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Sample records for pectus excavatum tratamiento

  1. Pectus excavatum repair - series (image)

    MedlinePLUS

    Repair of pectus excavatum may be recommended for: improved appearance (cosmetic repair) improved breathing (respiratory function) ... are removed 6 months later through a small skin incision under the arm. This procedure is usually ...

  2. Identifying pectus excavatum in the primary care setting.

    PubMed

    Lew, Kathryn Baker

    2014-06-15

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

  3. Hyperthermia during repair of pectus excavatum.

    PubMed

    Tobias, J D; Morgan, W M; Holcomb, G W; Neblett, W W; Hutchins, M

    1997-02-01

    We have observed an elevation of body temperature during surgical repair of pectus excavatum. To document this phenomenon and attempt to prevent it, we undertook a combination retrospective-prospective study. The retrospective arm included an analysis of the anesthetic records of patients undergoing repair of pectus excavatum during the past 5 years and included 22 boys and 3 girls. Body temperature increased in all 25 patients, from a starting temperature of 36.1 degrees C +/- 0.5 degree C to 38.0 degrees C +/- 0.6 degree C. The maximum temperature exceeded 38 degrees C in 12 patients and 39 degrees C in 3 patients. An additional retrospective review of the anesthetic records of 15 children undergoing another type of thoracic procedure (thoracotomy) for noninfectious problems revealed only a modest, statistically nonsignificant rise in temperature from a starting point of 35.9 degrees C +/- 0.7 degree C to a maximum of 36.3 degrees C +/- 1.2 degrees C. The maximum temperature was greater than 38 degrees C in one of these 15 patients. The prospective arm of the study included a standardized anesthetic technique in 10 patients. Neither a heated humidifier nor a warming blanket were used, and the ambient temperature of the room was maintained at 70 degrees F. Core body temperature increased from a starting temperature of 36.1 degrees C +/- 0.6 degree C to 36.8 degrees C +/- 0.8 degree C. A significant elevation of body temperature occurs in children during repair of pectus excavatum that may be avoided by eliminating the use of exogenous methods to prevent hypothermia (e.g., heated humidifier, warming blanket). PMID:9223942

  4. Acquired thoracic scoliosis following minimally invasive repair of pectus excavatum.

    PubMed

    Niedbala, Angela; Adams, Michael; Boswell, William C; Considine, John M

    2003-06-01

    The minimally invasive pectus excavatum repair as described by Nuss et al. is rapidly gaining acceptance as an effective method of repair of severe pectus excavatum deformities in the pediatric population. It potentially offers several advantages over previous techniques. The incidence of major complications of the procedure has been reduced by recent modifications including utilization of video-assisted thoracoscopy during placement of the Lorenz pectus bar as well as utilizing the pectus bar stabilizer that provides more rigid fixation of the strut. We report two cases of acquired thoracic scoliosis following minimally invasive repair of severe pectus excavatum deformity. This particular complication has not been reported in previous literature and warrants concern. In both cases the thoracic scoliosis slowly improved with physical therapy and range-of-motion exercises. PMID:12852514

  5. Elevation of serum lactate dehydrogenase in patients with pectus excavatum

    PubMed Central

    2014-01-01

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

  6. Silastic Molding Method for Pectus Excavatum Correction Using a Polyvinyl Alcohol (Ivalon) Sponge

    PubMed Central

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

    2012-01-01

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

  7. Pectus Excavatum and Heritable Disorders of the Connective Tissue

    PubMed Central

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

    2013-01-01

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

  8. Improvement of tracheal compression after pectus excavatum repair.

    PubMed

    Miyano, Go; Ignacio, Romeo C; Wood, Robert E; Inge, Thomas H

    2013-09-01

    A 4-year-old girl with pectus excavatum (PE), multiple prior respiratory infections, tracheomalacia and tracheal compression due to the innominate artery was referred for surgical evaluation. Aortopexy was deemed unlikely to improve airway diameter due to her chest concavity. Thoracoscopy-assisted PE repair was performed, resulting in marked improvement in the anteroposterior diameter of the trachea and resolution of her respiratory symptoms. Durability of the PE correction at 2 and 7 years following bar removal was demonstrated radiographically. PMID:23708973

  9. Repair of Pectus Excavatum and Carinatum Deformities in 116 Adults

    PubMed Central

    Fonkalsrud, Eric W.; DeUgarte, Daniel; Choi, Edmund

    2002-01-01

    Objective To determine the feasibility of surgically correcting pectus excavatum and carinatum deformities in adult patients. Summary Background Data Although pectus chest deformities are common, many patients progress to adulthood without surgical repair and experience increasing symptoms. There are sparse published data regarding repair of pectus deformities in adults. Methods Since 1987, 116 patients over the age of 18 years with pectus excavatum (n = 104) or carinatum (n = 12) deformities underwent correction using a highly modified Ravitch repair, with a temporary internal support bar. The ages ranged from 19 to 53 years (mean 30.1). Eighty-six patients sought repair after reviewing information regarding pectus deformities available on the Internet. Each patient experienced dyspnea with mild exertion and decreased endurance; 84 had chest pain with activity; 75 had palpitations and/or tachycardia. Seven patients underwent repair for symptomatic recurrent deformities. The mean severity score (chest width divided by distance from sternum to spine) was 4.8. The sternal bar was removed from 101 patients 6 months after the repair without complications. Results Each of the patients with reduced endurance or dyspnea with mild exercise experienced marked improvement within 6 months. Chest discomfort was reduced in 82 of the 84 patients. Complications included pleural effusion (n = 7), pneumothorax (n = 2), pericarditis (n = 2), dislodged sternal bar (n = 3), and mildly hypertrophic scar (n = 12). Mean hospitalization was 2.9 days; mean blood loss was 122 mL. Pain was mild and of short duration (intravenous analgesics were used a mean of 2.1 days). There were no deaths. With a mean follow-up of 4.3 years, 109 of 113 respondents had a very good or excellent result. Conclusions Although technically more difficult than in children, pectus deformities may be repaired in adults with low morbidity, short hospital stay, and very good physiologic and cosmetic results. PMID:12192317

  10. Pectus excavatum: evaluation of Nuss technique by objective methods.

    PubMed

    Brigato, Rodrigo R; Campos, José R M; Jatene, Fabio B; Moreira, Luiz F P; Rebeis, Eduardo B

    2008-12-01

    Pectus excavatum (PEX) is the most frequent congenital deformity of the anterior chest wall. Few studies have classified the degree of anatomical distortion in an objective manner. Our objective was to present two new clinical and original methods for evaluation of PEX deformity developed in our service (chest cyrtometry and anthropometric index) that are simple and easily applicable in the office. Twenty patients with PEX (submitted to the technique of Nuss) and forty normal chest patients were studied: all patients were evaluated by the same objective methods. Our results suggest that the objective clinical methods are more sensitive or precise than the radiological ones by measuring the deformity in a direct manner external to the chest. PMID:18772264

  11. Complex regional pain syndrome following the Nuss procedure for severe pectus excavatum.

    PubMed

    Chen, Yi-Ling; Chen, Liang-Cheng; Chen, Jen-Chih; Cheng, Yeung-Leung

    2014-01-01

    Complex regional pain syndrome (CRPS) is not an uncommon complication after surgery, but has never been reported after the Nuss procedure for repairing pectus excavatum. A 22-year-old man with pectus excavatum had type I CRPS that developed 2 weeks after the Nuss procedure. He complained of persistent pain, hyperalgesia, weakness, edema, and color and temperature changes on right upper extremity. Following intensive rehabilitation, the degree of pain, weakness and edema were ameliorated. He recovered 6 months after surgery and the pectus bars were removed uneventfully 3 years after the repair. PMID:23411836

  12. 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

  13. 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

  14. Open Repair of Pectus Excavatum With Minimal Cartilage Resection

    PubMed Central

    Fonkalsrud, Eric W.

    2004-01-01

    Objective: To summarize the clinical experience with a new open repair for pectus excavatum (PE), with minimal cartilage resection. Summary Background Data: A wide variety of modified techniques of the Ravitch repair for PE have been used over the past 5 decades, with the complications and results being inconsistent. Extensive subperiosteal costal cartilage resection and perichondrial sheath detachment from the sternum may not be necessary for optimal repair. Methods: During a 12-month period, 75 consecutive patients with symptomatic PE underwent open repair using a new less invasive technique. After exposing the deformed costal cartilages, a short chip was resected medially adjacent to the sternum and laterally at the level where the chest had a near normal contour, allowing the cartilage to be elevated to the desired level with minimal force. A transverse anterior sternal osteotomy was used on most patients. A substernal support strut was used for 66 patients; the strut was placed anterior to the sternum in 9 patients under age 12 and over age 40 years. The strut was routinely removed within 6 months. Results: With a mean follow-up of 8.2 months, all but 1 patient regarded the results as very good or excellent. Mean operating time was 174 minutes; mean hospitalization was 2.7 days. There were no major complications or deaths. Conclusions: The open repair using minimal cartilage resection is effective for all variations of PE in patients of all ages, uses short operating time, provides a stable early postoperative chest wall, causes only mild postoperative pain, and produces good physiologic and cosmetic results. PMID:15273545

  15. 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.

  16. Transcatheter Aortic Valve Replacement via Left Anterior Thoracotomy in a Patient With Severe Pectus Excavatum.

    PubMed

    Loberman, Dan; Rajab, Taufiek Konrad; Yammine, Maroun; Welt, Frederick G; Eisenhauer, Andrew C; Davidson, Michael J

    2016-01-01

    With the development of the transcatheter aortic valve replacement, innovative approaches can be geared to atypical and challenging cases. We describe a case of transcatheter aortic valve replacement via a left anterior thoracotomy in a patient with pectus excavatum and unusual intrathoracic anatomy where surgical and traditional transcatheter aortic valve replacement approaches were deemed inapplicable. PMID:26694273

  17. Screening for pectus excavatum among primary students and establishment of a pectus excavatum screening program in Dongguan, China

    PubMed Central

    Zou, Xusen; Lin, Yanqing; Jin, Hui; Cai, Sumei; Xu, Xin; Yin, Weiqiang; Geng, Qingshan; Chen, Jiuhao; Liang, Bing

    2015-01-01

    Objective To carry out pectus excavatum (PEx) screening among primary school students in Dongguan, with an attempt to establish a PEx screening program and provide epidemiological evidences for developing guidelines on the diagnosis and treatment of PEx for young children. Methods A total of 479,402 primary school students who were already in school in 2012 or newly enrolled in 2013 from 422 primary schools in 32 towns in Dongguan, Guangdong Province were screened for PEx. Meanwhile, about 420 medical staff from the infirmaries of 422 primary schools were provided with a serial of training, with an attempt to establish a PEx screening program and network. Results Valid screening results were obtained from 477,627 pupils (99.62%) from 406 primary schools in 31 towns. These students aged 4-15 years (mean: 8.78 years), among whom there were 244,545 males (N1; mean age: 8.22 years) and 233,082 females (N2; mean age: 8.89 years). Totally 257 PEx patients were identified, yielding a prevalence of 0.583%, among whom there were 176 males (N3; mean age: 8.79 years) and 81 females (N4; mean age: 8.77 years). With the PEx patients as the PEx group and the healthy children as the control group, chi square test with gender as the dependent variable showed that the incidence of PEx was significantly different between male and female students (P=0.00) (N3:N4 =2.172:1). In addition, 410 medical staff from the school infirmaries were trained, and a PEx screening program and network was established. Conclusions The screening for PEx was successfully performed among pupils who were already in school in 2012 or newly enrolled in 2013 from 422 primary schools in Dongguan, Guangdong Province. Statistical analysis showed that the incidence of PEx differed between male and female pupils. A stable effective PEx screening program was established, which will provide personal and technical supports for the early diagnosis and treatment of this condition. PMID:26101642

  18. Evaluation of Unexplained Dyspnea in A Young Athletic Male with Pectus Excavatum

    PubMed Central

    Tardie, Gregory B.; Dorsey, David A.; Kaeferlein, Bernhard H.

    2005-01-01

    Pectus excavatum (PE) is a relatively common congenital deformity of the anterior chest wall associated with reduced exercise capacity. Uncertainty exists over the nature of physiologic impairment in PE. Evidence suggests that myocardial compression exerted by the displaced sternum on the right heart chambers, disables the ability of the heart to augment stroke volume during exercise. This case study describes the evaluation of an athletic 20 year old Caucasian male, lifelong non-smoker, with severe pectus deformity and previous fixation procedure to repair a sternal fracture. The patient performed an incremental cycle ergometer exercise test to determine the etiology of his dyspnea with exertion. The patient demonstrated normal work output and normal aerobic capacity but displayed dynamic hyperinflation. Mechanical restriction of tidal volume expansion appeared to be the major contributors to exercise limitation. These results are compared and contrasted with similar cases reported in the literature. Key Points Pectus excavatum (PE) is a relatively common phenomenon affecting approximately 1 in 300 births, with a 9:1 ratio of male to female rate of incidence. The etiology or exercise limitation is most frequently due to cardiovascular limitation due to the compression of the sternum upon the myocardium, impairing the ability to augment stroke volume. The Pectus Severity Index (PSI) is a useful indicator of pectus severity. Cardiopulmonary exercise testing provides useful data to distinguish between cardiovascular limitation, ventilatory limitation, or deconditioning in the evaluation of PE. In this case study, ventilatory limitation was due to the mechanical restriction of the thoracic cavity. PMID:24453537

  19. 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

  20. 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

  1. [Quality of life evaluation of the patients and parents satisfaction after Nuss procedure in the management of Pectus Excavatum].

    PubMed

    Soares, Tony R; Henriques-Coelho, Tiago; Vilaça, João; Silva, Ana Raquel; Carvalho, José Luis; Correia-Pinto, Jorge

    2012-01-01

    Pectus Excavatum is the most common congenital deformity of the chest. Although Pectus Excavatum can be associated with heart or lung problems, the main indication for surgical correction of this congenital anomaly is the body image dissatisfaction. The Nuss technique is a minimally invasive procedure that allows the placement of an intrathoracic prosthetic convex bar, previously bended, which mobilize the sternum anteriorly. The aim of this study was to evaluate the degree of satisfaction of the patients and parents after the application of the Nuss technique using the Pectus Excavatum Evaluation Questionnaire. All parameters of psychosocial character - self-image, difficulties in exposing the chest, frustration, sadness, social isolation and ridicule - found a statistically significant improvement after surgical correction of Pectus Excavatum from the perspective of patients and their parents. There was not a marked improvement and consensus regarding the overall physical performance of patients. Which is understandable, since, theoretically, the physical deformity is not responsible for significant limitations on exertion. The current surgical correction of Pectus Excavatum by the Nuss technique allows obtaining aesthetic results of the chest with the resolution of the main problems with body image. Increase awareness of health issues for psychosocial and physical factors which might be involved in this kind of deformities is important, especially when there is a satisfactory solution. PMID:24490196

  2. Pectus excavatum: historical background, clinical picture, preoperative evaluation and criteria for operation.

    PubMed

    Kelly, Robert E

    2008-08-01

    Pectus excavatum is a depression of the sternum and costal cartilages which may present at birth, or more commonly during the teenage growth spurt. Symptoms of lack of endurance, shortness of breath with exercise, or chest pain are frequent. Although pectus excavatum may be a component of some uncommon syndromes, patients usually are healthy. Evaluation should include careful anatomic description with photographs, radiography to demonstrate the depth of the depression, extent of cardiac compression, or displacement, measurement of pulmonary function, and echocardiography to look for mitral valve prolapse (in 15%) or diminished right ventricular volume. Indications for surgical treatment include two or more of the following: a severe, symptomatic deformity; progression of deformity; paradoxical respiratory chest wall motion; computer tomography scan with a pectus index greater than 3.25; cardiac compression/displacement and/or pulmonary compression; pulmonary function studies showing restrictive disease; mitral valve prolapse, bundle branch block, or other cardiac pathology secondary to compression of the heart; or failed previous repair(s). The developmental factors, genetics, and physiologic abnormalities associated with the condition are reviewed. PMID:18582824

  3. Superior mesenteric artery syndrome after minimally invasive correction of pectus excavatum: impact of post-operative weight loss.

    PubMed

    Ricca, Robert L; Kasten, Jennifer; Javid, Patrick J

    2012-11-01

    We report the case of a 14-year-old boy with pectus excavatum and mild scoliosis. The patient underwent a minimally invasive Nuss repair with excellent cosmetic result. He returned 3 weeks post-operatively with bilious emesis and a 3.6-kg weight loss (5.5% of total body weight). Radiographic evaluation was consistent with the diagnosis of superior mesenteric artery syndrome and the child ultimately required nasojejunal feedings. Following return to his baseline weight, he was transitioned to oral feedings and has done well in follow-up. This is the first report of SMA syndrome following minimally invasive pectus excavatum repair. PMID:23164012

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  5. 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.

  6. Automatic prebent customized prosthesis for pectus excavatum minimally invasive surgery correction.

    PubMed

    Vilaça, João L; Rodrigues, Pedro L; Soares, Tony R; Fonseca, Jaime C; Pinho, António C M; Henriques-Coelho, Tiago; Correia-Pinto, Jorge

    2014-06-01

    Pectus excavatum is the most common deformity of the thorax. A minimally invasive surgical correction is commonly carried out to remodel the anterior chest wall by using an intrathoracic convex prosthesis in the substernal position. The process of prosthesis modeling and bending still remains an area of improvement. The authors developed a new system, i3DExcavatum, which can automatically model and bend the bar preoperatively based on a thoracic CT scan. This article presents a comparison between automatic and manual bending. The i3DExcavatum was used to personalize prostheses for 41 patients who underwent pectus excavatum surgical correction between 2007 and 2012. Regarding the anatomical variations, the soft-tissue thicknesses external to the ribs show that both symmetric and asymmetric patients always have asymmetric variations, by comparing the patients' sides. It highlighted that the prosthesis bar should be modeled according to each patient's rib positions and dimensions. The average differences between the skin and costal line curvature lengths were 84 ± 4 mm and 96 ± 11 mm, for male and female patients, respectively. On the other hand, the i3DExcavatum ensured a smooth curvature of the surgical prosthesis and was capable of predicting and simulating a virtual shape and size of the bar for asymmetric and symmetric patients. In conclusion, the i3DExcavatum allows preoperative personalization according to the thoracic morphology of each patient. It reduces surgery time and minimizes the margin error introduced by the manually bent bar, which only uses a template that copies the chest wall curvature. PMID:24151136

  7. Feasibility and Complications in Concomitant Lung Resection With Minimally Invasive Repair of Pectus Excavatum.

    PubMed

    Bilgi, Zeynep; Ermerak, Nezih Onur; Bostanc?, Korkut; Saçak, Bülent; Bat?rel, Hasan Fevzi; Yüksel, Mustafa

    2015-08-01

    Minimally invasive repair of pectus excavatum (MIRPE) is the procedure of choice in experienced centers and can be offered in combination with other thoracic procedures. Between 2001 and 2013, 3 cases involving MIRPE and lung surgery were done in our clinic. While postoperative course of 2 procedures (MIRPE and video-assisted thoracoscopic surgery [VATS] segmentectomy and MIRPE and VATS bullectomy) were uncomplicated, the MIRPE and VATS lung biopsy patient developed major complications arising from prolonged air leak and was ultimately managed with an Eloesser flap. In carefully selected cases, simultaneous lung surgery and MIRPE can be done safely but problems of lung reexpansion, long-term drainage, and infection should be kept in mind. PMID:26234844

  8. Combined severe pectus excavatum correction and aortic root replacement in Marfan's syndrome.

    PubMed

    Javangula, Kalyana C; Batchelor, Timothy J P; Jaber, Osama; Watterson, Kevin G; Papagiannopoulos, Kostas

    2006-05-01

    A 23-year-old man with Marfan's syndrome was admitted for repair of annulo-aortic ectasia and severe pectus excavatum. A submammary skin incision approach followed by bilateral subperichondrial resection of abnormal costal cartilages was performed. The left intercostal muscles and perichondrial sheaths were divided 2 inches lateral to the sternum in a parasternal fashion to place the retractor. The aortic root was replaced with a 23-mm St. Jude's composite graft (St. Jude Medical, Inc, St. Paul, MN). Chest wall reconstruction was completed with a high sternal osteotomy and support of the sternum was made with Gortex strips (W.L. Gore & Associates, Inc, Flagstaff, AZ). The patient made an uneventful recovery. PMID:16631712

  9. Automatic modeling of pectus excavatum corrective prosthesis using artificial neural networks.

    PubMed

    Rodrigues, Pedro L; Rodrigues, Nuno F; Pinho, A C M; Fonseca, Jaime C; Correia-Pinto, Jorge; Vilaça, João L

    2014-10-01

    Pectus excavatum is the most common deformity of the thorax. Pre-operative diagnosis usually includes Computed Tomography (CT) to successfully employ a thoracic prosthesis for anterior chest wall remodeling. Aiming at the elimination of radiation exposure, this paper presents a novel methodology for the replacement of CT by a 3D laser scanner (radiation-free) for prosthesis modeling. The complete elimination of CT is based on an accurate determination of ribs position and prosthesis placement region through skin surface points. The developed solution resorts to a normalized and combined outcome of an artificial neural network (ANN) set. Each ANN model was trained with data vectors from 165 male patients and using soft tissue thicknesses (STT) comprising information from the skin and rib cage (automatically determined by image processing algorithms). Tests revealed that ribs position for prosthesis placement and modeling can be estimated with an average error of 5.0 ± 3.6mm. One also showed that the ANN performance can be improved by introducing a manually determined initial STT value in the ANN normalization procedure (average error of 2.82 ± 0.76 mm). Such error range is well below current prosthesis manual modeling (approximately 11 mm), which can provide a valuable and radiation-free procedure for prosthesis personalization. PMID:25070021

