrageenan-induced nociceptive behaviors, mechanical allodynia, thermal hyperalgesia, weight bearing deficits and paw edema. In addition, excavatolide B inhibited iNOS, as well as the infiltration of immune cells in carrageenan-induced inflammatory paw tissue. PMID:25923315

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

    PubMed

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

    2012-11-23

    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

  13. Infant with multiple congenital anomalies and deletion (9) (q34.3)

    SciTech Connect

    Schimmenti, L.A.; Berry, S.A.; Tuchman, M.; Hirsch, B.

    1994-06-01

    The authors report on a male infant with developmental delay, growth failure, hypotonia, dolichocephaly, hypoplastic midface, epicanthal folds, down-slanting palpebral fissures, foveal hypoplasia, tracheomalacia, pectus excavatum, supraventricular tachycardia, gut malrotation, hypospadias, talipes equinovarus, short third metatarsals, capillary hemangiomata, and a de novo terminal deletion at 9q34.3.

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

    PubMed

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

    2014-08-01

    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

  15. Foraminotomia cervical posterior en el tratamiento de conflictos foraminales

    PubMed Central

    Campero, Álvaro; Barrera, Ramiro; Ajler, Pablo

    2012-01-01

    Introducción: La foraminomotima cervical posterior es un procedimiento utilizado para la descompresion radicular por via posterior y constituye una alternativa a la via clásica anterior. En este trabajo evaluamos nuestra serie de pacientes tratados por esta via. Método: Desde enero de 2008 a diciembre de 2011, 17 pacientes (18 foraminotomías) fueron operados por presentar cervicobraquialgia a causa de un conflicto foraminal, realizando un foraminotomía cervical posterior. Los pacientes fueron evaluados en el postoperatorio inmediato, al mes y a los 3 meses de la cirugía. Los parámetros para valorar los resultados fueron la Escala Análoga del Dolor (VAS), la Neck Disability Index y los criterios de Odom. Resultados: El dolor radicular por conflicto foraminal secundario a hernia de disco cervical fue el síntoma y la patología predominante. El nivel más afectado fue C5-C6. La resolución completa del dolor radicular se observó en casi todos los pacientes. La VAS preoperatoria en promedio fue de 8.8 (mínimo 8 – máximo 10), con una franca mejoría en todos los casos (0.4 en el último control). La media en la Neck Disability Index al inicio fue de 35.3 (mínimo 32 – máximo 45), con una evolución favorable en la evaluación final (0.6). Los Criterios de Odom para la evaluación de pacientes operados de columna cervical fueron satisfactorios con un promedio de 1.17. Se observaron complicaciones en 4 pacientes (23%), todas tuvieron una evolución favorable. No hubo infecciones, discitis ni empeoramiento de los síntomas preexistentes en ningún paciente. Conclusión: La foraminotomía cervical posterior es un procedimiento efectivo para el tratamiento del dolor radicular en los conflictos foraminales PMID:23596556

  16. El uso de la neuromodulación para el tratamiento del temblor

    PubMed Central

    Bendersky, Damián; Ajler, Pablo; Yampolsky, Claudio

    2014-01-01

    Introducción: El temblor puede ser un desorden incapacitante y el tratamiento de primera línea para estos pacientes es farmacológico. Sin embargo, este tratamiento puede llevar a una reducción satisfactoria del temblor en sólo el 50% de los pacientes con temblor esencial. La talamotomía era el tratamiento de elección para el temblor refractario al tratamiento médico hasta que comenzó a utilizarse la estimulación cerebral profunda (ECP) del núcleo ventral intermedio (Vim) del tálamo. En la actualidad, raramente se realiza la talamotomía. Métodos: Este artículo es una revisión no sistemática de las indicaciones, resultados, parámetros de programación y técnica quirúrgica de la ECP del Vim para el tratamiento del temblor. Resultados: Aunque los resultados clínicos son similares usando la talamotomía o la ECP del Vim, la primera causa más efectos adversos que la última. Además, la ECP puede ser usada bilateralmente, mientras que la talamotomía tiene un alto riesgo de causar disartria cuando se realiza de ambos lados. La ECP del Vim logró una adecuada mejoría del temblor en varias series de pacientes con temblor causado por temblor esencial, enfermedad de Parkinson o esclerosis múltiple. Además del Vim, hay otros blancos que están siendo usados por varios autores, tales como la zona incerta y las radiaciones prelemniscales. Conclusión: La ECP del Vim es un tratamiento útil para el temblor incapacitante refractario al tratamiento médico. Es esencial realizar una precisa selección de pacientes, así como utilizar una técnica quirúrgica correcta. Aún se desconoce el mejor blanco estereotáctico para el temblor, aunque el Vim es el más usado. PMID:25165613

  17. Un nuevo fármaco puede ser una opción de tratamiento para algunos cánceres de mama

    Cancer.gov

    Los resultados de un estudio clínico internacional permiten suponer que, en poco tiempo, habrá otra opción de tratamiento para las mujeres con cáncer de mama metastásico HER2 positivo que deja de responder a los tratamientos dirigidos con trastuzumab.

  18. Validation of an Objective Assessment Instrument for Non-Surgical Treatments of Chest Wall Deformities.

    PubMed

    Obeid, Mohammad F; Kidane, Nahom; Rechowicz, Krzysztof J; Chemlal, Salim; Kelly, Robert E; Mckenzie, Frederic D

    2016-01-01

    Depending on the severity of the condition and associated risk, surgical intervention may not always be the first choice. This is true for treating chest wall deformities such as pectus excavatum and pectus carinatum. For both conditions, novel non-surgical treatments have been developed to gradually alleviate the malformation making use of the elastic nature of the costal cartilages at an early age of the patient. To quantify the performance of such treatments, this paper introduces and discusses the development of a software-based instrument that utilizes 3D chest optical images (surface scans) as input and uses registration techniques to produce an objective gauge of a patient's physical improvement after undergoing treatments. Further discussed is an experiment designed to investigate the construct validity of the developed instrument. PMID:27046591

  19. Fumar durante el tratamiento de cáncer (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    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.

  20. Tratamiento ayuda a mujeres jóvenes a preservar fertilidad durante quimioterapia para cáncer de seno

    Cancer.gov

    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 con

  1. Fumar durante el tratamiento de cáncer (PDQ®)—Versión para pacientes

    Cancer.gov

    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.

  2. ACT-asthma control y tratamiento para niños: a progress report.

    PubMed

    Lewis, M A; de la Sota, A; Rachelefsky, G; Lewis, C E; Quinones, H; Richards, W

    1987-01-01

    A randomized clinical trial is in progress to evaluate an asthma educational program for Latino children and their parents. The intervention, "ACT-Asma Control y Tratamiento Para Niños," was adapted from ACT for Kids, an asthma self-management program for English-speaking families. Results of a pilot study indicated that socioeconomic status was a critical variable to be considered in the design of such programs. Latino children and parents encounter significant barriers to access and continuity of medical care. Therefore, the intervention was redesigned to include "linkages" using a nurse to reduce barriers and to coordinate care. The lesson plans emphasize concrete, experimental learning experiences, with repetition of key points in each session. PMID:3654235

  3. New material for Nuss procedure.

    PubMed

    Osawa, Hisayoshi; Mawatari, Tohru; Watanabe, Atsushi; Abe, Tomio

    2004-10-01

    The Nuss procedure for pectus excavatum repair has been considered an acceptable method in terms of its decreased invasiveness and excellent cosmetic results. Although a steel bar is usually used for elevating the sternum, we used a titanium alloy plate for pectus excavatum repair for the first time. The characteristics of this plate are that 1) it comes out translucently on X-rays, 2) MRI examination is possible because titanium will not be magnetized, and 3) it is possible to go through the security checkpoint at the airport without setting off the metal detector. Furthermore, the titanium alloy is highly elastic, which reduces complications such as dislocation, and it excels in the conformity to organization. Patients who have received the Nuss operation are forced to somewhat limit their daily life for two or three years until the bar is removed. A plate made from titanium alloy resolves this problem because of its material and it is thought to be an ideal candidate for elevating the sternum during the Nuss operation. PMID:15563267

  4. Estimation of cartilaginous region in noncontrast CT of the chest

    NASA Astrophysics Data System (ADS)

    Zhao, Qian; Safdar, Nabile; Yu, Glenna; Myers, Emmarie; Sandler, Anthony; Linguraru, Marius George

    2014-03-01

    Pectus excavatum is a posterior depression of the sternum and adjacent costal cartilages and is the most common congenital deformity of the anterior chest wall. Its surgical repair can be performed via minimally invasive procedures that involve sternum and cartilage relocation and benefit from adequate surgical planning. In this study, we propose a method to estimate the cartilage regions in thoracic CT scans, which is the first step of statistical modeling of the osseous and cartilaginous structures for the rib cage. The ribs and sternum are first segmented by using interactive region growing and removing the vertebral column with morphological operations. The entire chest wall is also segmented to estimate the skin surface. After the segmentation, surface meshes are generated from the volumetric data and the skeleton of the ribs is extracted using surface contraction method. Then the cartilage surface is approximated via contracting the skin surface to the osseous structure. The ribs' skeleton is projected to the cartilage surface and the cartilages are estimated using cubic interpolation given the joints with the sternum. The final cartilage regions are formed by the cartilage surface inside the convex hull of the estimated cartilages. The method was validated with the CT scans of two pectus excavatum patients and three healthy subjects. The average distance between the estimated cartilage surface and the ground truth is 2.89 mm. The promising results indicate the effectiveness of cartilage surface estimation using the skin surface.

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

    PubMed Central

    Yano, Terdsak

    2013-01-01

    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

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

    Cancer.gov

    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 ta

  7. The phenotype of multiple congenital anomalies-hypotonia-seizures syndrome 1: report and review.

    PubMed

    Couser, Natario L; Masood, Maheer M; Strande, Natasha T; Foreman, Ann Katherine M; Crooks, Kristy; Weck, Karen E; Lu, Mei; Wilhelmsen, Kirk C; Roche, Myra; Evans, James P; Berg, Jonathan S; Powell, Cynthia M

    2015-09-01

    The Multiple Congenital Anomalies-Hypotonia-Seizures Syndrome 1 (MCAHS1) has been described in two families to date. We describe a 2-year-old Mexican American boy with the syndrome and additional manifestations not yet reported as part of the phenotype. The patient presented with severe hypotonia, microphallus and left cryptorchidism, and was later diagnosed with epilepsy and severe cortical visual impairment. He also had supernumerary nipples, pectus excavatum, a short upturned nose, fleshy ear lobes, and a right auricular pit. Massively parallel exome sequencing and analysis revealed two novel compound heterozygous missense (Trp136Gly and Ser859Thr) variants in the PIGN gene. This report extends and further defines the phenotype of this syndrome. PMID:25920937

  8. Ellis van Creveld syndome.

    PubMed

    Ghanekar, Jaishree; Sangrampurkar, Sujata; Hulinaykar, Raman; Ahmer, Tariq

    2009-07-01

    Ellis-van Creveld syndrome (EVC) or chondroectodermal dysplasia is a rare autosomal recessive disorder. It is a tetrad of chondrodysplasia, ectodermal dysplasia, polydactyly, and congenital heart disease. In several case reports, dysplasia involving other organs has also been identified. The exact prevalence is unknown, but the syndrome seems more common among the Amish community. Many Indian cases have also been reported. This report describes a classical case of EVC syndrome in a 22 year old woman of Indian origin born of a consanginous marriage. The patient had chondrodysplasia of tubular bones resulting in disproportionate dwarfism, postaxial polydactyly, severely dystrophic nails, partially absent teeth, pectus excavatum with narrow chest, knock knees and AV canal defect. PMID:20329417

  9. Minimally Invasive Thoracic Surgery in Pediatric Patients: The Taiwan Experience

    PubMed Central

    Huang, Yu-Kai; Chou, Chieh; Li, Chung-Liang; Chiu, Hui-Gin; Chang, Yu-Tang

    2013-01-01

    Minimally invasive technology or laparoscopic surgery underwent a major breakthrough over the past two decades. The first experience of thoracoscopy in children was reported around 1980 for diagnosis of intrathoracic pathology and neoplasia. Up until the middle of the 1990s, the surgical community in Taiwan was still not well prepared to accept the coming era of minimally invasive surgery. In the beginning, laparoscopy was performed in only a few specialties and only relatively short or simple surgeries were considered. But now, the Taiwan's experiences over the several different clinical scenarios were dramatically increased. Therefore, we elaborated on the experience about pectus excavatum: Nuss procedure, primary spontaneous hemopneumothorax, thoracoscopic thymectomy, and empyema in Taiwan. PMID:23819123

  10. Evaluation of the effects of rehabilitation after surgery using the Ravitch and Nuss methods: a case study

    PubMed Central

    2016-01-01

    Rehabilitation may be helpful in the prevention of complications associated with the treatment of patients with pectus excavatum who are subjected to surgery using the Ravitch and Nuss methods. This paper presents the case of a patient who underwent successful physical rehabilitation after 8 weeks from the surgery using the combined method. As part of the Nuss procedure, two plates were implanted to form a scaffolding for the patient's chest, which had previously been corrected with the Ravitch method. The plates were to be removed after 24 months of treatment. After the procedure, in spite of the favorable cosmetic effect of the repair, there was a significant decrease in the spirometric values and physical fitness of the patient. He underwent an individual physiotherapy program, which lasted four weeks. The streamlining of the respiratory system has significantly improved the spirometric values and raised the overall performance of the patient's organism. PMID:27212987

  11. Gorlin syndrome and bilateral ovarian fibroma

    PubMed Central

    Pirschner, Fernanda; Bastos, Pollyana Marçal; Contarato, George Luiz; Bimbato, Anna Carolina Bon Lima; Filho, Antônio Chambô

    2012-01-01

    INTRODUCTION Gorlin syndrome (GS), also known as nevoid basal cell carcinoma syndrome (NBCCS), is a rare hereditary, autosomal dominant disease that affects various systems. Its prevalence is estimated at 1/57,000 to 1/256,000 of the population. It is characterized by basal cell carcinomas, multiple odontogenic keratocysts, skeletal abnormalities and ovarian fibroma, among other disorders. PRESENTATION OF CASE To report the case of a young patient with Gorlin syndrome and bilateral ovarian fibroma. DISCUSSION A 20-year old patient with Gorlin syndrome presented with facial asymmetry, broad nasal root, dental abnormalities, micrognathism, convergent strabismus, multiple pigmented lesions on the trunk and face, pectus excavatum, kyphoscoliosis and a palpable mass in the abdomen occupying the entire pelvic region. CONCLUSION Gorlin–Goltz syndrome is a hereditary pathology that includes numerous clinical manifestations. Diagnosis is clinical and genetic confirmation is unnecessary. PMID:22771908

  12. Male Pectoral Implants: Radiographic Appearance of Complications.

    PubMed

    Kuzmiak, Cherie M; Damitz, Lynn; Burke, Rachael; Hwang, Michael

    2016-03-01

    There has been a significant surge in aesthetic chest surgery for men in the last several years. Male chest enhancement is performed with surgical placement of a solid silicone pectoral implant. In the past, male chest correction and implantation were limited to the treatment of men who had congenital absence or atrophy of the pectoralis muscle and pectus excavatum deformity. But today, the popularization of increased chest and pectoral size fostered by body builders has more men desiring chest correction with implantation for non-medical reasons. We present a case of a 44-year-old, male with a displaced left pectoral implant with near extrusion and with an associated peri-implant soft tissue mass and fluid collection. While the imaging of these patients is uncommon, our case study presents the radiographic findings of male chest enhancement with associated complications. PMID:27200162

  13. Robinow Syndrome: A Rare Diagnosis

    PubMed Central

    Agarwalla, Sunil Kumar; Pradhan, Swayanprava

    2015-01-01

    Robinow syndrome is a rare entity characterized by short stature and abnormalities of the head, face and external genitalia. It is otherwise called ‘fetal face syndrome’ due to its resemblance with fetal face. We present an eight-year-old female child who came with mesomelic short stature, abnormal facial features, multiple sets of teeth (both deciduous and permanent), pectus excavatum, umbilical hernia, limb abnormalities like shortening of fore arm, simian crease, broad thumbs and other fingers, clinodactyly, abnormal carrying angle, absent labia minora, absent clitoris. Apart from physical appearance she was having diversification of recti and umbilical hernia. Due to the several physical presentation mild systemic involvement it was diagnosed as autosomal dominant robinow syndrome. She is now on follow up and planned for a cosmetic surgery to repair facial defects. PMID:26816964

  14. Evaluation of the effects of rehabilitation after surgery using the Ravitch and Nuss methods: a case study.

    PubMed

    Bal-Bocheńska, Monika Anna

    2016-03-01

    Rehabilitation may be helpful in the prevention of complications associated with the treatment of patients with pectus excavatum who are subjected to surgery using the Ravitch and Nuss methods. This paper presents the case of a patient who underwent successful physical rehabilitation after 8 weeks from the surgery using the combined method. As part of the Nuss procedure, two plates were implanted to form a scaffolding for the patient's chest, which had previously been corrected with the Ravitch method. The plates were to be removed after 24 months of treatment. After the procedure, in spite of the favorable cosmetic effect of the repair, there was a significant decrease in the spirometric values and physical fitness of the patient. He underwent an individual physiotherapy program, which lasted four weeks. The streamlining of the respiratory system has significantly improved the spirometric values and raised the overall performance of the patient's organism. PMID:27212987

  15. A case of simultaneous bilateral spontaneous pneumothorax after the Nuss procedure.

    PubMed

    Matsuoka, Shunichiro; Miyazawa, Masahisa; Kashimoto, Kentaro; Kobayashi, Hiroaki; Mitsui, Fumihiko; Tsunoda, Hajime; Kunitomo, Kazuyoshi; Chisuwa, Hisanao; Haba, Yoshiaki

    2016-06-01

    We present a case of simultaneous bilateral spontaneous pneumothorax caused by a pleuro-pleural communication formed from Nuss procedure for pectus excavatum. A 17-year-old man with a history of Nuss operation complained chest pain and dyspnea. A chest roentgenogram demonstrated a tiny bilateral pneumothorax and two metallic bars inserted at the Nuss procedure. Computed tomography revealed furthermore a bulla in the apex of the left lung. The bilateral pneumothorax critically deteriorated after 4 days from onset and urgent bilateral chest drainages were performed. Nevertheless the drainages the full expansion of both lungs was not obtained and air leakage only from left side was continued. A video-assisted left bullectomy was performed 9 days after the tube insertion. The two bars penetrating anterior mediastinal pleura were thought to be a cause of the simultaneous bilateral spontaneous pneumothorax. PMID:25352312

  16. [Resection of a Subclavian Artery Aneurysm without Dividing the Clavicle;Report of a Case].

    PubMed

    Suzuki, Shuhei; Sogawa, Masakazu; Wakabayashi, Takashi; Nakamura, Norihito

    2016-09-01

    A 57-year-old woman with Marfan syndrome had undergone the surgical treatment for pectus excavatum at 15 years of age. She had since been screened regularly by computed tomography(CT) to detect any vascular diseases. CT demonstrated a left subclavian arterial aneurysm at 55 years of age. It enlarged to a diameter of 32 mm, and surgical treatment was performed. The subclavian artery and the aneurysm were identified by echography in order to locate the exact sites of supraclavicular and subclavicular skin incisions. The subclavian artery aneurysm was resected without dividing the clavicle, and replaced by a vascular graft. Echography is useful for precisely locating a subclavian artery aneurysm, which enables feasible resection without dividing the clavicle. PMID:27586322

  17. Extensión del Formalismo de Orbitales de Defecto Cuántico al tratamiento del efecto Stark (SQDO).

    NASA Astrophysics Data System (ADS)

    Menéndez, J. M.; Martín, I.; Velasco, A. M.

    El estudio experimental de las interacciones de átomos Rydberg altamente excitados con campos eléctricos ha experimentado un creciente interés durante las dos últimas décadas debido, en gran medida, al desarrollo de nuevas técnicas para crear y estudiar átomos Rydberg en el laboratorio. Acompañando a estas nuevas técnicas experimentales, es necesario el desarrollo de modelos teóricos que nos permitan contrastar sus medidas y conocer mejor los fundamentos de los mismos. Desde el punto de vista teórico el conocimiento del desdoblamiento de los niveles energéticos de un átomo en función de la magnitud del campo eléctrico aplicado (lo que se conoce como mapa Stark) es el mejor punto de partida para la descripción del sistema y un prerrequisito fundamental para el cálculo de distintas propiedades atómicas en presencia del campo eléctrico tales como intensidades de transición, umbrales de ionización de campo eléctrico, tiempos de vida, posición y anchura de cruces evitados, etc. En este trabajo presentamos la adaptación del método de orbitales de defecto cuántico [1,2,3] al tratamiento del efecto Stark (SQDO) [4] y su aplicación al cálculo de los desdoblamientos energéticos y fuerzas de oscilador de estados Rydberg en los átomos de Li, Na y K. El propósito de este estudio es, por un lado, desarrollar métodos fiables para la determinación de propiedades atómicas en presencia de campos eléctricos y, por otro, mostrar la fiabilidad de las funciones de onda QDO en la descripción del efecto Stark en sistemas atómicos.

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

    PubMed

    Lewis, Mary L

    2014-09-01

    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

  19. Classification of chest wall diseases.

    PubMed

    Pozzi, E; Gulotta, C

    1993-01-01

    Several disorders of the thoracic cage are known to cause respiratory failure, by means of relatively simple mechanisms, such as the increased work of breathing, which results in alveolar hypoventilation. A variety of pathogenic mechanisms may be considered, as functions of the types of thoracic disorders present. As causes of these additional potential mechanisms, we considered the following: 1) ventilation-perfusion (V/Q) inhomogeneity; 2) inability to cough; 3) malformation or acquired defect of the respiratory centres; and 4) excess blood volume and fluid retention, which aggravate work of breathing and V/Q inhomogeneity. All of these disorders can be grouped into two major categories (which nevertheless have some of the pathophysiology in common): the mechanical syndrome and the neuromuscular or paralytic syndrome. In this paper we discuss chest wall diseases falling into the first category; namely, kyphoscoliosis, fibrothorax, thoracoplasty, ankylosing spondylitis and obesity-hypoventilation. Congenital deformities of the thoracic cage, which do not have important effects on ventilatory apparatus (e.g. pectus excavatum and pectus carinatum), were also considered. PMID:8472068

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

    PubMed

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

    1989-12-01

    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

  1. Tratamiento Quirúrgico de los Meningiomas del Foramen Óptico, Técnicay Resultados de una Serie de 18 Pacientes

    PubMed Central

    Goldschmidt, Ezequiel; Ajler, Pablo; Campero, Álvaro; Landriel, Federico; Sposito, Maximiliano; Carrizo, Antonio

    2014-01-01

    Introducción: los meningiomas del foramen óptico producen un rápido deterioro de la función visual aún cuando su tamaño es pequeño, por eso su diagnóstico y manejo difiere del resto de los meningiomas clinoideos. El propósito de este estudio es presentar la técnica y los resultados de nuestro manejo quirúrgico de meningiomas foraminales (MF). Pacientes y Métodos: se llevó a cabo una revisión de las historias clínicas de 47 pacientes con meningiomas primarios intraorbitarios. Se realizaron 52 cirugías en los pacientes con MF. Se empleó una craneotomía fronto-orbitaria, seguida de una descompresión extradural del canal óptico, resección del componente intraorbitario y exploración intradural del nervio óptico. Resultados: de los 12 pacientes con MF que presentaban la visión conservada, la agudeza visual fue preservada en 7 casos, mejoró en 2, y empeoró en 3. En 18 pacientes, el principal síntoma fue exoftalmos y en 35 pacientes ceguera unilateral. Ocurrieron 6 recurrencias, 2 a 10 años después de la resección quirúrgica. Cinco de ellos fueron reoperados. Se indicó radioterapia después de la recurrencia en 3 pacientes. Conclusión: el manejo de los MF continúa siendo controvertido y frecuentemente se propone un tratamiento conservador. Basados en nuestros hallazgos de frecuente extensión intracraneal, proponemos realizar una resección total o subtotal del tumor, preservando el nervio óptico en pacientes con visión prequirúrgica conservada. PMID:25165616

  2. Epidural versus Patient-Controlled Analgesia after Pediatric Thoracotomy for Malignancy: A Preliminary Review.

    PubMed

    Gonzalez, Katherine W; Dalton, Brian G; Millspaugh, Daniel L; Thomas, Priscilla G; St Peter, Shawn David

    2016-08-01

    Introduction The use of thoracic epidural is standard in adult thoracotomy patients facilitating earlier mobilization, deep breathing, and minimizing narcotic effects. However, a recent randomized trial in pediatric patients who undergo repair of pectus excavatum suggests patient-controlled analgesia (PCA) produces a less costly, minimally invasive postoperative course compared with epidural. Given that thoracotomy is typically less painful than pectus bar placement, we compared the outcomes of epidural to PCA for pain management after pediatric thoracotomy. Methods A retrospective review of 17 oncologic thoracotomies was performed at a children's hospital from 2004 to 2013. Data points included operative details, epidural or PCA use, urinary catheterization, days to regular diet, days to oral pain regimen, postoperative pain scores, length of stay, and anesthesia charges. Patients were excluded if they did not have epidural or PCA following thoracotomy. Results Six thoracotomies were managed with an epidural and 11 with a PCA. Three epidural patients were opiate naïve compared with two with a PCA. The most common indication for thoracotomy was metastatic osteosarcoma (n = 13). When comparing epidural to PCA, there was no significant difference in days to removal of Foley catheter, regular diet, oral pain control, length of stay, or total operating room time. Postoperative pain scores were also comparable. The mean anesthesia charges were significantly higher in patients with an epidural than with a PCA. Conclusion Epidural catheter and PCA provided comparable pain relief and objective recovery course in children who underwent thoracotomy for oncologic disease; however, epidural catheter placement was associated with increased anesthesia charges, suggesting that PCA is a noninvasive, cost-effective alternative. PMID:26018213

  3. Modern CT applications in veterinary medicine.

    PubMed

    Garland, Melissa R; Lawler, Leo P; Whitaker, Brent R; Walker, Ian D F; Corl, Frank M; Fishman, Elliot K

    2002-01-01

    Although computed tomography (CT) is used primarily for diagnosis in humans, it can also be used to diagnose disease in veterinary patients. CT and associated three-dimensional reconstruction have a role in diagnosis of a range of illnesses in a variety of animals. In a sea turtle with failure to thrive, CT showed a nodal mass in the chest, granulomas in the lungs, and a ball in the stomach. CT of a sea dragon with balance and movement problems showed absence of the swim bladder. In a sloth with failure to thrive, CT allowed diagnosis of a coin in the intestine. CT of a puffin with failure to thrive showed a mass in the chest, which was found to be a hematoma. In a smooth-sided toad whose head was tilted to one side and who was circling in that direction, CT showed partial destruction of the temporal bone. CT of a domestic cat with listlessness showed a mass with focal calcification, which proved to be a leiomyosarcoma. CT of a sea otter showed pectus excavatum, which is caused by the animal smashing oysters against its chest. In a Japanese koi with abdominal swelling, CT allowed diagnosis of a hepatoma. PMID:11796898

  4. Patterns of pulmonary perfusion scans in normal subjects

    SciTech Connect

    Wallace, J.M.; Moser, K.M.; Hartman, M.T.; Ashburn, W.L.

    1981-01-01

    A vital factor conditioning the usage of the pulmonary perfusion (Q) scan in the evaluation of patients suspected of pulmonary embolism is the prevalence of abnormal Q scans in subjects free of cardiopulmonary disease. Because this prevalence has not been well defined, we performed Q scans in 80 nonsmoking subjects 18 to 29 yr of age having no known active cardiopulmonary disease. Each subject underwent a history, physical examination, electrocardiogram, spirometry, and PA chest roentgenogram, followed by a 6-view Q scan. Two subjects in whom a Q defect was suspected underwent a /sup 133/Xe equilibrium-washout ventilation (V) scan. All Q scans were interpreted blindly and independently by 2 experienced readers. Seventy-nine of the 80 Q scans were read as normal. No subject demonstrated a lobar or segmental defect. One of the 80 subjects, who had a mild pectus excavatum, had a left upper lobe subsegmental defect, which was not seen on the V scan. Based on the statistical analysis of these data, no more than 3.68% of normal nonsmoking persons in this age group may have a lobar or segmental Q scan defect and no more than 6.77% may have a subsegmental defect (with 95% confidence). Therefore, our study indicated that Q scan defects, particularly lobar or segmental, are rarely present among normal nonsmokers in this age group.

  5. Apparent Ruvalcaba syndrome with genitourinary abnormalities.

    PubMed

    Bialer, M G; Wilson, W G; Kelly, T E

    1989-07-01

    The Ruvalcaba syndrome is a rare malformation syndrome characterized by skeletal dysplasia, facial anomalies, and mental retardation. We report on a 22-year-old woman with severe growth and mental retardation and numerous manifestations characteristic of the Ruvalcaba syndrome. In addition, she has several anomalies not previously described in the Ruvalcaba syndrome, including upslanting palpebral fissures, torus palatinus, hiatal hernia with gastroesophageal reflux, recurrent respiratory infections, pectus excavatum, equinovarous deformity, hypotonia, unilateral renal hypoplasia, an accessory ovary, and atretic fallopian tube. Review of published reports of Ruvalcaba syndrome confirms variability of the clinical and radiographic changes. Findings present in at least 50% of reported patients include mental retardation, short stature, pubertal delay, an abnormal nose (usually beaked) with hypoplastic nasal alae, microstomia with narrow maxilla, thin upper lip vermilion, broad hips, small hands, joint limitation, short fingers and toes, and vertebral abnormalities. Because 5 of the reported patients had renal abnormalities, a renal ultrasound or contrast study is indicated in the evaluation of these patients. Additional reports, particular from multiplex families, will be important to better characterize this syndrome. PMID:2679089

  6. Normalized mean shapes and reference index values for computerized quantitative assessment indices of chest wall deformities

    NASA Astrophysics Data System (ADS)

    Kim, Ho Chul; Park, Man Sik; Lee, Seong Keon; Nam, Ki Chang; Park, Hyung Joo; Kim, Min Gi; Song, Jae-Jun; Choi, Hyuk

    2015-11-01

    We previously proposed a computerized index (eccentricity index [EI]) for chest-wall deformity measurements, such as pectus excavatum. We sought to define mean shapes based on normal chest walls and to propose for computerized index reference values of that are used in the quantitative analysis of the severity of chest-wall deformities. A total of 584 patients were classified into 18 groups, and a database of their chest-wall computed tomography (CT) scan images was constructed. The boundaries of the chest wall were extracted by using a segmentation algorithm, and the mean shapes were subsequently developed. The reference index values were calculated from the developed mean shapes. Reference index values for the EI were compared with a conventional index, the Haller index (HI). A close association has been shown between the two indices in multiple subjects (r = 0.974, P < 0.001). The newly developed mean shapes and reference index values supply both reliability and objectivity to the diagnosis, analysis, and treatment of chest-wall deformities. They promise to be highly useful in clinical settings.

  7. Epidural and opioid analgesia following the Nuss procedure

    PubMed Central

    Walaszczyk, Malgorzata; Knapik, Piotr; Misiolek, Hanna; Korlacki, Wojciech

    2011-01-01

    Summary Background Parents have the right to decide on behalf of their children and deny consent to regional anaesthesia. The investigators decided to investigate quality of postoperative analgesia in adolescents undergoing epidural and opioid analgesia following the Nuss procedure. Material/Methods The study subjects were 61 adolescents aged 11–18 years who underwent pectus excavatum repair with the Nuss procedure. Patients were divided into epidural (n=41) and opioid (n=20) groups, depending on their parents’ consent to epidural catheter insertion. Intraoperatively, 0.5% epidural ropivacaine with fentanyl or intermittent intravenous injections of fentanyl were used. Postoperative analgesia was achieved with either epidural infusion of 0.1% ropivacaine with fentanyl, or subcutaneous morphine via an intraoperatively inserted “butterfly” cannula. Additionally, both groups received metamizol and paracetamol. Primary outcome variables were postoperative pain scores (Numeric Rating Scale and Prince Henry Hospital Pain Score). Secondary outcome variables included hemodynamic parameters, additional analgesia and side effects. Results Heart rate and blood pressure values in the postoperative period were significantly higher in the opioid group. Pain scores requiring intervention were noted almost exclusively in the opioid group. Conclusions Denial of parental consent to epidural analgesia following the Nuss procedure results in significantly worse control of postoperative pain. Our data may be useful when discussing with parents the available anaesthetic techniques for exceptionally painful procedures. PMID:22037752

  8. 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.

    PubMed

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

    2010-06-01

    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

  9. Generation of heterozygous fibrillin-1 mutant cloned pigs from genome-edited foetal fibroblasts

    PubMed Central

    Umeyama, Kazuhiro; Watanabe, Kota; Watanabe, Masahito; Horiuchi, Keisuke; Nakano, Kazuaki; Kitashiro, Masateru; Matsunari, Hitomi; Kimura, Tokuhiro; Arima, Yoshimi; Sampetrean, Oltea; Nagaya, Masaki; Saito, Masahiro; Saya, Hideyuki; Kosaki, Kenjiro; Nagashima, Hiroshi; Matsumoto, Morio

    2016-01-01

    Marfan syndrome (MFS) is an autosomal dominant genetic disease caused by abnormal formation of the extracellular matrix with an incidence of 1 in 3, 000 to 5, 000. Patients with Marfan syndrome experience poor quality of life caused by skeletal disorders such as scoliosis, and they are at high risk of sudden death from cardiovascular impairment. Suitable animal models of MFS are essential for conquering this intractable disease. In particular, studies employing pig models will likely provide valuable information that can be extrapolated to humans because of the physiological and anatomical similarities between the two species. Here we describe the generation of heterozygous fibrillin-1 (FBN1) mutant cloned pigs (+/Glu433AsnfsX98) using genome editing and somatic cell nuclear transfer technologies. The FBN1 mutant pigs exhibited phenotypes resembling those of humans with MFS, such as scoliosis, pectus excavatum, delayed mineralization of the epiphysis and disrupted structure of elastic fibres of the aortic medial tissue. These findings indicate the value of FBN1 mutant pigs as a model for understanding the pathogenesis of MFS and for developing treatments. PMID:27074716

  10. LTBP2 mutations cause Weill-Marchesani and Weill-Marchesani-like syndrome and affect disruptions in the extracellular matrix.