  10. 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

  11. Minimally invasive repair of pectus excavatum--the Nuss procedure. A European multicentre experience.

    PubMed

    Hosie, S; Sitkiewicz, T; Petersen, C; Göbel, P; Schaarschmidt, K; Till, H; Noatnick, M; Winiker, H; Hagl, C; Schmedding, A; Waag, K-L

    2002-08-01

    Since the first description in 1998, the minimally invasive repair of pectus excavatum has gained increasing acceptance. The aim of this survey is to report on the experiences of eight European centres with this technique. 172 patients with a mean age of 15.1 (+/- 4.6) years were treated and evaluated, 35.5 % were symptomatic. 45.3 % of the patients had an asymmetric configuration of the chest, 74.3 % had a CT index above 3.25. Mean duration of the operative procedure was 76 minutes. Major complications, including dislocation of the bar or stabiliser, pneumonia, atelectasis, local infection, pleural and pericardial effusion and liver injury occurred in 11.1 % of the patients. Minor complications, such as self-resolving pneumothorax, atelectasis and subcutaneous emphysema were reported in another 8.1 %. Early cosmetic results were excellent or good in 81.5 %. Although the surgical procedure is simple, blood-sparing and short, consideration of some important technical details, proper patient selection and knowledge of the limitations is of vital importance. Long-term results are still lacking. PMID:12368999

  12. Left lateral liver lobe torsion in a cat with moderate pectus excavatum.

    PubMed

    Haider, Georg; Dokic, Zelimir; Petritsch, Birgitt; Lorinson, Dragan

    2015-12-01

    A 6-year-old neutered female domestic shorthair cat weighing 3.1 kg was referred to the clinic owing to a 2 day history of anorexia. On physical examination, a pectus excavatum (PE) was apparent, and a cranial abdominal mass was palpated. Serum biochemical analysis showed severely elevated liver enzymes. On radiography, the PE was graded as moderate, and a 5 × 3 cm soft tissue density mass was detected in the cranial abdomen. Using duplex ultrasonography, the mass was identified as an enlarged liver lobe with vascular thrombosis. The diagnosis of liver lobe torsion (LLT) was confirmed surgically, and the affected left lateral lobe was resected. On follow-up, performed 1 and 6 months postoperatively, no further abnormalities were found on clinical examination or serum biochemical analysis. At follow-up examination, the PE did not appear to cause any additional clinical signs, indicating that treatment of moderate PE in older animals is not obligatory. This is the first reported case of LLT with concurrent PE, and the second feline case of LLT treated surgically. Animals with anatomical malformation of the diaphragm caused by PE may be at higher risk of developing LLT. Early diagnosis and surgical intervention of LLT can produce a good clinical outcome without further repercussions. PMID:25715646

  13. Patient Satisfaction Following Minimally Invasive Repair of Pectus Excavatum: Single Surgeon Experience

    PubMed Central

    Barua, Anupama; Rao, Vinay P.; Barua, Biplab; Majewski, Andrzej

    2012-01-01

    Background: Pectus excavatum (PE) is the most common chest wall deformity in adolescent life. Nuss procedure is a well-established technique for the repair of PE. The indication for correction is mainly medical aesthetic. Advantages of Nuss over conventional methods include reduced length of hospital stay, smaller incisions, and absence of need for osteochondrectomies. Here, we describe our experience with this procedure. Materials and Methods: This was a retrospective study of patients who underwent Nuss procedure by a single surgeon between 2006 and 2010 in a regional center. Indications for surgery included the following: Progressive deformity and psychological stress. All patients underwent chest X-ray and pulmonary function testing. A standard Nuss procedure was performed using a single bar. Patients’ satisfaction was assessed by a questionnaire and follow-up clinic letters. Satisfaction with body image was scored on a scale of 1-10. Results: Eleven patients with PE underwent correction by Nuss procedure. Mean age of the patient was 19 years (range: 15-30). The average hospital stay was 7 days (range: 4-23 days). There was no mortality and no episodes of wound infection. In the immediate post-operative period, three patients (12.5%) were noted to have poor pain control. The post-operative course was uneventful in all cases except one patient who developed lung collapse, pleural effusion, and bar dislocation. Hundred percent of patients were satisfied with the scar. Seven patients scored 7 out of 10 on satisfaction with body image and two patients scored 6 or less. None of the patients complained of chronic pain. Conclusion: Nuss procedure is an effective method for the correction of PE. Most patients were satisfied with the outcome and none experienced chronic pain. PMID:23741581

  14. Assessment of psychosocial functioning and its risk factors in children with pectus excavatum

    PubMed Central

    2011-01-01

    Background Psychosocial functioning is poor in patients with pectus excavatum (PE). However, a comprehensive understanding of this issue does not exist. The aim of this study was to assess the severity of psychosocial problems as associated with PE, as well as to identify its risk factors. Methods A comparative study was performed at the Sichuan Academy of Medical Sciences/Sichuan Provincial People's Hospital in Chengdu, China. Patients age 6 to 16 who admitted to the outpatient department for the evaluation or treatment for PE were included in the study. In addition to parental reports of child psychosocial problems on the Achenbach Child Behavior Checklist (CBCL), parents also filled in other structured questionnaires, including socio-demographic variables, patients' medical and psychological characteristics. The severity of malformation was assessed by CT scan. For comparison, an age- and gender- matched control group was recruited from the general population. The socio-demographic and scores on CBCL were compared between patients and control subjects. Univariate and multivariate analysis were performed to examine risk factors for psychosocial problems in patients. Results No statistically significant differences were found with respect to social-demographic variables between children with PE and control subjects. Compared with control subjects, children with PE displayed higher prevalence of psychosocial problems in the different scales of the CBCL questionnaire such as 'withdraw', 'anxious-depressed', 'social problems' and 'total problems'. Both univariate and multivariate analyses suggested that age, severity of malformation, and being teased about PE were significantly associated with patients' psychosocial problems. Conclusions The information derived from this study supports the opinion that children with PE have more psychosocial problems than children from the general population. Multiple medical and psychosocial factors were associated with patients' impairment of psychosocial functioning. PMID:21542911

  15. 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

  16. 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.

  17. 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

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

    NASA Astrophysics Data System (ADS)

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

    2012-03-01

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

  19. Peri-operative data on the nuss procedure in children with pectus excavatum: independent survey of the first 20 years' data

    PubMed Central

    Protopapas, Aristotle D; Athanasiou, Thanos

    2008-01-01

    Objective To review the literature and assess the cumulative data on the Nuss operation in children on its twenty years' anniversary: The Nuss procedure corrects the pectus excavatum by minimal access semi-permanent insertion of metal bars in order to reduce the deformity and refashion the contour of the growing thorax. The advantage over previous techniques is avoidance of osteochondrotomies and thence allowance for normal growth of the thorax. Study design PubMed search was performed. Primary outcomes were mortality, morbidity and individual complications. Secondary outcomes were procedure time and hospital stay. Results We merged the data from 19 reports comprising 1949 children of mean age 10.6 years. No mortality was observed and the procedure was associated with morbidity of 15.4%. The commonest complications are bar-related adverse events (5.7%) and pneumothorax (3.5%). The average procedure time and the average hospital stay were 68 minutes and 5.5 days respectively. Conclusion 20 years of initial evidence suggests that the Nuss group of procedures is a safe minimal access option for correction of pectus excavatum in childhood. PMID:18601720

  20. Pectus excavatum repair

    MedlinePLUS

    ... in a deep sleep and pain-free from general anesthesia . Open surgery is more traditional. The surgery is done the ... Risks for anesthesia and surgery in general are: Reactions to ... or infection Risks for this surgery are: Injury to the heart ...

  1. Pectus excavatum - discharge

    MedlinePLUS

    ... when you or your child can return to work or school. Most dressings (bandages) will be removed by the time your child leaves the hospital. There may still be strips of tape on the incisions. Leave these in place. They will fall off on their own. There ...

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

    NASA Astrophysics Data System (ADS)

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

    2009-02-01

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

  3. The prevalence and effects of Pectus Excavatum and Pectus Carinatum on the respiratory function in children between 7-14 years old.

    PubMed

    Coskun, Zafer Kutay; Turgut, Hasan Basri; Demirsoy, Sadik; Cansu, Ali

    2010-09-01

    The study involved 1342 primary school students aged 7-14 years who applied to Ankara, a primary care center for general health check-up between 2006 and 2007. Forty-three students, 35 of whom had PE and 8 of whom had PC, were subjected to thorax measurement. All 43 students underwent pulmonary function tests (PFT).The prevalence rate of PC was 0.6%, and of PE, 2.6%. The thorax widths of the groups were similar (P?=?0.273). The thorax circumference and depth of PE group were lower than those of the controls (P?pectus deformity do not have any physical complaints and do not have statistically significant differences in their PFT parameters. PMID:20814837

  4. Right ventricular outflow tract obstruction caused by a displaced pectus bar 30 months following the Nuss procedure.

    PubMed

    Maagaard, Marie; Udholm, Sebastian; Hjortdal, Vibeke E; Pilegaard, Hans K

    2015-01-01

    Complications following the Nuss procedure for the correction of pectus excavatum later than 30 days are rare. We report of a 40-year old man who developed dyspnoea and was diagnosed with a pulmonary stenosis more than 2 years after undergoing the Nuss procedure. This was discovered to be caused by a displaced pectus bar. Following removal of the pectus bars, the symptoms along with the right ventricular outflow tract obstruction disappeared. PMID:25312526

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

    PubMed Central

    Haje, D. P.

    2006-01-01

    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

  6. 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.

  7. Modified Nuss repair for pectus carinatum.

    PubMed

    Poullis, Michael

    2010-09-01

    A minimally-invasive modified Nuss technique is described for pectus carinatum which has reduced risk of cardiac perforation compared to a standard Nuss procedure, and avoids performing the Ravitch procedure. PMID:20591894

  8. A new technique for mixed-type pectus carinatum: modified Onen method.

    PubMed

    Akkas, Yucel; Kocer, Bulent; Peri, Neslihan Gulay

    2016-02-01

    We modified the Onen method for pectus carinatum repair and used a vertical incision instead of a transverse incision. The most important advantage gained by the vertical incision is that we can switch to the Ravitch method without needing an additional incision, by elongating the existing incision in patients in whom a pectus bar cannot be placed. We successfully performed the modified Onen technique in a 16-year-old boy with a mixed-type pectus carinatum deformity. PMID:26758385

  9. Genetics Home Reference: Noonan syndrome

    MedlinePLUS

    ... palate ; pectus excavatum ; phenotype ; philtrum ; protein ; puberty ; pulmonary ; scoliosis ; short stature ; stature ; stenosis ; surgery ; syndrome ; testicles ; tissue You may find definitions for ...

  10. Plummer-Vinson syndrome with pectus carinatum mitral valve prolapsus and exotropia in an 18-year-old boy

    PubMed Central

    Sahin, Cem; Ozseker, Burak; Rencuzogullari, Ibrahim; Zeybek, Arife

    2014-01-01

    The Plummer-Vinson syndrome is a clinical syndrome characterised by dysphagia, web or webs in upper oesophagus and iron-deficiency anaemia. The syndrome is often seen in women of age 40–70?years and rarely in adolescents. Plummer-Vinson syndrome might be associated with malignancy, myeloproliferative disorder and autoimmune diseases including coeliac disease, rheumatoid arthritis and Sjögren syndrome. However, according to our literature search, there are no reports of such case associated with thorax deformity, cardiac pathology and ocular findings. We present a case of an 18-year-old boy with a rare presentation of this syndrome including pectus carinatum, exotropia and mitral valve prolapsus. PMID:24451233

  11. 38 CFR 3.815 - Monetary allowance under 38 U.S.C. chapter 18 for an individual with disability from covered...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) Osteogenesis imperfecta; (xiv) Pectus excavatum; (xv) Phenylketonuria; (xvi) Sickle cell disease; (xvii) Tay-Sachs disease; (xviii) Thalassemia; and (xix) Wilson's disease. (3) Conditions that are congenital...) Congenital heart disease; (iv) Congenital talipes equinovarus (clubfoot); (v) Esophageal and...

  12. 38 CFR 3.815 - Monetary allowance under 38 U.S.C. chapter 18 for an individual with disability from covered...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) Osteogenesis imperfecta; (xiv) Pectus excavatum; (xv) Phenylketonuria; (xvi) Sickle cell disease; (xvii) Tay-Sachs disease; (xviii) Thalassemia; and (xix) Wilson's disease. (3) Conditions that are congenital...) Congenital heart disease; (iv) Congenital talipes equinovarus (clubfoot); (v) Esophageal and...

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

    PubMed

    Apanaskevich, D A

    2003-01-01

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

  14. 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

  15. 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.

  16. Positioning challenges in mammography.

    PubMed

    Peart, Olive

    2014-01-01

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

  17. Management of Congenital Chest Wall Deformities

    PubMed Central

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

    2011-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  19. Shprintzen-Goldberg marfanoid syndrome: a case followed up for 24 years.

    PubMed

    Stoll, C

    2002-01-01

    A patient with Shprintzen-Goldberg syndrome was followed up for 24 years. The patient's parents were unrelated and unaffected. Walking and speech were delayed. Facial dysmorphism was obvious as well as pectus excavatum, scoliosis, bilateral dislocation of the radial heads, hammer toes and hallux valgus, pes planus, arachnodactyly, and camptodactyly. Skin was thin and fragile. CT scan showed ventricular enlargement. He had a mitral valve prolapse. He was operated on twice for bilateral inguinal and crural hernia and several times for his foot deformities. Puberty was delayed until 18 years. At 24 years of age he was still thin, dolichocephalic, and the facial dysmorphic features were still obvious. Pectus excavatum was still severe but the thoracolumbar scoliosis was mild. His foot deformities had improved and his joints were less hypermobile. Psychomotor development was quite normal. His main concern was the minimal subcutaneous fat and fragility of skin. Echocardiography was now normal. PMID:11822698

  20. Imaging and Clinical Features in a Child with Loeys-Dietz Syndrome

    PubMed Central

    Suarez, B.; Caldera, A.; Castillo, M.

    2011-01-01

    Summary We describe a boy with Loeys-Dietz syndrome (LDS) a genetic and recently described condition that affects connective tissues belonging to a group of Marfan-related disorders. Since there are only a few cases reported misdiagnosis may not be uncommon. Radiological findings in our patient include pectus excavatum, aortic root dilatation, diffuse dilatation of the intracerebral vessels and a Chiari I malformation. We describe the imaging findings, clinical presentation and diagnosis criteria of this entity. PMID:21561552

  1. Qué es la medicina de precisión en el tratamiento del cáncer

    Cancer.gov

    Información sobre el papel que tiene la medicina de precisión en el tratamiento del cáncer. Incluye cómo se identifican los cambios genéticos en el cáncer de una persona y pueden usarse para seleccionar tratamientos con más probabilidad de ayudarle.

  2. Isolated Asymptomatic Short Sternum in a Healthy Young Girl

    PubMed Central

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

    2014-01-01

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

  3. Warfarin-Associated Diaphragmatic Hernia: An Unusual Diagnosis

    PubMed Central

    Vilhena, Cristina; Gameiro, Cátia; Tomás, Cláudia; Santos, Antónia; Ilgenfritz, Raquel

    2015-01-01

    Fetal warfarin syndrome is a consequence of maternal intake of warfarin during pregnancy and comprises a wide range of manifestations, including some typical facial dysmorphologic features. The authors report a case of prenatal ultrasonographic diagnosis of warfarin embryopathy in an obese woman on unsupervised warfarin prophylaxis at the 16th week of gestation. The fetus presented with facial dysmorphism, pectus excavatum, diaphragmatic hernia, and pulmonary hypoplasia. To the best of our knowledge, this is the second reported case of warfarin-associated diaphragmatic hernia. PMID:26078896

  4. Warfarin-Associated Diaphragmatic Hernia: An Unusual Diagnosis.

    PubMed

    Vilhena, Cristina; Gameiro, Cátia; Tomás, Cláudia; Santos, Antónia; Ilgenfritz, Raquel

    2015-01-01

    Fetal warfarin syndrome is a consequence of maternal intake of warfarin during pregnancy and comprises a wide range of manifestations, including some typical facial dysmorphologic features. The authors report a case of prenatal ultrasonographic diagnosis of warfarin embryopathy in an obese woman on unsupervised warfarin prophylaxis at the 16th week of gestation. The fetus presented with facial dysmorphism, pectus excavatum, diaphragmatic hernia, and pulmonary hypoplasia. To the best of our knowledge, this is the second reported case of warfarin-associated diaphragmatic hernia. PMID:26078896

  5. 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

  6. 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

  7. 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.

  8. 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

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

    PubMed

    Nganvongpanit, Korakot; 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

  10. [Correction of the congenital malformations of the front chest wall by the modelling technique of sternochondroplasty: technique and results on a series of 14 cases].

    PubMed

    Duhamel, P; Brunel, C; Le Pimpec, F; Pons, F; Jancovici, R

    2003-04-01

    In the congenital malformations of the front chest wall showing depression or protrusion, the cardiorespiratory disorders are inconstant and often not linked with the distortion. On the other hand psychoaffective repercussions are major in adolescents and young adults justifying recourse to surgery with morphological and aesthetic aiming. The authors present the technique of modelling sternochondroplasty by raising with osteosynthesis by slide fastener-handle of Martin-Borrelly, applied to the correction of congenital malformation of the front chest wall in young adult, both of protrusion (pectus carinatum), of thoraxes in funnel (pectus excavatum) types or of mixed types (pectus arcuatum). This surgical replanning intervention is carried out by under-mammary way and aims at reestablishing a normal anatomy of the front chest wall. It leads to a genuine wide sternochondrocostal volet, which is stabilised by a specific, multipurpose, adaptable and reliable osteosynthesis equipment. The results obtained on a series of 14 cases are good or excellent in 86% of the cases and stable over time in the absence of major complications. A good cooperation of the patient is essential to obtain a good result in particular via the continuation of musculation exercises after assembly consolidation, possibly associated with remote mammary plastic surgery in the event of hypoplasia or of associated mammary agenesia. PMID:12801547

  11. 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.

  12. Do Nuss bars compromise the blood flow of the internal mammary arteries?

    PubMed Central

    Yüksel, Mustafa; Özalper, Mehmet Hakan; Bostanc?, Korkut; Ermerak, Nezih Onur; Cim?it, Çagatay; Tasal?, Nuri; Y?ld?zeli, Bedrettin; Fevzi Bat?rel, Hasan

    2013-01-01

    OBJECTIVES Minimally invasive repair of pectus excavatum, the so-called Nuss procedure, has become a popular technique in recent years. The internal mammary arteries (IMAs) lie on the posterolateral surface of the sternum, and the Nuss bar is likely to obstruct the blood flow in these arteries. This obstruction could become important in the later stages of the lives of these young people if they were to require coronary artery bypass grafting. The goal of this study is to investigate the extent of obstruction of the IMAs caused by Nuss bars. METHODS Data were collected prospectively on all patients who underwent the Nuss procedure between October 2011 and May 2012. Patients with a history of pectus excavatum repair by open surgery and those who were younger than 16 years of age were excluded. Computed tomography–angiography (CTA) was performed for the detection of IMA blood flow preoperatively and on the 10th postoperative day. Blood flow in the IMAs was evaluated blindly by two radiologists and classified as blood flow unaffected (group I) or affected (group II) by comparing the assessment of preoperative and postoperative CTAs. The patients in group II were also categorized as having blood flow obstructed bilaterally, blood flow obstructed unilaterally and others (diminished unilaterally/diminished on one side or obstructed on the other side). RESULTS Thirty-four patients (31 male and three female; mean age 20.7 ± 4.2 years) underwent surgery. Blood flow was affected in 15 patients (44%), with bilateral obstruction in five, unilateral obstruction in seven, and unilateral diminished flow in two patients. In one patient, blood flow was diminished on one side and obstructed on the other. There was no significant difference between unaffected group I patients and affected group II patients in terms of sex, age, type of deformity, Haller index and the number of bars placed. CONCLUSIONS Nuss bars cause pressure on the IMAs, but a risk factor for this effect could not be identified. This is a relatively common clinical consequence of minimally invasive repair of pectus excavatum, and the long-term effects will be apparent following bar removal. PMID:23788198

  13. 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

  14. 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.

  15. 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.

  16. 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

  17. [Autosomal dominant Mendelian midline complex. Secundum atrial septal defect associated with cardiac and facial-thoracic defects. A familial case].