    PubMed

    Haji-Seyed-Javadi, Ramona; Jelodari-Mamaghani, Sahar; Paylakhi, Seyed Hassan; Yazdani, Shahin; Nilforushan, Naveed; Fan, Jian-Bing; Klotzle, Brandy; Mahmoudi, Mohammad Jafar; Ebrahimian, Mohammad Jafar; Chelich, Noori; Taghiabadi, Ehsan; Kamyab, Kambiz; Boileau, Catherine; Paisan-Ruiz, Coro; Ronaghi, Mostafa; Elahi, Elahe

    2012-08-01

    Latent transforming growth factor (TGF) beta-binding protein 2 (LTBP2) is an extracellular matrix (ECM) protein that associates with fibrillin-1 containing microfibrils. Various factors prompted considering LTBP2 in the etiology of isolated ectopia lentis and associated conditions such as Weill-Marchesani syndrome (WMS) and Marfan syndrome (MFS). LTBP2 was screened in 30 unrelated Iranian patients. Mutations were found only in one WMS proband and one MFS proband. Homozygous c.3529G>A (p.Val1177Met) was shown to cause autosomal recessive WMS or WM-like syndrome by several approaches, including homozygosity mapping. Light, fluorescent, and electron microscopy evidenced disruptions of the microfibrillar network in the ECM of the proband's skin. In conjunction with recent findings regarding other ECM proteins, the results presented strongly support the contention that anomalies in WMS patients are due to disruptions in the ECM. Heterozygous c.1642C >T (p.Arg548*) possibly contributed to MFS-related phenotypes, including ocular manifestations, mitral valve prolapse, and pectus excavatum, but was not cause of MFS. PMID:22539340

  11. Generation of heterozygous fibrillin-1 mutant cloned pigs from genome-edited foetal fibroblasts.

    PubMed

    Umeyama, Kazuhiro; Watanabe, Kota; Watanabe, Masahito; Horiuchi, Keisuke; Nakano, Kazuaki; Kitashiro, Masateru; Matsunari, Hitomi; Kimura, Tokuhiro; Arima, Yoshimi; Sampetrean, Oltea; Nagaya, Masaki; Saito, Masahiro; Saya, Hideyuki; Kosaki, Kenjiro; Nagashima, Hiroshi; Matsumoto, Morio

    2016-01-01

    Marfan syndrome (MFS) is an autosomal dominant genetic disease caused by abnormal formation of the extracellular matrix with an incidence of 1 in 3, 000 to 5, 000. Patients with Marfan syndrome experience poor quality of life caused by skeletal disorders such as scoliosis, and they are at high risk of sudden death from cardiovascular impairment. Suitable animal models of MFS are essential for conquering this intractable disease. In particular, studies employing pig models will likely provide valuable information that can be extrapolated to humans because of the physiological and anatomical similarities between the two species. Here we describe the generation of heterozygous fibrillin-1 (FBN1) mutant cloned pigs (+/Glu433AsnfsX98) using genome editing and somatic cell nuclear transfer technologies. The FBN1 mutant pigs exhibited phenotypes resembling those of humans with MFS, such as scoliosis, pectus excavatum, delayed mineralization of the epiphysis and disrupted structure of elastic fibres of the aortic medial tissue. These findings indicate the value of FBN1 mutant pigs as a model for understanding the pathogenesis of MFS and for developing treatments. PMID:27074716

  12. Recurrent duplications of 17q12 associated with variable phenotypes.

    PubMed

    Mitchell, Elyse; Douglas, Andrew; Kjaegaard, Susanne; Callewaert, Bert; Vanlander, Arnaud; Janssens, Sandra; Yuen, Amy Lawson; Skinner, Cindy; Failla, Pinella; Alberti, Antonino; Avola, Emanuela; Fichera, Marco; Kibaek, Maria; Digilio, Maria C; Hannibal, Mark C; den Hollander, Nicolette S; Bizzarri, Veronica; Renieri, Alessandra; Mencarelli, Maria Antonietta; Fitzgerald, Tomas; Piazzolla, Serena; van Oudenhove, Elke; Romano, Corrado; Schwartz, Charles; Eichler, Evan E; Slavotinek, Anne; Escobar, Luis; Rajan, Diana; Crolla, John; Carter, Nigel; Hodge, Jennelle C; Mefford, Heather C

    2015-12-01

    The ability to identify the clinical nature of the recurrent duplication of chromosome 17q12 has been limited by its rarity and the diverse range of phenotypes associated with this genomic change. In order to further define the clinical features of affected patients, detailed clinical information was collected in the largest series to date (30 patients and 2 of their siblings) through a multi-institutional collaborative effort. The majority of patients presented with developmental delays varying from mild to severe. Though dysmorphic features were commonly reported, patients do not have consistent and recognizable features. Cardiac, ophthalmologic, growth, behavioral, and other abnormalities were each present in a subset of patients. The newly associated features potentially resulting from 17q12 duplication include height and weight above the 95th percentile, cataracts, microphthalmia, coloboma, astigmatism, tracheomalacia, cutaneous mosaicism, pectus excavatum, scoliosis, hypermobility, hypospadias, diverticulum of Kommerell, pyloric stenosis, and pseudohypoparathryoidism. The majority of duplications were inherited with some carrier parents reporting learning disabilities or microcephaly. We identified additional, potentially contributory copy number changes in a subset of patients, including one patient each with 16p11.2 deletion and 15q13.3 deletion. Our data further define and expand the clinical spectrum associated with duplications of 17q12 and provide support for the role of genomic modifiers contributing to phenotypic variability. PMID:26420380

  13. Nuss procedure: Technical modifications to ease bending of the support bar and lateral stabilizer placement

    PubMed Central

    Karakuş, Osman Zeki; Ulusoy, Oktay; Hakgüder, Gülce; Ateş, Oğuz; Olguner, Çimen; Olguner, Mustafa; Akgür, Feza Mirac

    2016-01-01

    BACKGROUND: Modifications defined to ease bending of the support bar and lateral stabilizer placement during minimal invasive repair of pectus excavatum (MIRPE) have not been reported. We herein report our experience with MIRPE including several technical modifications. METHODS: A total of 87 patients who underwent MIRPE were evaluated retrospectively. Technical modifications are (1) a template drawn preoperatively according to the anthropometric measurements, (2) more laterally placed thoracal incisions, (3) single existing incision for multiple support bars, (4) to secure lateral stabilizers to support bar in inverted position. RESULTS: The mean patient age was 11.2 ± 3.8 years. The mean operating time was 63.7 ± 18.7 min. The mean Haller index was 5.4 ± 2.1. Eight patients necessitated two support bars. The support bars were removed in 69 patients after the completion of treatment. Support bars were left in place 26.8 ± 4.3 months. Final chest contours of the 56 patients were evaluated as 12 months passed after support bar removal and excellent repair results were determined in 84.2%. CONCLUSION: Preoperative bending of the support bar according to anthropometric measurements and fixation of the lateral stabilizers to the support bar in inverted position facilitates bar shaping and lateral stabilizer placement. PMID:27512512

  14. Familial interstitial deletion of the short arm of chromosome 4 (p15.33-p16.3) characterized by molecular cytogenetic analysis.

    PubMed

    Basinko, Audrey; Douet-Guilbert, Nathalie; Parent, Philippe; Blondin, Gilles; Mingam, M; Monot, Françoise; Morel, Frédéric; Le Bris, Marie-Josée; De Braekeleer, Marc

    2008-04-01

    This 15-month boy was expressed at the cytogenetic laboratory because of psychomotor development delay. He was tall and had plagiocephaly, micrognathia, high nasal bridge, anteverted nostrils and pectus excavatum. A 46,XY,del(4)(p16.1p16.3) karyotype was found using high-resolution R-banding technique. FISH studies using the LSI Wolf-Hirschhorn dual color 4p16.3 and the TelVysion 4p probes showed no deletion. Using BACs, the distal breakpoint was located in 4p16.3, between RP11-165K4 and RP11-717M10 and the proximal breakpoint in 4p15.33, between RP11-74M11 and RP11-1J7; therefore, approximately 7.96 Mb of the short arm were deleted. The maternal karyotype showed the same deletion, but in a mosaic status. Two distinct phenotypes have been recognized on the basis of the chromosomal bands involved in 4p deletion: the Wolf-Hirschhorn syndrome (WHS) and a proximal 4p deletion syndrome (4p15.2-p15.32). Our observation confirms that the basic WHS phenotype maps distally to this region. PMID:18302281

  15. [Prune-Belly Syndrome: a case report].

    PubMed

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

    2014-01-01

    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

  16. Impact of Epidural Failures on the Results of a Prospective, Randomized Trial.

    PubMed

    Desai, Amita; Alemayehu, Hanna; Weesner, Kathryn A; St Peter, Shawn D

    2016-04-01

    Introduction We conducted a prospective randomized trial to evaluate the merits of two established postoperative pain management strategies: thoracic epidural (EPI) versus patient-controlled analgesia (PCA) with intravenous narcotics after minimally invasive repair of pectus excavatum. Pain scores favored the EPI group for the first two postoperative days only. Critics of the trial suggest that if the epidural failure rate was not so high, results may have favored the EPI group. Therefore, we performed a subset analysis of the EPI group to evaluate the impact of these failures. Methods Patients for whom epidural catheter could not be placed or whose catheters were removed early owing to dysfunction were compared with those with well-functioning catheters. Those with well-functioning catheters were also compared with the PCA group. A two-tailed independent Student t-test and a two-tailed Fisher exact test were used where appropriate. Results Of 55 patients in the EPI group, 12 patients (21.8%) had failed placement or required early removal. Comparing those with failed placements with the rest of the group, there was no difference in daily visual analogue scale pain scores or measures of hospital course. Likewise, comparing those with well-functioning catheters only to those in the PCA group, the results of the trial are replicated in terms of pain scores, hospital course, and length of stay. Conclusion In patients with failed epidural therapy, there is no significant difference in postoperative hospital course. Comparing those with well-functioning catheters to those in the PCA group, trial results are replicated-that is, no significant difference in length of stay, time to regular diet, or time to transition to oral medications. Therefore, failure rate in the EPI group did not influence the results of the trial. PMID:25643246

  17. Malan syndrome: Sotos-like overgrowth with de novo NFIX sequence variants and deletions in six new patients and a review of the literature.

    PubMed

    Klaassens, Merel; Morrogh, Deborah; Rosser, Elisabeth M; Jaffer, Fatima; Vreeburg, Maaike; Bok, Levinus A; Segboer, Tim; van Belzen, Martine; Quinlivan, Ros M; Kumar, Ajith; Hurst, Jane A; Scott, Richard H

    2015-05-01

    De novo monoallelic variants in NFIX cause two distinct syndromes. Whole gene deletions, nonsense variants and missense variants affecting the DNA-binding domain have been seen in association with a Sotos-like phenotype that we propose is referred to as Malan syndrome. Frameshift and splice-site variants thought to avoid nonsense-mediated RNA decay have been seen in Marshall-Smith syndrome. We report six additional patients with Malan syndrome and de novo NFIX deletions or sequence variants and review the 20 patients now reported. The phenotype is characterised by moderate postnatal overgrowth and macrocephaly. Median height and head circumference in childhood are 2.0 and 2.3 standard deviations (SD) above the mean, respectively. There is overlap of the facial phenotype with NSD1-positive Sotos syndrome in some cases including a prominent forehead, high anterior hairline, downslanting palpebral fissures and prominent chin. Neonatal feeding difficulties and/or hypotonia have been reported in 30% of patients. Developmental delay/learning disability have been reported in all cases and are typically moderate. Ocular phenotypes are common, including strabismus (65%), nystagmus (25% ) and optic disc pallor/hypoplasia (25%). Other recurrent features include pectus excavatum (40%) and scoliosis (25%). Eight reported patients have a deletion also encompassing CACNA1A, haploinsufficiency of which causes episodic ataxia type 2 or familial hemiplegic migraine. One previous case had episodic ataxia and one case we report has had cyclical vomiting responsive to pizotifen. In individuals with this contiguous gene deletion syndrome, awareness of possible later neurological manifestations is important, although their penetrance is not yet clear. PMID:25118028

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

    PubMed Central

    2009-01-01

    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

  19. Randomized trial of epidural vs. subcutaneous catheters for managing pain after modified Nuss in adults

    PubMed Central

    Temkit, M’hamed; Ewais, MennatAllah M.; Luckritz, Todd C.; Stearns, Joshua D.; Craner, Ryan C.; Gaitan, Brantley D.; Ramakrishna, Harish; Thunberg, Christopher A.; Weis, Ricardo A.; Myers, Kelly M.; Merritt, Marianne V.; Rosenfeld, David M.

    2016-01-01

    Background Minimally invasive repair of pectus excavatum (MIRPE) is now performed in adults. Managing adult patients’ pain postoperatively has been challenging due to increased chest wall rigidity and the pressure required for supporting the elevated sternum. The optimal pain management regimen has not been determined. We designed this prospective, randomized trial to compare postoperative pain management and outcomes between thoracic epidural analgesia (TEA) and bilateral subcutaneous infusion pump catheters (On-Q). Methods Patients undergoing MIRPE (modified Nuss) underwent random assignment to TEA or On-Q group. Both groups received intravenous, patient-controlled opioid analgesia, with concomitant delivery of local anesthetic. Primary outcomes were length of stay (LOS), opioid use, and pain scores. Results Of 85 randomly assigned patients, 68 completed the study [52 men, 76.5%; mean (range) age, 32.2 (20.0–58.0) years; Haller index, 5.9 (range, 3.0-26.7)]. The groups were equally matched for preoperative variables; however, the On-Q arm had more patients (60.3%). No significant differences were found between groups in mean daily pain scores (P=0.52), morphine-equivalent opioid usage (P=0.28), or hospital stay 3.5 vs. 3.3 days (TEA vs. On-Q; P=0.55). Thirteen patients randomized to TEA refused the epidural and withdrew from the study because they perceived greater benefit of the On-Q system. Conclusions Postoperative pain management in adults after MIRPE can be difficult. Both continuous local anesthetic delivery by TEA and On-Q catheters with concomitant, intravenous, patient-controlled anesthesia maintained acceptable analgesia with a reasonable LOS. In our cohort, there was preference for the On-Q system for pain management.

  20. Malan syndrome: Sotos-like overgrowth with de novo NFIX sequence variants and deletions in six new patients and a review of the literature

    PubMed Central

    Klaassens, Merel; Morrogh, Deborah; Rosser, Elisabeth M; Jaffer, Fatima; Vreeburg, Maaike; Bok, Levinus A; Segboer, Tim; van Belzen, Martine; Quinlivan, Ros M; Kumar, Ajith; Hurst, Jane A; Scott, Richard H

    2015-01-01

    De novo monoallelic variants in NFIX cause two distinct syndromes. Whole gene deletions, nonsense variants and missense variants affecting the DNA-binding domain have been seen in association with a Sotos-like phenotype that we propose is referred to as Malan syndrome. Frameshift and splice-site variants thought to avoid nonsense-mediated RNA decay have been seen in Marshall–Smith syndrome. We report six additional patients with Malan syndrome and de novo NFIX deletions or sequence variants and review the 20 patients now reported. The phenotype is characterised by moderate postnatal overgrowth and macrocephaly. Median height and head circumference in childhood are 2.0 and 2.3 standard deviations (SD) above the mean, respectively. There is overlap of the facial phenotype with NSD1-positive Sotos syndrome in some cases including a prominent forehead, high anterior hairline, downslanting palpebral fissures and prominent chin. Neonatal feeding difficulties and/or hypotonia have been reported in 30% of patients. Developmental delay/learning disability have been reported in all cases and are typically moderate. Ocular phenotypes are common, including strabismus (65%), nystagmus (25% ) and optic disc pallor/hypoplasia (25%). Other recurrent features include pectus excavatum (40%) and scoliosis (25%). Eight reported patients have a deletion also encompassing CACNA1A, haploinsufficiency of which causes episodic ataxia type 2 or familial hemiplegic migraine. One previous case had episodic ataxia and one case we report has had cyclical vomiting responsive to pizotifen. In individuals with this contiguous gene deletion syndrome, awareness of possible later neurological manifestations is important, although their penetrance is not yet clear. PMID:25118028

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

    PubMed Central

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

    2009-01-01

    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

  2. A novel rasopathy caused by recurrent de novo missense mutations in PPP1CB closely resembles Noonan syndrome with loose anagen hair.

    PubMed

    Gripp, Karen W; Aldinger, Kimberly A; Bennett, James T; Baker, Laura; Tusi, Jessica; Powell-Hamilton, Nina; Stabley, Deborah; Sol-Church, Katia; Timms, Andrew E; Dobyns, William B

    2016-09-01

    Noonan syndrome is a rasopathy caused by mutations in multiple genes encoding components of the RAS/MAPK pathway. Despite its variable phenotype, limited genotype-phenotype correlations exist. Noonan syndrome with loose anagen hair (NS-LAH) is characterized by its distinctive hair anomalies, developmental differences, and structural brain abnormalities and is caused by a single recurrent missense SHOC2 mutation. SHOC2 forms a complex with protein phosphatase 1 (PP1C). Protein phosphatases counterbalance kinases and control activation of signaling proteins, such as the mitogen-activated protein kinases of the RAS/MAPK pathway. Here we report four patients with de novo missense mutations in protein phosphatase one catalytic subunit beta (PPP1CB), sharing a recognizable phenotype. Three individuals had the recurrent PPP1CB c.146G>C, p.Pro49Arg mutation, the fourth had a c.166G>C, p.Ala56Pro change. All had relative or absolute macrocephaly, low-set and posteriorly angulated ears, and developmental delay. Slow growing and/or sparse hair and/or an unruly hair texture was present in all. Three individuals had feeding difficulties requiring feeding tubes. One of two males had cryptorchidism, another had pectus excavatum. Short stature was present in three. A female with the recurrent mutation had a Dandy-Walker malformation and optic nerve hypoplasia. Mild ventriculomegaly occurred in all, cerebellar tonsillar ectopia was seen in two and progressed to Chiari 1 malformation in one individual. Based on the combination of phenotypic findings and PPP1CB's effect on RAF dephosphorylation within the RAS/MAPK pathway, this novel condition can be considered a rasopathy, most similar to NS-LAH. Collectively, these mutations meet the standardized criteria for pathogenicity. © 2016 Wiley Periodicals, Inc. PMID:27264673

  3. Como Lo Hago Yo: Tratamiento Quirurgico Del Mielomeningocele

    PubMed Central

    Portillo, Santiago

    2014-01-01

    En Argentina hay plan de fortificación con ácido fólico. Diagnostico prenatal no siempre es correcto. Cierre según técnica. Cerramos músculo. No favorecemos corpectomía temprana en casos de cifosis. Suturamos la plaqueta. Cerramos el plano muscular. Hidrocefalia: Válvula de derivación, generalmente dentro de los dos primeros meses. Ventriculostomía no está indicada. Chiari II. Laminectomia cervical alta. Siringomielia: Derivación desde la cavidad al peritoneo. PMID:24791219

  4. Chromosome 10q tetrasomy: First reported case

    SciTech Connect

    Blackston, R.D.; May, K.M.; Jones, F.D.

    1994-09-01

    While there are several reports of trisomy 10q (at least 35), we are not aware of previous cases of 10q tetrasomy. We present what we believe to be the initial report of such a case. R.J. is a 6 1/2 year old white male who presented with multiple dysmorphic features, marked articulation problems, hyperactivity, and developmental delays. He is the product of a term uncomplicated pregnancy. There was a normal spontaneous vaginal delivery with a birth weight of 6 lbs. 4oz. and length was 19 1/2 inch. Dysmorphic features include small size, an asymmetrically small head, low set ears with overfolded helixes, bilateral ptosis, downslanting eyes, right eye esotropia, prominent nose, asymmetric facies, high palate, mild pectus excavatum deformity of chest, and hyperextensible elbow joints. The patient is in special needs classes for mildly mentally handicapped students. Chromosome analysis at a resolution of 800 bands revealed a complex rearrangement of chromosomes 10 and 11. The segment 10q25.3 to q16.3 appears to be inverted and duplicated within the long arm of chromosome 10 at band q25.3 and the same segment of chromosome 10 is present on the terminal end of the short arm of chromosome 11. There is no visible loss of material from chromosome 11. Fluorescence in situ hybridization was performed with a chromosome 10 specific {open_quotes}paint{close_quotes} to confirm that all of the material on the abnormal 10 and the material on the terminal short arm of 11 was from chromosome 10. Thus, it appears that the segment 10q25.3 to q26.3 is present in four copies. Parental chromosome studies are normal. We compared findings which differ in that the case of 10q tetrasomy did not have prenatal growth deficiency, microphthalmia, cleft palate, digital anomalies, heart, or renal defects. Whereas most cases of 10q trisomy are said to have severe mental deficiency, our case of 10q tetrasomy was only mildly delayed. We report this first apparent cited case of 10q tetrasomy.

  5. Prevalence of Olfactory and Other Developmental Anomalies in Patients with Central Hypogonadotropic Hypogonadism

    PubMed Central

    Della Valle, Elisa; Vezzani, Silvia; Rochira, Vincenzo; Granata, Antonio Raffaele Michele; Madeo, Bruno; Genovese, Elisabetta; Pignatti, Elisa; Marino, Marco; Carani, Cesare; Simoni, Manuela

    2013-01-01

    Introduction: Hypogonadotropic hypogonadism (HH) is a heterogeneous disease caused by mutations in several genes. Based on the presence of hyposmia/anosmia it is distinguished into Kallmann syndrome (KS) and isolated HH. The prevalence of other developmental anomalies is not well established. Methods: We studied 36 patients with HH (31 males, 5 females, mean age 41.5), 9 with familial and 27 with sporadic HH (33 congenital, 3 adult-onset), by physical examination, smell test (BSIT Sensonics), audiometry, renal ultrasound, and magnetic resonance imaging of the olfactory structures. Results: Based on the smell test, patients were classified as normosmic (n = 21, 58.3%) and hypo/anosmic (n = 15, 41.6%). Hypoplasia/agenesis of olfactory bulbs was found in 40% of patients (10/25; 75% hypo/anosmic, 7.6% normosmic, p < 0.01, Fisher’s test). Remarkably, olfactory structures were normal in two anosmic patients, while one normosmic patient presented a unilateral hypoplastic bulb. Fourteen of 33 patients (42.4%) presented neurosensorial hearing loss of various degrees (28.5% hypo/anosmic, 52.6% normosmic, p = NS). Renal ultrasound revealed 27.7% of cases with renal anomalies (26.6% hypo/anosmic, 28.5% normosmic, p = NS). At least one midline defect was found in 50% of the patients (53.3% hypo/anosmic, 47.6% normosmic, p = NS), including abnormal palate, dental anomalies, pectus excavatum, bimanual synkinesis, iris coloboma, and absent nasal cartilage. Anamnestically 4/31 patients reported cryptorchidism (25% hypo/anosmic, 5.2% normosmic, p = NS). Conclusion: Hypo/anosmia is significantly related to anatomical anomalies of the olfactory bulbs/tracts but the prevalence of other developmental anomalies, especially midline defects and neurosensorial hearing loss, is high both in HH and KS and independent of the presence of anosmia/hyposmia. From the clinical standpoint KS and normosmic HH should be considered as the same complex, developmental

  6. Tratamiento del cáncer sin daño al corazón

    Cancer.gov

    Investigadores de los campos de oncología y de cardiología están trabajando para encontrar formas de impedir, manejar y posiblemente aun revertir los efectos secundarios cardiovasculares de ciertas terapias del cáncer.

  7. Innovative manure treatments in the USA – state of the art (Tratamientos Innovadores de estiercoles en USA - estado del arte)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Currently, the potential impact of manure on the environment represents one of the world agriculture’s major challenges. Treatment technologies can play an important role in the management of livestock manure by providing a more flexible approach to land application and acreage limitations and by so...

  8. La espiritualidad en el tratamiento del cáncer (PDQ®)—Versión para pacientes

    Cancer.gov

    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.

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

    PubMed Central

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

    2011-01-01

    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

  10. La espiritualidad en el tratamiento del cáncer (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    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.

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

    PubMed

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

    2010-09-01

    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

  12. Los pronombres de cortesia: su tratamiento en espanol y en otros idiomas, El adverbio (Pronouns of Courtesy: Their Treatment in Spanish and Other Languages, the Adverbs)

    ERIC Educational Resources Information Center

    Criado de Val, Manuel

    1973-01-01

    Compares use of pronouns and adverbs in Spanish, French, Italian, Portuguese, English, German, Rumanian, and Slavic languages. Excerpted from the book Fisonomia del y de las lenguas modernas'' ( Features of Modern Languages''). (DS)

  13. Testing road surface treatments to reduce erosion in forest roads in Honduras [Tratamientos de la superficie de rodadura para reducir la erosion en caminos forestales en Honduras

    USGS Publications Warehouse

    Rivera, Samuel; Kershner, Jeffrey L.; Keller, Gordon R.

    2009-01-01

    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.

  14. Late Holocene Bottom Water Temperature Variations from the Herald Canyon, western Chukchi Sea

    NASA Astrophysics Data System (ADS)

    Barrientos, N.; Coxall, H.; Lear, C. H.; Jakobsson, M.; O'Regan, M.; Pearce, C.; Stranne, C.; Muschitiello, F.; Koshurnikov, A.

    2015-12-01

    We present coupled stable isotope and trace metal records in benthic foraminifera to investigate the variability in past bottom water temperatures (BWT) from Core SWERUS-L2-2-PC1 (8.28 m) collected during the SWERUS-C3 Leg 2 Expedition in 2014. The core was retrieved at 71.7 m water depth from the Herald Trough, western Chukchi Sea. Radiocarbon dates revealed late Holocene linear sedimentation rates allowing the study of the core in high resolution. Preliminary Mg/Ca ratios in Nonionella labradorica and Elphidium excavatum clavatum with paired stable isotopes in Elphidium excavatum clavatum show a shift to either warmer or fresher bottom waters at around 2000-1800 years BP that suggests changes in the Pacific freshwater input via the Bering Strait.

  15. Interaction between ticks (Acari: Ixodidae) and pathogenic nematodes (Nematoda): susceptibility of tick species at various developmental stages.

    PubMed

    Samish, M; Alekseev, E; Glazer, I

    1999-11-01

    The virulence of entomopathogenic nematodes (Steinernematidae and Heterorhabditidae) to tick species under laboratory conditions is reported. The susceptibility of larval, nymphal, and adult stages of the ticks Hyalomma excavatum (Koch), Rhipicephalus bursa (Canestrini & Fanz), and R. sanguineus (Latereille) to 2 strains of Steinernema carpocapsae and 3 strains of Heterorhabditis bacteriophora were compared in laboratory assays. Preimaginal stages of ticks were found to be more resistant to the nematodes than were adult ticks which exhibited 80-100% mortality in a dish containing 5,000 infective juveniles of H. bacteriophora IS-3 or IS-5 strains isolated in Israel. These 2 strains were found to be much more virulent to unfed adult ticks than were the other isolates. No marked difference was found between engorged ticks and unfed adults of R. sanguineus or H. excavatum in terms of mortality, whereas engorged males and unfed females of R. bursa were significantly more susceptible than unfed males or engorged females. PMID:10593074

  16. [Treatment of type 2 diabetes mellitus in patients with chronic kidney disease. Grupo de Trabajo para el Documento de Consenso sobre el tratamiento de la diabetes tipo 2 en el paciente con enfermedad renal crónica].

    PubMed

    Gómez-Huelgas, Ricardo; Martínez-Castelao, Alberto; Artola, Sara; Górriz, José Luis; Menéndez, Edelmiro

    2014-01-21

    Chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM) are highly prevalent chronic diseases, which represent an important public health problem and require a multidisciplinary management. T2DM is the main cause of CKD and it also causes a significant comorbidity with regard to non-diabetic nephropathy. Patients with diabetes and kidney disease represent a special risk group as they have higher morbi-mortality as well as higher risk of hypoglycemia than diabetic individuals with a normal kidney function. Treatment of T2DM in patients with CKD is controversial because of the scarcity of available evidence. The current consensus report aims to ease the appropriate selection and dosage of antidiabetic treatments as well as the establishment of safety objectives of glycemic control in patients with CKD. PMID:24268912

  17. Primary angioplasty vs. fibrinolysis in very old patients with acute myocardial infarction: TRIANA (TRatamiento del Infarto Agudo de miocardio eN Ancianos) randomized trial and pooled analysis with previous studies

    PubMed Central

    Bueno, Héctor; Betriu, Amadeo; Heras, Magda; Alonso, Joaquín J.; Cequier, Angel; García, Eulogio J.; López-Sendón, José L.; Macaya, Carlos; Hernández-Antolín, Rosana; Bueno, Héctor; Hernández-Antolín, Rosana; Alonso, Joaquín J.; Betriu, Amadeo; Cequier, Angel; García, Eulogio J.; Heras, Magda; López-Sendón, José L.; Macaya, Carlos; Azpitarte, José; Sanz, Ginés; Chamorro, Angel; López-Palop, Ramón; Sionis, Alex; Arós, Fernando; García-Fernández, Eulogio; Rubio, Rafael; Hernández, Felipe; Tascón, Juan Carlos; Moreu, José; Betriu, Amadeu; Heras, Magda; Hernández-Antolín, Rosana; Fernández-Ortiz, Antonio; Morís, César; de Posada, Ignacio Sánchez; Cequier, Ángel; Esplugas, Enrique; Melgares, Rafael; Bosa, Francisco; García-González, Martín Jesús; Lezáun, Román; Carmona, José Ramón; Vázquez, José Manuel; Castro-Beiras, Alfonso; Picart, Joan García; de Rozas, José Domínguez; Fernández, José Díaz; Vázquez, Felipe Fernández; Alonso, Norberto; Zueco, José Javier; San José, José María; San Román, Alberto; Hernández, Carolina; García, José María Hernández; Alcántara, Ángel García; Bethencourt, Armando; Fiol, Miquel; Mancisidor, Xabier; Mancisidor, Xabier; Ruiz, Rafael; Hidalgo, Rafael; Sobrino, Nicolás; Maqueda, Isidoro González; Torres, Alfonso; Arós, Fernando; Amaro, Antonio; Jaquet, Michel

    2011-01-01

    Aims To compare primary percutaneous coronary intervention (pPCI) and fibrinolysis in very old patients with ST-segment elevation myocardial infarction (STEMI), in whom head-to-head comparisons between both strategies are scarce. Methods and results Patients ≥75 years old with STEMI <6 h were randomized to pPCI or fibrinolysis. The primary endpoint was a composite of all-cause mortality, re-infarction, or disabling stroke at 30 days. The trial was prematurely stopped due to slow recruitment after enroling 266 patients (134 allocated to pPCI and 132 to fibrinolysis). Both groups were well balanced in baseline characteristics. Mean age was 81 years. The primary endpoint was reached in 25 patients in the pPCI group (18.9%) and 34 (25.4%) in the fibrinolysis arm [odds ratio (OR), 0.69; 95% confidence interval (CI) 0.38–1.23; P = 0.21]. Similarly, non-significant reductions were found in death (13.6 vs. 17.2%, P = 0.43), re-infarction (5.3 vs. 8.2%, P = 0.35), or disabling stroke (0.8 vs. 3.0%, P = 0.18). Recurrent ischaemia was less common in pPCI-treated patients (0.8 vs. 9.7%, P< 0.001). No differences were found in major bleeds. A pooled analysis with the two previous reperfusion trials performed in older patients showed an advantage of pPCI over fibrinolysis in reducing death, re-infarction, or stroke at 30 days (OR, 0.64; 95% CI 0.45–0.91). Conclusion Primary PCI seems to be the best reperfusion therapy for STEMI even for the oldest patients. Early contemporary fibrinolytic therapy may be a safe alternative to pPCI in the elderly when this is not available. Clinicaltrials.gov # NCT00257309. PMID:20971744

  18. Presentation of parathyroid adenoma with genu valgum and thoracic deformities.

    PubMed

    Zil-E-Ali, Ahsan; Latif, Aiza; Rashid, Anam; Malik, Asim; Khan, Haseeb Ahmed

    2016-01-01

    Parathyroid adenoma is the main cause of primary hyperparathyroidism. It is usually asymptomatic and occurs more commonly in adults. It presents with raised parathormone (PTH) and Ca+ levels in serum. Its presentation in adolescence is rare. We report one such incidence of a 14 years old girl who presented with bone pains short stature, and generalized muscle wasting. She was found to have genu valgum at the knee joint, pectus carniatum, scoliosis and cystic changes in pelvis and calvarium. Biochemical investigations and parathyroid Tc-99mMIBI scan confirmed the diagnosis of a parathyroid adenoma. The gland was removed by parathyroidectomy. Till date 12 such cases are reported and none had thoracic, vertebral or calvarium involvement. PMID:26712192

  19. Safe intubation in Morquio-Brailsford syndrome: A challenge for the anesthesiologist.

    PubMed

    Chaudhuri, Souvik; Duggappa, Arun Kumar Handigodu; Mathew, Shaji; Venkatesh, Sandeep

    2013-04-01

    Morquio-Brailsford syndrome is a type of mucopolysaccharidoses. It is a rare disease with features of short stature, atlantoaxial instability with risk of cord damage, odontoid hypoplasia, pectus carinatum, spine deformities, hepatomegaly, and restrictive lung disease. Neck movements during intubation are associated with the risk of quadriparesis due to cervical instability. This, along with the distortion of the airway anatomy due to deposition of mucopolysaccharides makes airway management arduous. We present our experience in management of difficult airway in a 3-year-old girl with Morquio-Brailsford syndrome posted for magnetic resonance imaging and computerized tomography scan of a suspected unstable cervical spine. As utmost sagacity during intubation is required, the child was intubated inside operation theatre in the presence of experienced anesthesiologists and then shifted to the peripheral location. Intubation was done with an endotracheal tube railroaded over a pediatric fibreoptic bronchoscope passed through the lumen of a classic laryngeal mask airway, keeping head in neutral position. PMID:23878456

  20. El dolor y el cáncer (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    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.

  1. Prurito (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    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.

  2. Cabozantinib y lenvatinib para cáncer renal

    Cancer.gov

    Artículo del blog del NCI sobre la aprobación reciente de la FDA de cabozantinib (Cabometyx®) y de lenvatinib (Lenvima®) para el tratamiento de pacientes cuyo cáncer avanzado de riñón ha evolucionado después de tratamiento con terapias antiangiogénicas.

  3. Prurito (PDQ®)—Versión para pacientes

    Cancer.gov

    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.

  4. Cáncer que regresa

    Cancer.gov

    El cáncer puede regresar cuando el tratamiento no elimina o destruye por completo todas las células cancerosas. Aprenda acerca de los diferentes tipos de recurrencia -recidiva- y cómo se vuelve a asignar un estadio al cáncer y se da tratamiento.

  5. Cannabis y canabinoides (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    Resumen de información revisada por expertos sobre el uso del Cannabis y canabinoides para el tratamiento de los efectos secundarios relacionados con el tratamiento del cáncer, como la náusea y el vómito.

  6. Cannabis y canabinoides (PDQ®)—Versión para pacientes

    Cancer.gov

    Resumen de información revisada por expertos sobre el uso del Cannabis y canabinoides para el tratamiento de los efectos secundarios relacionados con el tratamiento del cáncer como la náusea y el vómito.

  7. Hacer frente - Supervivencia

    Cancer.gov

    Muchos supervivientes de cáncer dicen que cuando terminó el tratamiento, fue difícil ajustarse a una nueva forma de vida. Entérese de cómo ajustarse a nuevos sentimientos y problemas que aparecen después del tratamiento del cáncer.

  8. Efectos tardíos y el linfoma de Hodgkin en estadio inicial

    Cancer.gov

    Los pacientes con linfoma de Hodgkin en estadio inicial que recibieron varios fármacos de quimioterapia como único tratamiento, tenían más probabilidad de sobrevivir 12 años después que los pacientes que recibieron tratamiento que incluía radioterapia.

  9. El dolor y el cáncer (PDQ®)—Versión para pacientes

    Cancer.gov

    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.

  10. Faltar a sesiones de radioterapia aumenta el riesgo de que regrese el cáncer

    Cancer.gov

    Pacientes que faltan a sesiones de radioterapia durante el tratamiento del cáncer tienen un riesgo mayor de que regrese su enfermedad, aun cuando eventualmente completen su plan de tratamiento con radiación, según un nuevo estudio.

  11. Prurito (PDQ®)—Versión para pacientes

    Cancer.gov

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

  12. Prurito (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    Resumen de información revisada por expertos acerca del prurito (picazón en la piel) como complicación del cáncer o su tratamiento. Se consideran los abordajes de manejo y tratamiento del prurito.

  13. New Coleoptera records from New Brunswick, Canada: Tenebrionidae and Zopheridae

    PubMed Central

    Webster, Reginald P.; Sweeney, Jon D.; DeMerchant, Ian; Bouchard, Patrice; Bousquet, Yves

    2012-01-01

    Abstract Thirteen species of Tenebrionidae are newly reported for New Brunswick, Canada. Paratenetus punctatus Spinola, Pseudocistela brevis (Say), Mycetochara foveata (LeConte), and Xylopinus aenescens LeConte are recorded for the first time from the Maritime provinces. Platydema excavatum (Say) is removed from the faunal list of New Brunswick, and the presence of Platydema americanum Laporte and Brullé for the province is confirmed. This brings the total number of species of Tenebrionidae known from New Brunswick to 42. Two species of Zopheridae, Bitoma crenata Fabricius and Synchita fuliginosa Melsheimer, are newly recorded for New Brunswick, bringing the number of species known from the province to four. Bitoma crenata is new to the Maritime provinces. Collection and habitat data are presented for these species. PMID:22539897

  14. High-resolution foraminiferal, isotopic, and trace element records from holocene estuarine deposits of San Francisco Bay, California

    USGS Publications Warehouse

    McGann, M.

    2008-01-01

    A 3.5-m gravity core (DJ6-93SF-6) from San Francisco Bay reveals a complex paleoclimatic history of the region over the last 3870 cal YBP. A polynomial equation based on 11 AMS 14C ages provides an excellent age model for the core, and environmental proxies for water temperature and salinity are derived from various foraminiferal abundances, stable carbon and oxygen isotopes, and Mg/Ca ratios. Two foraminiferal associations were identified by Q-mode cluster analysis: a colder-water Elphidium excavatum association and the warmer-water Ammonia beccarii-Elphidium gunteri association. The E. excavatum association dominates the core for all but about 600 years out of the last four millennia. At 3870 cal YBP, water temperatures were warm (13.9??C) and freshwater inflow was reduced compared with today. From 3590 to 2860 cal YBP, temperatures dropped 0.5??C and the climate remained dry. This was followed by a period of pronounced lower ??13C values, indicating that conditions became considerably wetter from 2860 to 2170 cal YBP. During this interval, the temperature oscillated frequently, peaking at 13.9??C at 2710 cal YBP, then dropping shortly thereafter to 12.8??C at 2420 cal YBP. Freshwater inflow gradually decreased between 2170 and 1950 cal YBP with a minimal rise in temperature, then changed quickly to colder and wetter conditions at 1900 cal YBP. Drier conditions then prevailed until 1480 cal YBP with water temperatures fluctuating between 13.1??C and 13.8??C, followed by wetter climate from 1480 to 1320 cal YBP. A significant faunal shift from the E. excavatum association to the A. beccarii-E. gunteri association occurred from 1250 to 650 cal YBP, possibly due to regional warming, decreased oxygen availability, and/or a change in the phyto-plankton community. Associated with this change in faunal composition were warm and dry conditions, representative of the Medieval Warm Period (Medieval Climatic Anomaly). A climatic shift coincident with the onset of the Little

  15. 137Cs content in the fruit bodies of various Tuber species.

    PubMed

    Lorenzelli, R; Zambonelli, A; Serra, F; Lamma, A

    1996-12-01

    In this research, the concentration of 137Cs in the fruit bodies of the Tuber species T. magnatum Pico, T. borchii Vitt., T. aestivum Vitt., and T. excavatum Vitt. collected in three different regions of Italy was determined. The values obtained have been compared to the soil concentration of 137Cs, and the transfer factor was determined. The radiocesium content of the examined fruit bodies ranged from 2.5 Bq kg(-1) to 33.3 Bq kg(-1) fresh weight; the median transfer factor values of the four species ranged between 0.06 and 0.6. Our findings indicate that the radiocesium level in truffles from these regions of Italy is generally low, and, thus, their consumption is not of radiological concern. The results may suggest certain hypotheses as to the mechanisms involved in radiocesium uptake in these fungi. PMID:8919081

  16. Rickettsial agents in Egyptian ticks collected from domestic animals.

    PubMed

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

    2006-01-01

    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

  17. Overview of the genus Briareum (Cnidaria, Octocorallia, Briareidae) in the Indo-Pacific, with the description of a new species

    PubMed Central

    Samimi-Namin, Kaveh; van Ofwegen, Leen P.

    2016-01-01

    Abstract The status of Indo-Pacific Briareum species (Cnidaria, Octocorallia, Briareidae) is reviewed by presenting their sclerite features and habitus descriptions. Following the re-examination of type material, museum specimens and newly collected specimens, a species identification key is provided. The species distributions are discussed and updated distribution ranges are depicted. Moreover, a new taxon, Briareum cylindrum sp. n. is described and depicted, whereas Briareum excavatum (Nutting, 1911) is synonymised with Briareum stechei (Kükenthal, 1908). Briareum hamrum (Gohar, 1948) is recorded from the Persian Gulf and Oman Sea for the first time. Consequently, in total four Briareum species are recognized in the Indo-Pacific; Briareum hamrum from the western Indian Ocean, and Briareum cylindrum sp. n., Briareum stechei, and Briareum violaceum from the central and eastern Indo-Pacific region. PMID:26877697

  18. {sup 137}Cs content in the fruit bodies of various Tuber species

    SciTech Connect

    Lorenzelli, R.; Lamma, A.; Zambonelli, A.; Serra, F.

    1996-12-01

    In this research, the concentration of {sup 137}Cs in the fruit bodies of the Tuber species T. magnatum Pico, T. borchii Vitt., T. aestivum Vitt., and T. excavatum Vitt. collected in three different regions of Italy was determined. The values obtained have been compared to the soil concentration of {sup 137}Cs, and the transfer factor was determined. The radiocesium content of the examined fruit bodies ranged from 2.5 Bq kg{sup {minus}1} to 33.3 Bq kg{sup {minus}1} fresh weight; the median transfer factor values of the four species ranged between 0.06 and 0.6. Our findings indicate that the radiocesium level in truffles from these regions of Italy is generally low, and, thus, their consumption is not of radiological concern. The results may suggest certain hypotheses as to the mechanisms involved in radiocesium uptake in these fungi. 19 refs., 1 fig., 4 tabs.

  19. Distribution of foraminifera in Pamlico Sound, North Carolina, over the past century

    USGS Publications Warehouse

    Abbene, I.J.; Culver, S.J.; Corbett, D.R.; Buzas, M.A.; Tully, L.S.

    2006-01-01

    Foraminiferal and radionuclide data have been used to investigate environmental change that has occurred within Pamlico Sound, North Carolina, over the last century. Environmental conditions were evaluated for three time slices; (1) the modern environment as determined by surficial (0-1 cm) sediments, (2) short-core intervals representing approximately 40 years BP, as determined by 137Cs activity, and (3) short-core intervals representing approximately 120 years BP, as determined by 210Pb activity. Cluster analysis distinguished four foraminiferal assemblages at the surface (0-1 cm): (1) Marsh Biofacies, (2) Estuarine Biofacies A, (3) Estuarine Biofacies B, and (4) Marine Biofacies. The Marsh Biofacies is characterized by typical marsh foraminifera such as Tiphotrocha comprimata, Trochammina inflata, Miliammina fusca and Haplophragmoides wilberti. Estuarine Biofacies A is distinguished from Estuarine Biofacies B by the greater relative abundance of the agglutinated species Ammotium salsum and Ammobaculites crassus in the former and the greater relative abundance of Elphidium excavatum in the latter. The Marine Biofacies is comprised completely of calcareous foraminifera (e.g., Elphidium excavatum, Hanzawaia strattoni, Cibicides lobatulus, Elphidium subarcticum, Quinqueloculina seminula and Elphidium galvestonense) and is restricted to tidal inlets. Down-core foraminiferal data indicate that approximately 120 years BP, Pamlico Sound was dominated by Estuarine Biofacies A, which is indicative of brackish conditions. Upcore in the 40 years BP and modern time slices, Estuarine Biofacies B is the more prominent assemblage within Pamlico Sound; this is indicative of increased salinity over time. Lowered salinity conditions 120 years BP may be the result of high hurricane activity over a several year period.

  20. Benthic foraminifera and environmental changes in Long Island Sound

    USGS Publications Warehouse

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

    2000-01-01

    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.

  1. Understanding and Facing Discipline-Related Challenges in the English as a Foreign Language Classroom at Public Schools (Comprensión y tratamiento de los retos asociados a la disciplina en el aula de lengua extranjera en escuelas públicas)

    ERIC Educational Resources Information Center

    Quintero Corzo, Josefina; Ramírez Contreras, Odilia

    2011-01-01

    Complying with school regulations and teachers' instructions is a basic principle of an excellent class; both novice and experienced teachers face challenging situations when getting into real classrooms, especially those related to classroom management. There are various reasons that explain discipline problems in public schools, as well as…

  2. Explore medicamentos | Smokefree Español

    Cancer.gov

    Aprenda sobre los medicamentos que lo ayudarán a dejar de fumar, incluso el tratamiento de reemplazo de la nicotina. El uso de estos medicamentos puede duplicar sus probabilidades de dejar de fumar definitivamente.

  3. ADHD Medications

    MedlinePlus

    ... How Can I Help a Friend Who Cuts? ADHD Medicines KidsHealth > For Teens > ADHD Medicines Print A ... Medicación para el tratamiento del TDAH (ADHD) Managing ADHD With Medicine Just about everyone has trouble concentrating ...

  4. Tumores carcinoides gastrointestinales—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del tumor carcinoide gastrointestinal, así como referencias a estudios clínicos y otros temas relacionados.

  5. Carcinoma de tumor primario desconocido—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del carcinoma de tumor primario desconocido, así como referencias a estudios clínicos y otros temas relacionados.

  6. Neoplasias mieloproliferativas y síndromes mielodisplásicos—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento de las neoplasias mieloproliferativas, así como referencias a estudios clínicos y otros temas relacionados.

  7. Benthic Foraminifera in the Changing Ecosystem of Long Island Sound

    NASA Astrophysics Data System (ADS)

    Thaler, B.; Thomas, E.; Varekamp, J. C.

    2004-05-01

    Long Island Sound (LIS) is an estuary in a heavily urbanized region; Long Island lies to its South, New York City (NYC) to its West and Connecticut to its North. The Connecticut River contributes >70% of the fresh water influx. LIS has a narrow opening to the West (into East River), but exchange with the ocean occurs dominantly at its eastern end, resulting in an east-west gradient in salinity. An east-west gradient is also present in indicators of anthropogenic contamination in the surface sediments (e.g., trace metals) because western LIS is close to the major source of anthropogenic input (NYC). In addition, bottom currents focus fine-grained, contaminant-loaded sediments there. Since the early 1970's western LIS and parts of central LIS have suffered summer hypoxia, probably as a result of increased algal growth caused by anthropogenic nitrogen input. Benthic foraminifera are eukaryote heterotrophic organisms with a calcareous or agglutinated test. We investigated changes in their populations over time in about 2m-long gravity cores in westernmost (WLIS75GGC1; 73o 40'W, 40o 52'N, 19m waterdepth) and coastal central LIS (B1GGC1; 73o 4'W, 41o 10'N, 8m water depth), to document environmental changes over the last millennium, including the time of European settlement and the industrial revolution and population increase. An age model was derived from metal pollution records and 14C dating. Before European settlement, the low-diversity benthic faunas in core B1GGC1, at a depth within the zone of light penetration, were dominated by Elphidium excavatum, a species feeding on living diatoms. In western LIS (below the zone of light penetration) this species was less abundant and Elphidium incertum and Buccella frigida were common. In both cores, the absolute abundance of benthic foraminifera and the relative abundance of Elphidium excavatum increased in the early 1800's, coinciding with a time of rapid increase in human population around LIS and slightly before an

  8. Paleoenvironmental changes during the past 2000 years, evidence from Kongsfjorden, Svalbard

    NASA Astrophysics Data System (ADS)

    Jernas, P.; Kristensen, D.; Koc, N.; Skirbekk, K.

    2009-04-01

    of fine grained sediment and decrease in ice rafting indicating less influence from glaciers. The foraminiferal species composition show decreasing content of agglutinated foraminifera down core caused by their low preservation potential. For this core site it confirms the importance of calcareous foraminifera as a fossil record tool. The two dominant species in the core are Elphidium excavatum and Nonionellina labradorica. During the last 2000 years the percentage of E. excavatum shows a general tendency to decrease while N. labradorica increases toward present. Elphidium excavatum is typical for arctic glaciomarine environments close to glaciers and ice caps, indicating harsh conditions (cold bottom waters temperatures, lower salinity) and probably extensive ice cover. Nonionellina labradorica indicates the vicinity of oceanographic fronts and high productivity. Another species Islandiella spp., often associated with increased productivity and presence of the sea ice edge, shows significant increase in percentage from 1000 to 800 cal yr BP. From 600 to 400 cal yr BP Bucella spp. start to decline suggesting increased sea ice cover and diminished influence of the Coastal Current on the inner shelf of Svalbard.

  9. 100 Years of benthic foraminiferal history on the inner Texas shelf inferred from fauna and stable isotopes: Preliminary results from two cores

    NASA Astrophysics Data System (ADS)

    Strauss, Josiah; Grossman, Ethan L.; Carlin, Joseph A.; Dellapenna, Timothy M.

    2012-04-01

    Coastal regions, such as the Texas-Louisiana shelf, are subject to seasonal hypoxia that strongly depends on the magnitude of freshwater discharge from local and regional river systems. We have determined benthic foraminiferal fauna and isotopic compositions in two 210Pb dated box cores (BR4 and BR5) to examine the evidence for nearshore hypoxia and freshwater discharge on the Texas shelf during the last 100 years. The 210Pb chronologies of both cores reveal sedimentation rates of 0.2 and 0.1 cm yr-1, translating to ˜60 and ˜90 year records. The fauna of both cores were almost exclusively composed of Ammonia parkinsoniana and Elphidium excavatum, indicating euryhaline ambient waters. The Ammonia-Elphidium (A-E) index, a qualitative measure of low oxygen conditions, shows an increase from values between 20 and 50 to near 100 in both cores, suggesting low oxygen conditions between 1960 and the core top. Between 1950 and 1960 (9-10 cm), low A-E values in BR4 coincide with high δ18O and δ13C values greater than 0‰ and -1‰ respectively. This event corresponds to severe drought (the Texas Drought of Record) over the Brazos River drainage basin and considerably reduced river discharge from 1948 to 1957. High A-E values prior to this event imply low-oxygen conditions were prevalent prior to anthropogenic exacerbation of Louisiana shelf hypoxia and at least since the dredging of a new Brazos River delta in 1929. Elphidium excavatum δ13C values are very low (-4‰) and indicative of significant vital effect. The δ13C values of A. parkinsoniana average -3‰ and exhibit little variability, most likely reflecting pore waters influenced by aerobic and anaerobic respiration. The association of lowered Brazos River discharge with more oxygenated shelf bottom waters suggests Brazos River discharge and shelf hypoxia are linked, but the influence of Mississippi-Atchafalaya discharge can also contribute to shelf stratification.

  10. Lack of segregation of a Marfan-like phenotype associating marfanoie habitus and mitral valve disease with fibrillin gene on chromosome 15

    SciTech Connect

    VanMaldergen, L.; Hilbert, P.; Gillerot, Y.

    1994-09-01

    Apart from typical Marfan syndrome (MS), several Marfan-like conditions are known. One of those is the MASS syndrome (Mitral involvement, Aortic dilatation, Skin and Skeletal abnormalities) defined by Pyeritz et al. Among these, a dominantly inherited mitral valve prolapse with marfanoid habitus have also been reported. Until now, except for a Marfan-like condition described by Boileau et al., all Marfan families are linked to fib 15. A large Belgian pedigree with 25 affected patients among 62 at risk subjects spanning four generations is described. A syndrome including marfanoid skeletal dysplasia (tall stature, dolichostenomelia, arachnodactyly, pectus carinatum joint dislocation), prolapse and/or myxomatous degeneration of the mitral valve, but without aortic dilatation of eye involvement was observed. Although the phenotype fulfills Berlin diagnostic criteria for MS, it closely resembles MASS syndrome. Preliminary linkage results show discordance aggregation insertion in the fib 15 gene, as evaluated by intragenic microsatellite fib 15. Since Dietz et al. described a similar patient with fib 15 gene, we suggest that this variant of Marfan syndrome is genetically heterogeneous and caused by mutations, some of which are allelic to classical Marfan syndrome plus a subtype, some of which are not. Linkage studies are under way to further characterize the gene involved in the present family.

  11. Dominant mutations in the type II collagen gene, COL2A1, produce spondyloepimetaphyseal dysplasia, Strudwick type.

    PubMed

    Tiller, G E; Polumbo, P A; Weis, M A; Bogaert, R; Lachman, R S; Cohn, D H; Rimoin, D L; Eyre, D R

    1995-09-01

    The chondrodysplasias are a heterogeneous group of disorders characterized by abnormal growth or development of cartilage. Current classification is based on mode of inheritance as well as clinical, histologic, and/or radiographic features. A clinical spectrum of chondrodysplasia phenotypes, ranging from mild to perinatal lethal, is due to defects in the gene for type II collagen, COL2A1. This spectrum includes Stickler syndrome, Kniest dysplasia, spondyloepiphyseal dysplasia congenita (SEDC), achondrogenesis type II, and hypochondrogenesis. Individuals affected with these disorders exhibit abnormalities of the growth plate, nucleus pulposus, and vitreous humor, which are tissues that contain type II collagen. The Strudwick type of spondyloepimetaphyseal dysplasia (SEMD) is characterized by disproportionate short stature, pectus carinatum, and scoliosis, as well as dappled metaphyses (which are not seen in SEDC). The phenotype was first described by Murdoch and Walker in 1969, and a series of 14 patients was later reported by Anderson et al. The observation of two affected sibs born to unaffected parents led to the classification of SEMD Strudwick as an autosomal recessive disorder. We now describe the biochemical characterization of defects in alpha 1(II) collagen in three unrelated individuals with SEMD Strudwick, each of which is due to heterozygosity for a unique mutation in COL2A1. Our data support the hypothesis that some cases, if not all cases, of this distinctive chondrodysplasia result from dominant mutations in COL2A1, thus expanding the clinical spectrum of phenotypes associated with this gene. PMID:7550321

  12. Phylloid pattern of pigmentary disturbance in a case of complex mosaicism.

    PubMed

    Ribeiro Noce, T; de Pina-Neto, J M; Happle, R

    2001-01-15

    Among the various types of pigmentary disturbances associated with mosaicism, the phylloid pattern (Greek phyllon = leaf, eidos = form) is characterized by multiple leaf-like patches reminiscent of an art nouveau painting. The number of cases displaying this unusual pattern is so far limited. We describe a phylloid pattern of hypomelanosis in a 3-year-old girl with multiple congenital anomalies including microcephaly, midfacial hypoplasia, cleft lip, coloboma, posteriorly rotated ears, pectus carinatum, and pronounced mental and physical retardation. In addition, this child had oval or oblong patches of hyperpigmentation involving the trunk in a horizontal arrangement dissimilar from the phylloid hypomelanotic pattern. In peripheral blood lymphocytes a karyotype 46,XX,-13,+t(13q;13q) was consistently found, whereas cultured skin fibroblasts showed a complex form of mosaicism comprising three different abnormal cell lines (46,XX,-13,+t(13q;13q)/45,XX,-13/45,XX,-13,+frag). This case provides further evidence that the phylloid pattern represents a separate category of pigmentary disturbance to be distinguished from other types of cutaneous mosaicism such as the lines of Blaschko or the checkerboard arrangement. PMID:11223850

  13. Identification of a Novel Missense FBN2 Mutation in a Chinese Family with Congenital Contractural Arachnodactyly Using Exome Sequencing.

    PubMed

    Deng, Hao; Lu, Qian; Xu, Hongbo; Deng, Xiong; Yuan, Lamei; Yang, Zhijian; Guo, Yi; Lin, Qiongfen; Xiao, Jingjing; Guan, Liping; Song, Zhi

    2016-01-01

    Congenital contractural arachnodactyly (CCA, OMIM 121050), also known as Beals-Hecht syndrome, is an autosomal dominant disorder of connective tissue. CCA is characterized by arachnodactyly, dolichostenomelia, pectus deformities, kyphoscoliosis, congenital contractures and a crumpled appearance of the helix of the ear. The aim of this study is to identify the genetic cause of a 4-generation Chinese family of Tujia ethnicity with congenital contractural arachnodactyly by exome sequencing. The clinical features of patients in this family are consistent with CCA. A novel missense mutation, c.3769T>C (p.C1257R), in the fibrillin 2 gene (FBN2) was identified responsible for the genetic cause of our family with CCA. The p.C1257R mutation occurs in the 19th calcium-binding epidermal growth factor-like (cbEGF) domain. The amino acid residue cysteine in this domain is conserved among different species. Our findings suggest that exome sequencing is a powerful tool to discover mutation(s) in CCA. Our results may also provide new insights into the cause and diagnosis of CCA, and may have implications for genetic counseling and clinical management. PMID:27196565

  14. Mucopolysaccharidosis type IVA (Morquio A disease): clinical review and current treatment.

    PubMed

    Tomatsu, S; Montaño, A M; Oikawa, H; Smith, M; Barrera, L; Chinen, Y; Thacker, M M; Mackenzie, W G; Suzuki, Y; Orii, T

    2011-06-01

    Mucopolysaccharidosis IVA (MPS IVA), also known as Morquio A, is a rare, autosomal recessive disorder caused by a deficiency of the lysosomal enzyme N-acetylgalatosamine-6-sulfate-sulfatase (GALNS), which catalyzes a step in the catabolism of glycosaminoglycans (GAGs), keratan sulfate (KS) and chondroitin-6-sulfate (C6S). It leads to accumulation of the KS and C6S, mainly in bone and cornea, causing a systemic skeletal chondrodysplasia. MPS IVA has a variable age of onset and variable rate of progression. Common presenting features include elevation of urinary and blood KS, marked short stature, hypoplasia of the odontoid process, pectus carinatum, kyphoscoliosis, genu valgum, laxity of joints and corneal clouding; however there is no central nervous system impairment. Generally, MPS IVA patients with a severe form do not survive beyond the third decade of life whereas those patients with an attenuated form may survive over 70 years. There has been no effective therapy for MPS IVA, and care has been palliative. Enzyme replacement therapy (ERT) and hematopoietic stem cell therapy (HSCT) have emerged as a treatment for mucopolysaccharidoses disorders, including Morquio A disease. This review provides an overview of the clinical manifestations, diagnosis and symptomatic management of patients with MPS IVA and describes potential perspectives of ERT and HSCT. The issue of treating very young patients is also discussed. PMID:21506915

  15. Skeletal Dysplasia, Global Developmental Delay, and Multiple Congenital Anomalies in a 5 year-old boy– Report of the Second Family with B3GAT3 mutation and Expansion of the Phenotype

    PubMed Central

    von Oettingen, Julia E.; Tan, Wen-Hann; Dauber, Andrew

    2015-01-01

    As a major component of the extracellular matrix, proteoglycans influence the mechanical properties of connective tissue and play an important role in cell-cell and cell-matrix interactions. Genetic defects of proteoglycan biosynthesis lead to multi-system disorders, often most prominently affecting the skeletal system and skin. Specific deficiencies in the enzymes involved in the biosynthesis of the linkage region between the core of the proteoglycan protein and its glycosaminoglycan side chains are known as linkeropathies. We report on a patient from a second family with a homozygous c.830 G>A (p.Arg277Gln) mutation in the B3GAT3 gene. The clinical features expand the previously reported phenotype of B3GAT3 mutations and of linkeropathies in general. This patient has short stature, facial dysmorphisms, skeletal findings, joint laxity, and cardiac manifestations similar to those previously associated with B3GAT3 mutations. However, he also has developmental delay, a visual refractory defect, dental defects, pectus carinatum, and skin abnormalities that have only been associated with linkeropathies caused by mutations in B4GALT6 and B4GALT7. He has bilateral inguinal hernias and atlanto-axial as well as atlanto-occipital instability that have not been previously associated with B3GAT3 mutations. We provide a detailed clinical report and a comparative overview of the phenotypic features of the linkeropathies caused by mutations in B3GAT3, B4GALT6 and B4GALT7. PMID:24668659

  16. In vitro and ex vivo evaluation of silica-coated super paramagnetic iron oxide nanoparticles (SPION) as biomedical photoacoustic contrast agent

    NASA Astrophysics Data System (ADS)

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

    2013-03-01

    The employment of contrast agents in photoacoustic imaging has gained significant attention within the past few years for their biomedical applications. In this study, the use of silica-coated superparamagnetic iron oxide (Fe3O4) nanoparticles (SPION) was investigated as a contrast agent in biomedical photoacoustic imaging. SPIONs have been widely used as Food-and-Drug-Administration (FDA)-approved contrast agents for magnetic resonance imaging (MRI) and are known to have an excellent safety profile. Using our frequency-domain photoacoustic correlation technique ("the photoacoustic radar") with modulated laser excitation, we examined the effects of nanoparticle size, concentration and biological medium (e.g. serum, sheep blood) on its photoacoustic response in turbid media (intralipid solution). Maximum detection depth and minimum measurable SPION concentration were determined experimentally. The detection was performed using a single element transducer. The nanoparticle-induced optical contrast ex vivo in dense muscular tissues (avian pectus) was evaluated using a phased array photoacoustic probe and the strong potential of silicacoated SPION as a possible photoacoustic contrast agent was demonstrated. This study opens the way for future clinical applications of nanoparticle-enhanced photoacoustic imaging in cancer therapy.

  17. Clinical report of a 17q12 microdeletion with additionally unreported clinical features.

    PubMed

    Roberts, Jennifer L; Gandomi, Stephanie K; Parra, Melissa; Lu, Ira; Gau, Chia-Ling; Dasouki, Majed; Butler, Merlin G

    2014-01-01

    Copy number variations involving the 17q12 region have been associated with developmental and speech delay, autism, aggression, self-injury, biting and hitting, oppositional defiance, inappropriate language, and auditory hallucinations. We present a tall-appearing 17-year-old boy with marfanoid habitus, hypermobile joints, mild scoliosis, pectus deformity, widely spaced nipples, pes cavus, autism spectrum disorder, intellectual disability, and psychiatric manifestations including physical and verbal aggression, obsessive-compulsive behaviors, and oppositional defiance. An echocardiogram showed borderline increased aortic root size. An abdominal ultrasound revealed a small pancreas, mild splenomegaly with a 1.3 cm accessory splenule, and normal kidneys and liver. A testing panel for Marfan, aneurysm, and related disorders was negative. Subsequently, a 400 K array-based comparative genomic hybridization (aCGH) + SNP analysis was performed which identified a de novo suspected pathogenic deletion on chromosome 17q12 encompassing 28 genes. Despite the limited number of cases described in the literature with 17q12 rearrangements, our proband's phenotypic features both overlap and expand on previously reported cases. Since syndrome-specific DNA sequencing studies failed to provide an explanation for this patient's unusual habitus, we postulate that this case represents an expansion of the 17q12 microdeletion phenotype. Further analysis of the deleted interval is recommended for new genotype-phenotype correlations. PMID:24991439

  18. Identification of a Novel Missense FBN2 Mutation in a Chinese Family with Congenital Contractural Arachnodactyly Using Exome Sequencing

    PubMed Central

    Deng, Hao; Lu, Qian; Xu, Hongbo; Deng, Xiong; Yuan, Lamei; Yang, Zhijian; Guo, Yi; Lin, Qiongfen; Xiao, Jingjing; Guan, Liping; Song, Zhi

    2016-01-01

    Congenital contractural arachnodactyly (CCA, OMIM 121050), also known as Beals-Hecht syndrome, is an autosomal dominant disorder of connective tissue. CCA is characterized by arachnodactyly, dolichostenomelia, pectus deformities, kyphoscoliosis, congenital contractures and a crumpled appearance of the helix of the ear. The aim of this study is to identify the genetic cause of a 4-generation Chinese family of Tujia ethnicity with congenital contractural arachnodactyly by exome sequencing. The clinical features of patients in this family are consistent with CCA. A novel missense mutation, c.3769T>C (p.C1257R), in the fibrillin 2 gene (FBN2) was identified responsible for the genetic cause of our family with CCA. The p.C1257R mutation occurs in the 19th calcium-binding epidermal growth factor-like (cbEGF) domain. The amino acid residue cysteine in this domain is conserved among different species. Our findings suggest that exome sequencing is a powerful tool to discover mutation(s) in CCA. Our results may also provide new insights into the cause and diagnosis of CCA, and may have implications for genetic counseling and clinical management. PMID:27196565

  19. Digital stereophotogrammetry as a new technique to quantify truncal deformity: a pilot study in persons with osteogenesis imperfecta.

    PubMed

    Gabor, Lisa R; Chamberlin, Andrew P; Levy, Ellen; Perry, Monique B; Cintas, Holly; Paul, Scott M

    2011-10-01

    The objective of this pilot study was to determine the usability of stereophotogrammetry (SP) as a noninvasive technique for obtaining linear measures and anatomical data of the torso in people with osteogenesis imperfecta in comparison with clinical observations. Ten participants were recruited from subjects enrolled in ongoing institutional review board-approved osteogenesis imperfecta protocols at the National Institute of Child Health and Human Development. Using a Gulick tape measure, anthropometer, and the SP system proprietary software, linear measurements of the torso were taken. In addition, the presence or absence of specific torso deformities was documented from both clinical observation and evaluation of SP images. Measurements of torso diameter and circumference by SP demonstrated strong agreement with the manual measurements (intraclass correlation coefficient = 0.995 and 0.964, respectively). Substantial and statistically significant agreement was present between SP image evaluation and clinical observation for pectus carinatum (κ = 0.52 ± 0.23) and thoracic scoliosis (κ = 0.72 ± 0.12). The kappa values between clinical observation and SP evaluations of other torso deformities were not significant. The strong correlations and P values determined by this study demonstrate the potential value of SP in studying persons with truncal deformities. However, the weak agreement between SP and some clinical observations suggests that further development of SP image analysis tools is required before SP can be used as a standard method of diagnosis or assessment of treatment success. PMID:21862911

  20. Preferences of different tick species for human hosts in Turkey.

    PubMed

    Kar, S; Dervis, E; Akın, A; Ergonul, O; Gargili, A

    2013-11-01

    The ticks removed from the patients who applied to the hospitals in Istanbul and neighboring cities, Turkey, with the complaint of tick bite were examined in this study, on account of their species, biological stages, attachment sites on the body, and the age of the affected patients. A total of 16,969 ticks were identified. Encountered species were as follows: 33.6 % Ixodes spp. immature, 25.3 % Hyalomma spp. immature, 24.3 % I. ricinus, 9.5 % Rhipicephalus sanguineus gr., 3.2 % R. bursa, 2.2 % Hyalomma marginatum, 1.96 % Haemaphysalis adults, 1.66 % Hyalomma aegyptium, 0.52 % Dermacentor marginatus, 0.39 % Rhipicephalus spp. nymphs, 0.12 % Dermacentor spp. nymphs, 0.11 % Haemaphysalis spp. nymphs, 0.09 % Hyalomma scupense, and 0.03 % Hyalomma excavatum. The distribution of attachment sites of the species and instars showed significant differences. Furthermore, age data of the patients also revealed that certain tick species were more common within certain age groups. PMID:23620419

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

    USGS Publications Warehouse

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

    1987-01-01

    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

  2. Palaeo-ecological quality status based on foraminifera of Boulogne-sur-Mer harbour (Pas-de-Calais, Northeastern France) over the last 200 years.

    PubMed

    Francescangeli, F; Armynot du Chatelet, E; Billon, G; Trentesaux, A; Bouchet, V M P

    2016-06-01

    Over the last centuries, coastal areas have experienced dramatic degradations of their environmental quality, which has led to a huge reduction of marine biodiversity. The objective of the present study was to use geochemical parameters and benthic fossil foraminifera to assess environmental changes that have occurred over the last 200 years in a harbour area (Boulogne-sur-Mer, Northern France) heavily modified by human activities. A multidisciplinary approach including major and trace metals, grain-size, total organic carbon and benthic fossil foraminifera, has been performed on a 33-cm long core. The dating was carried out using the activity of (210)Pb and (137)Cs. Embayment of the area and increase of trace metals concentrations induced a shift in benthic communities. Human activities modified a sandy nearshore bank, colonized by typical marine foraminiferal species, such as Cribroelphiudium excavatum, into a sheltered environment, dominated by brackish end-members, such as Haynesina germanica. Along the sedimentary record, the interaction between meiofaunal and geochemical elements made it possible to distinguish between a pre-impacted period and an industrial period. The upper part of the core reflects better ecological conditions, indicating an environmental recovery. Our results provide baselines for future environmental bio-monitoring in the area. PMID:27074196

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

    PubMed

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

    2007-12-01

    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

  4. Allergy to Surgical Implants.

    PubMed

    Pacheco, Karin A

    2015-01-01

    Surgical implants have a wide array of therapeutic uses, most commonly in joint replacements, but also in repair of pes excavatum and spinal disorders, in cardiac devices (stents, patches, pacers, valves), in gynecological implants, and in dentistry. Many of the metals used are immunologically active, as are the methacrylates and epoxies used in conjunction with several of these devices. Allergic responses to surgical components can present atypically as failure of the device, with nonspecific symptoms of localized pain, swelling, warmth, loosening, instability, itching, or burning; localized rash is infrequent. Identification of the specific metal and cement components used in a particular implant can be difficult, but is crucial to guide testing and interpretation of results. Nickel, cobalt, and chromium remain the most common metals implicated in implant failure due to metal sensitization; methacrylate-based cements are also important contributors. This review will provide a guide on how to assess and interpret the clinical history, identify the components used in surgery, test for sensitization, and provide advice on possible solutions. Data on the pathways of metal-induced immune stimulation are included. In this setting, the allergist, the dermatologist, or both have the potential to significantly improve surgical outcomes and patient care. PMID:26362550

  5. Survey on infection rate, vectors and molecular identification of Theileria annulata in cattle from North West, Iran.

    PubMed

    Arjmand Yamchi, Jafar; Tavassoli, Mousa

    2016-09-01

    Tropical theileriosis is a progressive bovine lymphoproliferative disease caused by the intracellular protozoan parasite Theileria annulata. In this study 138 blood samples and 289 ticks were collected and examined from cattle that belonged to 10 randomly selected flocks. The Tbs-S/Tbs-A primer set was used for PCR amplification of Theileria spp. and the Ta-S/Tbs-A specific primer set was used in semi-nested PCR technique for detection of T. annulata. Blood smears of each case were examined by Giemsa staining method. The semi-nested PCR accurately revealed 22 (15.94 %) positive samples; whereas Giemsa staining method could detect 15 (10.86 %) out of 138 blood samples. The examination of 289 ticks by semi-nested PCR revealed that, 32.86 % of Hyalomma anatulicum anatulicum, 26.47 % of Hyalomma anatulicum excavatum and 22.42 % of Hyalomma asiaticum asiaticum, were infected with T. annulata. The results suggest that H. anatulicum anatolicum may play a major role in transmission of T. annulata infection in Iran. The results indicated that the Giemsa staining method, having low sensitivity, while the semi-nested PCR technique can be used as a gold standard method for this purpose. PMID:27605839

  6. Late Holocene evolution and increasing pollution in Guanabara Bay, Rio de Janeiro, SE Brazil.

    PubMed

    Vilela, Claudia Gutterres; Figueira, Brígida Orioli; Macedo, Mariana Cardoso; Baptista Neto, José Antonio

    2014-02-15

    To detect changes during the Late Holocene and historical periods in Guanabara Bay, the paleoecological and ecological parameters from nine cores were analysed using foraminiferal assemblages and bioindicators. Using radiocarbon dates and sedimentation rates in the cores, it was possible to detect the first Europeans' arrival in the 16th century. Foraminiferal bioindicators of organic matter and human pollution were correlated with radiocarbon dates from the bottom and middle of the cores in each region and revealed an increase in pollution along the cores. The foraminiferal results were compared with total organic carbon (TOC) values before, during and after European settlement and showed a historical increase in organic matter. Pristine mangrove ecosystems are characterised by agglutinated species such as Ammotium salsum, and the presence of this organism also confirmed the extent of historical mangrove forests. Ammonia tepida, Buliminella elegantissima and Elphidium excavatum were the dominant species, but they presented distinct patterns over time. B. elegantissima was dominant before the European influence in older sediments with high organic matter content that were found at deeper intervals. A. tepida is dominant in younger sediments at upper intervals, as a bioindicator of human pollution. PMID:24373667

  7. Molecular Investigation of Francisella-Like Endosymbiont in Ticks and Francisella tularensis in Ixodid Ticks and Mosquitoes in Turkey.

    PubMed

    Duzlu, Onder; Yildirim, Alparslan; Inci, Abdullah; Gumussoy, Kadir Semih; Ciloglu, Arif; Onder, Zuhal

    2016-01-01

    This study was carried out to investigate the molecular prevalence of Francisella-like endosymbionts (FLEs) and Francisella tularensis in ticks (Acari: Ixodidae) and mosquitoes in Turkey. Genomic DNA pools were constructed from a total of 1477 adult hard ticks of Rhipicephalus (Rh.) annulatus, Rh. turanicus, Rh. sanguineus, Rh. bursa, Haemaphysalis (Hae.) parva, Hae. sulcata, Hyalomma marginatum marginatum, H. anatolicum anatolicum, H. anatolicum excavatum, H. detritum detritum, H. dromedarii, Dermacentor marginatus, and Ixodes ricinus species, which were collected from several barns, cattle, and people. Genomic DNA was also extracted from pools consisting of 6203 adult female mosquito species belonging to Aedes vexans, Culex (Cx.) pipiens, Cx. hortensis, Cx. theileri, Culiseta annulata, and Anopheles maculipennis species. Conventional PCR and TaqMan probe-based real- time PCR targeting the 16S rRNA gene for FLEs and the lpnA gene for F. tularensis, respectively, were performed on the DNA isolates obtained. FLEs and F. tularensis were not found in any genomic DNA pools constructed from ixodid ticks and mosquitos. This study represents the first investigation of F. tularensis and FLEs in potential vector ticks and mosquitoes by molecular methods in Turkey. The present study provides useful insights into the molecular epidemiology of F. tularensis and FLEs. One of the major conclusions of the study is that tularemia outbreaks may be essentially due to direct transmission from the environment (especially from water) in Turkey and not to vector-borne transmission. PMID:26741324

  8. First Molecular Identification and Genetic Characterization of Theileria lestoquardi in Sheep of the Maghreb Region.

    PubMed

    Rjeibi, M R; Darghouth, M A; Rekik, M; Amor, B; Sassi, L; Gharbi, M

    2016-06-01

    Theileria lestoquardi is the most prominent Theileria species in small ruminants that causes malignant theileriosis of sheep in Africa and Asia. In the present survey, blood samples and ticks were collected in Kebili (southern Tunisia) from 166 Queue Fine de l'Ouest sheep. Giemsa-stained blood smears, immunofluorescent antibody test (IFAT) and PCR were performed. The DNA was extracted from blood and analysed by PCR targeting 18S rRNA gene of Theileria spp. and then sequenced. A total number of 140 ticks were collected from a total number of 166 sheep during the four seasons. The ticks belonged to two genera and 4 species; the most frequent tick was Hyalomma excavatum 84.3% (118/140) and then Rhipicephalus spp. 15.7% (22/140). Only two animals had positive Giemsa-stained blood smears, and they were also positive by IFAT. The amplicons had 99.3 and 99.6% homology with the BLAST published T. lestoquardi amplicons. To our knowledge, this is the first report of T. lestoquardi in small ruminants within the Maghreb region. PMID:25208526

  9. How many entities exist for the spectrum of disorders associated with brachydactyly, syndactyly, short stature, microcephaly, and intellectual disability?