    PubMed

    Stéphan, E; Ashoush, R; Mégarbané, A; Kassab, R; Salem, N; Loiselet, J; Bouvagnet, P

    2000-05-01

    The kindred of 38 individuals reported here have various anomalies: 1. facio-thoracic malformations: hypertelorism, nasal deviation, cleft lip and palate, upper-incisors diastema and pectus excavatum; 2. cardiac anomalies: sinus node bradycardia, atrial fibrillation, nodal rhythm, atrial septal defect. Wolff-Parkinson-White syndrome, low insertion of the septal tricuspid valve corresponding to an Ebstein syndrome, pulmonic "en dôme" valve stenosis, aortic valve stenosis, long QT, and intraventricular conduction blocks. Almost all these defects are septal or para-septal. Mitral stenosis is probably rheumatoid. Such median varied pathology has not been yet reported. All the extra-cardiac anomalies are situated along the vertical upper half-body midline. All cardiac anomalies are in the septal or para-septal region. It is an autosomal dominant trait that implies the early embryonic development of the midline of cardiac and extra-cardiac structures. PMID:10858865

  18. Di Sala syndrome.

    PubMed

    Kumar, Manoj; Bhasker, Shashi Kumar; Singh, Ragini; Kohli, Neera; Kumar, Rashmi

    2012-01-01

    Di Sala syndrome or fetal warfarin syndrome/fetal warfarin embryopathy is a rare condition as result of fetal exposure due to maternal ingestion of warfarin during pregnancy. The authors report here a male infant with this condition whose mother was suffering from rheumatic mitral valvular heart disease for which she underwent prosthetic mitral valvular replacement surgery and put on injectable long acting penicillin and oral low-molecular weight anticoagulant drug (warfarin) for life long. The patient presented with facial dysmorphism, pectus excavatum, stippled epiphyses dolichocephaly, brachydactyly, polydactyly short neck and growth retardation. Shortened fourth metacarpal bones were also noted in this case which was not yet reported in literatures, to the best of our knowledge. PMID:22605711

  19. Autosomal dominant secundum atrial septal defect with various cardiac and noncardiac defects: a new midline disorder.

    PubMed

    Mégarbané, A; Stephan, E; Kassab, R; Ashoush, R; Salem, N; Bouvagnet, P; Loiselet, J

    1999-03-19

    We report on a Lebanese family in which 12 persons had an atrial septal defect and various cardiac and noncardiac anomalies. Cardiac anomalies are left axis deviation of QRS, right bundle branch block, atrial fibrillation, Wolff-Parkinson-White syndrome, nodal atrioventricular rhythm, aortic stenosis, pulmonic valve stenosis, mitral stenosis (Lutembacher syndrome), and low implantation of the tricuspid valve (Ebstein disease). Noncardiac abnormalities consisted specially of the presence of hypertelorism, cleft lip, and pectus excavatum. This combination appears to constitute a hitherto undescribed autosomal dominant midline disorder of the heart and upper half of the body with almost full penetrance and variable expressivity. The mutation does not map to any known locus involved in atrial septal defect or conduction block. PMID:10096596

  20. Robinow Syndrome: A Rare Diagnosis.

    PubMed

    Mishra, Shubhankar; Agarwalla, Sunil Kumar; Pradhan, Swayanprava

    2015-12-01

    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

  1. Long-term Surveillance Comparing Satisfaction between the Early Experience of Nuss Procedure vs. Ravitch Procedure

    PubMed Central

    Park, Samina; Park, In Kyu; Kim, Young Tae; Kim, Joo Hyun

    2012-01-01

    Background Long-term surveillance comparing satisfaction between the early experience of Nuss procedure vs. Ravitch procedure. Materials and Methods A total of 100 patients that underwent surgical correction of a pectus excavatum between 2001 and 2004 and were followed for ?2 years were included. Surveillance on the degree of satisfaction was performed using five-levels of the Likert scale and self-assessment scoring. Results Nuss or Ravitch surgery was performed in 63 and 37 patients, respectively. The Nuss procedure required a shorter operation time and shorter hospital stay than the Ravitch procedure (p<0.001). The surveillance demonstrated that 17.6% of the Nuss group and 35.7% of the Ravitch group were not satisfied with the outcome of the surgery (p=0.072). The most common causes of dissatisfaction were redepression in the Nuss group (n=5) and incomplete correction in the Ravitch group (n=7). The multivariate analysis showed that reoperation and a high postoperative pectus index were significant risk factors for a low satisfaction score. Conclusion The Nuss procedure had several advantages over the Ravitch procedure in the immediate postoperative period. However, the long-term satisfaction was determined by a complete correction without recurrence or need for re-intervention rather than by the operation type. PMID:23130304

  2. 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

  3. 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

  4. 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.

  5. Validity and Reliability of the Turkish Version of the Nuss Questionnaire Modified for Adults

    PubMed Central

    Bahadir, A. Tugba; Kuru, Pinar; Afacan, Ceyda; Ermerak, Nezih Onur; Bostanci, Korkut; Yuksel, Mustafa

    2015-01-01

    Background Pectus excavatum (PE) is the most common chest wall deformity. The Nuss Questionnaire modified for Adults (NQmA) is a disease-specific health-related quality of life assessment tool for patients with pectus deformities. The aim of this study is to adapt the NQmA into Turkish. Methods Two hundred and sixty-five patients with PE were participated, with an age range of 14 to 29 years. All patients underwent a physical examination and had not undergone corrective surgery. The Turkish version of the NQmA was completed by patients and their parents. Results The content validity index based on expert opinions was 91% for the patient questionnaire and 96% for the parent questionnaire. The Cronbach’s alpha value for the NQmA was found to be 0.805 for the patient questionnaire and 0.800 for the parent questionnaire. Exploratory factor analysis was used to assess construct validity. Two factors explained 51.1% of the total variance in the patient questionnaire (psychosocial: 31.145%, Cronbach’s alpha=0.818; physical: 19.955%, Cronbach’s alpha=0.862). In the parent questionnaire, two factors explained 51.422% of the total variance (psychosocial: 26.097%, Cronbach’s alpha=0.743; physical: 25.325%, Cronbach’s alpha=0.827). Construct validity was confirmed by confirmatory factor analysis. Conclusion The Turkish version of the NQmA was found to be valid and reliable for the assessment of quality of life in patients with PE. PMID:25883894

  6. 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.

  7. 4q12-4q21.21 deletion genotype-phenotype correlation and the absence of piebaldism in presence of KIT haploinsufficiency.

    PubMed

    Hemati, Parisa; du Souich, Christèle; Boerkoel, Cornelius F

    2015-01-01

    Chromosome 4q deletion syndrome is a rare intellectual disability disorder caused by a variety of non-recurrent deletions of 4q. We describe the evolution of the phenotypic features of a female patient with a previously unreported deletion of 4q12-4q21.21 (hg 18; 54,711,575-79,601,919). By review reported individuals with interstitial deletions extending telomeric from 4q12 have syndromic intellectual disability with variable piebaldism. We expand the phenotype to include dolichocephaly, pectus excavatum, hip dysplasia, pes planus, myopia, lens opacities, and an absence of spoken language but not of communication through sign. The proposita also did not have piebaldism suggesting again that piebaldism arises from a mechanism more complex than simple haploinsufficiency of KIT. Comparing deletions among affected individuals localizes the critical interval within 4q12-4q13.1, although the absence of molecular boundaries for nearly all reported cases precludes precise delineation and genotype-phenotype correlation. PMID:25355368

  8. Previously Complicated Nuss Procedure Does Not Preclude Blind Removal of the Bar.

    PubMed

    Bilgi, Zeynep; Ermerak, Nezih Onur; Laçin, Tunç; Bostanc?, Korkut; Yüksel, Mustafa

    2016-01-01

    Background?Nuss procedure has become the procedure of choice for well-selected patients with pectus excavatum. Perioperative complications may pose difficulty during the subsequent bar removal due to adhesions and tissue plane disruptions during the initial surgery and repair. This report describes bar removal experience in patients whose Nuss procedures were complicated by cardiac injury, pericardial breach, and lung parenchyma/diaphragm injury during the initial procedure. Methods?A total of 529 patients who underwent Nuss procedure between 2007 and 2014 were recorded in a prospective database. Twenty patients with complications (cardiac injury [n?=?1], pericardial breach [n?=?3], and lung parenchyma/diaphragm injury [n?=?16]) were identified. All bars were removed via subcutaneous tissue dissection, without intrathoracic visualization. Results?Average duration of bars was 36 months (±16 months). All bar removal procedures were completed without any need for extra interventions with negligible blood loss. Eighteen patients were able to be discharged within 2 postoperative days. Conclusion?Blind bar removal in patients with previously complicated Nuss procedure seems safe and no other interventions (videothoracoscopy, subxiphoid incision, etc.) during bar removal seem to be necessary. PMID:26422553

  9. 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.

  10. Pulmonary sequelae in survivors of congenital diaphragmatic hernia.

    PubMed Central

    Falconer, A R; Brown, R A; Helms, P; Gordon, I; Baron, J A

    1990-01-01

    Nineteen survivors of congenital diaphragmatic hernia repair were compared with age and sex matched control children six to 11 years after repair. All subjects were examined clinically and underwent lung function testing. The patients also had individual lung volumes assessed radiographically and had radionuclide (krypton-81 m, technetium-99 m macroaggregates) ventilation-perfusion (V/Q) lung scans. Four patients had pectus excavatum and two had mild scoliosis. Spirometric measurements were lower in the patients than in the control subjects but only the differences in peak expiratory flow and flow at 50% of expired vital capacity were significant. The radiographic left lung volumes in patients surviving left diaphragmatic repair were larger than expected at 49.3% (SD 2%), suggesting alveolar overdistension. V/Q scans showed a mismatch in the ipsilateral lung, mean Q (40% (7%] being significantly lower than mean V (47% (6%)). In seven patients who had required ventilation for four days or more perfusion to the ipsilateral lung was significantly lower (34% (6%)) than values for the 12 patients ventilated for less than four days (43% (6%)). Survivors of right diaphragmatic repair had a better outcome in terms of relative radiographic lung volumes and V/Q distribution. More severely affected children are now surviving repair of congenital diaphragmatic herniation, with residual pulmonary abnormalities that could produce functional impairment in adult life. PMID:2315875

  11. Gastrointestinal manifestations in diploid/triploid mixoploidy.

    PubMed

    Lalani, Farida K; Elsner, Garrett L; Lebel, Robert Roger; Beg, Mirza B

    2015-06-01

    A girl infant was delivered by cesarean section at 32 weeks of gestation because of growth arrest and poor movement patterns. The infant had feeding problems, which were based on gastroesophageal reflux, laryngomalacia, and decreased gut motility. Hypotonia was notable from the outset, and the patient eventually displayed significant delays in both motor and cognitive milestones. Meanwhile, lymphocytes had yielded a normal karyotype (46,XX), but at 2 years of age the patient underwent a skin biopsy and mosaicism because a 68,XX cell line was discovered in fibroblasts. At the age 6.4 years, the patient is short of stature below the 3rd percentile but has a weight at the 42nd percentile and head circumference above the 97th percentile. Other phenotypic features include low-set ears, piebald irides and scalp hair, eyelid ptosis, strabismus, broad nasal bridge, anteverted nares, upswept eyebrows, hypoplastic teeth, pectus excavatum, hypoplastic labia, scoliosis, 3-4 finger syndactyly, and 2-3 toe syndactyly. We present this case with a review of the literature for mixoploidy (the rare event of mosaicism for diploid and triploid cell lines). We add to the existing data on the clinical features of diploid/triploid mixoploidy. The complexities of the gastrointestinal problems make this case unusual. PMID:25373857

  12. A Turkish patient of typical Loeys-Dietz syndrome with a TGFBR2 mutation.

    PubMed

    Tug, E; Loeys, B; De Paepe, A; Aydin, H; Gideroglu, K

    2010-01-01

    We describe a 2-year-old male patient with skeletal, neurological, cardiovascular, and connective tissue anomalies. Skeletal anomalies included pectus excavatum, hammer toes and hallux valgus and camptodactyly. The characteristic craniofacial findings of hypertelorism, down slanting palpebral fissures, strabismus, ptosis of eyelids, bifid uvula, high-arched palate and retrognathia were present. The proband has been operated on twice for bilateral inguinal hernia and several times for his foot deformities. Psychomotor development was retarded. At present, echocardiographic findings show aortic root dilation. The patient has important characteristics of Loeys-Dietz syndrome (LDS). Direct sequencing analysis of the transforming growth factor beta receptor I and II (TGFBR1 and 2) genes was performed and was demonstrated heterozygous missense mutation of the TGFBR2 gene in the patient, which confirms the diagnosis of LDS. This is the first Turkish patient with typical clinical signs of LDS. This report also illustrates that LDS and Shprintzen-Goldberg syndrome (SGS) have some common clinical characteristics. PMID:20681224

  13. A new syndrome: multiple congenital abnormalities and mental retardation in two brothers.

    PubMed

    Dundar, M; Ozdemir, S Y; Fryns, J P

    2012-01-01

    In this report we present two brothers with abnormal neurological development, hypotonia, short stature, pylorus stenosis, pectus excavatum, brachycephaly due to craniosynostosis, frontal bossing, depressed nasal bridge, high arched-wide palate, downslant palpebral fissures, low-set, large ears, thin upper lip and bilateral cryptorchidism. The brothers were born to a couple of second cousins and were the third and fourth pregnancies of the mother. The father, the mother and the eldest sibling were phenotypically and chromosomally normal. The clinical findings of the brothers were found to be similar. These clinical findings were compared with syndromes showing some of the symptoms, namely Apert, FG, Floating-Harbor, Shprintzen-Goldberg and Rett Syndromes. However, when the findings were detailed, we observed that they did not match completely any of the syndromes in a discernable way. The MECP2 gene mutation was analysed because of mental retardation, poor neurological evolution and large ears, but no mutation was found. So these cases are presented as a new syndrome with apparent autosomal recessive inheritance. PMID:22611637

  14. 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. © 2015 Wiley Periodicals, Inc. PMID:26420380

  15. Pigmentary mosaicism, subcortical band heterotopia, and brain cystic lesions.

    PubMed

    Ruggieri, Martino; Roggini, Mario; Spalice, Alberto; Addis, Maria; Iannetti, Paola

    2009-05-01

    A 10-year-old boy presented with a severe and diffuse mosaic skin hypopigmentation running (in narrow bands) along the lines of Blaschko associated with mosaic areas of alopecia, facial dysmorphism with midface hypoplasia, bilateral punctate cataract, microretrognathia, short neck, pectus excavatum, joint hypermobility, mild muscular hypotonia, generalized seizures, and mild mental retardation. Cranial magnetic resonance imaging revealed hypoplastic corpus callosum (primarily posterior), subcortical band heterotopia, and diffuse subcortical, periventricular cystic-like lesions. Similar dysmorphic features were observed in the child's mother, but with no imaging abnormalities. The facial phenotype coupled with the cysts in the brain was strongly reminiscent of the oculocerebrorenal Lowe syndrome. Full chromosome studies in the parents and the proband and mutation analysis on peripheral blood lymphocytes (and on skin cultured fibroblasts from affected and unaffected skin areas in the child) in the genes for subcortical band heterotopia (DCX (Xq22.3-q23)], lissencephaly (PAFAH1B1, alias LIS1, at 17p13.3), and oculocerebrorenal syndrome of Lowe (OCRL at Xq23-q24)] were unrevealing. This constellation of multiple congenital anomalies including skin hypopigmentation and eye, musculoskeletal, and nervous system abnormalities was sufficiently characterized to be regarded as a novel example of pigmentary mosaicism of the Ito type (i.e., hypomelanosis of Ito). PMID:19380077

  16. Haploinsufficiency of ANO6, NELL2 and DBX2 in a boy with intellectual disability and growth delay.

    PubMed

    Carlsen, Ellen Ø; Frengen, Eirik; Fannemel, Madeleine; Misceo, Doriana

    2015-08-01

    We report on a 10-year-old-boy presenting with moderate intellectual disability (ID), impaired motor skills, hypotonia, growth delay, minor anomalies, misaligned teeth, pectus excavatum, small hands and feet, widely spaced nipples, and a 1.13 Mb de novo deletion on HSA12q12 (chr12:44,830,147-45,964,945 bp, hg19), deleting ANO6, NELL2, and DBX2 and the pseudogenes PLEKHA8P1 and RACGAP1P. We suggest DBX2 and NELL2 as disease-causing genes and their haploinsufficiency to be involved in the psychomotor delay in the patient. DBX2 encodes a homeobox protein, highly expressed during neuronal development and regulating differentiation of interneurons in brain and spinal cord. NELL2 is expressed in most of the central and peripheral nervous system, with highest expression in hippocampus and cerebellum, maximizing during neuronal differentiation. The deletion in our patient is the smallest in HSA12q12 reported to date, and it is included in the deletion carried by four previously reported patients. The clinical presentation of these patients points to the recurrence of the following manifestation, possibly delineating a 12q12 deletion syndrome phenotype: moderate to severe developmental/intellectual delay, hypotonia, postnatal growth retardation, skeletal and dental anomalies, minor facial anomalies including strabismus, down slanting palpebral fissures, and large/low-set ears. PMID:25846056

  17. 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

  18. Importance of a multidisciplinary approach and monitoring in fetal warfarin syndrome.

    PubMed

    Silveira, Daniélle B; da Rosa, Ernani B; de Mattos, Vinicius F; Goetze, Thayse B; Sleifer, Pricila; Santa Maria, Fernanda D; Rosa, Rosana C M; Rosa, Rafael F M; Zen, Paulo R G

    2015-06-01

    Warfarin is a synthetic oral anticoagulant that crosses the placenta and can lead to a number of congenital abnormalities known as fetal warfarin syndrome. Our aim is to report on the follow-up from birth to age 8 years of a patient with fetal warfarin syndrome. He presented significant respiratory dysfunction, as well as dental and speech and language complications. The patient was the second child of a mother who took warfarin during pregnancy due to a metallic heart valve. The patient had respiratory dysfunction at birth. On physical examination, he had a hypoplastic nose, pectus excavatum, and clubbing of the fingers. Nasal fibrobronchoscopy showed upper airway obstruction due to narrowing of the nasal cavities. He underwent surgical correction with Max Pereira graft, zetaplasty, and osteotomies for the piriform aperture. At dental evaluation, he had caries and delayed eruption of the upper incisors. Speech and language assessment revealed high palate, mouth breathing, little nasal patency, and shortened upper lip. Auditory long latency and cognitive-related potential to auditory stimuli demonstrated functional changes in the cortical auditory pathways. We believe that the frequency of certain findings observed in our patient may be higher in fetal warfarin syndrome than is appreciated, since a significant number result in abortions, stillbirths, or children evaluated in the first year of life without a follow-up. Thus, a multidisciplinary approach and long-term monitoring of these patients may be necessary. PMID:25899236

  19. The efficacy of predeposited autologous blood transfusions in general pediatric surgery.

    PubMed

    Taguchi, T; Suita, S; Nakao, M; Yamanouchi, T; Inaba, S

    2000-01-01

    Allogeneic blood transfusions are associated with a risk of infection, immunological reactions, immunosuppression, and the induction of antibodies in blood cells. We report our results of giving predeposited autologous blood transfusions (PABT) to children when it was anticipated that transfusions would be required for an elective operation. Autologous blood was collected for deposit from 16 patients ranging in age from 1 to 11 years old (mean 5.6 years old, mode 4 years old), and weighing from 9.7 to 42 kg (mean 20.8kg). They included 12 patients with pectus excavatum (funnel chest) and 4 patients with choledochal cyst (CBD). Blood was collected once from 2 patients and twice from the other 14 patients, then centrifuged and stored in a freezer at -80 degrees C. Between 7 and 14 ml/kg was collected at one time, the total mean volume of predeposited blood being 21.0 +/- 3.3 ml/kg for the children operated on for funnel chest, and 16.2 +/- 4.5 ml/ kg for those operated on for CBD. None of the patients required allogeneic transfusions and no complications occurred. PABT was found to be a safe and effective means for elective general pediatric surgical procedures for avoidance of allogeneic blood transfusion. PMID:11039703

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

    PubMed Central

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

    2013-01-01

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

  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. [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

  3. Interstitial deletion 9q22.32-q33.2 associated with additional familial translocation t(9;17)(q34.11;p11.2) in a patient with Gorlin-Goltz syndrome and features of Nail-Patella syndrome.