    PubMed

    Ravel, Aimé; Chouery, Eliane; Stora, Samantha; Jalkh, Nadine; Villard, Laurent; Temtamy, Samia; Mégarbané, André

    2011-04-01

    We describe a French young man with digital anomalies consisting of brachydactyly, F1-5 bilateral camptodactyly, interdigital webbing, F5 bilateral radial clinodactyly, and partial syndactyly of some fingers and toes. He had psychomotor retardation, short stature, umbilical hernia, a secundum atrial septal defect, seizures, hearing impairment, and dysmorphic features consisting of microcephaly, a prominent metopic ridge, upslanting palpebral fissures, synophrys, enophthalmia, large ears, a bulbous nose, a high palate, a smooth and short philtrum, a low hanging columella, a thin upper vermillion, an everted lower lip, prognathism, pectum excavatum, and supernumerary nipples. Osteotendinous reflexes were brisk. Mild nystagmus, myopia, and astigmatia were also noted. Total body X-rays showed short terminal phalanges of the hands, short middle phalanges of the index and little fingers, clinodactyly of the little fingers, short and fused proximal 4th and 5th metacarpals of the right hand, a short 5th metacarpal of the left hand, a fused left lunate-triquetrum, fused capitate-hamates, a prominent mandibula, and partial sacral agenesis. A thin posterior corpus callosum was apparent by MRI. Differential diagnoses for mainly the Rubinstein-Taybi syndrome, the Tsukahara syndrome, the Filippi syndrome, the Feingold syndrome, and the Tonoki syndrome are discussed, and the possibility that we might be reporting a novel entity is raised. © 2011 Wiley-Liss, Inc. PMID:21416592

  10. Novel mitoviruses in Rhizoctonia solani AG-3PT infecting potato.

    PubMed

    Das, Subha; Falloon, Richard E; Stewart, Alison; Pitman, Andrew R

    2016-03-01

    Double-stranded RNA (dsRNA) elements are ubiquitous in Rhizoctonia solani. Total dsRNA was randomly amplified from a R. solani isolate (RS002) belonging to anastomosis group-3PT (AG-3PT), associated with black scurf in potato. Assembly of resulting cDNA sequences identified a nearly complete genome of a novel virus related to the genus Mitovirus (family Narnaviridae), herein named Rhizoctonia mitovirus 1 RS002 (RMV-1-RS002). The 2797 nucleotide partial genome of RMV-1-RS002 is A-U rich (59.06 %), and can be folded into stable stem-loop structures at 5' and 3' ends. Universal and mold mitochondrial codon usages revealed a large open reading frame in the genome, putatively encoding an 826 amino acid polypeptide, which has conserved motifs for mitoviral RNA-dependent RNA polymerase. The full length putative polypeptide shared 25.6 % sequence identity with the corresponding region of Tuber excavatum mitovirus (TeMV). The partial genome of a second mitovirus (proposed name Rhizoctonia mitovirus 2 RS002 (RMV-2-RS002)) was also amplified from RS002. A nearly identical copy of RMV-1-RS002 was detected in two additional AG-3PT isolates. These data indicate that multiple mitoviruses can exist in a single isolate of R. solani AG-3PT, and that mitoviruses such as RMV-1-RS002 are probably widespread in this pathogen. The roles of mitoviruses in the biology of R. solani AG-3PT remain unknown. PMID:26895862

  11. [Not Available].

    PubMed

    Fort Casamartina, Eduard; Arribas Hortiguela, Lorena; Bleda Pérez, Carmen; Muñoz Sánchez, Carme; Peiro Martínez, Imma; Perayre Badía, María; Clopés Estela, Ana

    2016-01-01

    Durante la última década, el conocimiento de nuevos mecanismos implicados en el desarrollo del cáncer ha permitido el diseño de nuevos fármacos para su tratamiento y la mayor parte de ellos son fármacos que se administran por vía oral. Uno de los principales problemas de los pacientes oncohematológicos es la desnutrición, que suele tener causas multifactoriales (de la propia enfermedad, de los pacientes y de los diferentes tratamientos administrados). Para minimizar el impacto de la desnutrición es necesaria una intervención nutricional, ya sea adaptando la dieta o mediante la instauración de soporte nutricional artificial, en función de la gravedad de cada caso. En cualquier paciente que esté recibiendo un tratamiento oncológico hay que evaluar las posibles interacciones que pueden existir con el soporte nutricional instaurado, ya sea dieta oral, suplementación oral o nutrición enteral. Estas interacciones pueden disminuir la eficacia, aumentar la toxicidad de los tratamientos o producir déficits nutricionales. Se detallan las principales interacciones que se pueden producir, las interacciones entre los tratamientos oncológicos y el soporte nutricional. PMID:27269219

  12. Criptococosis cutánea primaria en paciente inmunocompetente.

    PubMed

    Osorio, Igor Vázquez; García-Rodiño, Sara; Rodríguez-Rodríguez, Marta; Labandeira, Javier; Suárez-Peñaranda, José Manuel; Sánchez-Aguilar, MDolores; Vázquez-Veiga, Hugo

    2016-01-01

    La criptococosis cutánea es una micosis propia de pacientes inmunodeprimidos, sobre todo aquellos con infección por el virusde la inmunodeficiencia humana (VIH). Sin embargo, existen casos infrecuentes de criptococosis cutánea en pacientes inmunocompetentes, que suelen simular otras dermatosis, lo que retrasa su diagnóstico y tratamiento. Presentamos el caso de un varón pluripatológico de 79 años, con úlceras dolorosas en dorso de mano derecha que no respondían a tratamientos tópicos. A través del estudio histopatológico y micológico se alcanzó el diagnóstico de criptococosis cutánea primaria, lográndose la remisión de las lesiones tras 6 meses de tratamiento con fluconazol. PMID:27617525

  13. Neuropsychological Status in Children After Repair of Acyanotic Congenital Heart Disease

    PubMed Central

    Quartermain, Michael D.; Ittenbach, Richard F.; Flynn, Thomas B.; Gaynor, J. William; Zhang, Xuemei; Licht, Daniel J.; Ichord, Rebecca N.; Nance, Michael L.; Wernovsky, Gil

    2016-01-01

    OBJECTIVES The majority of previous studies that described the neuropsychological effects of cardiopulmonary bypass (CPB) in children were performed after surgery in infancy for complex congenital heart disease (CHD). We sought to limit confounding variables and isolate potential independent effects of CPB by describing neuropsychological function in school-aged children after repair of acyanotic CHD. METHODS This was a prospective study of patients who were aged 5 to 18 years and undergoing repair of acyanotic CHD. Neuropsychological testing battery included assessment of intelligence, memory, motor, attention, executive function, and behavior before and 6 months after CPB. The independent effects of anesthesia, surgery, and hospitalization on neuropsychological function were assessed by testing a surgical control group of patients who were undergoing repair of pectus deformities. In addition, an outpatient group of children with mild CHD were enrolled to assess the practice effects of serial testing. RESULTS Patients included CPB (n = 35), surgical control (n = 19), and nonsurgical (n = 12). Groups were comparable in age, gender, and race and demonstrated similar unadjusted group mean scores on baseline and 6-month follow-up neuropsychological testing. When adjusted for practice effects, the CPB group performed similar to the non-CPB groups in all assessed neuropsychological domains, with the exception of 1 of 4 tests of executive function. CONCLUSIONS When controlling for the non-CPB effects of surgery (eg, hospitalization, anesthesia, thoracotomy) and the practice effects of serial testing, there were no consistent independent effects of CPB on neuropsychological status in a cohort of children and adolescents 6 months after repair of acyanotic CHD. PMID:20660542

  14. Therapies for the bone in mucopolysaccharidoses.

    PubMed

    Tomatsu, Shunji; Alméciga-Díaz, Carlos J; Montaño, Adriana M; Yabe, Hiromasa; Tanaka, Akemi; Dung, Vu Chi; Giugliani, Roberto; Kubaski, Francyne; Mason, Robert W; Yasuda, Eriko; Sawamoto, Kazuki; Mackenzie, William; Suzuki, Yasuyuki; Orii, Kenji E; Barrera, Luis A; Sly, William S; Orii, Tadao

    2015-02-01

    Patients with mucopolysaccharidoses (MPS) have accumulation of glycosaminoglycans in multiple tissues which may cause coarse facial features, mental retardation, recurrent ear and nose infections, inguinal and umbilical hernias, hepatosplenomegaly, and skeletal deformities. Clinical features related to bone lesions may include marked short stature, cervical stenosis, pectus carinatum, small lungs, joint rigidity (but laxity for MPS IV), kyphoscoliosis, lumbar gibbus, and genu valgum. Patients with MPS are often wheelchair-bound and physical handicaps increase with age as a result of progressive skeletal dysplasia, abnormal joint mobility, and osteoarthritis, leading to 1) stenosis of the upper cervical region, 2) restrictive small lung, 3) hip dysplasia, 4) restriction of joint movement, and 5) surgical complications. Patients often need multiple orthopedic procedures including cervical decompression and fusion, carpal tunnel release, hip reconstruction and replacement, and femoral or tibial osteotomy through their lifetime. Current measures to intervene in bone disease progression are not perfect and palliative, and improved therapies are urgently required. Enzyme replacement therapy (ERT), hematopoietic stem cell transplantation (HSCT), and gene therapy are available or in development for some types of MPS. Delivery of sufficient enzyme to bone, especially avascular cartilage, to prevent or ameliorate the devastating skeletal dysplasias remains an unmet challenge. The use of an anti-inflammatory drug is also under clinical study. Therapies should start at a very early stage prior to irreversible bone lesion, and damage since the severity of skeletal dysplasia is associated with level of activity during daily life. This review illustrates a current overview of therapies and their impact for bone lesions in MPS including ERT, HSCT, gene therapy, and anti-inflammatory drugs. PMID:25537451

  15. Natural history and clinical assessment of Taiwanese patients with mucopolysaccharidosis IVA

    PubMed Central

    2014-01-01

    Background Mucopolysaccharidosis IVA (MPS IVA) is a rare lysosomal storage disorder caused by N-acetylgalactosamine-6-sulfatase deficiency, which catalyzes a step in the catabolism of glycosaminoglycans, keratan sulfate and chondroitin-6-sulfate. This disease has a variable age of onset and rate of progression. Methods A retrospective analysis of medical records of 24 patients with MPS IVA (11 males, 13 females; current mean age ± SD, 12.6 ± 6.6 years; age range, 1.4-29.4 years) seen at 6 medical centers in Taiwan from January 1996 through June 2013 was performed. Results Mean ages of onset of symptoms and confirmed diagnosis were 2.0 ± 1.6 and 5.7 ± 4.5 years, respectively. The most prevalent clinical manifestations were kyphosis (100%), pectus carinatum (96%), abnormal gait (93%), striking short trunk dwarfism (92%), genu valgum (92%), and valvular heart disease (91%). Eight patients (33%) experienced at least one surgical procedure with the most common being ear tube insertion (25%), adenoidectomy (17%), tonsillectomy (13%), supraglottoplasty (13%), spinal decompression (13%), and spinal fusion (13%). The most prevalent cardiac valve abnormalities were aortic stenosis (45%) and mitral regurgitation (45%). At the time of the study, 8 out of 24 patients (33%) have died at the mean age of 17.2 ± 7.7 years. Conclusions An understanding of the natural history involved in MPS IVA may allow early diagnosis of the disease. All affected Taiwanese patients experienced significant functional limitations. Adequate evaluations and timely management may improve clinical outcomes and quality of life. PMID:24513086

  16. Clinical manifestations in 105 persons with nevoid basal cell carcinoma syndrome

    SciTech Connect

    Kimonis, V.E.; Yang, M.L.; Bale, S.J.

    1997-03-31

    Nevoid basal cell carcinoma syndrome (NBCC; Gorlin syndrome), an autosomal dominant disorder linked to 9q22.3-q31, and caused by mutations in PTC, the human homologue of the Drosophila patched gene, comprises multiple basal cell carcinomas, keratocysts of the jaw, palmar/plantar pits, spine and rib anomalies and calcification of the falx cerebri. We reviewed the findings on 105 affected individuals examined at the NIH since 1985. The data included 48 males and 57 females ranging in age from 4 months to 87 years. Eighty percent of whites (71/90) and 38% (5/13) of African-Americans had at least one basal cell carcinoma (BCC), with the first tumor occurring at a mean age of 23 (median 20) years and 21 (median 20) years, respectively. Excluding individuals exposed to radiation therapy, the number of BCCs ranged from 1 to >1,000 (median 8) and 1 to 3 (median 2), respectively, in the 2 groups. Jaw cysts occurred in 78/105 (74%) with the first tumor occurring in 80% by the age of 20 years. The number of total jaw cysts ranged from 1 to 28 (median 3). Palmar pits and plantar pits were seen in 87%. Ovarian fibromas were diagnosed by ultrasound in 9/52 (17%) at a mean age of 30 years. Medulloblastoma occurred in 4 patients at a mean age of 2.3 years. Three patients had cleft lip or palate. Physical findings include {open_quotes}coarse face{close_quotes} in 54%, relative macrocephaly in 50%, hypertelorism in 42%, frontal bossing in 27%, pectus deformity in 13%, and Sprengel deformity in 11%. This study delineates the frequency of the clinical and radiological anomalies in NBCC in a large population of US patients and discusses guidelines for diagnosis and management. 48 refs., 3 figs., 5 tabs.

  17. Therapies for the bone in mucopolysaccharidoses

    PubMed Central

    Tomatsu, Shunji; Alméciga-Díaz, Carlos J.; Montaño, Adriana M.; Yabe, Hiromasa; Tanaka, Akemi; Dung, Vu Chi; Giugliani, Roberto; Kubaski, Francyne; Mason, Robert W.; Yasuda, Eriko; Sawamoto, Kazuki; Mackenzie, William; Suzuki, Yasuyuki; Orii, Kenji E.; Barrera, Luis A.; Sly, William S.; Orii, Tadao

    2014-01-01

    Patients with mucopolysaccharidoses (MPS) have accumulation of glycosaminoglycans in multiple tissues which may cause coarse facial features, mental retardation, recurrent ear and nose infections, inguinal and umbilical hernias, hepatosplenomegaly, and skeletal deformities. Clinical features related to bone lesions may include marked short stature, cervical stenosis, pectus carinatum, small lungs, joint rigidity (but laxity for MPS IV), kyphoscoliosis, lumbar gibbus, and genu valgum. Patients with MPS are often wheelchair-bound and physical handicaps increase with age as a result of progressive skeletal dysplasia, abnormal joint mobility, and osteoarthritis, leading to 1) stenosis of the upper cervical region, 2) restrictive small lung, 3) hip dysplasia, 4) restriction of joint movement, and 5) surgical complications. Patients often need multiple orthopedic procedures including cervical decompression and fusion, carpal tunnel release, hip reconstruction and replacement, and femoral or tibial osteotomy through their lifetime. Current measures to intervene in bone disease progression are not perfect and palliative, and improved therapies are urgently required. Enzyme replacement therapy (ERT), hematopoietic stem cell transplantation (HSCT), and gene therapy are available or in development for some types of MPS. Delivery of sufficient enzyme to bone, especially avascular cartilage, to prevent or ameliorate the devastating skeletal dysplasias remains an unmet challenge. The use of an anti-inflammatory drug is also under clinical study. Therapies should start at a very early stage prior to irreversible bone lesion, and damage since the severity of skeletal dysplasia is associated with level of activity during daily life. This review illustrates a current overview of therapies and their impact for bone lesions in MPS including ERT, HSCT, gene therapy, and anti-inflammatory drugs. PMID:25537451

  18. Neoplasias de células plasmáticas (incluso mieloma múltiple)—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del mieloma múltiple y otras neoplasias de células plasmáticas, así como referencias a estudios clínicos, investigación, estadísticas y otros temas.

  19. Cáncer de la corteza suprarrenal—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del carcinoma de corteza suprarrenal, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  20. Cáncer de tiroides—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del cáncer de tiroides, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  1. Complicaciones gastrointestinales (PDQ®)—Versión para pacientes

    Cancer.gov

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

  2. Cáncer de riñón (células renales)—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del cáncer de riñón, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados con este tipo de cáncer.

  3. Cáncer de riñón (células renales)—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de riñón, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados con este tipo de cáncer.

  4. Cáncer de páncreas—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de páncreas, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  5. Cáncer de páncreas—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del cáncer de páncreas, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  6. Cáncer de cuello uterino—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, la prevención, las causas y los exámenes de detección del cáncer de cuello uterino, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados.

  7. Cáncer de vagina—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de vagina, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  8. Cáncer de vagina—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del cáncer de vagina, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  9. Cáncer de vulva—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del cáncer de vulva, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  10. Cáncer de útero—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, la prevención, las causas y los exámenes de detección del cáncer uterino, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados.

  11. Neoplasias mielodisplásicas o mieloproliferativas (PDQ®)—Versión para pacientes

    Cancer.gov

    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.

  12. Neoplasias mielodisplásicas o mieloproliferativas (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    Resumen de información revisada por expertos acerca del tratamiento de las neoplasias mielodisplásicas o mieloproliferativas, incluso las leucemias mielomonocítica crónica o juvenil y la LMC atípica.

  13. Enfermedad trofoblástica de la gestación—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento de la enfermedad trofoblástica de la gestación, así como referencias a estudios clínicos y otros temas relacionados.

  14. Leucemia—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento de la leucemia, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados con este tipo de cáncer.

  15. Centro para la Salud Mundial del NCI anuncia becas de investigación para tecnologías portátiles

    Cancer.gov

    El Centro para la Salud Mundial del NCI (CGH) anunció el otorgamiento de subvenciones que apoyarán el desarrollo y la validación de tecnologías portátiles y de bajo costo para mejorar la detección temprana, el diagnóstico y el tratamiento del cáncer.

  16. Complicaciones gastrointestinales (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    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.

  17. Terapia hormonal para el cáncer de seno

    Cancer.gov

    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.

  18. Cánceres poco comunes en la niñez (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    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.

  19. Lo que usted necesita saber sobre™ el cáncer de cérvix

    Cancer.gov

    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.

  20. Añadir quimioterapia después de la radioterapia mejora la supervivencia de adultos con un tipo de tu

    Cancer.gov

    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 d

  1. Cáncer de riñón—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del cáncer de riñón, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados con este tipo de cáncer.

  2. Cuidados médicos de apoyo en niños (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    Resumen de información revisada por expertos acerca de la peculiaridad de los asuntos que surgen durante y después del tratamiento en los niños con cáncer y como sobrevivientes adultos de cáncer.

  3. Cáncer colorrectal—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, la prevención, las causas y los exámenes de detección del cáncer de colon y recto, así como referencias a estudios clínicos, estadísticas y otros temas relacionados.

  4. Cáncer de piel (incluye el melanoma)—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, la prevención, las causas, los exámenes de detección y los estudios clínicos del cáncer de piel, así como referencias a otros temas relacionados con este tipo de cáncer.

  5. Neuropatía periférica inducida por quimioterapia

    Cancer.gov

    Artículo sobre un efecto secundario de la quimioterapia que causa dolor y malestar en las manos y los pies. También incluye información sobre los esfuerzos para mejorar las opciones de detección, tratamiento y prevención.

  6. Sarcoma de tejido blando—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del sarcoma de tejido blando, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados con este tipo de cáncer.

  7. Sarcoma de tejido blando—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del sarcoma de tejido blando, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados con este tipo de cáncer.

  8. Náuseas y vómitos (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    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.

  9. Cáncer de cabeza y cuello—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, la prevención, las causas y los exámenes de detección de los cánceres de cabeza y cuello, así como referencias a estudios clínicos, investigaciones, estadísticas y temas relacionados.

  10. Neoplasias de células plasmáticas (incluso mieloma múltiple)—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del mieloma múltiple y otras neoplasias de células plasmáticas, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados.

  11. Cáncer de intestino delgado—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de intestino delgado, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  12. Cáncer de intestino delgado—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del cáncer de intestino delgado, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  13. Hacer frente - Para la familia y los amigos

    Cancer.gov

    Si usted ayuda a su familiar o amigo durante el tratamiento del cáncer, usted es quien le cuida. Estar al cuidado de una persona con cáncer puede incluir muchas tensiones. Sugerencias para que se cuide usted cuando cuida a otros.

  14. Leucemia—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento de la leucemia, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados con este tipo de cáncer.

  15. Tensión postraumática relacionada con el cáncer (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    Resumen de información revisada por expertos acerca de la tensión postraumática y síntomas relacionados en los pacientes con cáncer, sobrevivientes del cáncer y miembros de la familia. Se discuten la evaluación y tratamiento de estos síntomas.

  16. Tumores extracraneales de células germinativas—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del tumor extracraneal de células germinativas en los niños, así como referencias a estudios clínicos y otros temas relacionados.

  17. Tumores cerebrales—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento de los tumores cerebrales, así como referencias a estudios clínicos, estadísticas y otros temas relacionados con estos tipos de cáncer.

  18. Tumores cerebrales—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento de los tumores cerebrales, así como referencias a estudios clínicos, estadísticas y otros temas relacionados con estos tipos de cáncer.

  19. Fungal Diseases

    MedlinePlus

    ... Outcomes Health Professionals Statistics More Resources en Español Definición Síntomas Las Personas en Riesgo y Prevención Fuentes Diagnóstico y Exámenes Tratamiento y Resultados Profesionales de la Salud Estadísticas C. neoformans Infection Definition Symptoms People at ...

  20. Aspergillosis

    MedlinePlus

    ... Outcomes Health Professionals Statistics More Resources en Español Definición Síntomas Las Personas en Riesgo y Prevención Fuentes Diagnóstico y Exámenes Tratamiento y Resultados Profesionales de la Salud Estadísticas C. neoformans Infection Definition Symptoms People at ...

  1. Mucormycosis (Zygomycosis)

    MedlinePlus

    ... Outcomes Health Professionals Statistics More Resources en Español Definición Síntomas Las Personas en Riesgo y Prevención Fuentes Diagnóstico y Exámenes Tratamiento y Resultados Profesionales de la Salud Estadísticas C. neoformans Infection Definition Symptoms People at ...

  2. Treatment and Outcomes of Aspergillosis

    MedlinePlus

    ... Outcomes Health Professionals Statistics More Resources en Español Definición Síntomas Las Personas en Riesgo y Prevención Fuentes Diagnóstico y Exámenes Tratamiento y Resultados Profesionales de la Salud Estadísticas C. neoformans Infection Definition Symptoms People at ...

  3. Fungal Diseases: Ringworm

    MedlinePlus

    ... Outcomes Health Professionals Statistics More Resources en Español Definición Síntomas Las Personas en Riesgo y Prevención Fuentes Diagnóstico y Exámenes Tratamiento y Resultados Profesionales de la Salud Estadísticas C. neoformans Infection Definition Symptoms People at ...

  4. Blastomycosis

    MedlinePlus

    ... Outcomes Health Professionals Statistics More Resources en Español Definición Síntomas Las Personas en Riesgo y Prevención Fuentes Diagnóstico y Exámenes Tratamiento y Resultados Profesionales de la Salud Estadísticas C. neoformans Infection Definition Symptoms People at ...

  5. Histoplasmosis

    MedlinePlus

    ... Outcomes Health Professionals Statistics More Resources en Español Definición Síntomas Las Personas en Riesgo y Prevención Fuentes Diagnóstico y Exámenes Tratamiento y Resultados Profesionales de la Salud Estadísticas C. neoformans Infection Definition Symptoms People at ...

  6. Pneumocystis Pneumonia

    MedlinePlus

    ... Outcomes Health Professionals Statistics More Resources en Español Definición Síntomas Las Personas en Riesgo y Prevención Fuentes Diagnóstico y Exámenes Tratamiento y Resultados Profesionales de la Salud Estadísticas C. neoformans Infection Definition Symptoms People at ...

  7. Treatment and Outcomes of Histoplasmosis

    MedlinePlus

    ... Outcomes Health Professionals Statistics More Resources en Español Definición Síntomas Las Personas en Riesgo y Prevención Fuentes Diagnóstico y Exámenes Tratamiento y Resultados Profesionales de la Salud Estadísticas C. neoformans Infection Definition Symptoms People at ...

  8. Valley Fever (Coccidioidomycosis)

    MedlinePlus

    ... Outcomes Health Professionals Statistics More Resources en Español Definición Síntomas Las Personas en Riesgo y Prevención Fuentes Diagnóstico y Exámenes Tratamiento y Resultados Profesionales de la Salud Estadísticas C. neoformans Infection Definition Symptoms People at ...

  9. Hacer frente - Obtener cuidados médicos de seguimiento

    Cancer.gov

    Información sobre los cuidados médicos de seguimiento después del tratamiento del cáncer. Trata sobre su plan de cuidados de seguimiento, cómo obtener un plan para el bienestar e incluye una guía para una vida saludable.

  10. Linfoma—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del linfoma, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados con este tipo de cáncer.

  11. Hacer frente - Los sentimientos y el cáncer

    Cancer.gov

    El cáncer puede causar una amplia gama de sentimientos, ya sea que usted, un amigo o familiar esté en tratamiento ahora o que ya lo haya completado. Sugerencias para superar las muchas emociones causadas por el cáncer.

  12. Se lanza Red Nacional de Estudios Clínicos del NCI

    Cancer.gov

    El Instituto Nacional del Cáncer (NCI) puso en marcha una nueva red de investigación de estudios clínicos con el objetivo de mejorar el tratamiento de más de 1,6 millones de estadounidenses que reciben un diagnóstico de cáncer cada año.

  13. Cánceres poco comunes en la niñez (PDQ®)—Versión para pacientes

    Cancer.gov

    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.

  14. Cáncer colorrectal—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento, la prevención, las causas y los exámenes de detección del cáncer de colon y recto, así como referencias a estudios clínicos, estadísticas y otros temas.

  15. Linfoma—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del linfoma, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados con este tipo de cáncer.

  16. Neuropatía persistente aumenta el riesgo de caídas entre supervivientes de cáncer

    Cancer.gov

    Muchas mujeres supervivientes de cáncer tienen problemas de movilidad y de otras funciones físicas como resultado de la neuropatía periférica persistente causada por el tratamiento de quimioterapia, según un estudio nuevo.

  17. Hacer frente - Su imagen propia y su sexualidad

    Cancer.gov

    El cáncer y su tratamiento pueden cambiar la forma como usted se ve y siente de su persona y de su cuerpo. Puede tomar algunas medidas para superar los cambios de su cuerpo y problemas relacionados con su sexualidad e intimidad.

  18. Fatiga (PDQ®)—Versión para pacientes

    Cancer.gov

    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.

  19. Delirio (PDQ®)—Versión para pacientes

    Cancer.gov

    Resumen de información revisada por expertos acerca del delirio como una complicación del cáncer o su tratamiento. Se tratan enfoques de los cuidados médicos de apoyo y los abordajes farmacológicos para el manejo del delirio.

  20. Cuidados médicos de apoyo en niños (PDQ®)—Versión para pacientes

    Cancer.gov

    Resumen de información revisada por expertos acerca de la peculiaridad de los asuntos que surgen durante y después del tratamiento en los niños con cáncer, y como sobrevivientes adultos de cáncer.

  1. Tensión postraumática relacionada con el cáncer (PDQ®)—Versión para pacientes

    Cancer.gov

    Resumen de información revisada por expertos acerca de la tensión postraumática y los síntomas relacionados en los pacientes con cáncer, sobrevivientes del cáncer y miembros de la familia. Se discuten la evaluación y el tratamiento de estos síntomas.

  2. Cáncer de pene—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del cáncer de pene, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  3. Cáncer de paratiroides—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del cáncer de paratiroides, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  4. Mesotelioma maligno—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento y las causas del mesotelioma maligno, así como referencias a estudios clínicos y otros temas relacionados con este tipo de cáncer.

  5. Cáncer de la corteza suprarrenal—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del carcinoma de corteza suprarrenal, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  6. Tumores de hipófisis—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del tumor de hipófisis, así como referencias a estudios clínicos, investigación y otros temas relacionados.

  7. Retinoblastoma—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del retinoblastoma, así como referencias a estudios clínicos, estadísticas y otros temas relacionados con este tipo de cáncer.

  8. Cáncer de útero—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento, la prevención, las causas y los exámenes de detección del cáncer uterino, así como referencias a estudios clínicos, investigación, estadísticas y otros temas.

  9. Tumores extracraneales de células germinativas—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del tumor extracraneal de células germinativas en los niños, así como referencias a estudios clínicos y otros temas relacionados.

  10. El cáncer

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, la prevención, los exámenes de detección, la genética y las causas del cáncer, así como formas de hacer frente a la enfermedad.

  11. Lo que usted necesita saber sobre™ el cáncer de seno

    Cancer.gov

    Contiene información sobre 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 c

  12. Cáncer de piel (incluye el melanoma)—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento, la prevención, las causas y los exámenes de detección del cáncer de piel, así como referencias a estudios clínicos, investigación y otros temas.

  13. Cáncer de ano—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de ano, así como referencias a estudios clínicos y otros temas relacionados con este tipo de cáncer.

  14. Cáncer de tiroides—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de tiroides, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  15. Cáncer de pene—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de pene, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  16. Cáncer de testículo—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento, las causas y los exámenes de detección del cáncer de testículo, así como referencias a estudios clínicos, investigación y otros temas.

  17. Cáncer de vejiga—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento, las causas y los exámenes de detección del cáncer de vejiga, así como referencias a estudios clínicos, investigación, estadísticas y otros temas.

  18. Cáncer de testículo—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, las causas y los exámenes de detección del cáncer de testículo, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  19. Cáncer de vulva—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de vulva, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  20. Cáncer de vesícula biliar—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de vesícula biliar, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  1. Cáncer de paratiroides—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de paratiroides, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  2. Cáncer de uretra—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de uretra, así como referencias a estudios clínicos y otros temas relacionados con este tipo de cáncer.

  3. Jóvenes con cáncer y supervivientes participan en estudio de oncofertilidad

    Cancer.gov

    Artículo sobre los esfuerzos que se realizan para conectar con pacientes jóvenes y lograr su participación en estudios clínicos para evaluar y remediar la esterilidad causada por el cáncer y su tratamiento.

  4. Delirio (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    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.

  5. Terapia hormonal para el cáncer de próstata Hoja informativa

    Cancer.gov

    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.

  6. Cáncer de vesícula biliar—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del cáncer de vesícula biliar, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  7. Estudio muestra reducción de mortalidad en hombres con cáncer de próstata de grado intermedio

    Cancer.gov

    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 patroci

  8. Náuseas y vómitos (PDQ®)—Versión para pacientes

    Cancer.gov

    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.

  9. Qué tipos hay de estudios clínicos

    Cancer.gov

    Información sobre los diversos tipos de estudios clínicos de cáncer, como son los estudios de tratamiento, de prevención, de exámenes selectivos de detección, de cuidados médicos de apoyo y de cuidados paliativos.

  10. Tipos de cáncer

    Cancer.gov

    Lista alfabética de todos los tipos de cáncer con enlaces a enfermedades específicas e información general sobre tratamiento, cuidados de apoyo, exámenes de detección, prevención, estudios clínicos y otros temas.

  11. Cáncer de piel—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, la prevención, las causas, los exámenes de detección y los estudios clínicos del cáncer de piel, así como referencias a otros temas relacionados con este tipo de cáncer.

  12. Iniciativa de Respuestas Excepcionales: Preguntas y respuestas

    Cancer.gov

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

  13. Mesotelioma maligno—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento y las causas del mesotelioma maligno, así como referencias a estudios clínicos y otros temas relacionados con este tipo de cáncer.

  14. Personal de enfermería asume diversas funciones con expansión de programas de gestión para pacientes

    Cancer.gov

    Artículo sobre los profesionales de enfermería oncológica que ayudan a los pacientes durante todas las etapas de la atención oncológica, desde los exámenes de detección y el diagnóstico, hasta el tratamiento y la supervivencia.

  15. Capacitación del personal y de los pacientes en torno a los cuidados terminales

    Cancer.gov

    Artículo sobre programas innovadores de base científica para ayudar a médicos y pacientes a hablar sobre la transición de un tratamiento activo para el cáncer a los cuidados en la etapa final de la vida.

  16. El NCI inicia un estudio para evaluar la utilidad de la secuenciación genética para mejorar los resu

    Cancer.gov

    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 meta

  17. Fatiga (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    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.

  18. Neuroblastoma—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento y los exámenes de detección del neuroblastoma, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  19. Neuroblastoma—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento y los exámenes de detección del neuroblastoma, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  20. Cáncer de hueso—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de hueso (óseo), así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  1. El equilibrio correcto: cómo ayudar a los supervivientes de cáncer a tener un peso saludable

    Cancer.gov

    Artículo sobre las intervenciones que buscan ayudar a los supervivientes a mantener un peso saludable para reducir la recidiva y la muerte por cáncer, y disminuir la probabilidad de padecer efectos tardíos y crónicos del tratamiento.

  2. FDA aprueba la primera inmunoterapia para linfoma

    Cancer.gov

    La FDA ha aprobado nivolumab (Opdivo®) para el tratamiento de pacientes con el linfoma clásico de Hodgkin que ha recaído o empeorado después de recibir un trasplante autólogo hematopoyético seguido de brentuximab vedotin (Adcetris®)

  3. Cáncer de hueso—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del cáncer de hueso (óseo), así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  4. Cáncer de hígado y de conducto biliar—Versión para profesionales de salud

    Cancer.gov

    Información del NCI para profesionales de salud sobre el tratamiento, la prevención y los exámenes de detección del cáncer de hígado y de conducto biliar, así como referencias a estudios clínicos, investigación y otros temas.

  5. Long Island Sound: a Human Dominated Environment

    NASA Astrophysics Data System (ADS)

    Thomas, E.; Varekamp, J. C.

    2006-05-01

    Long Island Sound (LIS) is a marginally marine urban estuary, with Long Island (NY) as its southern coastline, New York and Connecticut along its northern coast. LIS has a narrow opening to the West (East River), but most exchange with the ocean occurs at its eastern end, resulting in an east-west gradient in salinity. There is also an east-west gradient in indicators of contamination in the surface sediments (e.g., trace metals). Western LIS is close to the main population center (New York City), but also is a focusing region for fine- grained sediments. Since the 1970s, western LIS and to a lesser extent, central LIS, suffer summer hypoxia or even anoxia. We used sediment cores in westernmost and central LIS to document environmental changes over the last millennium, including the time of European settlement, using microfossil, geochemical, sedimentological, and trace element proxies. Sediment ages were determined using metal pollution records and radiometric carbon dating. Before European settlement, the low-diversity benthic faunas were dominated by Elphidium excavatum (feeding on diatoms) at shallow depths (< 12 m, where light penetrates to the bottom), by Elphidium incertum in westernmost LIS and by Buccella frigida and/or Eggerella advena over most of LIS at greater depths. In almost all cores, the absolute abundance of benthic foraminifera and the relative abundance of Elphidium excavatum increased from the early-mid 1800s on. The faunal changes coincided with an increase in contaminant trace metal concentration, with human population growth in the region, with a marked decrease in salinity in westernmost LIS, and with the beginning of low oxygen conditions as indicated by carbon isotope values in foraminiferal tests. At the same time, accumulation rates of organic carbon and nitrogen increased several fold, most extremely so in westernmost LIS. These data thus all indicate that humans influenced LIS and its ecosystems from the mid 19th century on, causing

  6. Record of Environmental Change in San Francisco Bay, California

    NASA Astrophysics Data System (ADS)

    McGann, M.

    2004-05-01

    Benthic foraminifera in a 3.52 m core recovered from San Francisco Bay, CA yield a 3,800-year sediment record of climate and environmental change. The microfaunal assemblage of the core contains abundant subtidal estuarine benthic foraminifers found today at shallow water depths (<10 m) in the bay. A Q-mode cluster analysis of the samples grouped them into two clusters and one outlier. Cluster A is dominated by the herbivorous species Elphidium excavatum; its abundance often comprises 70-90% of the foraminiferal assemblage. Today, the species typically resides in cold, estuarine waters. Its dominance in the core from 352-150 cm (1920 B.C. to A.D. 652) and 88-18 cm (from A.D. 1224 to A.D. 1980) suggests that this area of the bay has remained relatively cold and shallow for about 3400 years out of the last four millennia. Cluster B, the Ammonia beccarii-Elphidium gunteri association, occurs from 150-88 cm in the core and is interpreted as representing warmer and possibly lower oxygenated conditions from A.D. 652 to A.D. 1224. The outlier, Cluster C (A.D. 1980 to present), is attributable to the recent appearance of the invasive Japanese species Trochammina hadai. Oxygen isotopes and trace elements were measured in specimens of Elphidium excavatum at 10 cm intervals throughout the length of the core. From 150-88 cm (A.D. 652 to A.D. 1224), d 18O values (mean = -3.81 mil) average 0.3 and 0.2 mil lighter than below and above this interval, respectively, corresponding to an increase in water temperature of about 1 deg C in the bay. A heightened Mg/Ca ratio at this time also indicates an increase in water temperature (by 0.3 deg C). The timing of this warming correlates well with records of the Medieval Warm Period. Trochammina hadai was introduced into the bay in the early 1980s, presumably in ballast sediment released from transoceanic vessels. In its native Japan, this species is often found in the most heavily polluted urban areas; its presence being regarded as an

  7. Reconstructing Long Island Sound Environmental Changes and Thier Influence on the Biota

    NASA Astrophysics Data System (ADS)

    Thomas, E.; Lugolobi, F.; Abramson, I.; Varekamp, J. C.

    2001-12-01

    Long Island Sound (LIS) is a large urban estuary. Its environmental problems include algal blooms, leading to hypoxia and die-off of submerged aquatic vegetation and, in the last few years, significant die-off of lobsters, particularly in western LIS. We use a combination of geochemical, isotope and micropaleontological data (benthic foraminifera) on cores from Long Island Sound to investigate the environmental changes since western European settlement and industrialization, and their effects on biota. Age models are based on 210Pb, 137Cs, and pollen profiles. In LIS, seawater from the Atlantic Ocean is mixed with freshwater from the Connecticut River, Housatonic River and Thames River, resulting in salinities from 22 to 32 per mille. Benthic foraminiferal assemblages are marginally marine, and dominated by Elphidium excavatum. In the deeper parts of LIS Buccella frigida is common, and since the 1960s Ammonia beccarii has strongly increased in abundance in western LIS and shallow waters close to river mouths. The carbonate tests of Elphidium excavatum reflect a combination of salinity and temperature in their δ 18O, Sr/Ca and Mg/Ca values. The δ 13C of carbonates reflects the isotopic values of dissolved carbonate in LIS waters, which depend on the mixing proportions of river and sea water, the δ 13C of carbonate in river water, and the degree of oxidation of organic carbon in the Sound. The latter process is responsible for the seasonal hypoxia in LIS. We hypothesize that the δ 13C in foraminiferal calcite can be used as a tracer for the degree of hypoxia that was prevalent when shells were being formed, and foraminiferal assemblages in the same samples will reveal whether faunal changes occurred coeval with changes in degree of hypoxia. We established a mixing model for modern LIS through analyses of river and LIS water samples for salinity, δ 18O, dissolved carbonate, δ 13C in dissolved carbonate and Ca, Mg and Sr. Bottom water oxygen contents and

  8. Reconstruction of climate and environmental changes in the Bornholm Basin during the last 6000 years, based on foraminiferal assemblages

    NASA Astrophysics Data System (ADS)

    Binczewska, Anna; Polovodova Asteman, Irina; Moros, Matthias; Sławińska, Joanna

    2016-04-01

    The Baltic Sea is the largest brackish sea in the world connected to the Atlantic Ocean through the narrow and shallow Danish Straits. The hydrography of the Baltic Sea is strongly dependent on inflows from the North Sea and its environmental conditions are influenced by meteorological and anthropogenic factors. To improve our understanding of the natural variability and forcing factors driving changes in the Baltic ecosystem, detailed analyses of palaeoecological archives are needed. Here we present a high-resolution study of foraminiferal assemblages together with sediment geochemistry (LOI, TOC, TIC, CNS) from a 8-m long gravity core (GC) and a 42-cm long multi core (MUC) taken in the Bornholm Basin in 2013. Both cores were investigated in order to reconstruct bottom water mass variability during the mid- and late Holocene. Cores were dated by AMS 14C (mostly on Macoma balthica shells), 210Pb and 137Cs. Age-model allowed us to place variability of foraminiferal assemblages in time and link them with the Holocene climate extremes and the Major Baltic Inflows (MBIs). High absolute abundances (ind./g wet sed.) of foraminifera are found within a core interval corresponding to the Dark Ages and the Medieval Warm Period (~AD 400-1200). The Little Ice Age is represented by rare to absent foraminiferal shells, while significant changes of foraminiferal abundances occur in the lower part of core(~ BC 2050-2995). The dominant species found in both cores are Cribroelphidium excavatum, C. excavatum f. clavatum, C. albiumbilicatum and C. incertum, all adapted to an ecologically unstable environment with high fluctuations of salinity and oxygen. The arenaceous species Reophax dentaliniformis strongly occurs at ~ AD 1450-1600, where calcareous species were rare. Presence of agglutinated foraminifera and prevailing small size of individuals in all studied material suggest bottom water undersaturation with respect to calcium carbonate. In the Baltic Sea, bottom waters

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

    PubMed

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

    2012-08-01

    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

  10. The Impact of Anthropogenic Activities on Ecosystems of Long Island Sound, N.Y.

    NASA Astrophysics Data System (ADS)

    Lauture, E.; McHugh, C. M.; Nitsche, F. O.; Kenna, T. C.

    2015-12-01

    Long Island Sound (LIS) is a tide-dominated estuary located along heavily populated regions on the eastern coast of the US. Western LIS has been impacted by heavy metals and is susceptible to hypoxic and anoxic conditions since the 1900's. As part of the Long Island Sound Cable Fund and the National Science Foundation programs, we surveyed the western and central regions of LIS in 2006 and 2013, respectively. From the R/V Hugh Sharp and the R/V Seawolf, we collected high-resolution subbottom profiles, multibeam bathymetry, sediment cores, and grabs in distinct sedimentary environments such as channels, terraces, and river mouths. The goal was to evaluate the impact of anthropogenic activities as they relate to physical processes and populated regions. Along western LIS, total organic carbon (TOC) and heavy metal concentrations are higher from the 1850s to the present, especially along locations of known high organic waste. Pre-industrial concentrations of TOC average 2.22% with maximum values of 4.75%. A similar trend is observed with heavy metals. For example, lead (Pb) increased from background levels of ~10 to 20 ppm to over 200 ppm. Benthic foraminifers seem to be influenced by these trends with changes in ecosystems. The dominant assemblage, Elphidium excavatum clavatum remains dominant with a slight decrease in their abundance during anthropogenic times. From ~1850's to the present Ammonia beccarii becomes more abundant. These shifts in foraminifer species to assemblages that tolerate low oxygen conditions reflect the increasing hypoxic conditions. In central LIS, surface sediments average TOC of 1.34% with highest values of 5.21% near the Housatonic River that drains industrialized portions of Connecticut, and lowest values of 0.073% near the Long Island coastline. Understanding the evolution of hypoxia as well as the sources of heavy metals can lead to important implications for restoration of marine ecosystems.

  11. Environmental impact assessment of sediment dumping in the southern Baltic Sea using meiofaunal indicators

    NASA Astrophysics Data System (ADS)

    Frenzel, Peter; Borrmann, Corinna; Lauenburg, Beate; Bohling, Björn; Bartholdy, Jan

    2009-02-01

    An experimental sediment dumping was carried out in the southern part of the Mecklenburg Bight in June 2001. Foraminiferans and ostracods from superficial sandy sediment were studied in a time series from before dumping until March 2004 in order to assess changes in associations and recolonization patterns of both groups. Additionally, an area sampling covering the dumping site and its surroundings from 15.5 to 20.7 m water depth made it possible to compare associations inside and outside the dumping area as well as the water depth dependent distribution of foraminiferans and ostracods. Salinity values vary within the high alpha-mesohaline and low polyhaline range. The dominating species are Ammotium cassis (Foraminifera) and Sarsicytheridea bradii (Ostracoda). The diversity is low (Fisher alpha index from 0.4 to 3.2 for foraminiferans and 1.0 to 2.5 for ostracods), but higher within the dumping site samples. These higher values are explainable by input of allochthonous tests and valves representing additional species. After the sediment dumping it took two and a half years to re-establish the total foraminiferan association and the total foraminifer/ostracod ratio within the dumping site. Total foraminiferan abundance increases remarkably with water depth (mean 83 tests in 100 ml) driven by higher nutrient availability and more suitable salinity and temperature values within the zone of the oscillating halocline. The distribution of shallow water species such as Cribroelphidium excavatum, Eucythere argus and Hirschmannia viridis, within the transient water layer A. cassis, Nodulina dentaliniformis, S. bradii and Palmoconcha laevata and below Eggerella scabra indicate the depth position of the halocline. Water depth and sediment dumping influence are the main driving factors for the distribution of foraminifer and ostracod associations within the study area. However, a significant sedimentological difference between samples inside and outside the dumping area is

  12. [Coleman lipofilling: experience of an Italian group and review of the literature].

    PubMed

    Iannace, Carlo; Di Libero, Lorenzo; Manetta, Fiorenza; Sciascia, Valerio; Pizza, Alessandra; Napolitano, Salvatore; Ferraro, Angela; Scetta, Giovanni; Esposito, Daniela; Varriale, Sergio; Candela, Giancarlo; Caracciolo, Francesco

    2009-01-01

    Although the first operation of reconstructive breast surgery dates back to the end of the nineteenth century, it was only in the last decade of the twentieth century that lipofilling became widely adopted in the management of diseases of the breast. The Coleman technique involves taking a sample of fat from the regions of the body where it is largely present (abdomen, trochanter region, groin, knee), followed by centrifugation and the grafting of the fat cells thus purified. In 1987 the American Society of Plastic and Reconstructive Surgery banned the diffusion of this procedure because it was considered of little benefit for both aesthetic and oncological purposes. From January 2005 to May 2007, 17 patients underwent lipofilling according to the Coleman technique at the Operative Unit of General Surgery of the "San Giuseppe Moscati" Hospital in Avellino. Previously, 15 (88%) of the 17 women had received reconstructive breast surgery with a prosthesis after a Madden total mastectomy. As regards the other 2 patients, when admitted to hospital, one (5.9%) presented a pectum excavatum and the other (5.9%) a congenital depression of the temporal bone. No important complications were observed in the postoperative course. At a distance of 6 and 12 months after the injection, follow-up monitoring revealed that the loss of substance in the grafted adipose tissue was about 53%. In conclusion, reconstructive breast surgery should always be attempted after radical surgery. The multidisciplinary cooperation of radiologists, surgeons, anatomical pathologists and psychologists, in our opinion, avoids the danger of poor aesthetic results and the risk of underestimating a possible tumour relapse. PMID:19391342

  13. Cáncer de ovario, de trompa de Falopio y primario de peritoneo—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, la prevención, la genética, las causas y los exámenes de detección del cáncer de ovario, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados.

  14. Cáncer de seno (mama)—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, la prevención, la genética, las causas y los exámenes de detección del cáncer de seno (mama), así como referencias a estudios clínicos, investigación, estadísticas y temas relacionados.

  15. Cáncer de estómago—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, la prevención, las causas y los exámenes de detección del cáncer de estómago (gástrico), así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados.

  16. Linfedema (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    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..

  17. Cáncer de esófago—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, la prevención y los exámenes de detección del cáncer de esófago, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados con este tipo de cáncer.

  18. Cáncer de cuello uterino—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento, la prevención, las causas y los exámenes de detección del cáncer de cuello uterino, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados.

  19. El cáncer según su ubicación en el cuerpo

    Cancer.gov

    Lista de todos los tipos de cáncer, organizados por ubicación o función en el cuerpo. Los cánceres que hay en esta lista tienen enlaces a información sobre tratamiento, cuidados de apoyo, exámenes de detección, prevención, estudios clínicos y otros temas.

  20. Encefalitis por anticuerpos contra el receptor de NMDA: experiencia con seis pacientes pediátricos. Potencial eficacia del metotrexato

    PubMed Central

    Bravo-Oro, Antonio; Abud-Mendoza, Carlos; Quezada-Corona, Arturo; Dalmau, Josep; Campos-Guevara, Verónica

    2016-01-01

    Introducción La encefalitis por anticuerpos contra el receptor de N-metil-D-aspartato (NMDA) es una entidad cada vez más diagnosticada en edad pediátrica. A diferencia de los adultos, en muchos casos no se asocia a tumores y las manifestaciones iniciales en niños más frecuentes son crisis convulsivas y trastornos del movimiento, mientras que en los adultos predominan las alteraciones psiquiátricas. Casos clínicos Presentamos seis casos pediátricos confirmados con anticuerpos contra la subunidad NR1 del receptor de NMDA en suero y líquido cefalorraquídeo. Cinco de los casos comenzaron con crisis convulsivas como manifestación clínica inicial antes de desarrollar el cuadro clásico de esta entidad. En todos los casos se utilizaron esteroides como primera línea de tratamiento, con los que sólo se observó control de las manifestaciones en uno, por lo que el resto de los pacientes requirió inmunomoduladores de segunda línea. Todos los pacientes recibieron metotrexato como tratamiento inmunomodulador para evitar recaídas y la evolución fue a la mejoría en todos ellos. Conclusiones En nuestra serie de pacientes con encefalitis por anticuerpos contra el receptor de NMDA, ninguno se asoció a tumores. Todos los casos recibieron metotrexato por lo menos durante un año, no observamos eventos adversos clínicos ni por laboratorio, ni hubo secuelas neurológicas ni recaídas durante el tratamiento. Aunque es una serie pequeña y es deseable incrementar el número y tiempo de evolución, consideramos el metotrexato una excelente alternativa como tratamiento inmunomodulador para esta patología. PMID:24150952

  1. [Anorectal diseases. Diagnosis and treatment].

    PubMed

    López-Ríos Fernández, F

    1999-01-01

    The presentation of the book Enfermedades Anorrectales. Diagnóstico y tratamiento edited by Dr Fernando López-Ríos (Madrid: Harcourt Brace, 1999) consisted of two parts. In the first part, the structure, goals and characteristics of the work were explained by its editor. In the second part, after a brief survey of the history of colorectal surgery, Dr López-Ríos discussed the importance of understanding colorectal surgery as a subspecialization of general surgery. PMID:10682396

  2. Cáncer de esófago—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, la prevención y los exámenes de detección del cáncer de esófago, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados con este tipo de cáncer.

  3. Cáncer de pulmón—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento, la prevención, las causas y los exámenes de detección del cáncer de pulmón, así como referencias a estudios clínicos, investigación, estadísticas y otros temas

  4. Cáncer de vejiga—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, las causas y los exámenes de detección del cáncer de vejiga, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados con este tipo de cáncer.

  5. Cáncer de pulmón—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, la prevención, las causas y los exámenes de detección del cáncer de pulmón, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados.

  6. Etapa final de la vida (PDQ®)—Versión para pacientes

    Cancer.gov

    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.

  7. El análisis de un estudio clínico indica que una combinación de fármacos puede ser de gran eficacia

    Cancer.gov

    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

  8. Cuando uno de tus papás tiene cáncer

    Cancer.gov

    Sugerencias para saber qué decir a los amigos, cómo superar la tensión y en dónde encontrar apoyo; también, información sobre el cáncer y sobre los tratamientos de cáncer, para jóvenes que tienen a uno de sus papás con cáncer.

  9. Cáncer de hígado y de conducto biliar—Versión para pacientes

    Cancer.gov

    Información del NCI sobre el tratamiento, la prevención y los exámenes de detección del cáncer de hígado y de conducto biliar, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer

  10. Cáncer de próstata—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, la prevención, las causas y los exámenes de detección del cáncer de próstata, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados.

  11. RETOS EN LA INTERVENCIÓN CON ADOLESCENTES PUERTORRIQUEÑOS/AS QUE MANIFIESTAN COMPORTAMIENTO SUICIDA*

    PubMed Central

    Vélez, Yovanska Duarté; Dávila, Paloma Torres; Hernández, Samariz Laboy

    2015-01-01

    Presentamos un estudio de caso de una adolescente puertorriqueña con comportamiento suicida. Esta comenzó una Terapia Socio Cognitivo-Conductual para el Comportamiento Suicida (TSCC-CS) de tipo ambulatorio luego de una hospitalización por intento suicida. La TSCC-CS incorpora una perspectiva ecológica y de desarrollo a la terapia cognitivo-conductual. Inicialmente mostró baja autoestima y severos síntomas depresivos y de ansiedad. Al finalizar el tratamiento, manifestó un cambio significativo en su sintomatología clínica y evidenció una mejoría en sus destrezas de manejo. No presentó ideas suicidas durante meses previos, ni durante el seguimiento. El análisis de este caso permitió realizar cambios en el protocolo de tratamiento, particularmente en las sesiones de familia y de comunicación con el fin de aumentar la viabilidad del tratamiento. PMID:26702337

  12. [Not Available].

    PubMed

    Torres Díaz, Cristina V; Martín Peña, Gonzalo; Ezquiaga, Elena; Navas García, Marta; García de Sola, Rafael

    2016-01-01

    Gracias a los avances técnicos en técnicas neuroquirúrgicas, y debido a que el diagnóstico y la clasificación de las enfermedades psiquiátricas han evolucionado significativamente a lo largo de las últimas décadas, se están desarrollando tratamientos a nivel experimental para aquellos pacientes resistentes al manejo conservador.La anorexia nerviosa es una enfermedad de prevalencia creciente, con la tasa de mortalidad más elevada dentro de los trastornos psiquiátricos, y con aproximadamente un 20% de pacientes que presentan una evolución tórpida. Para estos pacientes que no responden a manejo conservador, la estimulación cerebral profunda ha surgido como una alternativa terapéutica, si bien la literatura especializada al respecto es escasa.A continuación presentamos una revisión de la fisiopatología de la anorexia nerviosa, así como de los distintos tratamientos neuroquirúrgicos realizados a lo largo de la historia. Se detalla la perspectiva de tratamiento quirúrgico actual, así como los aspectos éticos que se han de considerar en relación con el surgimiento de estas nuevas terapias. PMID:27571678

  13. Neuroimagen en la enfermedad de Alzheimer: nuevas perspectivas

    PubMed Central

    Becker, James T.

    2012-01-01

    Introducción y desarrollo En los próximos 50 años vamos a presenciar un incremento significativo de la población mayor de 65 años y por lo tanto va a aumentar, considerablemente, el número de individuos con riesgo de desarrollar demencias neurodegenerativas, especialmente la enfermedad de Alzheimer (EA). Las estrategias actuales de tratamiento farmacológico y no farmacológico se han centrado en las fases sintomáticas de esta enfermedad y, gradualmente, vamos teniendo una mayor comprensión de los posibles factores de riesgo del síndrome clínico. Conclusiones Los estudios de neuroimagen han sido muy útiles para mostrar los cambios estructurales del envejecimiento normal y patológico, así como también los factores de riesgo para la EA. Los tratamientos apropiados de los factores de riesgo y su posible combinación con tratamientos específicos para la EA podrían prolongar el período presintomático de la EA y, por tanto, mejorar la calidad de vida y disminuir la carga para el paciente, la familia y la sociedad. PMID:20517866

  14. The Eutrophication of Long Island Sound

    NASA Astrophysics Data System (ADS)

    Varekamp, J. C.; Lugolobi, F.; Thomas, E.; Buchholtz Ten Brink, M.; Mecray, E.

    2004-05-01

    Long Island Sound (LIS) is an urban estuary that receives waste fluids from millions of coastal inhabitants. This influx of nutrients has led to high organic productivity with resulting hypoxia in the western and central sections of LIS during the summer months. We collected a set of short cores to determine the history of eutrophication and determined organic Carbon, Biogenic Silica, and stable isotope ratios on carbonates from core samples. Dating was accomplished with 137Cs, 210Pb and 14C determinations and the onset of Hg contamination, which was dated in land sections. Time constraints are not very precise because of variations in 14C reservoir effect and minor bioturbation effects. The tests of Elphidium excavatum were analyzed to determine paleo water temperature (from Mg/Ca), paleo salinity (from T and d18O) and dissolved O2 levels (from T, S and d13C). The various parameters were calibrated in modern LIS through measurements on `live foraminifera' from surface sediment and water column analyses. The strong seasonal temperature fluctuations and variable life span of live collected foraminifera introduce a certain amount of noise into these calibrations. A simple mixing model was created for the Sound using river waters and pure seawater as endmembers. The paleo temperature record seems to indicate a warm period around 1000 BP, followed by the Little Ice Age. The dissolved O2 record for the last 1000 years shows mean annual values of about 70 percent saturation prior to 1800 AD, when mean values dropped to about 30 percent saturation. Eutrophication thus started as early as 1800 AD as indicated by the increased accumulation rates of organic carbon, biogenic silica and low d13C values in carbonate. The Sound has shown a trend of increasing productivity from east to west for many hundreds of years. Earlier warm periods lack evidence for hypoxia and we therefore surmise that the increase in organic productivity is the main driver for the modern hypoxia. The

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

    NASA Astrophysics Data System (ADS)

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

    2002-12-01

    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

  16. Environmental changes and growth history of a cold-water carbonate mound (Propeller Mound, Porcupine Seabight)

    NASA Astrophysics Data System (ADS)

    Rüggeberg, Andres; Dullo, Christian; Dorschel, Boris; Hebbeln, Dierk

    2007-02-01

    On- and off-mound sediment cores from Propeller Mound (Hovland Mound province, Porcupine Seabight) were analysed to understand better the evolution of a carbonate mound. The evaluation of benthic foraminiferal assemblages from the off-mound position helps to determine the changes of the environmental controls on Propeller Mound in glacial and interglacial times. Two different assemblages describe the Holocene and Marine Isotope Stage (MIS) 2 and late MIS 3 (˜31 kyr BP). The different assemblages are related to changes in oceanographic conditions, surface productivity and the waxing and waning of the British Irish Ice Sheet (BIIS) during the last glacial stages. The interglacial assemblage is related to a higher supply of organic material and stronger current intensities in water depth of recent coral growth. During the last glaciation the benthic faunas showed high abundances of cassidulinid species, implying cold bottom waters and a reduced availability of organic matter. High sedimentation rates and the domination of Elphidium excavatum point to shelf erosion related to sea-level lowering (˜50 m) and the progradation of the BIIS onto the shelf. A different 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 their maximum contribution in the lower part of the record indicates a higher coral growth density on Propeller Mound in an earlier period. They are less abundant during the Holocene, however. This dataset portrays the boundary conditions of the habitable range for the cold-water coral Lophelia pertusa, which dominates the deep-water reefal ecosystem on the upper flanks of Propeller Mound. The growth of this ecosystem occurs during interglacial and interstadial periods, whereas a retreat of corals is documented in

  17. The Early Geological History of Long Island Sound

    NASA Astrophysics Data System (ADS)

    Varekamp, J. C.; Thomas, E.

    2005-12-01

    suggests that the marine transgression occurred much later than thought, just after the Younger Dryas cold period and during Melt Water Pulse 1b of Fairbanks et al. (1989). Estimated rates of relative sea level rise from dated oyster beds (about 1.2 cm/yr) agree with the high rates indicated by these authors. This new timing of the flooding of the LIS basin poses the question whether Lake Hitchcock drained into Glacial Lake Connecticut rather than in marine waters. Preliminary stable isotope data on Elphidium excavatum from core LISAT 12 indicate that early LIS may have had slightly lower salinities than modern LIS, but foraminiferal faunas strongly resemble assemblages described from samples dated at 1000-1800 AD.

  18. Temporal Assemblage Turnovers of Foraminiferal Communities from the Caribbean, United Kingdom and Mediterranean regions

    NASA Astrophysics Data System (ADS)

    Costelloe, Ashleigh; Wilson, Brent

    2016-04-01

    Temporal assemblage turnovers of intertidal foraminiferal communities were quantitatively determined using the assemblage turnover index (ATI), and contributing species were identified using the conditioned on-boundary index (CoBI). The live foraminiferal communities were examined as metacommunities (all stations) and assemblages (groups of stations defined by cluster analysis) over one and two year periods at Caroni Swamp, Claxton Bay (E Trinidad), Cowpen Marsh (NE England) and Bay of Cádiz (SW Spain). Major assemblage turnovers (when ATI > x + σ) of the Caroni Swamp metacommunity and assemblages coincided with seasonal changes from dry to wet conditions in 2011 and 2012. The abundant species (Ammonia tepida, Ammotium salsum, Arenoparella mexicana, Trochammina advena, Trochammina laevigata and Trochammina inflata) contributed the most to assemblage turnovers but showed no preference to either dry or wet conditions. At Claxton Bay major assemblage turnovers of the metacommunity and mid assemblage coincided with seasonal change and calcareous species (A. tepida and Triloculina oblonga) increased during wet conditions and decreased during dry conditions, while agglutinated species (T. advena and A. salsum) fluctuated oppositely. At Cowpen Marsh major assemblage turnovers of the metacommunity coincided with the start of summer and winter. Assemblages at higher elevations (mainly Jadammina macrescens and Haplophragmoides spp.) were responsible for the summer turnover, while the winter turnover was led by the assemblage at lower elevations (mainly Haynesina germanica, Elphidium earlandi, Elphidium williamsoni, Elphidium excavatum and Quinqueloculina spp.). At Bay of Cádiz, the foraminiferal assemblage at a tidal height of 1.5 to 1.7 m above the hydrographic zero was examined within three separate plots, and the seasonal occurrence of assemblage turnovers differed between plots. Thus, replicate samples and multiple plots may be necessary to overcome spatial

  19. Foram Farming in the Mid-Continent: Culturing Low-Mg Benthic Foraminifera to Calibrate the Mg/Ca Paleothermometer

    NASA Astrophysics Data System (ADS)

    Jennings, D.; Hasiuk, F.; Thomas, E.; Varekamp, J. C.

    2014-12-01

    The initiation of Cenozoic continental ice sheets and the history of their growth/decay is difficult to reconstruct because of the mixed effects of polar ice volume and temperature on benthic foraminiferal oxygen isotope values. Coupled measurements of foraminiferal δ18O and Mg/Ca are a promising tool to unlock the history of past continental glaciation by calculating the oxygen isotopic composition of paleo-seawater. This method has been applied on Quaternary timescales with success, but uncertainty about secular changes in seawater Mg/Ca and potential changes in carbonate saturation have produced varying results with deeper time data. Currently, no experimentally-calibrated model explains how the Mg/Ca of low-Mg calcite, such as secreted by benthic foraminifera, responds to variations in seawater temperature and Mg/Ca. Our "Foram Farm" is a culture system for low-Mg calcite benthic foraminifera, composed of a colony and an experimental line. Currently, the colony hosts several species of rotaliids, miliolids, and buliminids obtained from Qatar, the Dominican Republic, Scotland, and Long Island Sound, USA. In addition, two tanks contain "live sand," a mixture of sandy material and seawater obtained from tropical reefs, and commonly used to condition hobbyist saltwater aquaria. This sand contains foraminifera and numerous other microorganisms. "Live sand" could be a source for cheap and easy to obtain test subjects. The foram farm gives access to a constant supply and variety of test subjects for the experimental line, which consists of several analytical refrigerators with varying temperatures. Each refrigerator houses petri dishes where forams are grown in water with varying Mg/Ca compositions. Elphidium excavatum, a well-researched, eurytopic taxon, will be the first to be cultured in the experimental line. After growing under experimental conditions, specimens will be analyzed using LA-ICP-MS, in order to model effects of seawater T and Mg/Ca on foram Mg

  20. [Not Available].

    PubMed

    Germán Díaz, Marta; Moreno Villares, José Manuel; Gomis Muñoz, Pilar

    2016-01-01

    Introducción: la nutrición parenteral domiciliaria se ha convertido en un punto clave en el tratamiento de pacientes con fracaso intestinal crónico. A pesar de los importantes avances que se han producido en las últimas décadas, tanto en los accesos vasculares, como en las soluciones empleadas, las infecciones asociadas a catéter venoso central siguen constituyendo una de las complicaciones más importantes. Dentro de las estrategias para la prevención o el tratamiento de estas infecciones se encuentra el empleo de sellados con antisépticos, como el etanol o la taurolidina, o de antibióticos.Objetivo: el objetivo de este artículo es revisar la evidencia disponible sobre el empleo de sellados con antisépticos o antibióticos en el manejo de pacientes pediátricos con nutrición parenteral domiciliaria.Material y métodos: el uso de sellados con etanol o taurolidina para prevenir el desarrollo de infecciones asociadas a catéter central estaría indicado en pacientes con nutrición parenteral domiciliaria que hayan tenido más de una infección en el año anterior o que se consideren pacientes de riesgo. Los sellados con antibióticos están indicados en el tratamiento de bacteriemias asociadas a catéter central producidas por S. coagulasa-negativo o gramnegativos, asociados a un tratamiento sistémico, siempre que sea posible, con el fin de salvar el catéter. Se debería llevar a cabo la retirada del mismo cuando existan signos de infección del punto de entrada o del trayecto subcutáneo, o cuando el germen responsable de la infección sea S. aureus o Cándida.Conclusión: a pesar de que la fuerza de la evidencia sobre la eficacia del sellado en la prevención o el tratamiento de infecciones asociadas al catéter es limitada, tanto en el niño como en el adulto, cada vez existen más datos a usar esta alternativa en pacientes con nutrición parenteral domiciliaria en los que la atención y salvaguarda de los catéteres es primordial. PMID:27571647

  1. Aspergilosis cervical con diseminación al sistema nervioso central. Presentación de un caso y revisión de bibliografía

    PubMed Central

    Vergara, Guillermo Enrique; Roura, Natalia; del Castillo, Marcelo; Mora, Andrea; Alcorta, Santiago Condomi; Mormandi, Rubén; Cervio, Andrés; Salvat, Jorge

    2015-01-01

    Introducción: la Aspergilosis Invasiva (AI) del Sistema Nervioso Central (SNC) es infrecuente y ocurre generalmente en pacientes inmunocomprometidos. Puede presentarse con cuadros de meningitis, aneurismas micóticos, infartos o abscesos. Es una infección con pronóstico reservado y puede afectar el SNC de forma primaria o secundaria a partir de un foco que se disemina por vía hematógena. Presentamos el caso de un paciente con AI con invasión primaria a nivel óseo y diseminación posterior al cerebro. Caso clínico: Paciente masculino de 25 años con diagnóstico de leucemia linfática aguda en tratamiento quimioterápico que presentó neumonitis por metotrexate por lo que inicia tratamiento con corticoides. Posteriormente agregó cervicalgia y con el diagnóstico de osteomielitis cervical se realiza punción bajo tomografía computada (TC) sin aislarse gérmenes. Se colocó Halo Vest e inició tratamiento antibiótico empírico. Posteriormente presentó afasia de expresión secundaria a lesión frontal izquierda. Se realizó evacuación de absceso cerebral aislando A. fumigatus. El tratamiento antibiótico específico posterior permitió una buena respuesta clínica y radiológica. Conclusión: La presencia de lesiones en el SNC de pacientes inmunocomprometidos debe incluir a las micosis como diagnóstico diferencial. La evacuación quirúrgica permite llegar rápidamente al diagnóstico mejorando la respuesta posterior al tratamiento antibiótico. Para evaluar la respuesta terapéutica y posibles recaídas se debe realizar un seguimiento periódico clínico radiológico. Palabras clave: Aspergilosis cerebral; Aspergilosis cervical; Aspergilosis invasiva; Voriconazol. PMID:26600985

  2. Examining adherence among challenging patients in public and private HIV care in Argentina

    PubMed Central

    Jones, Deborah; Cook, Ryan; Cecchini, Diego; Sued, Omar; Bofill, Lina; Weiss, Stephen; Waldrop-Valverde, Drenna; Lopez, Maria R; Spence, Andrew

    2015-01-01

    Treatment engagement, retention and adherence to care are required for optimal HIV outcomes. Yet, patients may fall below the treatment recommendations for achieving undetectable viral load or not be retained in care. This study examined the most challenging patients in Buenos Aires, Argentina, those non-adherent to HIV care. Men (n = 61) and women (n = 59) prescribed antiretrovirals (ARVs) and non-adherent to treatment in the prior 3 to 6 months were enrolled and assessed regarding adherence, knowledge, motivation and attitudes regarding treatment. Private clinic patients had lower viral load and higher self-reported adherence than public clinic patients. Motivations to be adherent and positive beliefs regarding ARVs were associated with increased adherence in public clinic participants. Increased self-efficacy was associated with increased adherence among participants from both clinics. Results support patient and provider interventions that strengthen the characteristics supporting adherence, engagement and retention in public and private clinic settings. Resumen El compromiso, la retención en el cuidado y adherencia al tratamiento son esenciales para el manejo óptimo del paciente con VIH. Sin embargo, muchos pacientes con VIH no siguen las el tratamiento para lograr tener una carga viral indetectable, o no permanecen bajo cuidado médico. Este estudio examina los pacientes más difíciles de retener en el cuidado médico en Buenos Aires, Argentina. Hombres (n = 61) y mujeres (n = 59) a los que se les habían recetado antiretrovirales pero seguían el tratamiento en los últimos 3 - 6 meses participaron en el estudio. Adherencia, conocimiento, motivación y actitudes frente al tratamiento fueron evaluados. Los pacientes en la clínica privada tenían menor carga viral y mejor adherencia que los de la clínica pública. Motivación y pensamientos positivos con respecto a antiretrovirales estaban asociados con mejor adherencia en los pacientes de la clínica p

  3. [In Process Citation].

    PubMed

    Álvarez-Altamirano, Karolina; Mendoza-Hernández, Alma Nubia; Carcoba-Tenorio, Carolina; García-García, José Antonio; Fuchs-Tarlovsky, Vanessa

    2016-01-01

    Introducción y objetivos: la terapia con antioxidantes durante la quimioterapia y radioterapia en pacientes con cáncer cervicouterino es controvertida. Mientras existe evidencia que sugiere que el uso de antioxidantes disminuye los efectos secundarios propios del tratamiento contra el cáncer, hay datos que sugieren que los antioxidantes incrementan el riesgo de recurrencia de cáncer por la afectación de la terapia de los tratamientos. Métodos: se dirigió un estudio clínico controlado en pacientes con cáncer cervicouterino que fueron suplementados con una mezcla de antioxidantes o placebo, con seguimiento por 4 años posteriores al término de su tratamiento antineoplásico para evaluar el efecto de los antioxidantes en la recurrencia. Tomamos datos de niveles de hemoglobina y albúmina. Se analizaron las diferencias entre grupos con la prueba de Chi-cuadrado, la sobrevida se calculó con un análisis multivariado por medio de regresión de COX. Resultados: se dio seguimiento a 103 pacientes con cáncer cervicouterino en etapa clínica IIB y IIIB de los cuales 48% fueron tratados con suplementación de antioxidantes y el 52% con placebo, originalmente y de estos se dio seguimiento a 88 pacientes durante 4 años. El 23,9% de los pacientes tratados presentaron recurrencia por cáncer mientras que el 76,1% no la presentó. El 21,6% de los pacientes presentaron metástasis, el 8% de los pacientes perteneció al grupo de antioxidantes y el 15,9% al grupo placebo (p > 0,05). Implicaciones para los pacientes supervivientes: la suplementación con antioxidantes aparentemente no interfiere con la recurrencia por cáncer, sin embargo no hay evidencia suficiente para probarlo. Posiblemente una dosis distinta sea la clave para un mejor efecto, pero serán necesarios futuros estudios que prueben efectos sobre otro tipo de dosis. Conclusiones: la suplementación con antioxidantes durante el tratamiento de pacientes con cáncer cervicouterino no tiene efectos en la

  4. [In Process Citation].

    PubMed

    Valdivielso Cortázar, E; Prieto Martínez, C; Fernández-Urién Sainz, I; Vila Costas, J J; Jiménez Pérez, F J; Guerra Lacunza, A

    2016-01-01

    La pancreatitis autoinmune (PAI) es una patología poco frecuente, aunque con una creciente incidencia en países orientales, si bien esto podría deberse a una mayor tasa de detección. Puede asociarse a otras patologías autoinmunes, y se ha descrito su asociación con la enfermedad sistémica por IgG4. La clínica es variada y el tratamiento habitualmente es médico, mediante corticoides.Se describe un caso clínico diagnosticado.Palabras clave. Pancreatitis autoinmune. IgG4. PMID:27125615

  5. [Not Available].

    PubMed

    Sendrós Madroño, José M

    2016-01-01

    La atención nutricional en el paciente oncohematológico debe formar parte del tratamiento global del paciente. Las alteraciones debidas a la localización de la neoplasia y los efectos secundarios del tratamiento oncoespecífico muchas veces dificultan o impiden la alimentación oral. Esto puede dar lugar a una desnutrición y es de gran importancia su detección, valoración e intervención temprana. El primer paso en la intervención nutricional es el consejo dietético. Este artículo muestra qué aspectos deben tenerse en cuenta para poder elaborar un consejo dietético y la importancia de que este sea individualizado. Se describen como ejemplo cuatro situaciones especiales, donde es necesario trasladar las recomendaciones nutricionales a un plan dietético. También se incide en el uso de los probióticos en pacientes inmunocomprometidos. PMID:27269216

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

    NASA Astrophysics Data System (ADS)

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

    2002-12-01

    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

  7. [In Process Citation].