    PubMed

    Midro, Alina T; Panasiuk, Barbara; Tümer, Zeynep; Stankiewicz, Pawe?; Silahtaroglu, Asli; Lupski, James R; Zemanova, Zuzana; Stasiewicz-Jarocka, Beata; Hubert, Ewa; Tarasów, Eugeniusz; Famulski, Waldemar; Zadrozna-To?wi?ska, Barbara; Wasilewska, Ewa; Kirchhoff, Marie; Kalscheuer, Vera; Michalova, Kyra; Tommerup, Niels

    2004-01-15

    The phenotype of Gorlin-Goltz syndrome or basal cell nevus syndrome (BCNS, #109400, OMIM), a Mendelian trait due to PTCH mutations has been reported in a few cases of interstitial deletion of chromosome 9q. We present an 11-year-old girl with clinical features consistent with BCNS including bridging of sella turcica, biparietal bossing, downward slanting palpebral fissures, mandible prognathism, pectus excavatum, thumb abnormalities, occult spina bifida at L5-S4, numerous basal cell nevi, and single basal cell carcinoma. Cytogenetic analysis using high-resolution banding techniques and fluorescence in situ hybridization (FISH) revealed interstitial chromosome deletion 9q22.32-q33.2 involving the PTCH gene as a secondary breakage event to a chromosome translocation t(9;17)(q34.1;p11.2)mat. Further FISH studies showed the translocation breakpoint on 9q34.11 maps proximal to ABL, between the BAC clone RP11-88G17 and the LMX1B gene. The latter gene encodes a transcription factor, in which loss of function mutations are responsible for the nail-patella syndrome (NPS, #161200 OMIM). Interestingly, some features of our proband (e.g., bilateral patellar dysplasia and abnormal clavicular shape), as well as her healthy sister who carries the same translocation, are also found in patients with NPS. The chromosome 17p11.2 breakpoint maps in the Smith-Magenis syndrome common deletion region, within two overlapping BAC clones, CTD-2354J3 and RP11-311F12. PMID:14699618

  4. Consequences of chromsome18q deletions.

    PubMed

    Cody, Jannine D; Sebold, Courtney; Heard, Patricia; Carter, Erika; Soileau, Bridgette; Hasi-Zogaj, Minire; Hill, Annice; Rupert, David; Perry, Brian; O'Donnell, Louise; Gelfond, Jon; Lancaster, Jack; Fox, Peter T; Hale, Daniel E

    2015-09-01

    Providing clinically relevant prognoses and treatment information for people with a chromsome18q deletion is particularly challenging because every unrelated person has a unique region of hemizygosity. The hemizygous region can involve almost any region of 18q including between 1 and 101 genes (30 Mb of DNA). Most individuals have terminal deletions, but in our cohort of over 350 individuals 23% have interstitial deletions. Because of this heterogeneity, we take a gene by gene approach to understanding the clinical consequences. There are 196 genes on 18q. We classified 133 of them as dosage insensitive, 15 (8%) as dosage sensitive leading to haploinsufficiency while another 10 (5%) have effects that are conditionally haploinsufficient and are dependent on another factor, genetic or environmental in order to cause an abnormal phenotype. Thirty-seven genes (19%) have insufficient information to classify their dosage effect. Phenotypes attributed to single genes include: congenital heart disease, minor bone morphology changes, central nervous system dysmyelination, expressive speech delay, vesicouretreral reflux, polyposis, Pitt-Hopkins syndrome, intellectual disability, executive function impairment, male infertility, aural atresia, and high frequency sensorineural hearing loss. Additionally, identified critical regions for other phenotypes include: adolescent idiopathic scoliosis and pectus excavatum, Virchow-Robin perivascular spaces, small corpus callosum, strabismus, atopic disorders, mood disorder, IgA deficiency, nystagmus, congenital heart disease, kidney malformation, vertical talus, CNS dysmyelination growth hormone deficiency and cleft palate. Together these findings make it increasingly feasible to compile an individualized syndrome description based on each person's individuated genotype. Future work will focus on understanding molecular mechanisms leading to treatment. PMID:26235940

  5. 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

  6. Congenital abnormalities and indicators of germinal mutations in the vicinity of an acrylonitrile producing factory.

    PubMed

    Czeizel, A E; Hegedüs, S; Tímár, L

    1999-06-30

    The results of an environmental mutation and teratologic epidemiological study are presented which was performed in inhabitants living in the surrounding region of an acrylonitrile factory in Nyergesújfalu. The endpoint of the study was congenital abnormalities in 46,326 infants born to mothers living in the 30 settlements of the study region within a 25 km radius of the acrylonitrile factory between 1980 and 1996. The ascertainment of cases with congenital abnormalities was based on the dataset of the Hungarian Congenital Abnormality Registry complemented with the review of pediatric, pathology and cytogenetic records. A particular attention was paid to the indicators of germinal mutations as sentinel anomalies, Down syndrome and unidentified multiple congenital abnormalities and the indicators of teratogens as the specific pattern of multiple congenital abnormalities. Three congenital abnormalities: pectus excavatum in Tata, 1990-1992 (OR with 95%CI: 78.5, 8.4-729.6), undescended testis in Nyergesújfalu between 1980 and 1983 (8.6, 1.4-54.3) and in Esztergom, 1981-1982 (4. 2, 1.3-13.5) and clubfoot in Tata, 1980-1981 (5.5, 1.5-20.3) showed significant time-space clusters in the study region. There was a decrease in risk of undescended testis with increasing distance from the acrylonitrile factory. An unusual increase was found in the combination of oral cleft and cardiac septal defects in multimalformed babies in Tatabánya, 1990. The detailed analysis of congenital abnormalities in all settlements of a given territory may help to detect clusters of congenital abnormalities and their possible relation to the environmental hazards. PMID:10393265

  7. 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?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 disease. PMID:23760293

  8. 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

  9. Tratamiento canonico del problema de Poincaré. Movimiento del polo.

    NASA Astrophysics Data System (ADS)

    Romero, P.; Sevilla, M. J.

    The rotational motion for a rigid Earth model with a homogeneous liquid core has been obtained using Hamilton's equations. From the canonical equations for the precessional und nutational motions in an inertial frame, the corresponding equations in an Earth fixed frame are deduced. The linearized equations obtained for polar motion and liquid core motion are equivalent to the Moritz's equations (1980).

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. 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...

  15. Increasing social capital via local networks: analysis in the context of a surgical practice.

    PubMed

    Thakur, Anjani; Yang, Isaac; Lee, Michael Y; Goel, Arpan; Ashok, Ashwin; Fonkalsrud, Eric W

    2002-09-01

    The relationship between social capital (support, trust, patient awareness, and increased practice revenue) and local networks (university hospital) in communities has received little attention. The development of computer-based communication networks (social networks) has added a new dimension to the argument, posing the question of whether local networks can (re-)create social capital in local communities. This relationship is examined through a review of the literature on local networks and social capital and a surgeon's practice management from 1990 to 2001 with respect to repair of pectus chest deformities. With respect to pectus repair there was a consistent but small number of new referrals (15-20 new patients/year), lack of patient awareness (eight to 12 self-referred patients/year), and modest practice revenue. Since the inception of an Internet website (social network) dedicated to pectus repair in 1996 there has been increased social participation (n = 630 hits/year to the website); facilitation of spread of information through E-mail messages (n = 430 messages/year); and a greater participation of groups such as women, minorities, adults, and those with disability (n = 120 patients/year). The dissemination of information via the local network has also allowed an "outward movement" with increased participation by interconnecting communities (n = 698,300 global Internet participants based on statistical ratios). We conclude that local networks have enhanced social networks providing new grounds for the development of relationships based on choice and shared interest. PMID:12356148

  16. 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.

  17. 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)

  18. Bruck syndrome - a rare syndrome of bone fragility and joint contracture and novel homozygous FKBP10 mutation.

    PubMed

    Moravej, Hossein; Karamifar, Hamdollah; Karamizadeh, Zohreh; Amirhakimi, Gholamhossein; Atashi, Sepideh; Nasirabadi, Shiva

    2015-01-01

    Bruck syndrome is an autosomal recessive syndrome consisting of bone fragility and congenital joint contractures. According to the genotype, it has been classified into types 1 and 2. Recently, mutations in FKBP10, localised to chromosome 17q21, have been identified in some patients of Bruck syndrome. Twenty-seven patients of this syndrome have been reported so far. We present a new patient of this syndrome, with frequent fractures, congenital joint contractures, kyphoscoliosis, bilateral clubfoot, and pectus carinatum. The clinical and genetic features of all previously reported cases are also reviewed. PMID:25931047

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

    PubMed Central

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

    2012-01-01

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

  20. Pulmonary Nontuberculous Mycobacterial Infection in Congenital Contractural Arachnodactyly

    PubMed Central

    Paulson, Michelle L.; Olivier, Kenneth N.; Holland, Steven M.

    2013-01-01

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

  1. Pathogenicity of Metarhizium anisopliae (Hypocreales: Clavicipitaceae) to tick eggs and the effect of egg cuticular lipids on conidia development.

    PubMed

    Gindin, Galina; Ment, Dana; Rot, Asael; Glazer, Itamar; Samish, Michael

    2009-05-01

    The ovicidal efficacy of two entomopathogenic hyphomycetes fungi--Metarhizium anisopliae variety acridum (M. an. ac.) Driver and Milner (Hypocreales: Clavicipitaceae) and Metarhizium anisopliae variety anisopliae (M. an. an.) (Metschn.) Sorokin (Hypocreales: Clavicipitaceae)--was evaluated against eggs of three tick species (Acari: Ixodidae)--Hyalomma excavatum (Koch), Rhipicephalus (Boophilus) annulatus (Say), and Rhipicephalus sanguineus (Latereille)--by placing eggs, laid by surface-sterilized females, on conidia-impregnated filter paper. Although M. an. an. strains differed in their virulence to the tested ticks, they reduced the hatching percentages of eggs of all three tick species to 0-32% compared with 80-90% in the control eggs. The M. an. ac. strains were found highly virulent to H. excavatum and R. sanguineus eggs, reducing the hatching percentages to 2-6% but had no influence on hatching of R. annulatus eggs. Older tick eggs were more susceptible to fungal infection than newly laid ones. The effects of polar and nonpolar lipid fractions, extracted from the surface of tick eggs, on the development of conidia were tested. Both germination of M. an. an. conidia and formation of appressoria were stimulated by extracts from egg cuticles of all three tested tick species. However, the stimulating effect was lower when the conidia were exposed to lipids from relatively less susceptible R. annulatus eggs than when exposed to lipids from H. excavatum or R. sanguineus eggs. Unlike those of M. an. an., conidia of M. an. ac. exposed to such lipid extracts did not germinate and did not form appressoria. PMID:19496424

  2. Problemas sexuales y de fecundidad (hombres)

    Cancer.gov

    Muchos tratamientos del cáncer y algunos tipos de cáncer pueden causar efectos secundarios relacionados con la sexualidad y con la fecundidad. Ya sea que usted tenga o no estos problemas depende del tipo de tratamiento que recibe, de su edad al tiempo del tratamiento y del tiempo que ha pasado desde el tratamiento.

  3. 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…

  4. [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

  5. Whole-exome sequencing reveals a novel COL2A1 mutation in a patient with spondylo-epiphyseal dysplasia congenita.

    PubMed

    Sangsin, A; Srichomthong, C; Pongpanich, M; Suphapeetiporn, K; Shotelersuk, V

    2016-01-01

    Skeletal dysplasia is a group of disorders with more than 450 entities, many of which cannot be differentiated, especially during infancy, but could lead to different clinical courses and prognoses. In this study, we have described a case of a Thai infant with short stature, flat face, pectus carinatum, indirect inguinal hernia, platyspondyly, and generalized delayed endochondral ossification. Using whole-exome sequencing (WES), we successfully identified a de novo heterozygous mutation, c.2024G>A (p.G675D), in the COL2A1 gene, which, to our knowledge, has not been previously reported. These molecular findings helped provide a definite diagnosis of spondyloepiphyseal dysplasia congenita, aiding in proper management of the disease and improved genetic counseling. We demonstrated that WES is an efficient and cost-effective tool for molecular diagnosis for a type II collagenopathy. PMID:26985960

  6. 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

  7. 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

  8. Pathological fractures as an initial presentation of Wilson's disease

    PubMed Central

    Verma, Rajesh; Junewar, Vivek; Sahu, Ritesh

    2013-01-01

    Wilson's disease (WD) has varied phenotypic presentations. Here we report the case of a 16-year-old boy who presented with a history of multiple pathological fractures, severe joint deformities, hepatic dysfunction, cognitive decline and limb dystonia. On examination, the patient had pinched out facies, pallor and leukonychia totalis. Bilateral Kayser Fleischer (KF) ring was present. Musculoskeletal examination revealed pectus carinatum, bilateral genu valgus and gun-stock deformity of the left elbow joint. Splenomegaly and moderate ascites were present. Neurological examination revealed mild rigidity and intermittent episodes of dystonic posturing of all four limbs. On this basis a diagnosis of WD with dystonia with cirrhosis of liver with portal hypertension with renal tubular acidosis with renal rickets was thought likely. Investigations confirmed the diagnosis. The patient was started on treatment but he did not improve. He suffered aspiration pneumonia during his hospital stay and succumbed to the illness. PMID:23576656

  9. A familial case of Coffin-Lowry syndrome caused by RPS6KA3 C.898C>T mutation associated with multiple abnormal brain imaging findings.

    PubMed

    Tos, T; Alp, M Y; Aksoy, A; Ceylaner, S; Hanauer, A

    2015-01-01

    Coffin-Lowry syndrome (CLS) is a rare X linked mental retardation syndrome characterised by severe psychomotor and growth retardation, distinct facial phenotype, and progressive skeletal malformations. It is caused by mutations in the RPS6KA3 gene located at Xp22.2. In this report we describe a family with CLS consists of three affected males, and two affected females, arising from c.898C>T mutation in RPS6KA3 gene. A 6 year-old, and a 3 year-old boy both had distinct clinical features of Coffin-Lowry syndrome; severe mental and motor retardation, microcephaly, prominent forehead, hypertelorism, large mouth, large ears, large soft hands, puffy tapered fingers, and pectus carinatum. In addition, they had multiple abnormal brain MRI findings. Other siblings presented with a mild and variable phenotype. PMID:26043507

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

    PubMed Central

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

    2012-01-01

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

  11. Benthic foraminifera distribution in a tourist lagoon in Rio de Janeiro, Brazil: a response to anthropogenic impacts.

    PubMed

    Vilela, Claudia Gutterres; Batista, Daniele Silva; Baptista Neto, José Antonio; Ghiselli, Renato Olindo

    2011-10-01

    Rodrigo de Freitas Lagoon, located in the Rio de Janeiro City, receives several types of polluted discharges. The knowledge of the sediment microfauna correlated with heavy metal and organic matter concentrations could supply important data about the conditions of the lagoon. The benthic foraminiferal assemblage presented larger diversity and more abundant samples in the lagoon entrance than in the inner area. The Ammonia tepida - Elphidium excavatum foraminiferal assemblage is characterized by dwarf, corroded and weak organisms. Agglutinated species were found only near the entrance. Low abundance values and sterility of five samples in the inner area (north/northeast) can be caused by high levels of heavy metals and organic matter. A. tepida shows negative correlation with increasing heavy metals values. PAHs and coprostanol high indexes, and the absence or low presence of microfauna in samples around the lagoon margin confirm illegal flows from gas stations and domestic sewage. PMID:21871637

  12. 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

  13. The most recent results on orchid mycorrhizal fungi in Hungary.

    PubMed

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

    2010-01-01

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

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

    PubMed

    Samimi-Namin, Kaveh; van Ofwegen, Leen P

    2016-01-01

    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

  15. 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

  16. Radioterapia

    Cancer.gov

    La radioterapia es un tratamiento del cáncer que usa altas dosis de radiación para destruir células cancerosas y reducir tumores. Aprenda los diferentes tipos de radiación y lo que usted puede esperar del tratamiento.

  17. 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.

  18. 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 ?18O and ?13C 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 ?13C values are very low (-4‰) and indicative of significant vital effect. The ?13C 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.

  19. A Comparison of Changes in Faunal Assemblages Over the Past 12,000 Years in Isafjardardjup, a Fjord in NW Iceland

    NASA Astrophysics Data System (ADS)

    Quillmann, U.; Andrews, J. T.; Jennings, A. E.

    2005-12-01

    This study compares faunal assemblages over the past 12,000 cal yrs in the context of changes in stable isotopic composition and sedimentology at two different sites in Isafjardardjup, a fjord in NW Iceland. Isafjardardjup (66 deg N, 23 deg W) was chosen for its high sedimentation rates and for its sensitive location to both polar atmospheric and polar oceanic fronts. Core MD99-2266 was selected to represent the outer fjord environment and Core B997-339 the inner fjord environment. Faunal assemblages have changed dramatically throughout this period. Elphidium excavatum forma clavata an opportunistic species that thrives in unstable environmental conditions, was present in large numbers at both sites during the early Holocene when land-based glaciers calved and sediments accumulated rapidly. During warmer times, Cassidulina laevigata was dominant. The outer fjord site was dominated by {Cibicides lobatulus}, an indicator of strong bottom currents. Cassidulina reniforme and E. excavatum, both indicators of cooler, arctic waters and varying salinity concentrations, are prevalent at the inner fjord site, but are not so significant at the outer fjord site. Overall, infaunal species, such as Nonion labradoricum, have dominated the inner fjord site throughout the Holocene. C. lobatulus tests, found at both locations were analyzed for stable isotopic composition, which is a function of temperature, salinity, and global ice volume. The outer fjord site shows lighter oxygen isotopes overall, suggesting warmer and/or fresher bottom waters. The oxygen isotopes at the inner fjord site lighten around 8000 cal yr BP by 0.3 per mil, a shift not recorded at the outer site. The mass accumulation rates (MAR) in the outer fjord site were ten times as high as those in the inner fjord site in the early Holocene, five times as high in the middle Holocene, and roughly the same over the past 5000 years.

  20. Acute toxicity of cadmium to two species of infaunal marine amphipods (tube-dwelling and burrowing) from New Zealand

    SciTech Connect

    Hickey, C.W.; Roper, D.S.

    1992-07-01

    Chapman reviewed the range of species and different response levels used in sediment toxicity testing. He recommended that a battery of sediment bioassays incorporating different response criteria should be used in sediment toxicity evaluations as there is no single test which gives adequate assessment of sediment toxicity. However, one test which is becoming accepted as the {open_quotes}benchmark{close_quotes} technique, and which is now commonly included in any battery of tests, is the amphipod bioassay. This test was developed in North America and uses the phoxocephalid Rhepoxynius abronius. It has been subjected to rigorous interlaboratory evaluation and its sensitivity and usefulness has been demonstrated in a wide range of applications. Unfortunately, species import controls makes the use of existing test species (such as R. abronius) impractical for sediment toxicity testing in New Zealand. In view of the demonstrated sensitivity, reproducibility and value of the amphipod bioassay, we therefore initiated preliminary studies to assess the possibility of developing a test with a native New Zealand amphipod. Examination of intertidal sediments in several northern New Zealand estuaries has shown that the amphipods Proharpinia hurleyi, Paracorophium excavatum and Paracalliope novizealandiae can be found, at times, in large numbers (hundreds per square metre). The results of benthic studies in Auckland`s Manaukau Harbour also suggested that P. excavatum and P. hurleyi may be sensitive to pollution, as these species were noticeably absent from sites where there was measurable sediment contamination. Using the protocol of Swartz et al., we undertook to test the sensitivity and laboratory performance of two local amphipod species; the tube-dweller P. contrasting modes of existence may differ in their level of exposure to sediment contaminants and, therefore, show different toxic responses. 12 refs., 2 tabs.

  1. 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 increase in trace metal concentration. The ecological changes may have been caused by increased productivity of diatoms resulting from beginning anthropogenic eutrophication. From the middle 1960's on, absolute foraminiferal abundance decreased and Ammonia beccarii, formerly absent or rare, became common to dominant in WLIS75GGC1; in B1GGC1 a similar but less severe change started in the 1970's. The increase in relative abundance of A. beccarii could have been caused by hypoxia (possibly in conjunction with rising bottom water temperatures), but both Ammonia and Elphidium species survive hypoxia in the laboratory. We suggest that high N/Si resulting from strong eutrophication might favor primary producers other than diatoms (e.g., dinoflagellates, cyanobacteria), making E. excavatum less competitive. The LIS coastal ecosystem thus changed significantly with the enhanced nutrient input associated with human population growth in the middle 1800's, and again with more severe eutrophication over the last few decades.

  2. 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 ? 18O, Sr/Ca and Mg/Ca values. The ? 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 ? 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 ? 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, ? 18O, dissolved carbonate, ? 13C in dissolved carbonate and Ca, Mg and Sr. Bottom water oxygen contents and temperatures were measured at the time of collection of living foraminifera. We calibrated the elemental and oxygen isotopic composition of carbonates for salinity and temperature using field measurements. We determined the difference between measured and predicted ? 13C, which is a measure of the amount of oxidized organic matter in the system. Our field results in the western part of LIS show that when oxygen levels are at or below 4mg/l, significantly lighter carbon isotopic compositions are observed than those predicted. Results from the mixing model calibrations will be applied to carbonates from 4 short cores to establish changes in temperature, salinity and dissolved oxygen in LIS over the last 400 years, and correlate these with faunal assemblage changes observed in the same samples.

  3. Molecular and serological detection of Theileria equi and Babesia caballi infection in horses and ixodid ticks in Iran.