    PubMed

    Rodríguez-Valle, Ana; Navarro-Ferrando, María Ángeles; Boj-Carceller, Diana; Escanero-Marcén, Jesús Fernando; Sanz-Paris, Alejandro

    2016-01-01

    Objetivo: poco se conoce sobre el impacto de orlistat en el sistema leptina. Estudiamos la respuesta de la leptina plasmática y la sensación de saciedad tras dos días de tratamiento con orlistat sin dieta hipocalórica ni pérdida de peso. Material y métodos: reclutamos veinte mujeres obesas en nuestras consultas externas de medicina. Habían recibido restricción dietética y modificación del estilo de vida, pero se habían mantenido obesas con peso corporal estable durante seis meses antes de su inclusión en el estudio. Resultados: las pacientes tomaron 120 mg de orlistat 3 veces al día y mantuvieron su dieta habitual. Al inicio y dos días después del tratamiento con orlistat se repitieron el examen físico, la sensación de hambre y la analítica. No hubo diferencias significativas en el consumo de energía de la dieta, el peso corporal y la relación cintura-cadera, así como en glucosa sérica, insulina y péptido C. Solamente las concentraciones de leptina y triglicéridos en suero disminuyeron (p: 0,0001 y 0,01, respectivamente). La disminución de la concentración de leptina en suero se correlacionó positivamente con cambios en la concentración de triglicéridos (p: 0.01, r2: 0,45). La sensación de hambre aumento antes de la cena y se correlacionó negativamente con la disminución de la leptina (p: 0,0001, r2: 0,74) y triglicéridos (p: 0,02, r2: 0.59). Conclusión: estos datos sugieren que la malabsorción parcial de grasas por el tratamiento con orlistat disminuye rápidamente los niveles plasmáticos de triglicéridos y leptina. Este descenso se asoció con aumento del apetito antes de la ingesta que sigue a la comida principal del día. PMID:27238788

  8. [Not Available].

    PubMed

    Molina Villaverde, Raquel

    2016-01-01

    El cáncer es un problema sanitario de primera magnitud a escala mundial. Su tratamiento es uno de los mayores campos de innovación y desarrollo en medicina. La visión del cáncer como una enfermedad sistémica, heterogénea y de una elevada complejidad hace que los enfermos deban recibir una atención oncológica de calidad, proporcionada por equipos multidisciplinares altamente cualificados. Además de la gran incidencia de malnutrición en estos pacientes, la intervención nutricional precoz puede mejorar su pronóstico, aumentar la calidad de vida y disminuir la tasa de complicaciones de la enfermedad. Por ello, es necesaria una estrecha colaboración entre el oncólogo y el experto en nutrición. PMID:27269214

  9. [Not Available].

    PubMed

    Martínez Gómez, María Josefa; Melián Fernández, Cristóbal; Romeo Donlo, María

    2016-01-01

    La enfermedad inflamatoria intestinal (EII) es una patología crónica que cursa en brotes. En los últimos años se ha visto un aumento de la incidencia, sobre todo en edades más tempranas. La malnutrición se encuentra frecuentemente asociada a esta patología, por tanto, es de vital importancia una intervención nutricional adecuada, especialmente en pacientes pediátricos, que intente asegurar no solo un óptimo crecimiento, sino también una mejoría de la clínica. Nuestro objetivo será actualizar, según la evidencia publicada, el conocimiento del papel de la nutrición en la enfermedad y en el tratamiento de la misma. La desnutrición en estos pacientes es frecuente y se ve influida por varios factores, como son la disminución de la ingesta alimentaria, el aumento de las necesidades de nutrientes, el aumento de las pérdidas proteicas y la malabsorción de los nutrientes. Por esto se debería realizar un seguimiento nutricional a todos ellos en el que se hicieran mediciones antropométricas, determinaciones analíticas y densitometría, para establecer las necesidades y el aporte calórico suficiente adaptado a cada paciente. El uso de la nutrición enteral como tratamiento en la enfermedad de Crohn con brote leve-moderado en población infantil está ampliamente demostrado; incluso ha demostrado ser superior al uso de corticoides. Por todo ello podemos concluir recalcando que la intervención nutricional es un pilar fundamental en el manejo de los pacientes con EII, cuya finalidad es evitar y/o controlar la desnutrición relacionada con la enfermedad para disminuir su morbimortalidad y mejorar su calidad de vida. PMID:27571867

  10. [Not Available].

    PubMed

    Monereo Megías, Susana; Arnoriaga Rodríguez, María; Olmedilla Ishishi, Yoko Lucía; Martínez de Icaya, Purificación

    2016-01-01

    La obesidad es una enfermedad muy prevalente con múltiples complicaciones crónicas que se reducen o desaparecen tras pérdidas pequeñas (5-10%) pero mantenidas de peso. Sin embargo, mantener la pérdida de peso tras el tratamiento es muy difícil, siendo uno de los mayores retos en el control de esta enfermedad. Aunque las razones que contribuyen a recuperar el peso perdido son de diversa índole, relacionadas con la respuesta biológica a la restricción calórica y con la pérdida de adherencia al tratamiento, hasta un 20% de los pacientes son capaces de mantenerlo. Las claves del éxito están relacionadas con el mantenimiento de los hábitos de vida saludable, el ejercicio físico y una ingesta calórica razonable que permita realizar una vida normal, sin pérdida de vida social. En este sentido, aprender a distinguir las opciones de comida y bebida en una sociedad donde la vida social gira en torno a la mesa en muchas ocasiones es muy importante. Revisamos en este artículo las claves para mantener el peso tras una dieta, así como el papel de las bebidas fermentadas, en especial, la cerveza, en este proceso. En conclusión, mantener el peso perdido es más difícil que perderlo. El consumo leve-moderado de bebidas fermentadas como la cerveza no se asocia con incremento del peso. PMID:27571862

  11. Immunological failure of first-line and switch to second-line antiretroviral therapy among HIV-infected persons in Tanzania: analysis of routinely collected national data

    PubMed Central

    Vanobberghen, Fiona M; Kilama, Bonita; Wringe, Alison; Ramadhani, Angela; Zaba, Basia; Mmbando, Donan; Todd, Jim

    2015-01-01

    centres de santé et les établissements gouvernementaux étaient les moins susceptibles de changer de traitement. Conclusions Les taux d’échecs immunologiques du traitement et les besoins non satisfaits pour le traitement de 2nde ligne sont élevés en Tanzanie. La surveillance virologique, au moins pour les personnes avec un échec immunologique de traitement, est nécessaire pour minimiser les passages inutiles au traitement de 2nde ligne. Les établissements de santé gouvernementaux de niveau inférieur ont besoin de plus de support pour réduire les taux d’échec de traitement et pour améliorer l'adoption de la thérapie de 2nde ligne afin de maintenir les avantages d'une couverture accrue. Objetivos Las tasas de fallo de la terapia de primera línea y los cambios a la terapia de segunda línea son indicadores claves para los programas nacionales de VIH. Hemos evaluado los fallos en el tratamiento inmunológico definidos según criterios de la OMS dentro del programa nacional para VIH en Tanzania. Métodos Hemos incluido adultos que iniciaban la terapia de primera línea entre el 2004-2011 con un conteo de CD4 antes de recibir el tratamiento, y tras ≥6 meses de seguimiento. Hemos evaluado los subíndices de riesgo del fallo inmunológico en el tratamiento, y el cambio subsecuente a la segunda línea de tratamiento, utilizando análisis de riesgo competitivo para explicar las muertes. Resultados De 121,308 adultos, un 7% experimentó fallo inmunológico, y un 2% murió sin observarse un fallo inmunológico en el tratamiento, a lo largo de una mediana de 1.7 años. La probabilidad acumulada a lo largo de seis años de fallo terapéutico inmunológico era del 19.0% (IC 95% 18.5, 19.7) y de muerte del 5.1% (4.8,5.4). Los vaticinadores de fallo terapéutico inmunológico incluían haber empezado el tratamiento un año antes (p<0.001), haberlo iniciado en centros de menor nivel (SHR=2.23 [2.03,2.45] para dispensarios versus hospitales), ser ombre (1.27 [1

  12. Reframing HIV care: putting people at the centre of antiretroviral delivery

    PubMed Central

    Duncombe, Chris; Rosenblum, Scott; Hellmann, Nicholas; Holmes, Charles; Wilkinson, Lynne; Biot, Marc; Bygrave, Helen; Hoos, David; Garnett, Geoff

    2015-01-01

    érisée par quatre éléments de délivrance: (1) les types de services délivrés, (2) l’emplacement de la délivrance des services, (3) Les prestataires des services de santé et (4) la fréquence des services de santé. La façon dont ces éléments sont développés dans un cadre de prestation de services peut varier selon les pays et les populations, l’intention étant d’améliorer les résultats d’acceptabilité et des soins. Le but d’obtenir plus de personnes sous traitement avant qu’ils ne tombent malades nécessitera des modèles innovateurs de prestation à la fois pour dépistage et pour les soins. Comme les programmes VIH étendent l’éligibilité au traitement, beaucoup de gens qui entrent dans les soins ne seront pas des “malades- mais des éléments sains de la société, actifs et productifs. Afin de tenir le cadre à l’échelle, il sera important de: (1) définir les individus qui peuvent être traités par un cadre alternatif de prestation, (2) renforcer les systèmes de santé qui soutiennent la décentralisation, l’intégration et le transfert des tâches; (3) rendre la chaîne d’approvisionnement plus robuste et (4) investir dans des systèmes de données pour le suivi des patients et pour le suivi et l’évaluation du programme. Los servicios de atención del VIH durante el inicio de la primera etapa de rápida expansión del tratamiento y cuidados del VIH estaban basados en modelos clínicos existentes, comunes en lugares con abundancia de recursos y poco diferenciados en cuanto a necesidades individuales. Aquí se propone un nuevo marco para el tratamiento basado en intensidades variables de cuidados, hecho a medida según las necesidades específicas de los diferentes grupos de individuos a lo largo del tratamiento. La intensidad del servicio se caracteriza por cuatro componentes de entrega: (1) tipología de los servicios ofrecidos, (2) lugar de entrega de los servicios, (3) proveedor de los servicios sanitarios, y (4

  13. 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

    Liburd, O.E.; White, J.C.; Rhodes, E.M.; Browdy, A.A.

    2007-03-15

    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)

  14. [Not Available].

    PubMed

    Higuera Pulgar, Isabel; Bretón Lesmes, Irene; Carrascal Fabián, María Luisa; Prieto García, Alicia; Menchén Viso, Luis; Nogales Rincón, Óscar; Iglesias Hernández, Natalia Covadonga; Issasa Rodríguez, Leire; García Peris, Pilar

    2016-01-01

    Introducción: la esofagitis eosinofílica (EEo) es una enfermedad inmunoalérgica crónica emergente en adultos. Surge como respuesta disfuncional frente a los antígenos de los alimentos y se caracteriza por síntomas recurrentes de disfunción esofágica e inflamación. El tratamiento farmacológico y dietético se basa en su patogénesis y debe ser individualizado. Uno de los posibles abordajes dietéticos se basa en la eliminación empírica de alimentos que con mayor frecuencia causan EEo.Objetivo: evaluar la ingesta dietética de los pacientes con EEo que siguen la dieta de exclusión de los seis grupos de alimentos (DESGA) y conocer sus posibles carencias nutricionales.Métodos: estudio transversal descriptivo en un grupo de pacientes con EEo que inició tratamiento con DESGA durante el periodo de marzo de 2013 hasta marzo de 2015. Se evaluó la ingesta mediante registro de 72 horas. Se compararon los resultados con las referencias para población adulta sana española (23). Para el análisis estadístico se usaron los test de Mann-Whitney, Krhuskall-Wallis y Chi-cuadrado. Significación p < 0,05.Resultados: se incluyeron en el estudio 14 pacientes. En algunos de ellos, la ingesta dietética siguiendo DESGA fue deficitaria en energía, proteínas y fibra. Tampoco consiguieron cubrir las ingestas de micronutrientes de calcio, zinc, magnesio, ácido fólico, niacina y vitaminas B2 y D, teniendo en cuenta edad y sexo, el 60% de la muestra.Conclusiones: el abordaje terapéutico mediante DESGA, teniendo en cuenta las características de la dieta, debe acompañarse de una evaluación periódica del estado nutricional, que incluya micronutrientes y una pauta de suplementación específica. PMID:27571662

  15. [In Process Citation].

    PubMed

    Ballesteros Pomar, María D; Suárez Gutiérrez, Alfonso; Calleja Fernández, Alicia; Pintor de la Maza, Begoña; Urioste Fondo, Ana; Vidal Casariego, Alfonso; Villar Taibo, Rocío; Otero Redondo, Concepción; Herrero Moratiel, Manuel; Cano Rodríguez, Isidoro; Burón Llamazares, Juan Luis

    2016-01-01

    Introducción: la desnutrición relacionada con la enfermedad (DRE) afecta al menos a una cuarta parte de los pacientes hospitalizados, aumentando la morbimortalidad del paciente durante su hospitalización y al alta. Sin embargo, su repercusión en la actividad hospitalaria no está bien cuantificada.Objetivo: determinar el impacto de una adecuada codificación de la DRE y los procedimientos empleados para revertirla en el peso medio del hospital y otros índices hospitalarios.Material y métodos: estudio comparativo realizado en todos los pacientes subsidiarios de soporte nutricional artificial seguidos por la Unidad de Nutrición Clínica y Dietética de la Sección de Endocrinología y Nutrición (UNCyD-SEyN) del Complejo Asistencial Universitario de León durante los años 2008 y 2013. Se realizó un informe de codificación nutricional del diagnóstico, el tratamiento nutricional y la vía de acceso según la CIE-9-MC. Se comparó el peso medio depurado del hospital, el índice de estancia media ajustada (IEMA), la casuística e índice de funcionamiento previo a la codificación nutricional y tras la misma.Resultados: el peso medio depurado del hospital se incrementó tras la codificación, tanto en 2008 (+ 4,1%) como en 2013 (+1,7%) y especialmente en aquellos servicios en los que se realiza cribado nutricional (Hematología, +10,5%). El IEMA se redujo por debajo de 1 (-5,7% y -0,2% en 2008 y 2013), indicando un mejor funcionamiento, y también disminuyó el índice funcional (-5,6% y -0,4% en 2008 y 2013), lo que supondría una mayor eficiencia.Conclusión: la correcta codificación del diagnóstico y el tratamiento nutricional del paciente con desnutrición aumenta el peso medio depurado de un hospital de tercer nivel, y mejora el IEMA y el índice de funcionamiento. PMID:27019251

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

    PubMed Central

    2012-01-01

    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

  17. DIABETES MELLITUS COMO FACTOR DE RIESGO DE DEMENCIA EN LA POBLACIÓN ADULTA MAYOR MEXICANA

    PubMed Central

    Silvia, Mejía-Arango; Clemente, y Zúñiga-Gil

    2012-01-01

    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

  18. Los plaguicidas y la contaminacion del medio ambiente Venezolano

    USGS Publications Warehouse

    Stickel, L.F.; Stickel, W.H.

    1972-01-01

    RESUMEN DE RECOMENDACIONES Recomendaciones para el Programa de Investigacion: 1. Establecer un sistema de muestreo biologico para detectar los niveles tendencias de los productos quimicos toxicos en un peque?o numero de si tios representativos. 2. Mantener continua vigilancia de la contaminacion ambiental, mediante la seleccion acertadamente dirigida de las zonas afectadas y de las fuentes de contaminacion. 3. Realizar estudios acerca de las poblaciones de animales silvestres, y del exito de los procesos reproductivos de las especies o grupos clayes de animales que se consideran mas gravemente afectados. 4. Preparar recomendaciones para una accion gubernamental de proteccion al hombre, a la fauna silvestre y al medio ambiente. Recomendaciones para la Accion Administrativa: 1. Establecer limites a la tolerancia de los residuos de plaguicidas en los alimentos. Constituye una medida clave para disminuir la contaminacion ambiental. 2. Establecer normas de calidad del agua para las corrientes, represas, la gos y otros cuerpos. Es la segunda medida clave para reducir la contaminacion del ambiente 3. Exigir un tratamiento adecuado de los efluentes industriales, especialmente antes de que se construyan las nuevas plantas. 4. Exigir a los agricultores que en el uso de plaguicidas sigan los consejos tecnicos autorizados y negar a los vendedores el derecho a recomendar productos por su cuenta. 5. Tomar medidas para recoger y eliminar los recipientes y sobrantes de los plaguicidas.

  19. Resistencia a antibióticos de última línea en cocos Gram positivos: la era posterior a la vancomicina

    PubMed Central

    Rincón, Sandra; Panesso, Diana; Díaz, Lorena; Carvajal, Lina P.; Reyes, Jinnethe; Munita, José M.; Arias, César A.

    2015-01-01

    En los últimos años se han desarrollado nuevas alternativas para el tratamiento de infecciones por patógenos Gram positivos multirresistentes, entre los cuales Staphylococcus aureus resistente a la meticilina (SARM) y los enterococos resistentes a la vancomicina (ERV) se consideran un verdadero reto terapéutico, y aunque el uso de la vancomicina en infecciones graves causadas por SARM ha generado serias dudas en los últimos años, continúa siendo escasa la información clínica de respaldo al uso de agentes terapéuticos que la superen en eficacia. El linezolid, la daptomicina y la tigeciclina son agentes que tienen actividad contra los cocos Gram positivos y que fueron aprobados e introducidos en la terapia clínica en la década pasada. Además, se han probado o están en las fases finales de desarrollo otros agentes como las cefalosporinas de última generación (ceftarolina y ceftobiprol). El propósito de esta revisión fue describir las nuevas alternativas terapéuticas, particularmente en la era posterior a la vancomicina, y repasar las características químicas más relevantes de los compuestos y su espectro de actividad, haciendo énfasis en sus mecanismos de acción y resistencia. PMID:24968051

  20. Treatment Satisfaction Among Patients Taking Antidepressant Medication.

    PubMed

    López-Torres Hidalgo, Jesús; López Gallardo, Yolanda; Párraga Martínez, Ignacio; Del Campo Del Campo, José María; Villena Ferrer, Alejandro; Morena Rayo, Susana

    2016-08-01

    This study sought to assess treatment satisfaction among patients on antidepressants, ascertaining whether there might be an association with depressive symptomatology and other variables. Cross-sectional study conducted on 564 adult patients taking antidepressant medication. Satisfaction with antidepressant treatment was assessed using the Assessment of Satisfaction with Antidepressant Treatment Questionnaire (ESTA/Evaluación de la Satisfacción con el Tratamiento Antidepresivo). A moderate negative correlation was observed between satisfaction and intensity of depressive symptoms, as assessed with the Montgomery-Asberg scale. A weak negative correlation was observed between greater satisfaction and less favourable views about taking medication. Satisfaction scale scores were higher among those who took antidepressant medication for 1 year or more versus shorter periods. Most patients reported being satisfied with the antidepressant treatment but the level of satisfaction was higher among those who presented with less marked depressive symptoms, received longer-term treatment and viewed drug treatments favourably. Treatment satisfaction is one of the patient-reported outcome measures that can serve to complement clinical evaluation of depressive disorders. PMID:25833726

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

    PubMed

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

    2013-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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

  3. Smoldering multiple myeloma requiring treatment: time for a new definition?

    PubMed Central

    Stewart, A. Keith; Chanan-Khan, Asher; Rajkumar, S. Vincent; Kyle, Robert A.; Fonseca, Rafael; Kapoor, Prashant; Bergsagel, P. Leif; McCurdy, Arleigh; Gertz, Morie A.; Lacy, Martha Q.; Lust, John A.; Russell, Stephen J.; Zeldenrust, Steven R.; Reeder, Craig; Roy, Vivek; Buadi, Francis; Dingli, David; Hayman, Suzanne R.; Leung, Nelson; Lin, Yi; Mikhael, Joseph; Kumar, Shaji K.

    2013-01-01

    Smoldering multiple myeloma (SMM) bridges the gap between monoclonal gammopathy of undetermined significance (a mostly premalignant disorder) and active multiple myeloma (MM). Until recently, no interventional study in patients with SMM showed improved overall survival (OS) with therapy as compared with observation. A report from the PETHEMA-GEM (Programa Español de Tratamientos en Hematologica) group described both fewer myeloma-related events and better OS among patients with high-risk SMM who were treated with lenalidomide and dexamethasone. This unique study prompted us to review current knowledge about SMM and address the following questions: (1) Are there patients currently defined as SMM who should be treated routinely? (2) Should the definitions of SMM and MM be reconsidered? (3) Has the time come when not treating is more dangerous than treating? (4) Could unintended medical harm result from overzealous intervention? Our conclusion is that those patients with the highest-risk SMM (extreme bone marrow plasmacytosis, extremely abnormal serum immunoglobulin free light chain ratio, and multiple bone lesions detected only by modern imaging) should be reclassified as active MM so that they can receive MM-appropriate therapy and the paradigm of careful observation for patients with SMM can be preserved. PMID:24144641

  4. FACTORES SOCIO-ESTRUCTURALES Y EL ESTIGMA HACIA EL VIH/SIDA: EXPERIENCIAS DE PUERTORRIQUEÑOS/AS CON VIH/SIDA AL ACCEDER SERVICIOS DE SALUD

    PubMed Central

    RIVERA-DIAZ, MARINILDA; VARAS-DIAZ, NELSON; REYES-ESTRADA, MARCOS; SURO, BEATRIZ; CORIANO, DORALIS

    2013-01-01

    RESUMEN El estigma relacionado al VIH/SIDA continúa afectando la prestación de servicios de salud y el bienestar físico y mental de las personas con VIH/SIDA (PVS). Recientemente la literatura científica ha señalado la importancia de comprender las manifestaciones de estigma más allá de las interacciones individuales. Por tal razón, investigaciones recientes en y fuera de Puerto Rico enfatizan la importancia de entender cómo factores socio-estructurales (FSE) influyen en los procesos de estigmatización social. Con el propósito de examinar los FSE que influyen en las manifestaciones de estigma relacionado al VIH/SIDA, realizamos y analizamos nueve grupos focales compuestos por hombres y mujeres en tratamiento para el VIH/SIDA que habían tenido experiencias estigmatizantes. Los participantes identificaron FSE relacionados a las manifestaciones de estigma, tales como el uso de viviendas especializadas, descentralización de los servicios de salud y el desarrollo de protocolos administrativos excluyentes en los servicios de salud. Los resultados demuestran la importancia de considerar los FSE en el desarrollo e implementación de intervenciones dirigidas a la población. PMID:24639599

  5. Actividad funcional cerebral en estado de reposo: REDES EN CONEXIÓN

    PubMed Central

    Proal, Erika; Alvarez-Segura, Mar; de la Iglesia-Vayá, Maria; Martí-Bonmatí, Luis; Castellanos, F. Xavier

    2015-01-01

    Resumen El análisis de la conectividad funcional mediante resonancia magnética funcional (RMf) puede llevarse a cabo durante la realización de una tarea, la percepción de un estímulo o en estado de reposo. Estos análisis han demostrado su fiabilidad y reproducibilidad con diferentes enfoques (matemáticos, estadísticos, físicos) para seleccionar los vóxeles activados. El estudio de la señal de baja frecuencia en la actividad cerebral a través del contraste BOLD en estado de reposo ha revelado patrones de actividad cortical sincronizados, permitiendo describir la arquitectura funcional intrínseca del cerebro humano. La comunidad científica internacional dispone de recursos compartidos que contribuirán mediante este análisis de RMf en estado de reposo a la obtención de diagnósticos y tratamientos más precisos y avanzados en el campo de las neurociencias. PMID:21365601

  6. Lessons from scaling up a depression treatment program in primary care in Chile.

    PubMed

    Araya, Ricardo; Alvarado, Rubén; Sepúlveda, Rodrigo; Rojas, Graciela

    2012-09-01

    In Chile, the National Depression Detection and Treatment Program (Programa Nacional de Diagnóstico y Tratamiento de la Depresión, PNDTD) in primary care is a rare example of an evidence-based mental health program that was scaled up to the national level in a low- or middle-income country. This retrospective qualitative study aimed to better understand how policymakers made the decision to scale up mental health services to the national level, and to explore the elements, contexts, and processes that facilitated the decision to implement and sustain PNDTD. In-depth semistructured interviews with six key informants selected through intentional sampling were conducted in August-December 2008. Interviewees were senior officers at the Ministry of Health who were directly involved in the decision to scale up the program. Results yielded four elements pivotal to the decisionmaking process: scientific evidence, teamwork and leadership, strategic alliances, and program institutionalization. Each element contributed to building consensus, securing funding, attracting resources, and gaining lasting support from policymakers. Additionally, a review of available documentation led the authors to consider sociopolitical context and use of the media to be important factors. While research evidence for the effectiveness of mental health services in the primary care setting continues to accumulate, low- and middle-income countries should get started on the lengthy process of scaling up by incorporating the elements that led to decisionmaking and implementation of the PNDTD in Chile. PMID:23183564

  7. [In Process Citation].

    PubMed

    Santacruz-Cerdán, Elisa; Arcano, Karina; Arrieta Blanco, Francisco; Ortiz Flores, Andrés; Mateo Lobo, Raquel; Botella Carretero, José Ignacio; Vázquez Martínez, Clotilde; Zamarrón Cuesta, Isabel

    2016-01-01

    El uso de la nutrición parenteral domiciliaria (NPD) en pacientes que no pueden alcanzar sus requerimientos nutricionales por la vía enteral está aumentando en los últimos años, permitiendo la normalización del estilo de vida de los pacientes. Entre las patologías que más frecuentemente precisan de la NPD en España destacan la neoplasia y la isquemia mesentérica. Sin embargo, la NPD constituye uno de los pilares básicos del tratamiento de enfermedades mucho menos frecuentes como es el caso de la esclerosis peritoneal encapsulante. A continuación presentamos el caso de un paciente diagnosticado de esclerosis peritoneal encapsulante con soporte NPD de más de 7 años de NPD con un catéter central de inserción periférica (PICC) para la NPD sin complicaciones y pudiendo realizar su actividad laboral habitual. Dado lo excepcional del caso lo remitimos para su publicación. PMID:27019258

  8. Medicinal ethnobotany in Huacareta (Chuquisaca, Bolivia)

    PubMed Central

    2012-01-01

    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 des

  9. [Not Available].

    PubMed

    De Abajo Larriba, Ana Beatriz; Díaz Rodríguez, Ángel; González-Gallego, Javier; Méndez Rodríguez, Enrique; Álvarez Álvarez, María Jesús; Capón Álvarez, Jessica; Peleteiro Cobo, Beatriz; Mahmoud Atoui, Omar; De Abajo Olea, Serafín; Martínez de Mandojana Hernández, Juan

    2016-01-01

    Introducción: estimar la prevalencia del tabaquismo y analizar cómo se diagnostican y se trata a los fumadores diagnosticados de EPOC.Métodos: estudio epidemiológico, transversal, multicéntrico (30 centros salud de la provincia de León). Incluyó pacientes mayores de 35 años diagnosticados y tratados de EPOC. Variables analizadas: edad, sexo, hábitat, datos antropométricos, tabaquismo, número de paquetes/año, cooximetría, dependencia (escala analógico-visual), motivación (test de Fagerström), autoeficacia, estado anímico, intentos previos, terapia cognitivo-conductual, tratamiento farmacológico (TSN, bupropión, vareniclina) y recaídas. Los resultados se expresan con sus IC al 95,5%.Resultados: se incluyó a 833 pacientes, el 85,8% varones, edad media: 64,69 (53,66-75,61) años y 20,65 (4,47-36,8) años de evolución de la EPOC. El 86,67% (80,30-93,30) tenían antecedentes de tabaquismo (n = 722), de 35,26 (17,87-52,64) años de evolución, con consumo medio 28,36 (9,60-46,86) paquetes año, p < 0,001, siendo el 58% fumadores severos. El 57,4% (53,90-60,60) son exfumadores. El 29,3% (26,40-32,70) fumadores activos declarados vs. 35,11% (33,90-37,12) fumadores diagnosticados por cooximetría p < 0,05. Los 288 fumadores activos, presentaban baja motivación (49,80%), alta dependencia (49,5%), actitud negativa (52,60%), bajo estado de ánimo (32,05%), con 2,72 (1,74-3,67) intentos para dejar de fumar, p < 0,0001. La terapia conductivo-conductual (TCC) combinado con tratamiento farmacológico se realizó en el 55,8% (52,2-54,9), p < 0,05; La intervención más efectiva fue TCC combinada con vareniclina logrando una abstinencia del 29,86%. En total dejaron de fumar un 51,05% (49,49-52,70) de los pacientes con EPOC, p < 0,001.Conclusiones: la prevalencia de tabaquismo en la EPOC en nuestro medio continúa siendo inadmisiblemente elevada. Es necesaria una mayor implicación para disminuir su impacto en la salud de estos pacientes. PMID:27571673

  10. Grupos españoles de cálculos ab initio de moléculas de interés astrofísico

    NASA Astrophysics Data System (ADS)

    Yáñez, M.

    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

  11. Feasibility and effectiveness of two community-based HIV testing models in rural Swaziland

    PubMed Central

    Parker, Lucy Anne; Jobanputra, Kiran; Rusike, Lorraine; Mazibuko, Sikhathele; Okello, Velephi; Kerschberger, Bernhard; Jouquet, Guillaume; Cyr, Joanne; Teck, Roger

    2015-01-01

    -M) et le DC à domicile (DC-D). Les informations sur l’âge, le sexe, les tests précédents et les résultats VIH ont été obtenues à partir des dossiers de routine du DC. Une série d'individus séropositifs consécutifs a été suivie pendant six mois à partir de la date du test afin d’évaluer les liaisons aux soins. Résultats 9.060 personnes ont été testées: 2.034 par le biais du DC-M et 7026 par le biais du DC-D. Une plus grande proportion d'enfants et d'adolescents (<20 ans) ont été testés par le biais du DC-D que par celui du DC-M (57% vs 17%; p <0,001). Le DC-M a atteint une proportion plus élevée d'hommes adultes que le DC-D (42% vs 39%; p = 0,015). Des 398 personnes séropositives, seules 135 (34%) ont été inscrites à des soins VIH dans les 6 mois. De 42 personnes admissibles à la thérapie antirétrovirale, 22 (52%) ont commencé le traitement dans les 6 mois. Les liaisons avec les soins étaient plus faibles chez les personnes qui ont effectué un dépistage auparavant et celles âgées de 20 à 40 ans. Le DC-D était 50% moins cher (11 $ US par personne testée, 797 $ par personne inscrite dans les soins VIH) que le DC-M (24 $ et 1.698 $, respectivement). Conclusion Dans ce contexte à haute prévalence du VIH, un programme de dépistage communautaire a atteint une couverture élevée et semble être un moyen efficace et abordable pour encourager un grand nombre de personnes à connaître leur statut VIH (en particulier les populations mal desservies, telles que les hommes et les jeunes personnes). Cependant, afin que le DC communautaire ait un impact sur la mortalité et l'incidence, des stratégies doivent être mises en œuvre pour assurer que les personnes testées séropositives dans la communauté soient reliées aux soins du VIH. Objetivos Evaluar la viabilidad (población alcanzada, costes) y efectividad (tasas de positividad, vinculación al tratamiento) de dos estrategias comunitarias de asesoramiento y prueba para el VIH (APV

  12. Comparison of longevity between a laboratory strain and a natural population of Anastrepha Fraterculus (Diptera: Tephritidae) under field cage conditions

    SciTech Connect

    Gomez Cendra, P.; Vilardi, J.; Segura, D.; Cladera, J.; Allinghi, A.

    2007-03-15

    The South American fruit fly Anastrepha fraterculus (Wiedemann) is one of the most destructive fruit pests in this region, infesting major fruit crops. Implementation of the sterile insect technique (SIT) as part of an area-wide integrated approach against this species requires information on the survival of mass-reared and sterilized insects in the field and their ability to mate with wild females. The survival rates in field cages of both non-irradiated and irradiated laboratory flies were compared with that of wild flies. Both types of laboratory flies survived longer than their wild counterparts over the 8 days under the experimental conditions. The irradiation dose (70 Gy) did not affect survival of the laboratory reared flies. Our results improve the prospect of integrating the SIT into the control of A. fraterculus populations in Argentina. (author) [Spanish] Anastrepha fraterculus (Wiedemann), la mosca sudamericana de la fruta, es una de las plagas mas destructivas en la region que infesta a los principales cultivos de frutas. La implementacion de la Tecnica del Insecto Esteril (TIE) como parte de un manejo integrado en areas extensivas contra esta especie requiere ensayos que demuestren que los insectos producidos en forma masiva y esterilizados son capaces de sobrevivir en el campo y aparearse con las hembras silvestres. Se comparo la supervivencia de individuos de una linea de laboratorio, tanto irradiados como no irradiados con la de individuos de una poblacion natural. Los dos tratamientos de moscas de laboratorio sobrevivieron mas tiempo que las salvajes durante los 8 dias y en las condiciones ensayadas. La dosis de radiacion (70 Gy.) no afecto la supervivencia de las moscas criadas en laboratorio. Nuestros resultados mejoran las perspectivas de integrar la TIE en el control de las poblaciones argentinas de A. fraterculus. (author)

  13. Esquizofrenia y trastorno en el consumo de sustancias: prevalencia y characterísticas sociodemográficas en la población Latina

    PubMed Central

    Jiménez-Castro, Lorena; Raventós-Vorst, Henriette; Escamilla, Michael

    2012-01-01

    El interés por comprender la co-morbilidad de la esquizofrenia y el trastorno en el uso de sustancias, ha aumentado debido al incremento de este diagnóstico, a los efectos negativos observados en el sujeto y a los costos en los servicios de salud. Este trastorno dual puede tener efectos dramáticos en el curso clínico del trastorno psicótico tales como: mayores recaídas, re-hospitalizaciones, síntomas más severos, no adherencia al tratamiento antipsicótico, cambios marcados del humor, aumento en el grado de hostilidad e ideación suicida, así como alteraciones en otras áreas del funcionamiento incluyendo violencia, victimización, indigencia y problemas legales. La literatura proveniente en particular de Estados Unidos y Europa sugiere que el rango de prevalencia para este diagnóstico puede oscilar entre el 10% hasta el 70%. En este estudio, revisamos la prevalencia del diagnóstico dual de esquizofrenia y trastorno en el uso sustancias, así como sus características sociodemográficas, con base en la literatura disponible alrededor del mundo dando énfasis en la poblacion latina. A pesar de que este diagnóstico es ampliamente aceptado, se conoce poco sobre su prevalencia en la población latina, sobre los factores ambientales, demográficos, clínicos y otras características de estos individuos. Un mejor conocimiento sobre este diagnóstico permitiría mejorar los métodos para la detección y adecuada valoración del trastorno en el uso de sustancias en personas con trastornos metales severos como la esquizofrenia. PMID:21404151

  14. Ependimoma myxopapilar sacro gigante con osteolisis

    PubMed Central

    Ajler, Pablo; Landriel, Federico; Goldschmidt, Ezequiel; Campero, Álvaro; Yampolsky, Claudio

    2014-01-01

    Objetivo: la presentación de un caso de una paciente con un ependimoma sacro con extensa infiltración y destrucción ósea local. Descripción del caso: una mujer de 53 años acudió a la consulta por dolor lumbosacro y alteraciones sensitivas perineales y esfinterianas. La imágenes por Resonancia Magnética (IRM) y la Tomografía Axial Computada (TAC) mostraron una lesión expansiva gigante a nivel S2-S4 con extensa osteólisis e invasión de tejidos adyacentes. Se realizó una exéresis tumoral completa con mejoría del estatus funcional. La anatomía patológica informó ependimoma mixopapilar. Discusión: la extensión de la resección quirúrgica es el mejor predictor de buen pronóstico. El tratamiento radiante se reserva como opción adyuvante para las resecciones incompletas y recidiva tumoral. La quimioterapia sólo debería utilizarse en casos en que la cirugía y la radioterapia estén contraindicadas. Conclusión: Los ependimomas mixopapilares sacros con destrucción ósea y presentación intra y extradural son muy infrecuentes y deben ser tenidos en cuenta entre los diagnósticos diferenciales preoperatorios. Su resección total, siempre que sea posible, es la mejor alternativa terapéutica. PMID:25165615

  15. Estrategia innovadora enfocada en parejas del mismo sexo para disminuir la infección del VIH en hombres Latinos

    PubMed Central

    Martinez, Omar; Wu, Elwin; Sandfort, Theo; Shultz, Andrew Z.; Capote, Jonathan; Chávez, Silvia; Moya, Eva; Dodge, Brian; Morales, Gabriel; Porras, Antonio; Ovejero, Hugo

    2014-01-01

    Resumen El VIH es un problema de salud importante dentro de la comunidad latina de los Estados Unidos. Gracias a los esfuerzos de prevención, los niveles de contagio entre los latinos se han mantenido estables por más de una década. Sin embargo, esta población sigue siendo afectada a niveles muy altos, en particular entre hombres que tienen sexo con hombres (HSH), de origen latino y que hablan principalmente el idioma español. Existen varios factores que contribuyen a la transmisión del VIH entre esta población, como son: el uso de drogas; la violencia dentro de la pareja; la presencia de infecciones de transmisión sexual; relaciones sexuales sin protección, dentro y fuera de la pareja; el evadir la búsqueda de recursos (prueba y tratamiento adecuado) por temor a ser discriminado o por su estatus migratorio; la escasez de recursos económicos o estado de pobreza y los patrones relacionados a la migración. En particular, Investigaciones Epidemiológicas de Comportamientos han determinado: cómo algunas dinámicas en parejas están directamente asociadas a los comportamientos sexuales de riesgos. En consecuencia, es necesaria mayor investigación para identificar esas dinámicas, y a su vez, realizar intervenciones dirigidas a la reducción de conductas de riesgo enfocadas en parejas de hombres del mismo sexo. En este escrito, se describe la importancia del uso de las relaciones de pareja como estrategia en la reducción de la trasmisión del VIH/SIDA en HSH de origen latino y que hablan principalmente el idioma español en los Estados Unidos. PMID:25580466

  16. A prognostic model for survival after salvage treatment with FLAG-Ida +/- gemtuzumab-ozogamicine in adult patients with refractory/relapsed acute myeloid leukaemia.

    PubMed

    Bergua, Juan M; Montesinos, Pau; Martinez-Cuadrón, David; Fernández-Abellán, Pascual; Serrano, Josefina; Sayas, María J; Prieto-Fernandez, Julio; García, Raimundo; García-Huerta, Ana J; Barrios, Manuel; Benavente, Celina; Pérez-Encinas, Manuel; Simiele, Adriana; Rodríguez-Macias, Gabriela; Herrera-Puente, Pilar; Rodríguez-Veiga, Rebeca; Martínez-Sánchez, María P; Amador-Barciela, María L; Riaza-Grau, Rosalía; Sanz, Miguel A

    2016-09-01

    The combination of fludarabine, cytarabine, idarubicin, and granulocyte colony-stimulating factor (FLAG-Ida) is widely used in relapsed/refractory acute myeloid leukaemia (AML). We retrospectively analysed the results of 259 adult AML patients treated as first salvage with FLAG-Ida or FLAG-Ida plus Gentuzumab-Ozogamicin (FLAGO-Ida) of the Programa Español de Tratamientos en Hematología (PETHEMA) database, developing a prognostic score system of survival in this setting (SALFLAGE score). Overall, 221 patients received FLAG-Ida and 38 FLAGO-Ida; 92 were older than 60 years. The complete remission (CR)/CR with incomplete blood count recovery (CRi) rate was 51%, with 9% of induction deaths. Three covariates were associated with lower CR/CRi: high-risk cytogenetics and t(8;21) at diagnosis, no previous allogeneic stem cell transplantation (allo-SCT) and relapse-free interval <1 year. Allo-SCT was performed in second CR in 60 patients (23%). The median overall survival (OS) of the entire cohort was 0·7 years, with 22% OS at 5-years. Four independent variables were used to construct the score: cytogenetics, FLT3-internal tandem duplication, length of relapse-free interval and previous allo-SCT. Using this stratification system, three groups were defined: favourable (26% of patients), intermediate (29%) and poor-risk (45%), with an expected 5-year OS of 52%, 26% and 7%, respectively. The SALFLAGE score discriminated a subset of patients with an acceptable long-term outcome using FLAG-Ida/FLAGO-Ida regimen. The results of this retrospective analysis should be validated in independent external cohorts. PMID:27118319

  17. Prognostic value of FLT3 mutations in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and anthracycline monochemotherapy

    PubMed Central

    Barragán, Eva; Montesinos, Pau; Camos, Mireia; González, Marcos; Calasanz, Maria J.; Román-Gómez, José; Gómez-Casares, Maria T.; Ayala, Rosa; López, Javier; Fuster, Óscar; Colomer, Dolors; Chillón, Carmen; Larrayoz, María J.; Sánchez-Godoy, Pedro; González-Campos, José; Manso, Félix; Amador, Maria L.; Vellenga, Edo; Lowenberg, Bob; Sanz, Miguel A.

    2011-01-01

    Background Fms-like tyrosine kinase-3 (FLT3) gene mutations are frequent in acute promyelocytic leukemia but their prognostic value is not well established. Design and Methods We evaluated FLT3-internal tandem duplication and FLT3-D835 mutations in patients treated with all-trans retinoic acid and anthracycline-based chemotherapy enrolled in two subsequent trials of the Programa de Estudio y Tratamiento de las Hemopatías Malignas (PETHEMA) and Hemato-Oncologie voor Volwassenen Nederland (HOVON) groups between 1996 and 2005. Results FLT3-internal tandem duplication and FLT3-D835 mutation status was available for 306 (41%) and 213 (29%) patients, respectively. Sixty-eight (22%) and 20 (9%) patients had internal tandem duplication and D835 mutations, respectively. Internal tandem duplication was correlated with higher white blood cell and blast counts, lactate dehydrogenase, relapse-risk score, fever, hemorrhage, coagulopathy, BCR3 isoform, M3 variant subtype, and expression of CD2, CD34, human leukocyte antigen-DR, and CD11b surface antigens. The FLT3-D835 mutation was not significantly associated with any clinical or biological characteristic. Univariate analysis showed higher relapse and lower survival rates in patients with a FLT3-internal tandem duplication, while no impact was observed in relation to FLT3-D835. The prognostic value of the FLT3-internal tandem duplication was not retained in the multivariate analysis. Conclusions FLT3-internal tandem duplication mutations are associated with several hematologic features in acute promyelocytic leukemia, in particular with high white blood cell counts, but we were unable to demonstrate an independent prognostic value in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and anthracycline-based regimens. PMID:21685470

  18. [In Process Citation].

    PubMed

    Giménez Sánchez, Jaume; Fleta Sánchez, Yolanda; Meya Molina, Alba

    2016-01-01

    Introducción: debido a la alta prevalencia de sobrepeso y obesidad se hacen necesarias nuevas estrategias para su prevención y tratamiento. El coaching nutricional (CN) ha emergido en los últimos años y ha demostrado ser efectivo para la pérdida de peso aunque, al ser un concepto innovador, no siempre se utiliza apropiadamente.Objetivo: verificar si el CN, junto con el asesoramiento técnico, es una estrategia efectiva para la disminución de peso en población con sobrepeso u obesidad en comparación con el asesoramiento nutricional por sí solo.Material y métodos: se revisó la bibliografía referente a CN para determinar los parámetros de calidad en cuanto a esta intervención. Se realizó una búsqueda de estudios controlados aleatorizados que aplicaran CN según los parámetros seleccionados y lo compararan con asesoramiento técnico nutricional.Resultados: se analizaron ocho estudios con alta calidad en la intervención de coaching y calidad metodológica media o alta. Seis de ellos indicaron diferencias significativas a favor del grupo que recibió CN.Conclusión: el CN es una estrategia efectiva para bajar de peso. Se necesitan más investigaciones con una definición clara de la metodología utilizada para aportar solidez a este nuevo enfoque. PMID:27019247

  19. Absence of beta-amyloid in cortical cataracts of donors with and without Alzheimer's disease.

    PubMed

    Michael, Ralph; Rosandić, Jurja; Montenegro, Gustavo A; Lobato, Elvira; Tresserra, Francisco; Barraquer, Rafael I; Vrensen, Gijs F J M

    2013-01-01

    Eye lenses from human donors with and without Alzheimer's disease (AD) were studied to evaluate the presence of amyloid in cortical cataract. We obtained 39 lenses from 21 postmortem donors with AD and 15 lenses from age-matched controls provided by the Banco de Ojos para Tratamientos de la Ceguera (Barcelona, Spain). For 17 donors, AD was clinically diagnosed by general physicians and for 4 donors the AD diagnosis was neuropathologically confirmed. Of the 21 donors with AD, 6 had pronounced bilateral cortical lens opacities and 15 only minor or no cortical opacities. As controls, 7 donors with pronounced cortical opacities and 8 donors with almost transparent lenses were selected. All lenses were photographed in a dark field stereomicroscope. Histological sections were analyzed using a standard and a more sensitive Congo red protocol, thioflavin staining and beta-amyloid immunohistochemistry. Brain tissue from two donors, one with cerebral amyloid angiopathy and another with advanced AD-related changes and one cornea with lattice dystrophy were used as positive controls for the staining techniques. Thioflavin, standard and modified Congo red staining were positive in the control brain tissues and in the dystrophic cornea. Beta-amyloid immunohistochemistry was positive in the brain tissues but not in the cornea sample. Lenses from control and AD donors were, without exception, negative after Congo red, thioflavin, and beta-amyloid immunohistochemical staining. The results of the positive control tissues correspond well with known observations in AD, amyloid angiopathy and corneas with lattice dystrophy. The absence of staining in AD and control lenses with the techniques employed lead us to conclude that there is no beta-amyloid in lenses from donors with AD or in control cortical cataracts. The inconsistency with previous studies of Goldstein et al. (2003) and Moncaster et al. (2010), both of which demonstrated positive Congo red, thioflavin, and beta

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

    PubMed Central

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

    2012-01-01

    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

  1. [In Process Citation].

    PubMed

    Gómez-Candela, Carmen; Pérez Fernández, Laura; Sanz Paris, Alejandro; Burgos Peláez, Rosa; Matía Martín, Pilar; García Almeida, José M; Martín Palmero, Ángela

    2016-01-01

    Introducción: la malnutrición es un problema de primer orden en el paciente hospitalizado que prolonga la estancia hospitalaria y la tasa de infecciones. El paciente diabético representa un porcentaje importante de la población hospitalizada. El estudio VIDA tiene como objetivo analizar el estado nutricional de pacientes ancianos con diabetes hospitalizados en España.Objetivo: describir la población del estudio VIDA, incluyendo datos del perfil bioquímico y antropométrico en el momento del ingreso.Métodos: estudio multicéntrico, transversal, observacional llevado a cabo en 1098 pacientes mayores de 65 años. Se incluyeron 35 hospitales españoles.Resultados: la edad media de los pacientes ingresados fue 78 ± 7,1 años. El motivo de ingreso más frecuente fueron las infecciones respiratorias (32,4%). El 51,2% estaban diagnosticados de diabetes desde hacía más de 10 años. Un 33,09% recibía tratamiento con insulina. Un 39,07% presentaba riesgo de malnutrición y un 21,22% estaba mal nutrido en el momento del ingreso. Se encontró mayor prevalencia de malnutrición en el grupo de mujeres (p < 0,0002)Conclusiones: el estudio VIDA es el primero que analiza el estado nutricional de una cohorte de pacientes ancianos diabéticos en España. Enlos resultados de este proyecto se concluye que un 21,2% de la muestra presenta malnutrición. Esta condición es edad y sexo dependiente, y puede empeorar la tasa de mortalidad. PMID:27019239

  2. DISYUNTIVAS EN LAS CONCEPCIONES SOBRE AUTONOMÍA Y BENEFICENCIA QUE AFECTAN LA TERAPÉUTICA DEL INTENTO SUICIDA1

    PubMed Central

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

    2010-01-01

    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

  3. Obstáculos a la adherencia y retención en los sistemas de salud público y privado según pacientes y personal de salud

    PubMed Central

    Arístegui, Inés; Dorigo, Analía; Bofill, Lina; Bordatto, Alejandra; Lucas, Mar; Cabanillas, Graciela Fernández; Sued, Omar; Cahn, Pedro; Cassetti, Isabel; Weiss, Stephen; Jones., Deborah

    2016-01-01

    Resumen Introducción el Programa Nacional de Sida garantiza el acceso universal a los antirretrovirales, aun así las personas que reciben medicamentos a través del sistema público no logran obtener una carga viral indetectable en la misma proporción que los pacientes del sistema privado. Este estudio cualitativo tiene como objeto identificar los factores asociados a la adherencia y retención en la cascada de atención de VIH de los sistemas de salud público y privado de Buenos Aires, según las percepciones de pacientes y del personal de salud. Métodos se registraron datos cualitativos de 12 entrevistas semi-estructuradas a informantes clave y 4 grupos focales de pacientes y personal de salud tanto del sistema público como privado. Se codificaron y analizaron temas predeterminados sobre adherencia, utilizando el software QRS Nvivo9® de análisis de datos cualitativos. Resultados pacientes y personal de salud de ambos sistemas coinciden en la importancia del estigma asociado al VIH, la relación médicopaciente, la comunicación entre ambos y la división de responsabilidades en relación al tratamiento como aspectos fundamentales para la adherencia y retención en la cascada de atención. Se observan diferencias entre los sistemas en la forma en que algunos de estos aspectos actúan. Las barreras estructurales se presentan como principales obstáculos del sistema público. Discusión se resalta la necesidad de intervenciones focalizadas en la díada médico-paciente que considere las particularidades de cada sistema de atención para facilitar el compromiso del paciente en la adherencia. PMID:26878024

  4. Phase II trial to assess the safety and efficacy of clofarabine in combination with low-dose cytarabine in elderly patients with acute myeloid leukemia.

    PubMed

    Martínez-Cuadrón, David; Montesinos, Pau; Oriol, Albert; Salamero, Olga; Vidriales, Belén; Bergua, Juan; Herrera, Pilar; Vives, Susanna; Sanz, Jaime; Carpio, Cecilia; Rodríguez-Veiga, Rebeca; Moscardó, Federico; Sanz, Miguel A

    2014-01-01

    Previous studies have shown that clofarabine plus low-dose cytarabine (LDAC) could induce roughly 60 % of complete remissions (CR) with acceptable toxicity and induction mortality in elderly acute myeloid leukemia (AML) patients not suitable for intensive chemotherapy. The Programa Español de Tratamientos en Hematología group conducted a trial for patients diagnosed with untreated AML aged 60 years and older, using the combination of clofarabine (20 mg/m(2) × 5 days) plus low-dose cytarabine (20 mg/m(2) × 14 days). The protocol was flexible regarding the use of antifungal and antibacterial prophylaxis, and outpatient induction therapy was allowed. Although the planned recruitment goal was 75 patients, only 11 patients were enrolled (median age, 74 years) after observing high toxicity and unacceptable mortality (46 and 73 % at 4 and 8 weeks, respectively). The response assessment showed three CR (27 %), three resistant diseases (27 %), and five induction deaths (46 %). Induction was administered in an outpatient modality in five patients, while antifungal and antibacterial prophylaxis was not given in seven and five patients, respectively. In our context, induction therapy with the combination of clofarabine (20 mg/m(2)) plus LDAC was associated with high toxicity and unacceptable mortality in elderly AML patients, leading to the early interruption of the trial. Tight patients' clinical monitoring, follow-up, and intensive supportive care seem crucial to achieve at least acceptable clinical outcomes in elderly AML patients receiving clofarabine plus LDAC. This trial is registered at www.clinicaltrials.gov as no. NCT01193400. PMID:24081577

  5. Impact of a low-technology simulation-based obstetric and newborn care training scheme on non-emergency delivery practices in Guatemala

    PubMed Central

    Walton, Anna; Kestler, Edgar; Dettinger, Julia C.; Zelek, Sarah; Holme, Francesca; Walker, Dilys

    2016-01-01

    Objective To assess the effect of a low-technology simulation-based training scheme for obstetric and perinatal emergency management (PRONTO; Programa de Rescate Obstétrico y Neonatal: Tratamiento Óptimo y Oportuno) on non-emergency delivery practices at primary level clinics in Guatemala. Methods A paired cross-sectional birth observation study was conducted with a convenience sample of 18 clinics (nine pairs of intervention and control clinics) from June 28 to August 7, 2013. Outcomes included implementation of practices known to decrease maternal and/or neonatal mortality and improve patient care. Results Overall, 25 and 17 births occurred in intervention and control clinics, respectively. Active management of the third stage of labor was appropriately performed by 20 (83%) of 24 intervention teams versus 7 (50%) of 14 control teams (P = 0.015). Intervention teams implemented more practices to decrease neonatal mortality than did control teams (P < 0.001). Intervention teams ensured patient privacy in 23 (92%) of 25 births versus 11 (65%) of 17 births for control teams (P = 0.014). All 15 applicable intervention teams kept patients informed versus 6 (55%) of 11 control teams (P = 0.001). Differences were also noted in teamwork; in particular, skill-based tools were used more often at intervention sites than control sites (P = 0.012). Conclusion Use of PRONTO enhanced non-emergency delivery care by increasing evidence-based practice, patient-centered care, and teamwork. PMID:26797198

  6. [Not Available].

    PubMed

    Domínguez, Raúl; Garnacho-Castaño, Manuel Vicente; Maté-Muñoz, José Luis

    2016-01-01

    La fuerza influye directamente en el estado de salud y en la capacidad de fitness, motivo por el que el entrenamiento contra resistencias o resistance training (RT) se incluye dentro de aquellos programas de ejercicio encaminados a mejorar la salud y calidad de vida. Debido a que muchasenfermedades cursan con alteración de la masa y funcionalidad muscular y a que el RT es la principal modalidad de ejercicio encaminada a mejorar la función muscular, el objetivo de la presente revisión bibliográfica ha sido exponer las evidencias actuales sobre las adaptaciones delRT, así como su posible aplicación en patologías como la obesidad, diabetes, dislipemia, hipertensión, cáncer, Parkinson, esclerosis múltiple o fibromialgia. El RT en estas enfermedades puede aumentar los niveles de masa muscular, disminuyendo los niveles de masa grasa, los nivelesde ácidos grasos en sangre y la glucemia, incrementando la sensibilidad a la insulina, y disminuyendo los niveles de citokinas inflamatorias. El RT, además, mejora el gasto cardiaco y la funcionalidad endotelial, regulando la tensión arterial e incrementando el consumo de oxígeno. Las ganancias de fuerza muscular mejoran la funcionalidad y la calidad de vida, especialmente en población con una afectación neuromuscular grave, como pudieran ser los enfermos de esclerosis múltiple, fibromialgia o Parkinson. Por ello, el RT debe ser incorporado como parte del tratamiento en las personas que presentan determinado tipo de patologías. PMID:27513511

  7. Visual Inspection after Acetic Acid (VIA) Is Highly Heterogeneous in Primary Cervical Screening in Amazonian Peru

    PubMed Central

    Almonte, Maribel; Ferreccio, Catterina; Luciani, Silvana; Gonzales, Miguel; Delgado, Jose M.; Santos, Carlos; Alvarez, Manuel; Cuzick, Jack; Sasieni, Peter

    2015-01-01

    Background Conventional cytology (Pap) and visual inspection after the application of acetic acid (VIA) are currently used in primary screening in Peru. Studies suggest that the quality of VIA is highly variable. Over 36 000 women were screened with Pap and VIA in the TATI (Tamizaje y Tratamiento Inmediato de Lesiones Cervico-uterinas) project conducted in Amazonian Peru. Within a nested study to compare several screening techniques (C-TATI), a total of 5435 women were additionally screened with liquid-based cytology (LBC) and high-risk human papillomavirus testing (HR-HPV). We investigate the variation of positivity rates of VIA, Pap, LBC and HR-HPV in C-TATI and of VIA in the full TATI intervention. Methods At the screening visit, midwives collected three cervical samples for Pap, LBC and HC2 before performing VIA. The dispersion factor “D” (D = Pearson chi-square value/degrees-of-freedom) was used to measure the variability of tests results. Within C-TATI, the variability of positivity rates of VIA, Pap, LBC and HR-HPV was also graphically assessed with box- and scatter plots by midwife and month of screening. Funnel plots and smoothed scatter plots were used to correlate the variation of VIA by the number of examinations performed by each midwife over the full TATI intervention. Results Consistently over TATI, VIA results were highly variable, independently of the examiner, the time when the test was performed and the number of tests the examiner performed (D>6, p-values<0.001). In C-TATI, VIA results varied the most while those of HR-HPV varied the least (Ds>25, p-values<0.001 for VIA, Ds<1.6, p-values>0.05 for HR-HPV). No evidence for correlation between the number of VIAs done per midwife and the variability of VIA results was observed. Conclusion The lack of over-dispersion for HR-HPV detection suggests that the variable VIA results do not reflect true variation in underlying disease, but a lack of consistency in human judgement. PMID:25635965

  8. Effect of acclimation to outdoor condition on the sexual performance of mass-produced Medflies (Diptera: Tephritidae)

    SciTech Connect

    Pereira, R.; Silva, N.; Quintal, C.; Abreu, R.; Andrade, J.; Dantas, L.

    2007-03-15

    Application of the sterile insect technique (SIT) as part of integrated area-wide programs to control the Mediterranean fruit fly (medfly) Ceratitis capitata (Wiedemann) require that the released males attract wild females and transfer sterile sperm. However, knowledge about male sexual performance after they are released is scarce. We conducted a study to evaluate male sexual performance in field cage tests, according to standard quality control procedures. Mass-reared 5-d-old sterile males from the genetic sexing strain VIENNA 7mix2000 were acclimated for 0, 1, and 3 d to outdoor conditions before competing with wild males for wild females. Although the proportion of mating (PM) in the test was satisfactory, the resulting relative sterility index (RSI) data showed no significant differences among the treatments. The data indicate that pre-conditioning males to outdoor conditions in Madeira did not confer an advantage in field cage sexual performance. (author) [Spanish] La aplicacion de la tecnica del insecto esteril (TIE) como parte de un programa integrado de amplio efecto para el control de la mosca mediterranea de la fruta Ceratitis capitata (Wiedemann) requiere que los machos liberados atraigan las hembras naturales y transfieran su esperma. Sin embargo, el conocimiento del desempeno sexual de los machos despues de ser liberados es muy escaso. Nosotros realizamos un estudio para evaluar el desempeno sexual de los machos en pruebas usando jaulas del campo, segun los procedimientos estandardizados de calidad. Machos esteriles de 5 dias de edad de la raza que separa los sexos geneticamente VIENNA 7mix2000 criados en masa fueron aclimatados por 0, 1 y 3 dias en condiciones de campo antes de competir con machos naturales para las hembras naturales. Aunque la proporcion del apareamiento en la prueba fue satisfactorio, el indice relativo de esterilidad (IRS) resultante no mostro ninguna diferencia significativa entre los tratamientos. Los datos indicaron que al

  9. [Not Available].

    PubMed

    MIján de la Torre, Alberto

    2016-01-01

    El síndrome de caquexia cancerosa es responsable de la muerte de un número significativo de pacientes con cáncer. Se caracteriza por la presencia de una ingesta reducida, con inflamación sistémica y un metabolismo alterado. Los enfermos presentan característicamente una progresiva pérdida de peso y de masa muscular, junto a deterioro funcional. La pérdida muscular se debe a la combinación de reducción de la síntesis proteica con aumento de su degradación. Ello conduce tanto a un acortamiento como a una reducción en el área de la fibra muscular. Asimismo, existen datos que apoyan que selectivamente algunos de los tipos de fibra muscular se ven más afectados. Es necesario definir bien los valores de corte de sarcopenia para diagnosticar la pérdida muscular y existen diferentes métodos. El sistema de la ubiquitina-proteasoma parece desempeñar un papel predominante en la degradación de la proteína miofibrilar. La tendencia a perder masa muscular en los pacientes con caquexia cancerosa parece estar asociada a la activación de señales catabólicas por citoquinas proinflamatorias, así como por productos tumorales del tipo factor inductor de proteólisis. En referencia a los factores pronósticos, el riesgo de muerte está bien documentado en pacientes con sarcopenia y, especialmente, en aquellos con obesidad asociada a la sarcopenia. Asimismo, se ha establecido una relación directa entre la pérdida intensa de masa muscular y la supervivencia en pacientes con diferentes tipos de tumores del tipo de cáncer de páncreas, pulmón, tracto biliar o cáncer colorrectal. Respecto de la terapia en el síndrome de caquexia cancerosa, es factible que requiera tratamiento con varios grupos combinados que incluyan, junto al soporte nutricional, fármacos orexígenos, con efecto anabólico y antinflamatorio, asociados a intervenciones que estimulen el ejercicio físico. PMID:27269215

  10. [In Process Citation].

    PubMed

    Delgado Floody, Pedro; Caamaño Navarrete, Felipe; Osorio Poblete, Aldo; Jerez Mayorga, Daniel

    2016-01-01

    Introducción: la obesidad mórbida disminuye considerablemente la esperanza y la calidad de vida.Objetivo: el objetivo del estudio fue determinar los efectos del ejercicio físico con apoyo multidisciplinar sobre el estado nutricional, la capacidad cardiorrespiratoria y la presión arterial de obesos mórbidos candidatos a cirugía a bariátrica.Material y métodos: doce mujeres y un hombre entre 18 y 60 años candidatos a cirugía bariátrica, 10 con obesidad mórbida y 3 con obesidad y comorbilidades, fueron sometidos a un programa de ejercicio físico con educación nutricional y apoyo psicológico durante 5 meses. Peso corporal, índice de masa corporal (IMC), contorno de cintura (CC), capacidad cardiorrespiratoria, presión arterial sistólica y diastólica fueron evaluados antes y posterior a la intervención.Resultados: el promedio de edad de los participantes de la investigación fue de 49,92 años, el de altura fue 1,62 m. Todas las variables de estudio mejoraron significativamente (p < 0,05): peso (p = 0,000), IMC (p = 0,000), CC (p = 0,005), capacidad cardiorrespiratoria (p = 0,009), presión sistólica (p = 0,006) y presión arterial diastólica (p = 0,010). La capacidad cardiorrespiratoria aumentó un 9,17%, la presión arterial diastólica y sistólica disminuyeron 5,16% y 7,68% respectivamente. El IMC disminuyó un 8,39% y el CC un 6,63%. Conclusiones: el programa mejoró los niveles de presión arterial sistólica y diastólica y la capacidad cardiorrespiratoria, esto se vio complementado por la pérdida de peso significativa en los participantes de esta investigación. El ejercicio físico con apoyo multidisciplinar demuestra beneficios para el tratamiento preoperatorio produciendo adaptaciones favorables en los factores de riesgo cardiovascular. PMID:27019243

  11. [In Process Citation].

    PubMed

    González-Fandos, Elena; Simón, Ana

    2016-01-01

    Se ha estudiado el efecto de la cocción en agua sobre la capacidad antioxidante y calidad sensorial de coliflor que previamente ha sido cortada, envasada en atmósfera modificada (5,7-2,3% de CO 2 y 17,6-19,7% de O 2 ) y almacenada a 5 oC durante 13 días, comparándola con la coliflor recién recolectada. Se ha observado un aumento de ácido ascórbico (18%), polifenoles (74%) y actividad antioxidante (21%) en la coliflor almacenada cruda. La cocción produjo pérdidas de estos compuestos por lixiviación, que fueron mayores en la coliflor almacenada respecto a la inicial (19% y 13% res- pectivamente para el ácido ascórbico y 31% y 28% respectivamente para los polifenoles. Sin embargo, no se observaron variaciones en la actividad antioxidante de la coliflor inicial cocida respecto a la coliflor inicial fresca, mientras que en la coliflor almacenada dicha variación fue del 16%. Como resultado, la actividad antioxidante de la coliflor almacenada y cocida ha resultado similar a la de la coliflor inicial fresca. El almacenamiento produjo pequeños cambios en color (un aumento del parámetro b* de 19 a 20,9) y de la textura (un aumento de la fuerza de cizallamiento de 1948 N a 2375 N). La valoración sensorial del color y sabor de la coliflor cocida almacenada fue inferior al de la coliflor cocida inicial, pero dentro de niveles aceptables. El aumento de la dureza en la coliflor fresca almacenada no fue detectado por el panel de catadores en la coliflor cocida. Se observó una ligera incidencia de mohos en la coliflor almacenada 13 días, por lo que se recomienda realizar un tratamiento de lavado. PMID:27238800

  12. Regulando la Enfermedad a través de la Definición y la Restricción: Profesionales de la Salud Hablan sobre el VIH/SIDA1

    PubMed Central

    Rivera, Souhail Malavé; Díaz, Nelson Varas

    2009-01-01

    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

  13. [In Process Citation].

    PubMed

    Durán Agüero, Samuel; Fernández Godoy, Eloina; Carrasco Piña, Elena

    2016-01-01

    Introducción: la hiperglicemia es la característica principal de la diabetes (DM). La restricción de CHO en la dieta presenta el mayor efecto en la disminución de los niveles de glucosa en sangre tanto en DM 1 y 2.Objetivo: asociar la ingesta de macro y micronutrientes con el control metabólico de pacientes con diabetes tipo 2.Material y métodos: se entrevistó a 714 pacientes diabéticos tipo 2 de ambos sexos, entre 27 y 90 años, en centros de salud familiar de Santiago de Chile. Se les aplicó una encuesta alimentaria y una evaluación antropométrica. Se realizó prueba de regresión logística, se estimó además el valor del Odds Ratio (OR) y su correspondiente intervalo de confianza (IC).Resultados: el IMC promedio fue de 30,8 ± 5,7 kg/m2, el 29,8% de los sujetos tenía una HbA1c compensada. Se puede observar que solo la ingesta elevada de carbohidratos (percentil 75) se asoció con un incremento en el riesgo de tener HbA1c elevada OR = 2,7 (IC 95% 1,5-4,8; p < 0,001).Conclusiones: la ingesta elevada de carbohidratos de rápida absorción, altos en sacarosa y bajos en fibra se asocia como factor de riesgo en el incremento de HbA1c. La ingesta total de energía y el patrón de alimentación saludable se debe priorizar sobre la distribución de macronutrientes. Es importante la asesoría de un experto en nutrición especializado en diabetes quien, en colaboración con el equipo médico, debe determinar el tratamiento para cumplir con los objetivos individuales del paciente. PMID:27019245

  14. [Not Available].

    PubMed

    Baena González, Marta; Molina Recio, Guillermo

    2016-01-01

    Introducción: la disfagia es un síntoma que se refiere a la dificultad para mover el bolo alimentario desde la boca al estómago. A pesar de su relevancia y de la gravedad de sus posibles complicaciones, es poco conocida y estudiada. La prevalencia de la disfagia orofaríngea en enfermosde alzhéimer es de un 84% y puede originar complicaciones de gran trascendencia clínica como consecuencia de las alteraciones en la eficacia de la deglución, y en la seguridad de la misma.Objetivo: conocer el estado actual del conocimiento en relación al abordaje de la disfagia en enfermos de alzhéimer, localizando aquellos factores que permitan un diagnóstico precoz que facilite la prevención de complicaciones y la elección de la pauta de actuación más adecuada.Metodología: revisión sistemática. Estudios publicados entre 2005 y 2014 en inglés y castellano. Bases de datos: PubMed, Cochrane, Scopus, Elsevier, Scielo y Dialnet. Términos MeSH empleados: disfagia, dysphagia, alzheimer, modified y texture food.Resultados: el diagnóstico en los pacientes de alzhéimer se realiza mediante métodos clínicos y exploraciones complementarias como la videofluoroscopia, considerada como el estándar para el estudio de la disfagia orofaríngea, ya que permite identificar entre 1/3 y 1/4 de los pacientes que presentan aspiraciones silentes no diagnosticables clínicamente. Existen estrategias terapéuticas que incluyen cambios en el volumen y viscosidad del bolo, cambios posturales, maniobras deglutorias, procedimientos de rehabilitación y técnicas de incremento sensorial que han demostrado su eficacia, pero se trata de una labor compleja que exige un abordaje multidisciplinar para un correctodiagnóstico y tratamiento.Conclusiones: existe una escasa evidencia científica en el abordaje de la disfagia y un gran desconocimiento en cuanto a la alimentación de los enfermos de alzhéimer. Esta patología necesita una intervención multidisciplinar en la cual las medidas

  15. [Not Available].

    PubMed

    Chivu, Elena Cristina; Artero-Fullana, Ana; Alfonso García, Antonio; Sánchez Juan, Carlos

    2016-01-01

    Introducción: conociendo la elevada prevalencia de la desnutrición hospitalaria, se hace necesaria su detección precoz. Cuando, por diversos motivos, no es posible realizar una valoración completa del estado nutricional, se recomienda el empleo de herramientas validadas de cribado nutricional. Estas ayudarían a detectar de forma rápida a aquellos pacientes que necesiten de un tratamiento nutricional.Objetivos: determinar la prevalencia del riesgo de desnutrición, en el Hospital General Universitario de Valencia, empleando para ello la herramienta de cribado nutricional HEMAN y comprobar si la implementación de esta herramienta en la práctica clínica, sería lo más adecuado.Métodos: estudio transversal, realizado sobre una muestra de 1.099 pacientes ingresados en un hospital terciario. A todos ellos se les realizó el cribado nutricional HEMAN a las 24-48 horas del ingreso. Las variables cualitativas se compararon mediante Chi-cuadrado, y las cuantitativas mediante el test t de Student.Resultados: la prevalencia del riesgo de desnutrición fue del 33,5%. Los pacientes que resultaron positivos en el cribado (HEMAN ≥ 3), tenían mayor edad que los pacientes normonutridos, referían pérdidas de peso entre el 5-10%, el 55,2% disminuyó su ingesta a menos del 50% de la habitual. Además, ingresaron con patologías consideradas de leves a moderadas. La utilización del método HEMAN como herramienta de cribado, resultó ser práctica y efectiva, y ayudó a disminuir el tiempo empleado con cada paciente encuestado evaluado.Conclusiones: se detectó una elevada prevalencia de riesgo de desnutrición entre los pacientes evaluados, por lo tanto se hace imprescindible la utilización de métodos de cribado nutricional en la rutina diaria del hospital, para ello recomendamos especialmente la utilización del método HEMAN. PMID:27571664

  16. Cirugía de los trastornos del comportamiento: el estado del arte

    PubMed Central

    Yampolsky, Claudio; Bendersky, Damián

    2014-01-01

    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

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

    PubMed

    Pavlovsky, Santiago; Lastiri, Francisco

    2004-09-01

    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

  18. CONTAMINACIÓN AMBIENTAL, VARIABILIDAD CLIMÁTICA Y CAMBIO CLIMÁTICO: UNA REVISIÓN DEL IMPACTO EN LA SALUD DE LA POBLACIÓN PERUANA

    PubMed Central

    Gonzales, Gustavo F.; Zevallos, Alisson; Gonzales-Castañeda, Cynthia; Nuñez, Denisse; Gastañaga, Carmen; Cabezas, César; Naeher, Luke; Levy, Karen; Steenland, Kyle

    2015-01-01

    RESUMEN El presente artículo es una revisión sobre la contaminación del agua, el aire y el efecto del cambio climático en la salud de la población peruana. Uno de los principales contaminantes del aire es el material particulado menor de 2,5 μ (PM 2,5), en la ciudad de Lima, anualmente 2300 muertes prematuras son atribuibles a este contaminante. Otro problema es la contaminación del aire domiciliario por el uso de cocinas con combustible de biomasa, donde la exposición excesiva a PM 2,5 dentro de las casas es responsable de aproximadamente 3000 muertes prematuras anuales entre adultos, con otro número desconocido de muertes entre niños debido a infecciones respiratorias. La contaminación del agua tiene como principales causas los desagües vertidos directamente a los ríos, minerales (arsénico) de varias fuentes, y fallas de las plantas de tratamiento. En el Perú, el cambio climático puede impactar en la frecuencia y severidad del fenómeno de El Niño oscilación del sur (ENSO) que se ha asociado con un incremento en los casos de enfermedades como cólera, malaria y dengue. El cambio climático incrementa la temperatura y puede extender las áreas afectadas por enfermedades transmitidas por vectores, además de tener efecto en la disponibilidad del agua y en la contaminación del aire. En conclusión, el Perú, pasa por una transición de factores de riesgo ambientales, donde coexisten riesgos tradicionales y modernos, y persisten los problemas infecciosos y crónicos, algunos de los cuales se asocian con problemas de contaminación de agua y de aire. PMID:25418656

  19. [In Process Citation].

    PubMed

    Obispo Entrenas, Ana; Martín Carvajal, Francisco; Legupín Tubío, David; Lucena Navarro, Fabiola; García Caballero, Manuel; Gándara Adán, Norberto; Abilés Osinaga, Jimena

    2016-01-01

    Objetivo: el objetivo de este estudio fue evaluar la prevalencia de hipovitaminosis D en los candidatos a cirugía bariátrica (CB) y su relación con factores de riesgo y los componentes del síndrome metabólico.Material y métodos: los parámetros clínicos, antropométricos y bioquímicos se midieron en 56 pacientes caucásicos incluidos en un protocolo de cirugía bariátrica entre enero y junio de 2014. Los pacientes fueron estratificados en tres grupos de acuerdo al status de vitamina D: suficiencia (≥ 40 ng/ml), insuficiencia (40-20 ng/ml) y deficiencia (< 20 ng/ml).Resultados: se observó deficiencia de vitamina D en el 75% de los pacientes. Estos pacientes tenían mayor índice de masa corporal (p = 0,006) y concentraciones plasmáticas mas bajas de PTH (p = 0,045). Además, hubo más pacientes con diabetes mellitus tipo 2 (DM2) y dislipemia (DLPM) en el grupo con niveles de 25 (OH) D < 20 ng/ml. Asimismo la 25 (OH) D se correlacionó negativamente con la masa grasa (r = -0,504; p = 0,009), el IMC (r = -0,394; p = 0,046) y la hipertensión arterial (r = -0,637; p = 0,001).Conclusión: De nuestros hallazgos concluimos que la deficiencia de vitamina D es muy común entre los candidatos a CB y que la misma está asociada con DM2 y DLPM.Aunque hay pocos datos sobre el mejor tratamiento para el bajo nivel de vitamina D en los pacientes candidatos CB, la detección de la deficiencia de vitamina D debe realizarse de forma rutinaria en estos casos. PMID:27019241

  20. Reacciones de intercambio de carga

    NASA Astrophysics Data System (ADS)

    Errea, L. F.

    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.

  1. [Not Available].