    PubMed

    Abedi, Vali; Razmi, Golamreza; Seifi, Hesam; Naghibi, Abolghasem

    2014-04-01

    Equine piroplasmosis is a hemoprotozoan tick-borne disease with worldwide distribution that is caused by Theileria equi and Babesia caballi. However, the geographical distribution of equine piroplasmosis in Iran is unknown. The aim of the current study was to determine the causative agents and vector ticks of equine piroplasmosis in horses in the North Khorasan Province. In the year 2011, 100 horses were randomly selected from 14 villages. Blood samples and ixodid ticks were collected and examined using microscopical, molecular, and serological methods. Theileria equi infection was microscopically detected in 5 (5%) of the blood smears with low parasitemia, while serum samples were tested by the indirect immunofluorescent antibody test (IFAT). Antibodies against T. equi, B. caballi, and a mixed infection were detected in 48 (48%), 2 (2%), and 3 (3%) of the serum samples, respectively. A multiplex PCR was used to detect T. equi and B. caballi DNA in blood samples. No B. caballi infections could be found, but Theileria equi DNA was detected in 45 (45%) of the blood samples, and a BLAST analysis of the sequenced samples indicated a 99% similarity with T. equi 18S rRNA gene sequences in GenBank. Both molecular and serological results did not identify any significant association between T. equi infection and risk factors. A comparision of the results of 3 diagnostic methods demonstrated a poor agreement between microscopical examination with IFAT and PCR and a moderate agreement between IFAT and PCR. Thirty-seven adult ticks (20 females and 17 males) were collected from 15 horses. The most common tick was Hyalomma marginatum marginatum (n=19), followed by Hyalomma anatolicum excavatum (n=10), Rhipicephalus bursa (n=4), Hyalomma marginatum turanicum (n=3), and Hyalomma anatolicum anatolicum (n=1). The salivary glands and ovaries were also examined using PCR. The genomic DNA samples of the salivary glands of 3 ticks, H. a. excavatum (n=2) and R. bursa (n=1), had a positive reaction for T. equi, but no tick contained B. caballi DNA. Thus, our results indicate that T. equi occurs more frequently than B. caballi in the investigated geographical region. PMID:24556274

  4. Current and emerging treatments and surgical interventions for Morquio A syndrome: a review.

    PubMed

    Tomatsu, Shunji; Mackenzie, William G; Theroux, Mary C; Mason, Robert W; Thacker, Mihir M; Shaffer, Thomas H; Montaño, Adriana M; Rowan, Daniel; Sly, William; Alméciga-Díaz, Carlos J; Barrera, Luis A; Chinen, Yasutsugu; Yasuda, Eriko; Ruhnke, Kristen; Suzuki, Yasuyuki; Orii, Tadao

    2012-12-01

    Patients with mucopolysaccharidosis type IVA (MPS IVA; Morquio A syndrome) have accumulation of the glycosaminoglycans, keratan sulfate, and chondroitin-6-sulfate, in bone and cartilage, causing systemic spondyloepiphyseal dysplasia. Features include lumbar gibbus, pectus carinatum, faring of the rib cage, marked short stature, cervical instability and stenosis, kyphoscoliosis, genu valgum, and laxity of joints. Generally, MPS IVA patients are wheelchair-bound as teenagers and do not survive beyond the second or third decade of life as a result of severe bone dysplasia, causing restrictive lung disease and airway narrowing, increasing potential for pneumonia and apnea; stenosis and instability of the upper cervical region; high risk during anesthesia administration due to narrowed airway as well as thoracoabdominal dysfunction; and surgical complications. Patients often need multiple surgical procedures, including cervical decompression and fusion, hip reconstruction and replacement, and femoral or tibial osteotomy, throughout their lifetime. Current measures to intervene in disease progression are largely palliative, and improved therapies are urgently needed. A clinical trial for enzyme replacement therapy (ERT) and an investigational trial for hematopoietic stem cell transplantation (HSCT) are underway. Whether sufficient enzyme will be delivered effectively to bone, especially cartilage (avascular region) to prevent the devastating skeletal dysplasias remains unclear. This review provides an overview of historical aspects of studies on MPS IVA, including clinical manifestations and pathogenesis of MPS IVA, orthopedic surgical interventions, and anesthetic care. It also describes perspectives on potential ERT, HSCT, and gene therapy. PMID:24839594

  5. Gorlin–Goltz syndrome: A case series of 5 patients in North Indian population with comparative analysis of literature

    PubMed Central

    Lata, Jeevan; Verma, Nitin; Kaur, Amandeep

    2015-01-01

    Objective: In Indian scenario, Gorlin–Goltz syndrome (nevoid basal cell carcinoma syndrome [NBCCS]) has been rarely reported. The clinical, radiological, and histopathological findings and major and minor criteria in five cases of NBCCS in North Indian population have been presented along with a discussion of the role of gene mutation analysis in early diagnosis of syndrome. Materials and Methods: The diagnostic findings of Gorlin–Goltz syndrome in 5 patients were compared with other reports in Indian population and with reports of this syndrome in other parts of the world. Results: The most common features seen were keratocystic odontogenic tumors (100%), calcifications of falx cerebri (60%), palmar-plantar pits (80%), rib anomalies (80%), macroencephaly (60%), ocular hypertelorism (80%), and frontal bossing (60%) in our series. Retained deciduous teeth seen in 80% patients whose association has not been previously reported has been presented. None of our patients had basal cell carcinoma, syndactyly or polydactyly, pectus deformity, bridging of sella turcica, pigmented nevi, or family history of this syndrome in contrast to such findings in other Indian patients. Medulloblastoma has not been reported in any Indian patient so far compared to this finding in other studies conducted worldwide. Conclusions: Combining the features of 48 patients in 38 cases of NBCCS being published in Indian literature with five cases of our series and on comparison with other studies in the world, a wide disparity in different ethnic groups and a wide variation in presentation of syndrome within the same population is suggested. PMID:26604574

  6. A novel mutation (c.200T>C) in the NAGLU gene of a Korean patient with mucopolysaccharidosis IIIB.

    PubMed

    Kim, Young-Eun; Park, Hyung-Doo; Jang, Mi-Ae; Ki, Chang-Seok; Lee, Soo-Youn; Kim, Jong-Won; Cho, Sung Yoon; Jin, Dong-Kyu

    2013-05-01

    Mucopolysaccharidosis (MPS) IIIB is a lysosomal storage disorder (LSD) caused by abnormalities of the enzyme ?-N-acetylglucosaminidase (NAGLU) that is required for degradation of heparan sulfate. The patient in this study was a 4-yr-old boy. He presented with normal height and weight, pectus carinatum, and multiple persistent Mongolian spots on his back. He had mild dysmorphic features with prominent speech developmental delays and, to a lesser extent, motor developmental delays. The cetylpyridinium chloride precipitation test revealed excessive mucopolysacchariduria (657.2 mg glycosaminoglycan/g creatinine; reference range, <175 mg glycosaminoglycan/g creatinine). Thin layer chromatography showed urinary heparan sulfate excretion. NAGLU enzyme activity was significantly decreased in leukocytes (not detected; reference range, 0.9-1.51 nmol/hr/mg protein) as well as in plasma (0.14 nmol/hr/mg protein; reference range, 22.3-60.9 nmol/hr/mg protein). PCR and direct sequencing analysis of the NAGLU gene showed that the patient was a compound heterozygote for 2 mutations: c.200T>C (p.L67P) and c.1444C>T (p.R482W). The c.200T>C mutation was a novel finding. This is the first report of a Korean patient with MPS IIIB who was confirmed by molecular genetic analyses and biochemical investigation. PMID:23667853

  7. Shprintzen-Goldberg syndrome: fourteen new patients and a clinical analysis.

    PubMed

    Robinson, Peter N; Neumann, Luitgard M; Demuth, Stephanie; Enders, Herbert; Jung, Ursula; König, Rainer; Mitulla, Beate; Müller, Dietmar; Muschke, Petra; Pfeiffer, Lutz; Prager, Bettina; Somer, Mirja; Tinschert, Sigrid

    2005-06-15

    The Shprintzen-Goldberg syndrome (SGS) is a disorder of unknown cause comprising craniosynostosis, a marfanoid habitus and skeletal, neurological, cardiovascular, and connective-tissue anomalies. There are no pathognomonic signs of SGS and diagnosis depends on recognition of a characteristic combination of anomalies. Here, we describe 14 persons with SGS and compare their clinical findings with those of 23 previously reported individuals, including two families with more than one affected individual. Our analysis suggests that there is a characteristic facial appearance, with more than two thirds of all individuals having hypertelorism, down-slanting palpebral fissures, a high-arched palate, micrognathia, and apparently low-set and posteriorly rotated ears. Other commonly reported manifestations include hypotonia in at least the neonatal period, developmental delay, and inguinal or umbilical hernia. The degree of reported intellectual impairment ranges from mild to severe. The most common skeletal manifestations in SGS were arachnodactyly, pectus deformity, camptodactyly, scoliosis, and joint hypermobility. None of the skeletal signs alone is specific for SGS. Our study includes 14 mainly German individuals with SGS evaluated over a period of 10 years. Given that only 23 other persons with SGS have been reported to date worldwide, we suggest that SGS may be more common than previously assumed. PMID:15884042

  8. Arterial tortuosity and aneurysm in a case of Loeys-Dietz syndrome type IB with a mutation p.R537P in the TGFBR2 gene.

    PubMed

    Kiliç, Esra; Alanay, Yasemin; Utine, Eda; Ozgen-Mocan, Burçe; Robinson, Peter N; Boduro?lu, Koray

    2012-01-01

    We report a 13-year-old girl with Loeys-Dietz syndrome (LDS) caused by a known transforming growth factor beta receptor II (TGFBR2) gene mutation, who developed aortic root dilatation and saccular aneurysm of the internal carotid artery. LDS is a rare, autosomal dominant aortic aneurysm syndrome with multisystem involvement. The disease is typically characterized by the triad of arterial tortuosity and aneurysms, hypertelorism, and bifid uvula/cleft palate. The characteristic LDS symptoms observed in the reported case included craniofacial dysmorphism (hypertelorism, cleft palate, blue sclerae, malar hypoplasia, retrognathia), skeletal deformities (scoliosis, talipes equinovarus, pectus deformity, arachnodactyly), congenital heart defects (patent ductus arteriosus, PDA), and arterial tortuosity and aneurysms. Molecular genetic testing revealed a heterozygous mutation (c.1610 G>C, p.R528C) in the serine-threonine kinase domain of the TGFBR2 gene. Magnetic resonance (MR) angiography showed aortic dilatation, tortuosity of bilateral supraaortic arteries, and saccular aneurysm on the right cervical internal carotid artery. LDS resembles Marfan-related disorders (Marfan, Shprintzen-Goldberg and vascular Ehlers-Danlos syndrome), but arterial tortuosity and aneurysms are characteristic for LDS, so a timely diagnosis of LDS is important for early diagnosis and intervention of aneurysms to prevent vascular events. Here, we describe a LDS patient who presented with arterial tortuosity and saccular aneurysm. PMID:22734312

  9. 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.

  10. Current and emerging treatments and surgical interventions for Morquio A syndrome: a review

    PubMed Central

    Tomatsu, Shunji; Mackenzie, William G; Theroux, Mary C; Mason, Robert W; Thacker, Mihir M; Shaffer, Thomas H; Montaño, Adriana M; Rowan, Daniel; Sly, William; Alméciga-Díaz, Carlos J; Barrera, Luis A; Chinen, Yasutsugu; Yasuda, Eriko; Ruhnke, Kristen; Suzuki, Yasuyuki; Orii, Tadao

    2013-01-01

    Patients with mucopolysaccharidosis type IVA (MPS IVA; Morquio A syndrome) have accumulation of the glycosaminoglycans, keratan sulfate, and chondroitin-6-sulfate, in bone and cartilage, causing systemic spondyloepiphyseal dysplasia. Features include lumbar gibbus, pectus carinatum, faring of the rib cage, marked short stature, cervical instability and stenosis, kyphoscoliosis, genu valgum, and laxity of joints. Generally, MPS IVA patients are wheelchair-bound as teenagers and do not survive beyond the second or third decade of life as a result of severe bone dysplasia, causing restrictive lung disease and airway narrowing, increasing potential for pneumonia and apnea; stenosis and instability of the upper cervical region; high risk during anesthesia administration due to narrowed airway as well as thoracoabdominal dysfunction; and surgical complications. Patients often need multiple surgical procedures, including cervical decompression and fusion, hip reconstruction and replacement, and femoral or tibial osteotomy, throughout their lifetime. Current measures to intervene in disease progression are largely palliative, and improved therapies are urgently needed. A clinical trial for enzyme replacement therapy (ERT) and an investigational trial for hematopoietic stem cell transplantation (HSCT) are underway. Whether sufficient enzyme will be delivered effectively to bone, especially cartilage (avascular region) to prevent the devastating skeletal dysplasias remains unclear. This review provides an overview of historical aspects of studies on MPS IVA, including clinical manifestations and pathogenesis of MPS IVA, orthopedic surgical interventions, and anesthetic care. It also describes perspectives on potential ERT, HSCT, and gene therapy. PMID:24839594

  11. 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

  12. 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

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

    TOXLINE Toxicology Bibliographic Information

    Vilela CG; Figueira BO; Macedo MC; Baptista Neto JA

    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.

  14. 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

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

    PubMed Central

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

    1964-01-01

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

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

    PubMed

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

    2013-07-01

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

  17. 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

  18. Paleoenvironments of the Strait of Georgia, British Columbia during the last deglaciation: microfaunal and microfloral evidence

    NASA Astrophysics Data System (ADS)

    Guilbault, Jean-Pierre; Barrie, J. Vaughn; Conway, Kim; Lapointe, Martine; Radi, Taoufik

    2003-04-01

    The Strait of Georgia is situated between Vancouver Island and the western Canadian mainland. It was deglaciated quickly, around 12,500 14C yr BP, by in situ downwasting. The subsequent marine invasion has left glacimarine sediments with foraminifers, diatoms and dinocysts characterizing successive paleoenvironments recognizable basinwide. The first paleoenvironment represents near-ice conditions under the influence of the turbid meltwater plume marked by low algal productivity and few foraminifers, mostly Elphidium excavatum. Just off the plume, the second environment shows a peak of Nonionellina labradorica possibly resulting from an observed sudden increase in diatom numbers, mostly ice-dwelling forms implying a long annual sea-ice cover. Further away, Cassidulina reniforme increases, N. labradorica decreases while other calcareous foraminifer species colonize the area; there are fewer ice diatoms, more marine planktonic diatoms and dinocysts become more abundant. Finally, after 12,000 14C yr BP, calcareous foraminifers are gradually replaced because of dissolution of calcium carbonate by a low-diversity arenaceous assemblage. At the same time, abundant planktonic diatoms and dinocysts indicate warmer surface temperature. The succession of fossils and environments compares well with modern, horizontal, off-glacier successions observed in fjords of the European Arctic.

  19. 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

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

    PubMed

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

    2010-01-01

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

  1. 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

  2. Tick-borne bacteria in mouflons and their ectoparasites in Cyprus.

    PubMed

    Ioannou, Ioannis; Sandalakis, Vassilios; Kassinis, Nikos; Chochlakis, Dimosthenis; Papadopoulos, Byron; Loukaides, Fedias; Tselentis, Yannis; Psaroulaki, Anna

    2011-04-01

    The Cypriot mouflon (Ovis orientalis ophion), a once almost extirpated species of wild sheep, is under strict surveillance because it can be threatened by likely transmission of pathogenic bacteria, such as Anaplasma spp., Rickettsia spp., and Coxiella burnetii, primarily from domestic ungulates. We collected 77 blood samples from Cypriot mouflons and 663 of their ectoparasites (Rhipicephalus turanicus, Rhipicephalus sanguineus, Rhipicephalus bursa, Hyalomma anatolicum excavatum, Hyalomma marginatum, Haemaphysalis punctata, Haemaphysalis sulcata, and Ixodes gibossus) and tested them by polymerase chain reaction and sequencing. Twenty-three mouflon blood samples (30%) were positive for C. burnetii, 23 (30%) for Rickettsia spp., and 8 (10%) for Anaplasma ovis. Of 109 pools of ectoparasites, 32.1% were positive for C. burnetii, 28.4% for Rickettsia spp., and 10.9% for A. ovis; 11.9% were positive for both C. burnetii and Rickettsia spp., 6.4% for both Rickettsia spp. and A. ovis, and 2.8% for all three pathogens. This is the first survey that records the presence of tick-borne pathogens, both in the Cypriot mouflon and in ticks parasitizing it. PMID:21441182

  3. 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.

  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. 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.

  6. Hacer frente - Supervivencia

    Cancer.gov

    Información sobre la vida después del tratamiento, cómo planear los cuidados de seguimiento y cómo controlar los aspectos físicos, emocionales y familiares que usted puede enfrentar después del tratamiento.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. [Natural history of Morquio A disease].

    PubMed

    Baujat, G; Valayannopoulos, V

    2014-06-01

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

  14. A new lysosomal storage disorder resembling Morquio syndrome in sibs.

    PubMed

    Perrin, Laurence; Fenneteau, Odile; Ilharreborde, Brice; Capri, Yline; Gérard, Marion; Quoc, Emmanuel Bui; Passemard, Sandrine; Ghoumid, Jamal; Caillaud, Catherine; Froissart, Roseline; Tabet, Anne-Claude; Lebon, Sophie; El Ghouzzi, Vincent; Mazda, Keyvan; Verloes, Alain

    2012-03-01

    We report two male sibs, born from unrelated French Caribbean parents, presenting with an unclassifiable storage disorder. Pregnancy and delivery were uneventful. Stunted growth was noted during the first year of life. Both children have short stature (below - 4SD) with short trunk, barrel chest, micromelia with rhizomelic shortening, severe kyphoscoliosis, pectus carinatum, short hands and feet with metatarsus adductus, and excessive joint laxity of the small joints. Learning difficulties with borderline intelligence quotient (IQ) were noted in one of them. They had no hepatomegaly, no splenomegaly, and no dysmorphism. Skeletal X-rays survey demonstrated generalized platyspondyly with tongue-like deformity of the anterior part of the vertebral bodies, hypoplasia of the odontoid process, generalized epiphyseal dysplasia and abnormally shaped metaphyses. The acetabular roofs had a trident aspect. Ophthalmologic and cardiac examinations were normal. Spine deformity required surgical correction in one of the patient at age 4 years. Lysosomal enzymes assays including N-acetylgalactosamine-6-sulfate sulfatase and ?-galactosidase were normal, excluding mucopolysaccharidoses type IV A and IV B (Morquio syndrome), respectively. Qualitative analysis found traces of dermatan and chondroitin-sulfates in urine, but quantitative glycosaminoglycan excretion fell within normal limits. They were no vacuolated lymphocytes. Abnormal coarse inclusions were present in eosinophils. Mild Alder anomaly was observed in polymorphonuclears. Granulations were discretely metachromatic with toluidine blue. Those morphological anomalies are in favor of a lysosomal storage disease. No inclusions were found in skin fibroblasts. We hypothesize that these two boys have a distinct autosomal recessive or X-linked lysosomal storage disorder of unknown origin that shares clinical and radiological features with Morquio disease. PMID:22330346

  15. 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.

  16. 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

  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. 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 eutrophication, increased fresh water run-off due to urbanization and possibly re-routing of fresh water through waste water treatment plants, and increased organic carbon and trace metal storage in the sediments. A period of additional faunal changes started in the late 1960s, when overall foraminiferal abundance decreased, but Ammonia parkinsoniana, formerly absent or rare, became common to dominant especially in western LIS. This last faunal change might have resulted from even more increased eutrophication, with high N/Si values resulting in decreased dominance of primary producers by diatoms, affecting organisms that feed on them and thus reverberating through the whole ecosystem. We thus document a coastal ecosystem that changed significantly with human population growth in the middle 1800s, and again with more severe eutrophication over the last few decades.

  19. Hacer frente - La vida día a día

    Cancer.gov

    Información que trata sobre la vida diaria durante el tratamiento del cáncer. Incluye aspectos como mantener la rutina diaria, regresar al trabajo, la fe y la espiritualidad y los retos económicos.

  20. Bell's Palsy Treatment

    MedlinePLUS

    ... Answers Bell's Palsy and Sensitivity to Fluorescent Lighting Mar 10, 2014 Cataract Surgery After Bell's Palsy Feb ... m 20 years old. What could this be? Mar 30, 2011 Leer en Español: Tratamiento de la ...

  1. Mejor atención para niños con cáncer resulta en vidas más largas

    Cancer.gov

    Nuevos datos del Estudio sobre supervivientes de cánceres de la niñez indican que las mejoras en el tratamiento durante las últimas décadas han ayudado a extender la esperanza de vida de muchos supervivientes de cánceres de la niñez.

  2. Consejos para cuando le duelan la boca o la garganta

    Cancer.gov

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

  3. 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.

  4. Tomografía computarizada (TC) y exploraciones para cáncer

    Cancer.gov

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

  5. Symptoms of Aspergillosis

    MedlinePLUS

    ... en Riesgo y Prevención Fuentes Diagnóstico y Exámenes Tratamiento y Resultados Profesionales de la Salud Estadísticas C. ... Gets Fungal Infections HIV/AIDS Organ Transplant Patients Cancer Patients Hospitalized Patients Stem Cell Transplant Patients Medications ...

  6. Treatment and Outcomes of Aspergillosis

    MedlinePLUS

    ... en Riesgo y Prevención Fuentes Diagnóstico y Exámenes Tratamiento y Resultados Profesionales de la Salud Estadísticas C. ... Gets Fungal Infections HIV/AIDS Organ Transplant Patients Cancer Patients Hospitalized Patients Stem Cell Transplant Patients Medications ...

  7. Treatment and Outcomes of Histoplasmosis

    MedlinePLUS

    ... en Riesgo y Prevención Fuentes Diagnóstico y Exámenes Tratamiento y Resultados Profesionales de la Salud Estadísticas C. ... Gets Fungal Infections HIV/AIDS Organ Transplant Patients Cancer Patients Hospitalized Patients Stem Cell Transplant Patients Medications ...

  8. Aspergillosis

    MedlinePLUS

    ... en Riesgo y Prevención Fuentes Diagnóstico y Exámenes Tratamiento y Resultados Profesionales de la Salud Estadísticas C. ... Gets Fungal Infections HIV/AIDS Organ Transplant Patients Cancer Patients Hospitalized Patients Stem Cell Transplant Patients Medications ...

  9. Valley Fever (Coccidioidomycosis)

    MedlinePLUS

    ... en Riesgo y Prevención Fuentes Diagnóstico y Exámenes Tratamiento y Resultados Profesionales de la Salud Estadísticas C. ... Gets Fungal Infections HIV/AIDS Organ Transplant Patients Cancer Patients Hospitalized Patients Stem Cell Transplant Patients Medications ...

  10. Treatment for Valley Fever (Coccidioidomycosis)

    MedlinePLUS

    ... en Riesgo y Prevención Fuentes Diagnóstico y Exámenes Tratamiento y Resultados Profesionales de la Salud Estadísticas C. ... Gets Fungal Infections HIV/AIDS Organ Transplant Patients Cancer Patients Hospitalized Patients Stem Cell Transplant Patients Medications ...

  11. 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.

  12. 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 ...

  13. 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.

  14. 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 ...

  15. 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.

  16. Terapias adyuvantes y neoadyuvantes para el cáncer de seno

    Cancer.gov

    Hoja informativa que explica las terapias adyuvantes (tratamiento que se administra además de la terapia primaria para aumentar la posibilidad de supervivencia a largo plazo) y las neoadyuvantes (terapia que se administra antes de la terapia principal).

  17. Aspectos relacionados con la sexualidad y la reproducción (PDQ)—Versión para pacientes

    Cancer.gov

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

  18. Aspectos relacionados con la sexualidad y la reproducción (PDQ)—Versión para profesionales de salud

    Cancer.gov

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

  19. 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

  20. 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 not recognizable.

  1. Metarhizium anisopliae conidial responses to lipids from tick cuticle and tick mammalian host surface.

    PubMed

    Ment, Dana; Gindin, Galina; Soroker, Victoria; Glazer, Itamar; Rot, Asael; Samish, Michael

    2010-02-01

    Conidial germination and the formation of appressoria are important events in the interactions between entomopathogenic fungi and their arthropod hosts. In this study, we demonstrate the effects of lipids extracted from tick epicuticle and the surface of a mammalian host (calf) on conidial germination and the development of appressoria in two subspecies of Metarhizium anisopliae, M. anisopliae var. anisopliae (M.an.an.-7) and M. anisopliae var. acridum (M.an.ac.-5), which have different levels of virulence toward ticks. Pentane extracts of epicuticles of ticks susceptible and resistant to fungal infection always stimulated the germination of M.an.an.-7 conidia and the development of their appressoria; whereas the effects of dichloromethane (DCM) extracts of tick epicuticle varied depending on the tick. The DCM extracts from most of the tick species and developmental stages stimulated conidial germination and/or the formation of appressoria in M.an.an.-7. However, a DCM extract of lipids from the most resistant tick, engorged Hyalomma excavatum female, inhibited the germination of M.an.an.-7 conidia. Conidia of the non-virulent M.an.ac.-5 did not germinate on agarose amended with any of the examined tick extracts. However, when the tick extracts were placed on bactoagar, conidial germination increased 7- to 8-fold. Extracts from the skin, hair and ear secretions of a calf stimulated conidial germination and the formation of appressoria in M.an.an.-7, but not M.an.ac.-5. This study demonstrates that lipids from tick epicuticles and mammalian skin selectively affect the germination of conidia of entomopathogenic fungi. The effects of these lipids may explain the variability in tick control these fungi provide for different hosts. PMID:20036669

  2. [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

  3. Preliminary results of new benthic foraminifera Mg/Ca temperature calibrations and reconstruction of bottom water temperatures and salinity from a transect along the northern branch of the North Atlantic Current

    NASA Astrophysics Data System (ADS)

    Skirbekk, K.; Marchitto, T. M.; Hald, M.

    2012-12-01

    The purpose of the present study is to investigate the modern relationship between Mg/Ca in marine benthic foraminifera and bottom water temperatures in order to improve reconstructions of past ocean temperatures. Further we use the results of the modern relationship to investigate past temperatures in marine records from the Barents Sea and Svalbard margin covering the last 2 ka. In particular we aim to elucidate the natural variation in the inflow of warm Atlantic Water into the Arctic Ocean. In the years 2005-2010, several cruises during different seasons were conducted in the Svalbard area, retrieving both surface and down core samples. Five Arctic species of benthic foraminifera were collected in order to evaluate the relationship between Mg/Ca and temperature that can subsequently be used in down core temperature reconstructions. These species are: Nonionella labradorica, Cassidulina reniforme, Buccella frigida, Islandiella helenae and Elphidium excavatum forma clavata. Preliminary results indicate a correlation between temperature and Mg/Ca, and they also show interesting seasonal signals, implying the annual growth season for some of the species. More data points will be collected to draw more robust conclusions. In addition, three sediment cores containing sediments from the last 2K were collected creating a transect N-S (69-79 degrees N) along the flowpath of the North Atlantic Current: one from Malangen, northern Norway, one from the Barents Sea and one from Kongsfjorden, western Spitsbergen. The temperatures reconstructed from the Mg/Ca ratios were used to calculate the salinity contribution in the oxygen isotopes. Mg/Ca-ratios and stable isotopes show oscillations in temperature and salinity, hence elucidating which water masses prevailed at these sites during the last 2 ka.

  4. Benthic foraminifera record and geochemical studies to reconstruct the recent (~400 ya) paleoenvironment of Tomales Bay, California

    NASA Astrophysics Data System (ADS)

    Flores, S. C.; Hill, T. M.; Russell, A. D.; Brooks, G.

    2010-12-01

    We are conducting investigations of calcareous benthic foraminifera acquired from Tomales Bay, California to reconstruct geochemical conditions of the bay for the past ~400 years, a time period of both natural and anthropogenic environmental change. Tomales Bay, located ~50km northwest of San Francisco, is a long (20.4 km), narrow (0.7 - 1.7 km) and shallow (2.0 - 6.0 m) bay that exhibits long-residence times and is stratified in the summer due to seasonal hypersalinity. Tomales Bay is a unique environment for climate and environmental change research because of the wide documented variability in carbonate parameters (pH, alkalinity, DIC) due to freshwater input from terrestrial sources that decreases aragonite and calcite saturation states. The historical record provided by benthic foraminiferal species and geochemistry, sedimentary carbon (TOC and TIC) analyses, and investigations of recent (Rose-Bengal stained) foraminifera are being utilized to constrain 3 major processes: 1) the range of temperature and salinity shifts over the past 400 years, 2) the relative dominance of marine- vs. fresh-water sources to the bay, and 3) the extent to which freshwater input and runoff may influence water chemistry (saturation state, ?) with impacts on foraminiferal calcification. Four sediment cores were acquired in 2009 and 2010, and subsequently age-dated utilizing radiocarbon analyses (seven samples). Results indicate an increase in preservation of agglutinated versus calcareous foraminiferal tests (shells) since the mid-1900’s, and greater abundances of agglutinated tests found near freshwater sources. The major calcareous foraminifera present in the record include Elphidium hannai, Elphidium excavatum, Ammonia tepida, and Buccella frigida. Results from oxygen and carbon stable isotope analyses as well as total organic carbon (by weight) for all the cores will also be presented. These results will be compared to modern observations and instrumental records of temperature, salinity and pH variability to understand the context of historical changes compared to modern shifts due to human influence.

  5. AB168. Novel DYM compound heterozygous mutations in a Malaysian boy with Dyggve-Melchior-Clausen syndrome

    PubMed Central

    Ong, Winnie Peitee; Md Haniffa, Muzhirah Aisha; Leong, Huey Yin; Chew, Hui Bein; Ch’ng, Gaik Siew; Ngu, Lock Hock; Patel, Nisha; Hashem, Mais Omar; Alkuraya, Fowzan Sami; Keng, Wee Teik

    2015-01-01

    Background Dyggve-Melchior-Clausen (DMC) syndrome and Smith-McCort Dysplasia (SMC) are rare, progressive, autosomal recessive skeletal dysplasias caused by mutations in the Dymeclin (DYM) gene, mapped to chromosome 18q21.1. These are allelic disorders and share many features including short stature, a barrel-shaped chest, platyspondyly, abnormalities of the epiphyses and metaphyses, and a distinctive lacy appearance of the iliac crest. The distinguishing feature is that individuals with DMC have intellectual disabilities whereas SMC is associated with normal intelligence. Case presentation We present a 6-year-old Malaysian boy, the elder of two children born to a non-consanguineous Chinese couple. He was a term baby but was small and short for gestational age at birth. He initially presented to the paediatric endocrinologist for concerns of short stature and was subsequently referred prior to the age of three for suspicion of mucopolysaccharidosis (MPS) from his vertebral radiological findings. Clinical evaluation revealed that he had short stature, microcephaly and prominent pectus carinatum. He had normal early developmental milestones but on follow-up, it became obvious he had learning difficulties with expressive speech delay. His skeletal radiographs showed platyspondyly with a double hump and anterior breaking, broad ribs, widened metacarpals, abnormally shaped femoral heads and lacy crests of the iliac wings. Molecular testing of the DYM gene identified novel compound heterozygous mutations—a deletion c.242_249del8 in exon 4 was inherited from his father and a single nucleotide duplication c.1917dupT in exon 17 was inherited from his mother. Both these mutations cause a frameshift and result in aberrant mRNA processing. The parents are therefore heterozygous carriers. Our patient was initially thought to have Smith-McCort dysplasia SMC but his diagnosis had since been revised to DMC when it became evident he had speech delay and was faltering with his learning from the age of four. This diagnosis would also seem to be more in keeping with his genotypic change. A formal psychometric assessment was planned to evaluate his intelligence more objectively. Conclusions We wish to highlight the phenotypic and radiological features of this rare entity and the role of molecular testing. It is important to remember that certain other disorders especially Morquio A (MPS type IVA) may mimic this condition on vertebral radiological changes. Diagnosis confirmation with finding the DYM mutations not only allows for accurate genetic counselling and prenatal testing, but also directs one to be vigilant for potential life-threatening complications in this disorder like atlanto-axial instability.

  6. 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/Ca. These calibration data may reduce uncertainties surrounding deep-time estimates of continental ice volume as well as seawater temperature and chemistry.

  7. Paleoenvironmental History of Long Island Sound, CT, USA

    NASA Astrophysics Data System (ADS)

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

    2002-12-01

    Western Long Island Sound (LIS) is an urban estuary heavily impacted by waste water effluents from CT and New York city. The estuary has suffered seasonal hypoxia since the 1970s, and in 1999 lobsters suffered > 90% mortality. We used short sediment cores that cover the last several 100 years to reconstruct the temperature/salinity history of LIS, as well as its history of hypoxic episodes. We measured oxygen and carbon isotopic compositions and Mg/Ca and Sr/Ca in calcite tests of the benthic foraminifer Elphidium excavatum, collected alive (Rose Bengal stained) in grab samples and in core samples, as proxies for bottom water temperature and salinity. The level of bottom water oxygenation is derived from the carbon isotope values in foraminiferal calcite, after correction for paleosalinity. The strong seasonal temperature fluctuation in Long Island Sound bottom waters (about 20oC) and the long livespan of the foraminifer make precise paleotemperature estimates difficult. The oxygen isotope data (in vivo effect 1.1 o/_{oo} of the foraminiferal tests were recalculated at constant mean-annual water temperature (12.5^{o}C) into paleosalinities, ranging between 18 and 33 ^{o}/oo. The oxygen and carbon isotope ratios of river water, Long Island Sound water and dissolved inorganic carbon were used to construct a mixing model for the Sound. From calculated paleosalinities and the modern mixing model we derived expected carbon isotope ratios, which were subtracted from the observed values. We argue that the residuals (excess carbon isotope values) are proportional to the amount of organic carbon that was oxidized in these waters, and as such represent a proxy for paleohypoxia. Data from nine cores show no long term trends in salinity over the last 1000 years, but show more pronounced variations over the last 100 years. Several low salinity events could be correlated with wet climate periods documented in Southern New England. The excess carbon isotope values were between 0 and -1 o/_{oo} for most of the last millennium but became much more negative in the mid 18^{th} to 19^{th} century, with strong variability in the 20^{th} century. The low salinity events of the last 100 years correlate strongly with strongly negative excess carbon isotope values, suggesting a linkage between the wet periods and oxidation of organic matter on the bottom of the Sound (algal blooms, warm periods?). This linkage between low salinity events and strongly negative excess carbon isotope values did not occur prior to 1900 AD. More detailed dating (^{210}Pb, ^{137}$Cs) will improve the time resolution and correlation between cores of the various documented events.

  8. 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 sediment possessing excess 210Pb over sediments out of range of 210Pb dating. Based on 210Pb and 137Cs trends, as well as variations in different physio-chemical conditions present at each site, notably salinity, two short cores from the Albemarle Sound, one located at the head of the sound and the second 60 km away in the eastern part of the sound, were chosen for down core paleoenvironmental reconstruction using foraminiferal assemblages as environmental indicators. Analysis of these cores has enabled an historic reconstruction of environmental conditions within the AES, as well as an understanding of the taphonomic processes that affect estuarine foraminiferal assemblages.

  9. Paleoceanography and Ice Sheet-Ocean Interactions on the Central West Greenland Margin, LGM through Deglaciation

    NASA Astrophysics Data System (ADS)

    Jennings, A. E.; Andrews, J. T.; Ó Cofaigh, C.; St-Onge, G.; Belt, S. T.; Cabedo-Sanz, P.; Dowdeswell, J. A.

    2014-12-01

    Hemipelagic sediments in several central West Greenland trough mouth fan cores are critical for testing whether an ice shelf covered Baffin Bay during the late LGM and H1 (core HU2008029-12PC) and to investigate the role of ocean warming in initiating and/or sustaining retreat of the Greenland Ice Sheet from the shelf edge (cores JR175-VC29 & -VC46). We use benthic and planktic foram assemblages, IP25 sea ice biomarker, ice-rafted detritus (IRD), lithofacies and quantitative mineralogy to reconstruct paleoceanographic conditions. HU2008029-12PC comprises bioturbated, thin turbidites and hemipelagic sediments with Greenlandic provenance from >19.2 to 16.7 cal ka BP. Abundance spikes of planktic forams provide the radiocarbon dates in this interval and coincide with abundance spikes of benthic foram species indicative of chilled Atlantic Water and episodic marine productivity. IRD and IP25 are rare in this interval. These characteristics are consistent with the ice margin at the shelf edge meeting a heavily sea-ice covered ocean with chilled Atlantic Water at depth, rather than an ice shelf-covered ocean. Initial deglaciation from the West Greenland margin began c. 16.7 ka BP, as recorded by a lithofacies shift from turbidites to bioturbated mud with dispersed IRD and continued presence of Atlantic Water benthic species. After 16.7 ka BP, IP25, large diatoms and benthic forams indicative of sea-ice edge productivity show warming conditions. By 15.2 ka BP Greenlandic IRD and meltwater species, Elphidium excavatum, reflect accelerated ice sheet ablation. By 14.4 ka BP a strong rise in IP25 content, introduction of key Atlantic Water species Cassidulina neoteretis, and IRD spikes rich in detrital carbonate with a northern Baffin Bay provenance provide evidence for increased advection of West Greenland Current, collapse of the LIS ice streams, and formation of an IRD belt along the W. Greenland margin during the Bølling-Allerod and early Holocene warm intervals.

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

    PubMed Central

    Orkun, Ömer; Karaer, Zafer; Çakmak, Ayşe; Nalbantoğlu, Serpil

    2014-01-01

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

  11. The Early Geological History of Long Island Sound

    NASA Astrophysics Data System (ADS)

    Varekamp, J. C.; Thomas, E.

    2005-12-01

    Long Island Sound (LIS), an urban estuary on the east coast of the USA, formed when terminal moraines created Long Island (NY) during the last glaciation. During early deglaciation, a periglacial lake developed behind this moraine (Glacial Lake Connecticut), which was rapidly filled with red, varved lake clays. Glacial Lake Connecticut drained when a barrier at its eastern end towards the Atlantic Ocean failed, at about 18 (calibrated) ka. The LIS basin then dried out, and a fluvial drainage pattern was carved into the lake beds (Lewis and Stone, 1991). With ongoing rise in global sea level, the sea entered LIS from the east and a marine-estuarine sediment sequence was deposited on the partially eroded varved clays. Lake Hitchcock formed behind the rapidly retreating Laurentide ice sheet in eastern New England, drained (possibly catastrophically) around 14 (calibrated) ka (Brigham-Grette, 2001), and created a coarse deltaic structure in LIS. Radiocarbon dates on bulk organic matter from the varved lake clays and marine silts indicate a time frame for Glacial Lake Connecticut between 18 and 16 ka, with the marine transgression possibly occurring around 15 ka (Lewis and DiGiacomo-Cohen, 2000). We dated organic carbon (hand picked terrestrial plant fragments) and mollusk fragments from core samples. Calibrated radiocarbon ages from organic material (ours and existing dates) do not show a clear relationship between age and depth-in-core. Radiocarbon dates show consistently older dates of organic matter than mollusk fragments from the same samples, with differences of up to 3000 years. We infer that the plant remains were stored on land for extensive periods of time before being deposited in LIS. The radiocarbon ages from mollusks show a curvi-linear relationship with depth, and suggest an age of about 10 (calibrated) ka for the marine transgression at the location of core LISAT 12 (in eastern LIS off the coast near Orient Point, Long Island). This new time frame 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.

  12. Comments on controversial tick (Acari: Ixodida) species names and species described or resurrected from 2003 to 2008.

    PubMed

    Guglielmone, Alberto A; Robbins, Richard G; Apanaskevich, Dmitry A; Petney, Trevor N; Estrada-Peña, Agustín; Horak, Ivan G

    2009-08-01

    There are numerous discrepancies in recent published lists of the ticks of the world. Here we review the controversial names, presenting evidence for or against their validity and excluding some altogether. We also address spelling errors and present a list of 17 species described or resurrected during the years 2003-2008. We consider the following 35 tick species names to be invalid: Argas fischeri Audouin, 1826, Ornithodoros boliviensis Kohls and Clifford, 1964, Ornithodoros steini (Schulze, 1935), Amblyomma acutangulatum Neumann, 1899, Amblyomma arianae Keirans and Garris, 1986, Amblyomma bibroni (Gervais, 1842), Amblyomma colasbelcouri (Santos Dias, 1958), Amblyomma concolor Neumann, 1899, Amblyomma cooperi Nuttall and Warburton, 1908, Amblyomma curruca Schulze, 1936, Amblyomma cyprium Neumann, 1899, Amblyomma decorosum (Koch, 1867), Amblyomma nocens Robinson, 1912, Amblyomma perpunctatum (Packard, 1869), Amblyomma striatum Koch, 1844, Amblyomma superbum Santos Dias, 1953, Amblyomma testudinis (Conil, 1877), Amblyomma trinitatis Turk, 1948, Dermacentor confractus (Schulze 1933), Dermacentor daghestanicus Olenev, 1928, Haemaphysalis himalaya Hoogstraal, 1966, Haemaphysalis vietnamensis Hoogstraal and Wilson, 1966, Hyalomma detritum Schulze, 1919, Ixodes apteridis Maskell, 1897, Ixodes donarthuri Santos Dias, 1980, Ixodes kempi Nuttall, 1913, Ixodes neotomae Cooley, 1944, Ixodes rangtangensis Teng, 1973, Ixodes robertsi Camicas, Hervy, Adam and Morel, 1998, Ixodes serrafreirei Amorim, Gazetta, Bossi and Linhares, 2003, Ixodes tertiarius Scudder, 1885, Ixodes uruguayensis Kohls and Clifford, 1967, Ixodes zealandicus Dumbleton, 1961, Ixodes zumpti Arthur, 1960 and Rhipicephalus camelopardalis Walker and Wiley, 1959. We consider the following 40 names valid: Argas delicatus Neumann, 1910, Argas vulgaris Filippova, 1961, Ornithodoros aragaoi Fonseca, 1960, Ornithodoros dugesi Mazzoti, 1943, Ornithodoros knoxjonesi Jones and Clifford, 1972, Ornithodoros marocanus Velu, 1919, Ornithodoros nattereri Warburton, 1927, Amblyomma beaurepairei Vogelsang and Santos Dias, 1953, Amblyomma crassipes (Neumann, 1901), Amblyomma echidnae Roberts, 1953, Amblyomma fuscum Neumann, 1907, Amblyomma orlovi (Kolonin, 1995), Amblyomma parkeri Fonseca and Aragão, 1952, Amblyomma pseudoconcolor Aragão, 1908, Bothriocroton oudemansi (Neumann, 1910), Bothriocroton tachyglossi (Roberts, 1953), Dermacentor abaensis Teng, 1963, Dermacentor confragus (Schulze 1933), Dermacentor ushakovae Filippova and Panova, 1987, Haemaphysalis anomaloceraea Teng, 1984, Haemaphysalis filippovae Bolotin, 1979, Haemaphysalis pavlovskyi Pospelova-Shtrom, 1935, Hyalomma excavatum Koch, 1844, Hyalomma isaaci Sharif, 1928, Hyalomma rufipes Koch, 1844, Hyalomma turanicum Pomerantzev, 1946, Ixodes arabukiensis Arthur, 1959, Ixodes boliviensis Neumann, 1904, Ixodes columnae Takada and Fujita, 1992, Ixodes maslovi Emel'yanova and Kozlovskaya, 1967, Ixodes sachalinensis Filippova, 1971, Ixodes siamensis Kitaoka and Suzuki, 1983, Ixodes sigelos Keirans, Clifford and Corwin, 1976, Ixodes succineus Weidner, 1964, Rhipicephalus aurantiacus Neumann, 1907, Rhipicephalus cliffordi Morel, 1965, Rhipicephalus pilans Schulze, 1935, Rhipicephalus pseudolongus Santos Dias, 1953, Rhipicephalus serranoi Santos Dias, 1950 and Rhipicephalus tetracornus Kitaoka and Suzuki, 1983. PMID:19169832

  13. Cánceres infantiles

    Cancer.gov

    Los cánceres infantiles no siempre se tratan como los cánceres en adultos. La oncología pediátrica es una especialización médica que se concentra en la atención de niños con cáncer. Es importante saber que existen estos conocimientos especializados y que hay tratamientos eficaces para muchos cánceres infantiles.

  14. Tendencias del cáncer: Influjo en la atención y en prioridades de investigación

    Cancer.gov

    Muchas de las tendencias que observamos en el cáncer están cambiando cómo vemos el cáncer y cómo respondemos a él, desde impulsar la investigación hasta identificar las causas fundamentales de los cánceres que están aumentando en incidencia para dar forma a la investigación sobre el tratamiento y la prevención del cáncer.

  15. Estudio Lung-MAP: Protocolo modelo para el cáncer de pulmón de células escamosas

    Cancer.gov

    Conjunto de información sobre el estudio Lung-Map, el cual examinará los resultados del tratamiento en pacientes con cáncer de pulmón de células escamosas, quienes fueron asignados a recibir diferentes medicamentos dirigidos según los resultados del perfil genómico de sus tumores.