    PubMed

    Corella Aznar, Elena Guadalupe; Ayerza Casas, Ariadna; Samper Villagrasa, Pilar; Rodríguez Vigil, Carmen; Jiménez Montañés, Lorenzo; Calvo Escribano, Carlota; Labarta Aizpun, José Ignacio

    2016-01-01

    Introducción: los supervivientes de leucemia aguda (LA) infantil presentan un riesgo incrementado de alteraciones metabólicas y cardiovasculares que aumentan su morbimortalidad a largo plazo.Objetivo: estimar la prevalencia de obesidad, resistencia a la insulina, dislipemia e hipertensión arterial como factores de riesgo cardiometabólico (FRCM) en un grupo de supervivientes de LA infantil, y analizar las posibles causas asociadas a su desarrollo.Material y métodos: estudio observacional retrospectivo en 47 supervivientes de LA tratados en un periodo de 4 años, que recibieron seguimiento durante 10 años.Resultados: el 40% de los participantes presentaron al menos un FRCM durante el seguimiento, siendo la dislipemia (aumento LDL) el más frecuente (38,3%), seguido de obesidad/sobrepeso (31,9%) y HTA sistólica (23,4%). El sexo femenino se estableció como factor de riesgo parael desarrollo de todos ellos (RR 1,6; RR 3,16; RR 1,69; p < 0,05). Ningún superviviente desarrolló diabetes mellitus, pero sí resistencia a la insulina el 19,4%. Los pacientes con leucemias de peor pronóstico presentaron mayor riesgo de desarrollar obesidad, resistencia a la insulina y aumento de LDL (RR 3,56; RR 4,08; RR 2,53; p < 0,05). Los pacientes tratados con trasplante de progenitores hematopoyéticos presentaron mayor riesgo de obesidad, aumento de LDL e HTA sistólica (RR 2,86; RR 2,39; RR 3,12; p<0,05). La radioterapia se asoció de igual modo con un incremento de resistencia a la insulina e hipertensión arterial sistólica (RR 2,47; RR 2,53; p < 0,05).Conclusiones: existe un aumento en la prevalencia de obesidad/sobrepeso, dislipemia, resistencia a la insulina y alteración de la tensión arterial sistólica en supervivientes de leucemia aguda infantil a lo largo del tiempo, especialmente en aquellos con enfermedades y tratamientos más agresivos. PMID:27513487

  2. [In Process Citation].

    PubMed

    Hernández-Morante, Juan José; Galindo-Muñoz, Joaquín Santiago; Barberá-Ortega, María Del Carmen

    2016-01-01

    Introducción: actualmente el tratamiento dietético de la obesidad no suele ser efectivo en muchos casos, probablemente porque se diseña fundamentalmente teniendo en cuenta el gasto energético mientras que otros aspectos relevantes, como los ritmos de hambre/saciedad, apenas son considerados. Los nuevos dispositivos móviles (smartphones) podrían ayudar a este respecto. Objetivo: desarrollar una aplicación para smartphones con el fin de analizar variables subjetivas relacionadas con el apetito de forma precisa y fiable.  Métodos: se analizaron las sensaciones subjetivas de apetito de 15 voluntarios sanos mediante dos métodos: papel-lápiz (P-P) y una nueva aplicación para smartphones. Las sensaciones de apetito se analizaron cada 30 minutos durante 4 horas en dos situaciones: desayuno alto en carbohidratos (HC) y alto en grasas (HF). Además, los sujetos completaron la aplicación cada 30 minutos en condiciones ambientales. Resultados: los datos derivados del ANOVA indican que no existieron diferencias respecto al método (P-P vs. aplicación) o comida (HC vs. HF) (p > 0.05) para las puntuaciones de hambre, deseo de comer y saciedad. Los coeficientes de regresión mostraron una elevada concordancia (R 2 : 0.94-0.98). El test de Bland-Altman también reveló una alta reciprocidad entre ambos métodos. Además, la aplicación fue capaz de medir las variaciones subjetivas de apetito en condiciones ambientales. Conclusión: la aplicación para smartphones fue capaz de determinar de forma fiable y precisa las variables subjetivas de apetito tanto en condiciones de laboratorio como ambientales, lo que confirma la idoneidad de esta aplicación para llevar a cabo futuros estudios en los que se evalúe la regulación del apetito en humanos. PMID:27238807

  3. Malformaciones arteriovenosas revisión y análisis descriptivo de 52 mavs tratadas durante el periodo de 2000-2010

    PubMed Central

    Rinaldi, Mariano; Mezzano, Emilio; Berra, Matias S.; Parés, Herald R.; Olocco, Ricardo V.; Papalini, Francisco R.

    2015-01-01

    Objetivo: Describir nuestra experiencia en el manejo de las Mavs analizando las características clínicas de los pacientes y los resultados postoperatorios. Método de análisis: Realizamos un análisis retrospectivo de 52 pacientes admitidos en el Servicio de neurocirugía para manejo quirúrgico: La información de referencia incluyo síntomas al inicio, diagnostico de admisión, hallazgos neurológicos y hallazgos en estudio por imágenes tales como tomografía cerebral, IRM cerebral y angiografía por sustracción digital. Los hallazgos postoperatorios de interés fueron: Mortalidad, examen neurológico postoperatorio y complicaciones asociadas. Presentamos nuestro análisis estadístico. Resultados: Edad promedio: 37,7 años. Distribución: Hombres: 61,5%. Motivos de consulta más frecuentes: Cefalea 63,5%, evento hemorrágico 59,6%, convulsiones 26,9%. Localización: Supratentorial: 92,9%, Infratentorial: 7,2%. 30,8%, de las Mavs fueron grado 2 y grado 3 Cincuenta por ciento del total presentaron aneurismas, del total de la MAVs, 59,6% debutó con sangrado, 26,9% con Crisis Convulsivas y 13,5% con déficit neurológico. Recibieron tratamiento endovascular previo a cirugía 30,7%. Durante el postoperatorio 23,1% presentaron mejoría clínica, 57,7% no presento modificación, 19,2% empeoraron en el postoperatorio. La mortalidad fue 13,5%. Conclusión: Creemos que el subgrupo de Mavs grados III a V representan una entidad que requiere una compleja toma de decisiones dada la alta incidencia de aneurismas asociados que presentan y su asociación con eventos de sangrado. Nuestra mortalidad postoperatoria coincide con la bibliografía. Palabras clave, Mavs- aneurismas asociados- Acv hemorrágico- convulsiones. PMID:26600984

  4. [Not Available].

    PubMed

    Baladia, Eduard; Frutos Pérez-Surio, Alberto; Martínez-Rodríguez, Rodrigo

    2016-01-01

    Objetivos: dar a conocer las recomendaciones relacionadas con la Nutrición Humana y Dietética (NHyD) de la Guía de Práctica Clínica para el manejo de la enfermedad de Parkinson del Sistema Nacional de Salud (GPC-EP/SNS) y favorecer su difusión e implementación en la práctica. El objetivo secundario es presentar la implicación de los profesionales de la NHyD en la elaboración de la guía.Material y métodos: siguiendo el Manual Metodológico de Elaboración de Guías de Práctica Clínica en el Sistema Nacional de Salud, se formularon las preguntas clínicas, se realizó una búsqueda sistemática para cada pregunta en bases de datos (PubMed/Medline, Embase, Cochrane Library, CRD, LILACS, IBECS y ClinicalTrials), se definieron los criterios de elegibilidad, al menos dos investigadores seleccionaron los estudios, se realizó lectura crítica de la literatura se resumió en tablas de síntesis de evidencia y se establecieron las recomendaciones.Resultados: se propusieron 14 preguntas relacionadas directamente con NHyD-Parkinson, de las cuales solamente 3 pudieron incluirse. Se formuló una pregunta relacionada con la terapia de logopedia aplicada en personas con EP que presentan problemas de deglución, tratamiento donde se imbrican los profesionales de la NHyD. De 642 artículos localizados, únicamente 2 pudieron ser incluidos para contestar las correspondientes preguntas. De las evidencias halladas, se derivaron 11 recomendaciones directa o indirectamente relacionados con la NHyD.Conclusiones: la implicación de profesionales sanitarios en equipos multidisciplinares mejora el resultado final de las guías y la atención sanitaria de los pacientes. Es necesario que los profesionales sanitarios de la NHyD (los/las dietistas-nutricionistas) se impliquen en iniciativas basadas en la mejor evidencia científica disponible y que formen parte de los equipos de trabajo multidisciplinares. PMID:27513514

  5. Cirugía transnasal endoscópica para tumores de hipófisis

    PubMed Central

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

    2012-01-01

    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

  6. Descompresión microvascular en espasmo hemifacial: Reporte de 13 casos y revisión de la literatura

    PubMed Central

    Campero, Alvaro; Herreros, Isabel Cuervo-Arango; Barrenechea, Ignacio; Andjel, Germán; Ajler, Pablo; Rhoton, Albert

    2016-01-01

    Objetivo: El propósito del presente trabajo es presentar los resultados de 13 pacientes con diagnóstico de espasmo hemifacial (EHF), en los cuales se realizó una descompresión microvascular (DMV). Material y Método: Desde Junio de 2005 a Mayo de 2014, 13 pacientes con diagnóstico de EHF fueron intervenidos quirúrgicamente, realizando una DMV. Se evaluó: edad, sexo, tiempo de evolución de la sintomatología, hallazgos intraoperatorios y resultados postoperatorios. Resultados: De los 13 pacientes intervenidos, 7 fueron mujeres y 6 varones. La media de edad fue de 53 años. El tiempo medio entre el inicio de la sintomatología y la intervención quirúrgica osciló entre 3 y 9 años. En todos los casos el EHF era típico, uno de ellos con neuralgia trigeminal concomitante, observándose en todos compresión neurovascular intraoperatoria. Por orden decreciente de frecuencia la causa de la compresión fue arteria cerebelosa anteroinferior, arteria cerebelosa posteroinferior, arteria dolicomega basilar y arteria dolicomega vertebral. El seguimiento postoperatorio fue en promedio de 24 meses. El 62% presentó desaparición postquirúrgica inmediata de la sintomatología preoperatoria, el 30% desaparición tras un período de 3 semanas a 2 meses (8% con mejoría parcial), y en el 8% no hubo mejoría. En cuanto a las complicaciones postoperatorias: 3 pacientes presentaron paresia facial II-III en la escala de House-Brackman (se recuperaron en un período de 6 meses), y 1 paciente presentó fístula de líquido cefalorraquídeo. Ninguno de los pacientes de la serie presentaron hipoacusia transitorio o permanente. Conclusión: La DMV como tratamiento del EHF es un procedimiento efectivo y seguro, que permite la resolución completa de la patología en la mayoría de los casos. PMID:27127708

  7. [In Process Citation].

    PubMed

    Sznajder, Janusz; S Lefarska-Wasilewska, Marta; Kłek, Stanisław

    2016-01-01

    Objetivo: la esclerosis lateral amiotrófica (ELA) es una enfermedad crónica, neurodegenerativa que genera malnutrición. El objetivo principal de este estudio es analizar el impacto de la malnutrición en el curso de la enfermedad y la sobrevida a largo plazo.Materiales y métodos: se realizó un análisis retrospectivo de 48 pacientes (22 mujeres [45.83%] y 26 hombres [54.17%], con un promedio de edad de 66,2 [43-83]) del 2008 al 2014. El análisis del estado nutricional inicial se midió utilizando el índice de  masa corporal (IMC), el estado nutricional de acuerdo al NRS 2002, la valoración global subjetiva (VGS) y la concentración sérica de albúmina. Los pacientes se dividieron en dos grupos, dependiendo del estado nutricional en el que se encontraban: bien nutridos o malnutridos. Los grupos se crearon por  separado, lo que permitió un análisis comparativo adicional de las técnicas utilizadas para la evaluación del estado nutricional.Resultados: un estado nutricional adecuado se relaciona con mayor sobreviva a largo plazo (456 vs. 679 días, NRS 312 vs. 659 vs. 835 días, IMC respectivamente: 41, 541, 631 días, resultados estadísticamente significativos para NRS e IMC). Las concentraciones de albúmina no fueron un factor pronóstico, pero se observó mayor sobrevida si las concentraciones de albúmina incrementaban durante el tratamiento nutricional.Conclusiones: el estado nutricional inicial y la respuesta positiva a la alimentación enteral están asociados a mayor sobrevida en pacientes con ELA, razón por la cual, la terapia nutricional debe de iniciarse lo antes posible. PMID:27019234

  8. PubMed

    Rivera, Souhail Malavé; Díaz, Nelson Varas

    2006-01-01

    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 art

  9. [Not Available].

    PubMed

    Baena González, Marta; Molina Recio, Guillermo

    2016-01-01

    Introducción: la disfagia es un síntoma que se refiere a la dificultad para mover el bolo alimentario desde la boca al estómago. A pesar de su relevancia y de la gravedad de sus posibles complicaciones, es poco conocida y estudiada. La prevalencia de la disfagia orofaríngea en enfermosde alzhéimer es de un 84% y puede originar complicaciones de gran trascendencia clínica como consecuencia de las alteraciones en la eficacia de la deglución, y en la seguridad de la misma.Objetivo: conocer el estado actual del conocimiento en relación al abordaje de la disfagia en enfermos de alzhéimer, localizando aquellos factores que permitan un diagnóstico precoz que facilite la prevención de complicaciones y la elección de la pauta de actuación más adecuada.Metodología: revisión sistemática. Estudios publicados entre 2005 y 2014 en inglés y castellano. Bases de datos: PubMed, Cochrane, Scopus, Elsevier, Scielo y Dialnet. Términos MeSH empleados: disfagia, dysphagia, alzheimer, modified y texture food.Resultados: el diagnóstico en los pacientes de alzhéimer se realiza mediante métodos clínicos y exploraciones complementarias como la videofluoroscopia, considerada como el estándar para el estudio de la disfagia orofaríngea, ya que permite identificar entre 1/3 y 1/4 de los pacientes que presentan aspiraciones silentes no diagnosticables clínicamente. Existen estrategias terapéuticas que incluyen cambios en el volumen y viscosidad del bolo, cambios posturales, maniobras deglutorias, procedimientos de rehabilitación y técnicas de incremento sensorial que han demostrado su eficacia, pero se trata de una labor compleja que exige un abordaje multidisciplinar para un correctodiagnóstico y tratamiento.Conclusiones: existe una escasa evidencia científica en el abordaje de la disfagia y un gran desconocimiento en cuanto a la alimentación de los enfermos de alzhéimer. Esta patología necesita una intervención multidisciplinar en la cual las medidas

  10. An open, self-controlled study on the efficacy of topical indoxacarb for eliminating fleas and clinical signs of flea-allergy dermatitis in client-owned dogs in Queensland, Australia

    PubMed Central

    Fisara, Petr; Sargent, Roger M; Shipstone, Michael; von Berky, Andrew; von Berky, Janet

    2014-01-01

    atteints de FAD recevant de l'indoxacarb topique, un nouvel insecticide de la classe des oxadiazines. Sujets Vingt cinq chiens de propriétaires du Queensland, Australie, précédemment diagnostiqués allergiques aux puces à partir des signes cliniques, des tests intradermiques et des tests sérologiques. Méthodes Une étude ouverte, non contrôlée, dans laquelle tous les chiens ont été traités avec de l'indoxacarb topique à 4 semaines d'intervalles, trois fois sur 12 semaines. Résultats Vingt quatre chiens ont été inclus dans l'étude. Une résolution complète des signes cliniques de FAD a été observée pour 21 cas (87.5%), ave une résolution presque complète ou une amélioration marquée pour les trois autres cas. Les scores cliniques moyens (Canine Atopic Dermatitis Extent and Severity Index-03) ont été réduits de 93.3% à la semaine 12. Les scores de prurit moyens ont été réduits de 88% à la semaine 12. Les comptages moyens de puce ont été réduits de 98.7% et 100% respectivement aux semaines 8 et 12. Conclusions et importance clinique Le traitement topique d'indoxacarb appliqué toutes les 4 semaines pendant 12 semaines, sans antiprurigineux ou ectoparasitaire concomitant, a complètement supprimé l'infestation de puces pour tous les chiens et les signes cliniques associés à la FAD pour une large proportion de cette population de chiens dans un environnement contenant des puces. Resumen Introducción la dermatitis alérgica a las pulgas en perros (FAD), es una respuesta de hipersensibilidad a material antigénico en la saliva de las pulgas que se alimentan en los perros. Ocurre a nivel mundial y aún permanece como una presentación común en los animales de compañía en las prácticas veterinarias, a pesar de la disponibilidad de efectivos tratamientos sistémicos y tópicos para el control de las pulgas. Hipótesis/Objetivos evaluar la respuesta clínica en perros con FAD tratados tópicamente con inoxacarb, novedoso insecticida de tipo

  11. Compatibility and competitiveness of a laboratory strain of Anastrepha Fraterculus (Diptera: Tephritidae) after irradiation treatment

    SciTech Connect

    Allinghi, A.; Calcagno, G.; Gomez Cendra, P.; Vilardi, J.C.; Petit-Marty, N.; Segura, D.; Cladera, J.; Vera, T.; Gramajo, C.; Willink, E.

    2007-03-15

    salvaje (TUC) de Anastrepha fraterculus (Wiedemann). La linea de laboratorio se produce en condiciones de cria semi-masiva en las instalaciones de la Estacion Experimental Agroindustrial Obispo Colombres (Tucuman, Argentina). Las moscas salvajes se obtuvieron de frutas infestadas de guayabos en Horco Molle (Tucuman, Argentina). Las pupas de laboratorio fueron irradiadas ({sup 60}Co) 48 horas antes de la emergencia del adulto. Las dosis utilizadas fueron 0 (control), 40, 70, y 100 Gy. Se liberaron 25 machos y 25 hembras de TUC y LAB dentro de las jaulas y se recolectaron las parejas formadas. Solo se considero 1 dosis de irradiacion por vez. Las hembras apareadas fueron separadas y se les permitio poner huevos en frutas artificiales para estimar la esterilidad inducida a traves del porcentaje de eclosion. La hora de inicio de la copula no difirio significativamente entre poblaciones ni entre los tratamientos de irradiacion. La duracion de la copula mostro grandes diferencias entre dosis de irradiacion pero no entre cepas. Los indices ISI (aislamiento) y el RSI (esterilidad relativa) indican que LAB y TUC son totalmente compatibles, los machos de TUC y LAB no difieren en su competitividad y la irradiacion dentro del rango de dosis utilizadas tampoco afecto este indice. Las hembras LAB no irradiadas muestran una mayor propension para el apareamiento que las hembras de TUC. Sin embargo se observo una reduccion significativa del indice FRPI (actuacion relativa de hembras) a medida que se aumenta la dosis de irradiacion. El analisis de la esterilidad inducida indica que con dosis de 40 Gy la fertilidad disminuye del 80% al 0.75%, y con dosis mayores la esterilidad fue total. Las hembras irradiadas con dosis de 40 Gy tienen una fertilidad de aproximadamente 2% y con dosis mayores no ponen huevos. (author)

  12. [In Process Citation].

    PubMed

    Martínez González, Olaia; Vélez de Mendizábal, Itsaso Zabaleta; Galarza Iriarte, Uxue; Vicente Martín, María Soledad; De Vega Castaño, María Del Carmen; Salmerón Egea, Jesús

    2016-01-01

    posible variación de los parámetros de textura de alimentos con espesantes añadidos en base a estas y otras variables de preparación; lo cual resultaría de gran ayuda al profesional de cara a ofrecer a cada paciente el tratamiento más adecuado. PMID:27238799

  13. Breakfast of champions or kiss of death? Survival and sexual performance of protein-fed, sterile Mediterranean fruit flies (Diptera: Tephritidae)

    SciTech Connect

    Yuval, B.; Maor, M.; Levy, K.; Kaspi, R.; Taylor, P.; Shelly, T.

    2007-03-15

    dieta sobre los obstaculos sucesivos que los machos tienen que superar para inseminar las hembras, i.e., unir con otros machos en areas para el apareamiento, copula de las hembras, almacenar esperma e inhibir el re-apareamiento de hembras. Ademas discutimos los efectos de la dieta sobre el exito de su actividad forrajera despues de ser liberados, la longevidad y la habilidad para aguantar la inanicion. Mientras que la alimentacion con proteina universalmente aumentan el exito sexual de los machos naturales, su efecto sobre los machos esteriles varia segun la raza, el lugar de los experimentos y las condiciones ambientales. En algunos casos, los tratamientos que resultaron con mejor desempeno sexual fueron asociados significativamente con el aumento de la vulnerabilidad a la inanicion. Sin embargo, ninguna dieta en particular afecto la habilidad de los machos esteriles para encontrar nutrientes en el campo cuando fueron disponibles. Nosotros sugerimos que puede ser mejor el liberar moscas que tienen una vida relativamente corta y que son mas competidoras, en vez de moscas que tienen una vida larga y sexualmente inefectiva. (author)

  14. [In Process Citation].

    PubMed

    Laguna, S; Andrada, P; Silva, C; Rotellar, F; Valenti, V; Gil, M J; Gomez-Ambrosi, J; Fruhbeck, G; Salvador, J

    2016-01-01

    Fundamento. La cirugía bariátrica posee efectos beneficiosos sobre el perfil lipídico en pacientes con obesidad mórbida que puede atenuarse con la recuperación ponderal. El presente estudio se ha llevado a cabo para evaluar el perfil lipídico antes y a lo largo de los seis años consiguientes a la realización de bypass gástrico proximal (BPG).Método. Se han estudiado 177 pacientes (135 mujeres) con obesidad mórbida (IMC 44,2+0,4 kg/m2) de 42,4+0,9 años de edad antes, 3,6,9, 12,24,36,48,60 y 72 meses después de realizar BPG. En todas las revisiones se evaluó  el tratamiento hipolipemiante, antropometría (IMC, cintura), composición corporal (Bod-Pod) y determinaciones de colesterol total (CT), colesterol-LDL (LDL-C), colesterol-HDL (HDL-C), triglicéridos (TG), glucosa e insulina.Resultados. El BPG indujo marcada reducción de IMC (nadir IMC a 18 meses 28,3+0,4 kg/m2 p<0,001) y grasa corporal consiguiendo una pérdida de exceso IMC del 84,1% y del exceso de porcentaje de grasa del  87% que disminuyó al 65,6 y 38,3% (ambos p<0,005 respecto a nadir) respectivamente a los 6 años del BPG, indicando recuperación de peso y grasa corporal. Los valores de TG  alcanzaron el 70% a los 60 meses, los de LDL-C el 70,6% a los 18 meses y los de HDL-C el 197% del valor pre-intervención a los 48 meses. La elevación de HDL-C aumentó durante la fase de recuperación ponderal de forma continuada (p<0,001). Tanto los cocientes CT/HDL-C como TG/HDL-C se normalizaron de forma mantenida durante los 6 años de seguimiento.Conclusiones. Estos resultados confirman la mejoría de todas las fracciones lipídicas 6 años después del BPG, con especial mención a HDL-C, que mantuvo progresión creciente  incluso durante la recuperación ponderal, reduciendo la tasa de dislipemia a los 6 años del BPG. Palabras clave. Bypass gástrico. Dislipemia. Recuperación ponderal. Composición corporal. PMID:27125617

  15. [In Process Citation].

    PubMed

    Gonçalves Schemitt, Elizângela; Raskopf Colares, Josieli; Minuzzo Hartmann, Renata; Morgan-Martins, María Isabel; Marroni, Cláudio Augusto; Tuñón, M Jesús; Possa Marroni, Norma

    2016-01-01

    Introducción: la insuficiencia hepática fulminante (IHF) es un síndrome clínico poco frecuente, que se caracteriza por una disfunción hepática severa y repentina. La tioacetamida (TAA) es una hepatotoxina cuya administración puede inducir necrosis centrolobulillar en las células hepáticas y aumentar la formación de especies reactivas de oxígeno y la peroxidación lipídica en ratas. La glutamina es un precursor para la síntesis de glutatión. Objetivo: el objetivo del estudio es evaluar los efectos antioxidantes de la glutamina en un modelo de rata de IHF inducida por TAA. Métodos: ratas macho Wistar se dividieron en cuatro grupos de acuerdo con el tratamiento y el tiempo de evaluación: control, glutamina (25 mg/kg), tioacetamida (400 mg/kg) y tioacetamida más glutamina. Los animales se evaluaron después de 24, 36 y 48 horas. Se recogieron muestras de sangre para el análisis de los niveles de aspartato aminotransferasa (AST), alanina aminotransferasa (ALT), fosfatasa alcalina (AP), bilirrubina total (TB) y creatinina (CRE), y muestras de hígado para evaluar la peroxidación lipídica, las sustancias reactivas al ácido tiobarbitúrico (TBARS), la actividad de las enzimas antioxidantes superóxido dismutasa (SOD), glutatión peroxidasa (GPx), catalasa (CAT) y glutatión S-transferasa (GST). Además se midieron mediante inmunohistoquímica el factor nuclear kappa N (NF-κB), el fator de necrosis tumoral (TNF-α) y la óxido nítrico sintasa inducible (iNOS). Resultados: la TAA causó alteraciones en los parámetros bioquímicos e histológicos, y el aumento de los marcadores del proceso inflamatorio. Los niveles de TBARS y la actividad de SOD y GST fueron significativamente inferiores en los grupos de glutamina en comparación con TAA. La actividad de CAT se incrementó en los animales tratados con glutamina en comparación con la TAA. La actividad GPx también fue menor a las 36 y 48 h en los animales tratados com glutamina. El daño tisular y

  16. Como Lo Hago Yo: Mielomeningocele En Bolivia

    PubMed Central

    Dabdoub, Carlos F.; Dabdoub, Carlos B.; Villavicencio, Ramiro; Quevedo, Germán

    2014-01-01

    ón: En esta serie, el diagnóstico prenatal del MMC fue ocasional y la derivación al HUJ de los recién nacidos con esta malformación fue generalmente tardía. No hubo predominio de género y la mayoría de los casos presentaron sus lesiones en la región lumbar y lumbosacra. La mortalidad general y postoperatoria fue similar a la reportada en la literatura. Pocos enfermos realizaron controles posteriores al alta hospitalaria. Igual que otros países de Sudamérica, las falencias en el sistema público de salud y el nivel sociocultural, son factores determinantes para un mal pronóstico en estos niños. Por sus múltiples complicaciones, el MMC requiere de una especial atención gubernamental, sobre todo de carácter preventivo mediante el uso de ácido fólico en mujeres fértiles, como también de un equipo profesional multidisciplinario, a fin de realizar un tratamiento adecuado y oportuno. Al mismo tiempo, trabajos multicéntricos en hospitales de América Latina, ayudarán al mejor manejo de estos pacientes. PMID:24791220

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

    NASA Astrophysics Data System (ADS)

    Ferreres Sabater, Agustin

    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

  18. Moléculas orgánicas no-rígidas

    NASA Astrophysics Data System (ADS)

    Senent Díez, M. L.

    Se destaca la importancia del estudio espectroscópico ab initio de una serie de moléculas no-rígidas detectadas en el medio interestelar (acetona, dimetil-eter, etanol, metanol, metilamina, ldots), así como los últimos avances del desarrollo de la metodología para el tratamiento teórico de estas especies. Se describe, a modo de ejemplo, el análisis del espectro roto-torsional de la molécula de glicoaldehido que ha sido recientemente detectada en el centro Galáctico Sagitario B2 (N) [1]. Esta especie presenta dos movimientos de gran amplitud que interaccionan, descansan en el Infrarrojo Lejano y le confiere propiedades no-rígidas. La molécula puede existir en posiciones cis y trans y presenta cinco confórmeros estables, tres de simetría Cs (I, II y IV) y un doble mínimo trans de simetría C1 (III) . La conformación favorita, I, presenta simetría Cs y se estabiliza por la formación de un puente de hidrógeno entre los grupos OH y C=O. Los mínimos secundarios II, III, y IV se han determinado a 1278.2 cm-1 (trans, Cs), 1298.8 cm-1 (trans, C1) y 1865.2 cm-1 (cis, Cs) con cálculos MP4/cc-pVQZ que incluyen sustituciones triples. Para determinar que vibraciones interaccionan con las torsiones, se ha realizado un análisis armónico en los mínimos. Las frecuencias fundamentales armónicas correspondientes al mínimo I se han calculado en 213.4 cm-1 (torsión C-C) y 425.7 cm-1 (torsión OH). Es de esperar que tan sólo dos vibraciones, la flexión del grupo C-C-O y el aleteo del hidrógeno del grupo aldehídico puedan desplazar el espectro torsional de la molécula aislada. Para determinar el espectro torsional, se ha determinado la superficie de potencial en dos dimensiones mediante el cálculo ab initio de las geometrías y energías de 74 conformaciones seleccionadas. Estas últimas se han ajustado a un doble serie de Fourier. A partir de la PES y de los parámetros cinéticos del Hamiltoniano vibracional se han obtenido frecuencias e intensidades

  19. [In Process Citation].

    PubMed

    Molina Recio, Guillermo; Moreno Rojas, Rafael; García Rodríguez, María; Vaquero Abellán, Manuel

    2016-01-01

    Introducción: un gran número de encuestas nutricionales en Perú han identificado la magnitud y la ubicación de los diferentes tipos de desnutrición, siendo la forma crónica la más prevalente. Sin embargo, aunque las tasas pueden considerarse alarmantes (aún más en las zonas rurales), sólo un trabajo contiene información sobre las características de la ingesta, usando recordatorios de 24 horas (R24). Es decir, se carece de otros sistemas de estudio centrados en conocer las características gastronómicas de sus regiones y la biodisponibilidad de los alimentos, con el fin de localizar el origen de esta situación en cada área y proponer soluciones verdaderamente eficaces y eficientes.Objetivo: determinar el valor nutricional de los platos principales consumidos por los residentes de un barrio pobre de la Amazonía Peruana, para identificar las causas de la pérdida de un estado nutricional saludable.Métodos: noventa y ocho participantes completaron tres R24. Basándonos en estos datos, se seleccionaron los 25 platos más comúnmente consumidos y evaluamos su composición nutricional. Tomamos nota de las recetas, pesos y medidas caseras. Además, se observó la preparación y cocción. La composición nutricional media de cada plato se calculó por 100 g utilizando el software Nutriplato 4.6. También se calcularon lasganancias o pérdidas derivadas de los tratamientos culinarios.Resultados: dentro de los platos basados en la leche, el de más alta densidad de energía es el mingado de arroz. En el grupo de los pescados, la mayor cantidad de energía es aportada por el pescado frito, mientras que en las recetas a base de carne, las más energéticas son el tallarín con pollo, la res asada y el cerdo frito. Como platos preparados, el juane tiene la más alta densidad de energía de todas las recetas. Dentro de las guarniciones, aquellas que utilizan los plátanos como el ingrediente principal, el plátano frito y el madurito, son las más energ

  20. Impact of Chloroquine on Viral Load in Breast Milk

    PubMed Central

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

    2006-01-01

    , 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

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

    PubMed

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

    2000-02-01

    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 habr

  2. Capture-zone design in an aquifer influenced by cyclic fluctuations in hydraulic gradients

    NASA Astrophysics Data System (ADS)

    Zawadzki, Willy; Chorley, Don; Patrick, Guy

    2002-10-01

    alors réalisées sur la base du gradient hydraulique moyen déterminé au moyen de techniques de filtrage sur des mesures continues de la piézométrie. Lorsque la période de la fluctuation cyclique dans le gradient hydraulique est proche de ou supérieure au temps de parcours du contaminant, les variations résultantes de gradient hydraulique ne peuvent plus être ignorées. Dans ces cas-là, des procédures ont été mises au point pour prendre en compte ces fluctuations dans la conception de la zone d'extraction. Celles-ci prennent en considération la caractérisation propre du régime de la nappe, l'évaluation du temps de parcours moyen et de la période des fluctuations cycliques, et des techniques numériques qui permettent de considérer les fluctuations cycliques dans la conception de la zone d'extraction. Resumen. El diseño de un sistema de bombeo y tratamiento de aguas subterráneas para una instalación de manufactura de madera que está próxima al estuario del río Fraser, sometido a la influencia de las mareas, ha requerido el desarrollo de metodologías para tener en cuenta las variaciones cíclicas de los gradientes hidráulicos. El diseño de tales sistemas debe considerar los efectos de las fluctuaciones cíclicas en la captura de contaminantes en fase disuelta. Cuando el período de la fluctuación cíclica es mucho menor que el tiempo de tránsito del contaminante disuelto entre el punto de entrada y el de descarga, se puede ignorar las variaciones del gradiente hidráulico provocadas por dichos ciclos. Las zonas de captura se diseñan entonces en función del gradiente hidráulico promedio, que se determina mediante técnicas de filtrado de medidas continuas del nivel piezométrico. Cuando el período de la fluctuación cíclica del gradiente hidráulico es comparable o mayor que el tiempo de tránsito del contaminante, no puede ignorarse las variaciones resultantes en el gradiente hidráulico. En ese caso, se tiene que desarrollar

  3. Monitoring the Dynamic of a Fluvial Channel after Lahar Disturbance: Huiloac Gorge (Popocatepetl Volcano, Mexico)

    NASA Astrophysics Data System (ADS)

    Andres, N.; Palacios, D.; Zamorano, J. J.; Tanarro, L. M.; Renschler, C.; Sanjosé, J. J.; Atkinson, A.

    2009-04-01

    Capra, L.; Poblete, M.A. and Alvarado, R. 2004. The 1997 and 2001 lahars of Popocatépetl volcano (Central Mexico): textural and sedimentological constraints on their origin and hazards. Journal of Volcanology and Geothermal Research, 131: 351-369. Gran, K. y Montgomery, D., 2005. Spatial and temporal patterns in fluvial recovery following volcanic eruptions: Channel response to basin-wide sediment loading at Mount Pinatubo, Philippines. GSA Bulletin, 117; 1-2: 195-211. Hayes, S.K., Montgomery, D.R. and Newhall, C.G., 2002, Fluvial sediment transport and deposition following the 1991 eruption of Mt. Pinatubo. Geomorphology. Vol. 45: 211-224. Major, J.J., Pierson, T.C., Dinehart, R.L. y Costa, J.E. 2000. Sediment yield following severe volcanic disturbance- A two-decade perspective from Mount St. Helens. Geology, 28, n° 9: 819-822. Major, J.J., 2003. Post-eruption hydrology and sediment transport in volcanic river systems, Water Resources IMPACT, 5(3): 10-15. Muñoz, E. 2007. Los lahares del Popocatépetl: tratamiento de la información para la prevención de catástrofes. (PhD thesis, Universidad Complutense de Madrid.) Palacios, D., 1995. Rockslide processes on the north slope of Popocatépetl Volcano, Mexico, Permafrost and Periglaciar Processes, 6: 345-356. Palacios, D., J.J. Zamorano and G. Parrilla. 1998. Proglacial debris flows in Popocatépetl North Face and their relation to 1995 eruption. Z. Geomorph. N. P., 42(3), 273-295 Palacios, D., J.J. Zamorano and A. Gómez. 2001. The impact of present lahars on the geomorphologic evolution of proglacial gorges: Popocatépetl, Mexico. Geomorphology, 37(1-2), 15-42.

  4. Trends, prospects and challenges in quantifying flow and transport through fractured rocks

    NASA Astrophysics Data System (ADS)

    Neuman, Shlomo P.

    2005-03-01

    autre est de l'envisager comme un milieu non-uniforme (simple, double ou multiple) continu. Une troisième manière est de combiner ceci dans un modèle hybride d'un milieu non-uniforme, contenant un relativement petit nombre de fractures dominantes et discrètes. Dans d'auters cas la description peut être déterministe ou stochastique. L'article contient un brève apperçu de ces tendances à la lumière d'expériences récentes et de nouvelles théories, et se termine par une courte liste de «challenge» et de priorités pour le futur. Entre los problemas actuales que enfrentan los hidrogeólogos, quizá no hay uno tan desafiante como la caracterización de roca fracturada (Faybishenko y Benson, 2000). Este artículo discute problemas asociados con la cuantificación de flujo y transporte a través de rocas fracturadas en escalas que no exceden las típicas asociadas con presión (o flujo) en un solo pozo o varios pozos y pruebas con trazadores. Debido a que mucha de la literatura del tema se ha enfocado en rocas cristalinas fracturadas y rocas sedimentarias duras tal como areniscas, calizas (excluyendo karst) y creta, también en contumacia lo hace este artículo. La cuantificación directa del flujo y transporte en tales rocas se hace comúnmente en base a datos geométricos de fracturas acoplados con pruebas de presión (o flujo) y trazadores, los cuales por lo tanto constituyen nuestra principal orientación. Datos geológicos, geofísicos y geoquímicos (incluyendo isótopos) son críticos para la conceptualización cuantitativa de flujo y transporte en rocas fracturadas, y se han estado incorporando gradualmente en modelos cuantitativos de flujo y transporte, en formas que desafortunadamente este artículo solo puede describir de paso. La hidrogeología de rocas fracturadas y otros aspectos de ciencia de la tierra de hidrología de rocas fracturadas amerita tratamientos separados. Toda la evidencia sugiere que uno raramente puede modelizar flujo y transporte