  16. 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.

  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. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  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. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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

  12. 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.

  13. 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

  14. 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.

  15. Diagnóstico y estadificación

    Cancer.gov

    El cáncer puede causar muchos síntomas diferentes. El doctor ordenará pruebas para determinar si los síntomas son causados por cáncer o por algún otro problema. Si se diagnostica cáncer, el doctor efectuará algunas pruebas para determinar el estadio. Al conocer el estadio, el doctor podrá hacer un plan de tratamiento y hablar del pronóstico.

  16. Medicina de precisión y terapia dirigida

    Cancer.gov

    Información sobre la función que desempeñan las terapias dirigidas en la medicina de precisión. Explica cómo las terapias dirigidas actúan contra el cáncer, quién recibe estas terapias, los efectos secundarios más comunes y lo que se debe esperar al recibir este tipo de tratamientos.

  17. 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.

  18. Preservación de la fertilidad mientras se combate el cáncer

    Cancer.gov

    Algunos oncólogos omiten hablar sobre la posibilidad de que el tratamiento contra el cáncer cause esterilidad en pacientes en edad reproductiva. Los investigadores están diseñando mecanismos para ayudar a los pacientes a tomar decisiones con conocimiento de causa sobre la fertilidad.

  19. Cómo está la genómica dando forma a la medicina de precisión en oncología

    Cancer.gov

    En laboratorios en el NCI y en el mundo, investigadores están usando tecnologías avanzada de genómica para estudiar las diferencias entre las células cancerosas y las células normales, lo que conduce a tratamientos nuevos y más efectivos para pacientes con cáncer.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. Steroids for Treating Cancer (For Parents)

    MedlinePLUS

    ... in this article? How Cortisol Can Help Side Effects Tips for Managing Treatment en español Esteroides para el tratamiento del cáncer When you hear the word "steroid" you may immediately think of muscle-bound body builders and the health risks they incur from ...

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  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. 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.

  1. 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.

  2. 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

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. 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.

  8. Cáncer de riñón—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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  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. 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.

  20. 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.

  1. Cáncer de piel—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.

  2. 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.

  3. 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.

  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. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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 cal 180+/-40 BP. The four fining-upwards sequences have sharp erosional basal contacts. These deposits appear to reflect back-barrier processes including sequential deposition of flood-tide delta sands and/or sound sands adjacent to marshes. The shelly sands, containing open shelf foraminiferal assemblages, represent oceanic overwash, inlet deposits, or open embayment sands deposited behind a laterally extensive breach in the barrier island. The sequences are capped by the deposits of modern environments that include algal flats, tidal creeks, high and low marshes, back-barrier berms, overwash fans, and aeolian dunes. Several of the modern environments became covered with marsh vegetation after the construction of barrier dune ridges in the late 1930?s.

  13. 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.

  14. 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

  15. 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.

  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 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

  18. 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.

  19. 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

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  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. 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.

  7. 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.

  8. 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

  9. 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

  10. 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

  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

    Objectives Rates of first-line treatment failure and switches to second-line therapy are key indicators for national HIV programmes. We assessed immunological treatment failure defined by WHO criteria in the Tanzanian national HIV programme. Methods We included adults initiating first-line therapy in 2004–2011 with a pre-treatment CD4 count, and ≥6-months of follow-up. We assessed subhazard ratios (SHR) for immunological treatment failure, and subsequent switch to second-line therapy, using competing risks methods to account for deaths. Results Of 121 308 adults, 7% experienced immunological treatment failure, and 2% died without observed immunological treatment failure, over a median 1.7 years. The 6-year cumulative probability of immunological treatment failure was 19.0% (95% CI 18.5, 19.7) and of death, 5.1% (4.8, 5.4). Immunological treatment failure predictors included earlier year of treatment initiation (P < 0.001), initiation in lower level facilities (SHR = 2.23 [2.03, 2.45] for dispensaries vs. hospitals), being male (1.27 [1.19, 1.33]) and initiation at low or high CD4 counts (for example, 1.78 [1.65, 1.92] and 5.33 [4.65, 6.10] for <50 and ≥500 vs. 200–349 cells/mm3, respectively). Of 7382 participants in the time-to-switch analysis, 6% switched and 5% died before switching. Four years after immunological treatment failure, the cumulative probability of switching was 7.3% (6.6, 8.0) and of death, 6.8% (6.0, 7.6). Those who immunologically failed in dispensaries, health centres and government facilities were least likely to switch. Conclusions Immunological treatment failure rates and unmet need for second-line therapy are high in Tanzania; virological monitoring, at least for persons with immunological treatment failure, is required to minimise unnecessary switches to second-line therapy. Lower level government health facilities need more support to reduce treatment failure rates and improve second-line therapy uptake to sustain the benefits of increased coverage. Objectifs Les taux d’échec du traitement de 1ère ligne et les passages au traitement de 2nde ligne sont des indicateurs clés pour les programmes nationaux VIH. Nous avons évalué l’échec immunologique du traitement selon les critères de l’OMS dans le programme national VIH tanzanien. Méthodes Nous avons inclus les adultes entreprenant une thérapie de 1ère ligne entre 2004 et 2011 avec une numération des CD4 prétraitement disponible et un suivi ≥6 mois. Nous avons évalué les rapports en dessous du risque pour l’échec immunologique du traitement et le passage subséquent à la thérapie de 2nde ligne, en utilisant les méthodes de risques concurrents pour tenir compte des décès. Résultats Sur 121.308 adultes, 7% ont connu un échec immunologique du traitement et 2% sont décédés sans observation d’échec immunologique du traitement, sur une médiane de 1,7 ans. La probabilité cumulée d’échec immunologique du traitement sur six ans était de 19,0% (IC95%: 18,5 à 19,7) et 5,1% (4,8 à 5,4) de décès. Les prédicteurs d’échecs immunologiques du traitement comprenaient: l'instauration précoce du traitement (p <0,001), l'initiation dans les établissements de niveau inférieur (SHR = 2,23 [2,03 à 2,45] pour les dispensaires versus les hôpitaux), le sexe masculin (1,27 [1,19 à 1,33]) et l'initiation du traitement à des taux de CD4 faibles ou élevés (par exemple, 1,78 [1,65 à 1,92] et 5,33 [4,65 à 6,10] pour des taux <50 et ≥500 versus des taux compris entre 200 et 349 cellules/mm3, respectivement). Sur 7.382 participants à l'analyse sur le moment du changement de traitement, 6% ont changé de traitement et 5% sont décédés avant le changement. Quatre ans après l’échec immunologique du traitement, la probabilité cumulative du changement de traitement était de 7,3% (6,6 à 8,0) et de 6,8% (6,0 à 7,6) pour les décès. Ceux qui ont connu un échec immunologique dans les dispensaires, les 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 [1.19,1.33]) e iniciar con conteos de CD$ bajos o altos (por ejemplo, 1.78 [1.65,1.92] y 5.33 [4.65,6.10] para <50 y ≥500 versus 200-349 células/mm3, respectivamente). De 7,382 participantes en el análisis de tiempo-hasta-el-cambio, un 6% cambió y un 5% murió antes del cambio. Cuatro años después del fallo terapéutico inmunológico, la probabilidad acumulativa de cambiar era del 7.3% (6.6,8.0) y de muerte, del 6.8% (6.0,7.6). Aquellos que tuvieron un fallo terapéutico inmunológico en los dispensarios, centros sanitarios y centros gubernamentales tenían una menor probabilidad de cambiar. Conclusiones Las tasas de fallo terapéutico inmunológico y una necesidad de segunda línea de tratamiento no resuelta son altas en Tanzania; la monitorización virológica, al menos en el caso de personas con fallo terapéutico inmunológico, es necesaria para minimizar los cambios innecesarios a la segunda línea de tratamiento. Los centros sanitarios gubernamentales de menor nivel requieren de más apoyo para reducir las tasas de fallo terapéutico y mejorar la aceptación de la segunda línea de tratamiento asegurando la continuidad de los beneficios de una mayor cobertura. PMID:25779383

  12. 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

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

  13. 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

  14. 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 ingesta de la sangre fresca y el mecanismo de acción asociado es la transferencia de defensas a quien lo consume. Conclusiones La utilización del Coragyps atratus como tratamiento para el cáncer es una terapia alternativa usada popularmente en Colombia. El uso de este animal debe estudiarse más a fondo para conocer los efectos clínicos en los pacientes con cáncer. PMID:22651097

  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. 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

  17. 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

  18. Differentiation syndrome in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and anthracycline chemotherapy: characteristics, outcome, and prognostic factors.

    PubMed

    Montesinos, Pau; Bergua, Juan M; Vellenga, Edo; Rayón, Chelo; Parody, Ricardo; de la Serna, Javier; León, Angel; Esteve, Jordi; Milone, Gustavo; Debén, Guillermo; Rivas, Concha; González, Marcos; Tormo, Mar; Díaz-Mediavilla, Joaquín; González, Jose D; Negri, Silvia; Amutio, Elena; Brunet, Salut; Lowenberg, Bob; Sanz, Miguel A

    2009-01-22

    Differentiation syndrome (DS) can be a life-threatening complication in patients with acute promyelocytic leukemia (APL) undergoing induction therapy with all-trans retinoic acid (ATRA). Detailed knowledge about DS has remained limited. We present an analysis of the incidence, characteristics, prognostic factors, and outcome of 739 APL patients treated with ATRA plus idarubicin in 2 consecutive trials (Programa Español de Tratamientos en Hematología [PETHEMA] LPA96 and LPA99). Overall, 183 patients (24.8%) experienced DS, 93 with a severe form (12.6%) and 90 with a moderate form (12.2%). Severe but not moderate DS was associated with an increase in mortality. A bimodal incidence of DS was observed, with peaks occurring in the first and third weeks after the start of ATRA therapy. A multivariate analysis indicated that a WBC count greater than 5 x 10(9)/L and an abnormal serum creatinine level correlated with an increased risk of developing severe DS. Patients receiving systematic prednisone prophylaxis (LPA99 trial) in contrast to those receiving selective prophylaxis with dexamethasone (LPA96 trial) had a lower incidence of severe DS. Patients developing severe DS showed a reduced 7-year relapse-free survival in the LPA96 trial (60% vs 85%, P = .003), but this difference was not apparent in the LPA99 trial (86% vs 88%). PMID:18945964

  19. The Differentiation Syndrome in Patients with Acute Promyelocytic Leukemia: Experience of the Pethema Group and Review of the Literature

    PubMed Central

    Montesinos, Pau; Sanz, Miguel A.

    2011-01-01

    Differentiation syndrome (DS), formerly known as retinoic acid syndrome, is the main life-threatening complication of therapy with differentiating agents (all-trans retinoic acid [ATRA] or arsenic trioxide [ATO]) in patients with acute promyelocytic leukemia (APL). The differentiation of leukemic blasts and promyelocytes induced by ATRA and/or ATO may lead to cellular migration, endothelial activation, and release of interleukins and vascular factors responsible of tissue damage. Roughly one quarter of patients with APL undergoing induction therapy will develop the DS, characterized by unexplained fever, acute respiratory distress with interstitial pulmonary infiltrates, and/or a vascular capillary leak syndrome leading to acute renal failure. Although the development of the DS, particularly of the severe form, is still associated with a significant increase in morbidity and mortality during induction, the early administration of high-dose dexamethasone at the onset of the first symptoms seems likely to have dramatically reduced the mortality rate of this complication. In this article, we will review the clinical features, incidence, prognostic factors, management, and outcome of the DS reported in the scientific literature. We will make focus in the experience of the three consecutive Programa Español de Tratamientos en Hematología trials (PETHEMA LPA96, LPA99, and LPA2005), in which more than one thousand patients were treated with ATRA plus idarubicin for induction. PMID:22220256

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

    PubMed

    Dispenzieri, Angela; 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

    2013-12-19

    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

  1. 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

  2. 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

  3. 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

  4. DISYUNTIVAS EN LAS CONCEPCIONES SOBRE AUTONOMÍA Y BENEFICENCIA QUE AFECTAN LA TERAPÉUTICA DEL INTENTO SUICIDA.

    PubMed

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

    2010-06-01

    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

  5. 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

  6. 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

  7. Sobre el estado evolutivo de ? Pictoris

    NASA Astrophysics Data System (ADS)

    Brunini, A.; Benvenuto, O. G.

    Desde el descubrimiento de fuertes excesos infrarrojos en ? Pictoris, esta estrella ha sido muy estudiada y es considerada candidata a poseer un sistema planetario propio. ? Pic está rodeada de un disco asimétrico de polvo que se observa de canto y que esta vacío a distancias <= 40 AU. Esto se considera una fuerte evidencia en favor de la presencia de (al menos) un planeta gigante. Recientemente se han observado líneas de material circunestelar que se han interpretado como consecuencia de la caída de objetos cometarios sobre esta estrella. Recientemente se ha utilizado la existencia del disco de polvo para atribuir una edad corta (pre - secuencia principal) a ?Pic. Sin embargo, la evaporación de estos cometas provee suficiente polvo como para explicar la presencia del disco observado sin necesidad de edades cortas. En este trabajo mostramos que la comparación entre la tasa de impactos cometarios estimada en el Sistema Solar para diferentes etapas de su evolución y los datos observados en ? Pic indica edades avanzadas para ? Pic. Esta estimación debe tomarse con cautela ya que depende de la estructura de los sistemas planetarios. Además mostramos que, desde el punto de vista de la evolución estelar y con las incertezas presentes en la luminosidad y la temperatura efectiva, existe un continuo de edades posible para ? Pic. Sin embargo, empleando los datos provenientes de los flujos cometarios encontramos que una edad prolongada es consistente con ambos tratamientos.

  8. 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

  9. 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.

  10. Prevalence and correlates of treatment failure among Kenyan children hospitalised with severe community-acquired pneumonia: a prospective study of the clinical effectiveness of WHO pneumonia case management guidelines

    PubMed Central

    Agweyu, Ambrose; Kibore, Minnie; Digolo, Lina; Kosgei, Caroline; Maina, Virginia; Mugane, Samson; Muma, Sarah; Wachira, John; Waiyego, Mary; Maleche-Obimbo, Elizabeth

    2014-01-01

    Objective To determine the extent and pattern of treatment failure (TF) among children hospitalised with community-acquired pneumonia at a large tertiary hospital in Kenya. Methods We followed up children aged 2–59 months with WHO-defined severe pneumonia (SP) and very severe pneumonia (VSP) for up to 5 days for TF using two definitions: (i) documentation of pre-defined clinical signs resulting in change of treatment (ii) primary clinician's decision to change treatment with or without documentation of the same pre-defined clinical signs. Results We enrolled 385 children. The risk of TF varied between 1.8% (95% CI 0.4–5.1) and 12.4% (95% CI 7.9–18.4) for SP and 21.4% (95% CI 15.9–27) and 39.3% (95% CI 32.5–46.4) for VSP depending on the definition applied. Higher rates were associated with early changes in therapy by clinician in the absence of an obvious clinical rationale. Non-adherence to treatment guidelines was observed for 70/169 (41.4%) and 67/201 (33.3%) of children with SP and VSP, respectively. Among children with SP, adherence to treatment guidelines was associated with the presence of wheeze on initial assessment (P = 0.02), while clinician non-adherence to guideline-recommended treatments for VSP tended to occur in children with altered consciousness (P < 0.001). Using propensity score matching to account for imbalance in the distribution of baseline clinical characteristics among children with VSP revealed no difference in TF between those treated with the guideline-recommended regimen vs. more costly broad-spectrum alternatives [risk difference 0.37 (95% CI −0.84 to 0.51)]. Conclusion Before revising current pneumonia case management guidelines, standardised definitions of TF and appropriate studies of treatment effectiveness of alternative regimens are required. Objectif Déterminer l'ampleur et les caractéristiques de l’échec du traitement (ET) chez les enfants hospitalisés avec une pneumonie acquise dans la communauté dans un grand hôpital tertiaire du Kenya. Méthodes Nous avons suivi des enfants âgés de 2 à 59 mois avec une pneumonie sévère (PS) et une pneumonie très sévère (PTS) telles que définies par l’OMS, sur un maximum de cinq jours pour l’ET, en utilisant deux définitions: (a) documentation des signes cliniques prédéfinis ayant entraîné un changement du traitement, (b) décision primaire du clinicien de changer de traitement avec ou sans documentation des mêmes signes cliniques prédéfinis. Résultats Nous avons recruté 385 enfants. Le risque d’ET variait de 1,8% (IC95%: 0,4 à 5,1) à 12,4% (IC95%: 7,9 à 18,4) pour la PS et de 21,4% (IC95%: 15,9 à 27) à 39,3% (IC95%: 32,5 à 46,4) pour la PTS selon la définition appliquée. Des taux plus élevés étaient associés à des changements précoces du traitement par le clinicien en l'absence d'une justification clinique évidente. Le non-respect des directives de traitement a été observé pour 70/169 (41,4%) et 67/201 (33,3%) enfants avec une PS et une PTS respectivement. Chez les enfants avec une PS, le respect des directives de traitement était associé avec la présence d'une respiration sifflante au cours l’évaluation initiale (P = 0,02) tandis que le non respect par les cliniciens des traitements recommandés pour la PTS tendait à se produire chez les enfants avec une altération de la conscience (P <0,001). L'utilisation du score de propension correspondant pour tenir compte du déséquilibre dans la répartition des caractéristiques cliniques de base chez les enfants avec une PTS n'a révélé aucune différence dans l’ET entre ceux traités avec le régime recommandé par les directives et ceux traités par des alternatives plus coûteuses à large spectre (différence de risque: 0,37 (IC95%: -0,84 à 0,51). Conclusion Avant la révision des directives actuelles de prise en charge des cas de pneumonie, des définitions standard d’ET et des études appropriées de l'efficacité des traitements alternatifs sont nécessaires. Objetivo Determinar la extensión y el patrón del fallo en el tratamiento (FT) en niños hospitalizados con una neumonía adquirida en la comunidad, ingresados en un gran hospital terciario de Kenia. Métodos Hemos seguido a niños con edades entre los 2-59 meses con una neumonía severa (NS) y neumonía muy severa (NMS) según definición de la OMS de hasta cinco días para FT utilizando dos definiciones: (a) documentación de signos clínicos pre-definidos que resultaron en un cambio de tratamiento (b) decisión del clínico principal de cambiar el tratamiento con o sin documentación de los mismos signos clínicos pre-definidos. Resultados Incluimos a 385 niños. El riesgo de FT varió entre un 1.8% (IC 95% 0.4 a 5.1) y 12.4% (IC 95% 7.9 a 18.4) para NS y 21.4% (IC 95% 15.9 a 27) y 39.3% (IC 95% 32.5 a 46.4) para NMS dependiendo de la definición que se aplicase. Unas mayores tasas estaban asociadas con cambios tempranos en la terapia por el clínico y en ausencia de un razonamiento clínico obvio. Se observaba una no adherencia a las guías de tratamiento en 70/169 (41.4%) y 67/201 (33.3%) de los niños con NS y NMS respectivamente. Entre los niños con SP, la adherencia a las guías de tratamiento estaba asociada con la presencia de sibilancias en la evaluación inicial (P=0.02) mientras que la no adherencia del clínico a los tratamientos recomendados por las guías para NMS tendían a ocurrir en niños con un estado alterado de consciencia (P<0.001). Utilizando el pareamiento por puntaje de propensión para equilibrar los grupos en la distribución de las características clínicas de base de los niños con NMS, se observó que no existían diferencias en FT entre aquellos tratados con el régimen recomendado por las guías versus alternativas más costosas de amplio espectro (diferencias de riesgo 0.37 (IC 95% -0.84 a 0.51). Conclusión Antes de revisar las actuales guías de manejo de casos de neumonía, se requieren definiciones estandarizadas de FT y estudios apropiados de la efectividad del tratamiento de regímenes alternativos. PMID:25130866

  11. 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

    The delivery of HIV care in the initial rapid scale-up of HIV care and treatment was based on existing clinic-based models, which are common in highly resourced settings and largely undifferentiated for individual needs. A new framework for treatment based on variable intensities of care tailored to the specific needs of different groups of individuals across the cascade of care is proposed here. Service intensity is characterised by four delivery components: (i) types of services delivered, (ii) location of service delivery, (iii) provider of health services and (iv) frequency of health services. How these components are developed into a service delivery framework will vary across countries and populations, with the intention being to improve acceptability and care outcomes. The goal of getting more people on treatment before they become ill will necessitate innovative models of delivering both testing and care. As HIV programmes expand treatment eligibility, many people entering care will not be ‘patients’ but healthy, active and productive members of society 1. To take the framework to scale, it will be important to: (i) define which individuals can be served by an alternative delivery framework; (ii) strengthen health systems that support decentralisation, integration and task shifting; (iii) make the supply chain more robust; and (iv) invest in data systems for patient tracking and for programme monitoring and evaluation. La délivrance des soins du VIH dans le déploiement initial rapide des soins et du traitement du VIH a été basée sur des modèles existants dans les cliniques, qui sont courants dans les régions bénéficiant d’importantes ressources et largement indifférenciées pour les besoins individuels. Un nouveau cadre est proposé ici pour le traitement basé selon les intensités variables de soins, adaptés aux besoins spécifiques des différents groupes de personnes à travers la cascade de soins. L’intensité des services est caractérisée 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 lo

  12. 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 grupos españoles han llevado, y siguen llevando a cabo, sobre sistemas débilmente enlazados, como complejos de Van der Waals o complejos por enlace de hidrógeno, que sin duda juegan un papel importante tanto en medios atmosféricos como interestelares.

  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. 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

  15. 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

  16. 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

  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. 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)

  19. 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

    Objectives To evaluate the feasibility (population reached, costs) and effectiveness (positivity rates, linkage to care) of two strategies of community-based HIV testing and counselling (HTC) in rural Swaziland. Methods Strategies used were mobile HTC (MHTC) and home-based HTC (HBHTC). Information on age, sex, previous testing and HIV results was obtained from routine HTC records. A consecutive series of individuals testing HIV-positive were followed up for 6 months from the test date to assess linkage to care. Results A total of 9 060 people were tested: 2 034 through MHTC and 7 026 through HBHTC. A higher proportion of children and adolescents (<20 years) were tested through HBHTC than MHTC (57% vs. 17%; P < 0.001). MHTC reached a higher proportion of adult men than HBHTC (42% vs. 39%; P = 0.015). Of 398 HIV-positive individuals, only 135 (34%) were enrolled in HIV care within 6 months. Of 42 individuals eligible for antiretroviral therapy, 22 (52%) started treatment within 6 months. Linkage to care was lowest among people who had tested previously and those aged 20–40 years. HBHTC was 50% cheaper (US$11 per person tested; $797 per individual enrolled in HIV care) than MHTC ($24 and $1698, respectively). Conclusion In this high HIV prevalence setting, a community-based testing programme achieved high uptake of testing and appears to be an effective and affordable way to encourage large numbers of people to learn their HIV status (particularly underserved populations such as men and young people). However, for community HTC to impact mortality and incidence, strategies need to be implemented to ensure people testing HIV-positive in the community are linked to HIV care. Objectifs Evaluer la faisabilité (population atteinte, coûts) et l'efficacité (taux de positivité, liaison aux soins) de deux stratégies de dépistage et conseil (DC) communautaire du VIH en zone rurale au Swaziland. Méthodes Les stratégies utilisées étaient des DC mobiles (DC-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) en zonas rurales de Suazilandia. Métodos Las estrategias utilizadas fueron la de APV en instalaciones clínicas móviles (APVM) y el APV realizado en el hogar (APVBH). Se obtuvo información sobre la edad, el sexo, la realización de pruebas anteriores y resultados de VIH de los informes rutinarios de APV. A una serie consecutiva de individuos que habían dado positivo en la prueba de VIH se les siguió durante 6 meses a partir del día de la prueba, con el fin de evaluar la conexión posterior a los cuidados y tratamiento adecuados. Resultados Se evaluaron 9,060 personas: 2,034 mediante APVM y 7,026 mediante APVBH. A una mayor proporción de niños y adolescentes (<20 años) se les realizó la prueba mediante APVBH que mediante APVM (57% vs. 17%; p<0.001). El APVM llegó a una mayor proporción de hombres adultos que el APVBH (42% vs. 39%; p=0.015). De 398 individuos VIH positivos, solo 135 (34%) estaban recibiendo atención y cuidados para el VIH después de 6 meses. De 42 individuos elegibles para Terapia Antirretroviral, 22 (52%) comenzaron el tratamiento dentro de los 6 meses siguientes a la prueba. La vinculación a los cuidados y atención para VIH posterior a la prueba era menor entre aquellos que habían dado previamente positivo y aquellos con edades entre 20-40 años. El APVBH era un 50% más barato (US$11 por persona a la que se le realizó la prueba, $797 por individuo recibiendo cuidados para VIH) que el APVM ($24 y $1698, respectivamente). Conclusión En este emplazamiento con una alta prevalencia de VIH, un programa de prueba para el VIH basado en la comunidad alcanzó un alto nivel de aceptación de la prueba, y parece ser una manera efectiva y económicamente asumible de animar a un gran número de personas a conocer su estatus de VIH (en particular población actualmente poco alcanzada como los hombres y personas jóvenes). Sin embargo, para que el APV comunitario tenga un impacto sobre la mortalidad y la incidencia, es necesario implementar estrategias apoyen el tratamiento, asegurando que las personas que dan positivo en la prueba son remitidas y reciben los cuidados adecuados. PMID:25753897

  20. 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

  1. 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

  2. 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

  3. Improving mating performance of mass-reared sterile Mediterranean fruit flies (Diptera: Tephritidae) through changes in adult holding conditions: demography and mating competitiveness

    SciTech Connect

    Liedo, P.; Salgado, S.; Oropeza, A.; Toledo, J.

    2007-03-15

    Mass rearing conditions affect the mating behavior of Mediterranean fruit flies (medflies) Ceratitis capitata (Wiedemann). We evaluated the effect of slight changes in the adult holding conditions of adult flies maintained for egg production on their mating performance. Colonization was initiated from wild flies collected as larvae from infested coffee berries (Coffea arabica L.). When pupae were close to adult emergence, they were randomly divided into 3 groups and the emerging adults were reared under the following conditions: (1) Metapa System (MS, control), consisting of 70 x 45 x 15 cm aluminum frame, mesh covered cages, with a density of 2,200 flies per cage and a 1:1 initial sex ratio; (2) Insert System (IS), with the same type of cage, and the same fly density and sex ratio as in the MS treatment, but containing twelve Plexiglas pieces (23 x 8.5 cm) to provide additional horizontal surface areas inside the cage; and (3) Sex-ratio System (SS), same as IS, but in this case the initial male: female ratio was 4:1. Three d later, newly emerged females were introduced, so the ratio became 3:1 and on the 6th d another group of newly emerged females was added to provide a 2:1 final sex ratio, at which the final density reached 1,675 flies per cage. The eggs collected from each of the 3 treatments were reared independently following standard procedures and the adults were held under the same experimental conditions. This process was repeated for over 10 to 13 generations (1 year). The experiment was repeated 3 times in 3 consecutive years, starting each replicate with a new collection of wild flies. Life tables were constructed for each treatment at the parental, 3rd, 6th, and 9th generations. Standard quality control parameters (pupation at 24 h, pupal weight, adult emergence, and flight ability), were estimated for each treatment every third generation in the third year. For the last generation each year, mating competitiveness was evaluated in field cage tests with wild flies. As colonization progressed, life expectancy and fecundity rates increased in the 3 rearing systems. There was no significant difference in standard quality control parameters among the 3 rearing systems. Wild males always achieved more matings than any of the mass reared males. Mating competitiveness of males from the IS, although surprisingly not from the SS, was significantly greater than that of males from the MS. Our results indicate that these slight changes in the adult holding conditions can significantly reduce the harmful effects of mass rearing on the mating performance of sterile flies. (author) [Spanish] Se ha demostrado que las condiciones de cria masiva afectan el comportamiento de apareamiento de la mosca del Mediterraneo Ceratitis capitata (Wiedemann). Nosotros evaluamos el efecto de ligeros cambios en las condiciones en las que los adultos son mantenidos para la produccion de huevos, en el desempeno de apareamiento de las moscas esteriles. La colonizacion se inicio con moscas silvestres colectadas como larvas en cerezas de cafe (Coffea arabica L.) infestadas. Cuando las pupas estuvieron cerca de la emergencia de los adultos, se dividieron en tres grupos al azar y los adultos recien emergidos fueron criados en las siguientes condiciones: (1) Sistema Metapa (MS, testigo), consistente en jaulas con marco de aluminio de 70 x 45 x 15 cm, cubiertas con malla, con una densidad de 2,200 moscas por jaula y una relacion de sexos inicial de 1:1; (2); Sistema Insertos (IS), con el mismo tipo de jaula, densidad de moscas, y relacion de sexos que en el MS, pero conteniendo 12 piezas de plexiglas (23 x 8.5 cm) para proporcionar superficie horizontal al interior de la jaula; y (3) Sistema de Relacion de Sexos (SS), igual que el IS, pero en este caso la relacion inicial macho: hembra fue de 4:1, tres dias despues se introdujeron hembras recien emergidas para tener una relacion de 3:1 y en el 6 dia se anadio otro grupo de hembras para tener una relacion final de sexos de 2:1, que equivale a una densidad final de 1,675 moscas por jaula. Los huevos colectados de cada tratamiento fueron criados independientemente siguiendo los procedimientos estandares y los adultos fueron mantenidos en las mismas condiciones experimentales. Esto se repitio por 10 a 13 generaciones (un ano). El experimento se repitio en tres ocasiones en anos consecutivos, iniciando cada repeticion con una nueva colecta de moscas silvestres. Se construyeron tablas de vida de cada tratamiento en las generaciones parental, 3 a, 6 a y 9 a . Se estimaron los parametros estandares de calidad (pupacion a las 24 h, peso de pupa, emergencia de adultos y habilidad de vuelo) para cada tratamiento, cada tercera generacion en el tercer ano. En la ultima generacion de cada ano, se evaluo la competitividad sexual en pruebas en jaulas de campo con moscas silvestres. Conforme avanzo la colonizacion, se encontro que la esperanza de vida y las tasas de fecundidad se incrementaron en los tres sistemas de cria. No hubo diferencia significativa en los parametros estandar de control de calidad entre los tres sistemas. Los machos silvestres siempre lograron mas apareamientos que los machos procedentes de cada sistema de cria masiva. La competitividad de los machos del sistema IS fue significativamente mayor que la de los machos del sistema MS. Nuestros resultados indican que estas ligeras modificaciones en las condiciones de la colonia de adultos reducen los efectos adversos de la cria masiva sobre el desempeno de apareamiento de los machos esteriles. (author)

  4. 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

    Background Canine flea-allergy dermatitis (FAD), a hypersensitivity response to antigenic material in the saliva of feeding fleas, occurs worldwide and remains a common presentation in companion animal veterinary practice despite widespread availability of effective systemic and topical flea-control products. Hypothesis/Objectives To evaluate the clinical response in dogs with FAD treated topically with indoxacarb, a novel oxadiazine insecticide. Animals Twenty-five client-owned dogs in Queensland, Australia diagnosed with pre-existing FAD on the basis of clinical signs, flea-antigen intradermal and serological tests. Methods An open-label, noncontrolled study, in which all dogs were treated with topical indoxacarb at 4 week intervals, three times over 12 weeks. Results Twenty-four dogs completed the study. Complete resolution of clinical signs of FAD was observed in 21 cases (87.5%), with nearly complete resolution or marked improvement in the remaining three cases. Mean clinical scores (Canine Atopic Dermatitis Extent and Severity Index-03) were reduced by 93.3% at week 12. Mean owner-assessed pruritus scores were reduced by 88% by week 12. Mean flea counts reduced by 98.7 and 100% in weeks 8 and 12, respectively. Conclusions and clinical importance Topical indoxacarb treatment applied every 4 weeks for 12 weeks, without concomitant antipruritic or ectoparasiticide therapy, completely alleviated flea infestations in all dogs and associated clinical signs of FAD in a high proportion of this population of dogs in a challenging flea-infestation environment. Résumé Contexte La dermatite par allergie aux piqures de puces (FAD), une hypersensibilité aux antigènes salivaires des puces, est décrite dans le monde entier et reste une présentation fréquente en médicine vétérinaire des animaux de compagnie malgré une large gamme d'antiparasitaires topiques et systémiques efficaces disponibles. Hypothèses/Objectifs Estimer la réponse clinique des chiens 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 oxadiacina. Animales 25 animales de propietarios particulares en Queensland, Australia, diagnosticados con FAD en base a los signos clínicos, y pruebas serológicas intradérmicas para el antígeno de las pulgas. Métodos se realizó un estudio abierto no controlado en el cual los perros fueron tratados con indoxacarb por vía tópica a intervalos de cuatro semanas, tres veces en el curso de 12 semanas. Resultados 24 perros completaron el estudio. La resolución completa de los signos clínicos de FAD fue observada en 21 casos (87,5%), con casi completa resolución o una marcada mejora en los restantes tres casos. El valor medio de evaluación clínica (índice de extensión y severidad de la dermatitis atópica canina-03) se redujo un 93,3% en la semana 12. Los valores medios de prurito evaluados por los propietarios se redujeron en un 88% en la semana 12 los recuentos medios de pulgas se redujeron un 98,7 y un 100% en las semanas 8 y 12, respectivamente. Conclusiones e importancia clínica el tratamiento tópico con indoxacarb aplicado cada cuatro semanas durante 12 semanas, sin tratamientos complementarios antipruriticos o terapia ectoparásiticida, alivian completamente la infestación por pulgas en todos los perros y los signos clínicos asociados con FAD en una alta proporción de esta población de perros en un ambiente con contacto con pulgas. Zusammenfassung Hintergrund Die Flohspeichelallergie des Hundes (FAD), bei der es sich um eine Hypersensibilitätsreaktion auf das Antigenmaterial im Speichel von saugenden Flöhen handelt, kommt weltweit vor und stellt einen häufigen Vorstellungsgrund in der Kleintierpraxis dar, obwohl weltweit wirksame systemische und topische Flohkontrollprodukte verfügbar sind. Hypothese/Ziele Eine Evaluierung der klinischen Antwort von Hunden mit FAD, die topisch mit Indoxacarb, einem neuen Oxadiazin Insektizid, behandelt worden waren. Tiere Fünfundzwanzig private Hunde in Queensland, Australien, die mit bereits existierender FAD basierend auf klinischer Symptomatik, positiven Intradermaltests und positiver Serologie auf Flohallergen diagnostiziert worden waren. Methoden Eine offene, nicht kontrollierte Studie, in der alle Hunde mit topischem Indoxacarb in 4 wöchigen Intervallen, drei Mal über einen Zeitraum von 12 Wochen behandelt wurden. Ergebnisse Vierundzwanzig Hunde beendeten die Studie. Eine gänzliche Abheilung der klinischen Anzeichen von FAD wurde in 21 Fällen beobachtet (87,5%), bei nahezu völligem Verschwinden oder einer deutlichen Verbesserung in den restlichen drei Fällen. Die durchschnittlichen klinischen Werte (Canine Atopic Dermatitis Extent and Severity Index-03) waren in der zwölften Woche um 93,3% reduziert. Die durchschnittlichen, von den BesitzerInnen beurteilten, Juckreizwerte waren in der zwölften Woche um 88% reduziert. Die durchschnittliche Anzahl an Flöhen war in den Wochen 8 und 12 um 97,7 bzw 100% reduziert. Schlussfolgerungen und klinische Bedeutung Indoxacarb, welches topisch alle 4 Wochen 12 Wochen lang ohne begleitende juckreizstillende Behandlung oder einer Behandlung von Ektoparasiten verabreicht wurde, milderte die Flohinfestationen bei allen Hunden und die mit FAD auftretenden klinischen Symptome in einer großen Proportion dieser Hundepopulation, die in einer schwierigen Umgebung mit hohem Flohvorkommen, lebten. PMID:24797425

  5. 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

  6. Non-muscle invasive bladder cancer risk stratification

    PubMed Central

    Isharwal, Sumit; Konety, Badrinath

    2015-01-01

    Introduction: Non-muscle invasive bladder cancer (NMIBC) comprises about 70% of all newly diagnosed bladder cancer, and includes tumors with stage Ta, T1 and carcinoma in situ (CIS.) Since, NMIBC patients with progression to muscle-invasive disease tend to have worse prognosis than with patients with primary muscle-invasive disease, there is a need to significantly improve risk stratification and earlier definitive treatment for high-risk NMIBC. Materials and Methods: A detailed Medline search was performed to identify all publications on the topic of prognostic factors and risk predictions for superficial bladder cancer/NMIBC. The manuscripts were reviewed to identify variables that could predict recurrence and progression. Results: The most important prognostic factor for progression is grade of tumor. T category, tumor size, number of tumors, concurrent CIS, intravesical therapy, response to bacillus Calmette–Guerin at 3- or 6-month follow-up, prior recurrence rate, age, gender, lymphovascular invasion and depth of lamina propria invasion are other important clinical and pathological parameters to predict recurrence and progression in patients with NMIBC. The European Organization for Research and Treatment of Cancer (EORTC) and the Spanish Club UrológicoEspañol de Tratamiento Oncológico (CUETO) risk tables are the two best-established predictive models for recurrence and progression risk calculation, although they tend to overestimate risk and have poor discrimination for prognostic outcomes in external validation. Molecular biomarkers such as Ki-67, FGFR3 and p53 appear to be promising in predicting recurrence and progression but need further validation prior to using them in clinical practice. Conclusion: EORTC and CUETO risk tables are the two best-established models to predict recurrence and progression in patients with NMIBC though they tend to overestimate risk and have poor discrimination for prognostic outcomes in external validation. Future research should focus on enhancing the predictive accuracy of risk assessment tools by incorporating additional prognostic factors such as depth of lamina propria invasion and molecular biomarkers after rigorous validation in multi-institutional cohorts. PMID:26604439

  7. 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 condicionar los machos anteriormente a las condiciones de campo en Madeira no conferio ventaja alguna en el desempeno sexual en la jaula de campo. (author)

  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 artículo abordamos el potencial rol de la psicología para servir como vehículo de reconstrucción de dichas nociones, tomando en consideración su propio rol en la formación y mantenimiento de dicho sujeto socialmente deseable. PMID:22025907

  9. [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

  10. [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

  11. 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

  12. 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

  13. [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

  14. 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. En este artículo abordamos el potencial rol de la psicología para servir como vehículo de reconstrucción de dichas nociones, tomando en consideración su propio rol en la formación y mantenimiento de dicho sujeto socialmente deseable. PMID:22025907

  15. 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

  16. 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.

  17. 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

  18. 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 DFS and OS at 5 years were 60% and 90%. The DFS and OS were not reached at 10 years. The differences among the 3 phases in CR, DFS and OS were highly significant (P < 0.001). PMID:15453925

  19. [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

  20. Medicinal ethnobotany in Huacareta (Chuquisaca, Bolivia)

    PubMed Central

    2012-01-01

    Background The aim of this study was to document the types of diseases treated by the use of medicinal plants, their main applications and also to have a report of the major diseases treated at the Hospital of San Pablo de Huacareta (Chuquisaca Bolivia). Methods We conducted semi-structured interviews on the use medicinal plants with 10 local informants, and categorized the kinds of diseases treated by traditional medicine. We obtained reports of cases treated at the Hospital of Huacareta in order to compare the use frequency of traditional medicine and allopathic medicine for the treatment of recurrent diseases in the area. Results Our survey identified 258 traditional medicine uses, spanning a total of 13 diseases categories and including 91 native and exotic plant species and one unidentified sample plant type. Gastrointestinal disorders (55%) were most frequently treated with medicinal plants, followed by afflictions of the musculoskeletal system (25%) and dermatological disorders (24%). Hospital information indicates that the most common diseases are acute respiratory infections (47%) and acute diarrheal diseases (37%). The herbal remedies were mostly used in the form of teas and decoctions. The informants used mainly native plant species, although exotic species has been introduced to the pharmacopoeia. Conclusions The treatment of gastrointestinal disorders is the primary objective of the medical ethnobotany of the inhabitants of Huacareta, while respiratory system diseases are mostly treated in the hospital. Looking at the data from the Hospital records we can infer that gastrointestinal disorders are among the most common diseases in the study area. For most respondents, traditional medicine is a reliable choice for the care of their illnesses. However, the preference of the population for either traditional medicine or allopathic medicine needs to be clarified in future comparative studies to obtain more convincing results. The results presented can be used as a base for subsequent work related to traditional medicine and its contribution to allopathic medicine in San Pablo de Huacareta. Resumen Introducción El objetivo del presente estudio fue documentar los tipos de enfermedades tratadas mediante el uso de plantas medicinales, sus aplicaciones principales y también tener un reporte de las enfermedades mayormente atendidas en el Hospital de San Pablo de Huacareta (Chuquisaca, Bolivia). Métodos Se realizaron encuestas semiestructuradas a 10 informantes locales anotando los usos atribuidos a sus plantas medicinales, se agruparon las plantas por categorías de enfermedades tratadas en la medicina tradicional. Se obtuvieron reportes de casos tratados en el Hospital de Huacareta para poder relacionar el tratamiento de enfermedades recurrentes en la zona entre la medicina tradicional y la medicina occidental. Resultados Se reportaron 91 especies nativas y exóticas, además de un espécimen indeterminado exótico que intervienen en un total de 258 aplicaciones medicinales, las cuales son empleadas en un total de 13 categorías de enfermedades. Los desórdenes gastrointestinales (55%) son mayormente tratados mediante plantas medicinales, seguidas de las afecciones al sistema esqueleto-muscular (25%) y enfermedades dermatológicas (24%). La información del Hospital indica que las enfermedades más frecuentes son Infecciones Respiratorias Agudas (47%) y Enfermedades Diarreicas Agudas (37%). Los remedios vegetales se emplean en forma de infusiones y cocciones principalmente. Se emplean mayormente plantas nativas, también se introdujo en la farmacopea médica el uso de plantas exóticas al lugar. Conclusiones El tratamiento de trastornos gastrointestinales constituye el objetivo primordial de la etnobotánica médica de los habitantes de Huacareta, las enfermedades del sistema respiratorio, son mayormente tratadas en el Hospital. Observando los datos del libro de consultas del Hospital, se puede inferir que los desórdenes gastrointestinales están entre las enfermedades más frecuentes en el área estudiada. Para la mayoría de los entrevistados, la medicina tradicional es una opción confiable para la atención de sus enfermedades. Sin embargo, la preferencia de los habitantes entre la medicina tradicional y la medicina alopática podría ser clarificada a partir de futuros estudios comparativos que permitan obtener resultados más convincentes. Los resultados expuestos pueden ser usados como una base de datos para posteriores trabajos relacionados a la medicina tradicional y su contribución con la medicina alopática en San Pablo de Huacareta. PMID:22856877

  1. 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

    The sterile insect technique (SIT) is increasingly being used around the world to control Ceratitis capitata (Wiedemann) (Diptera: Tephritidae), the Mediterranean fruit fly as part of an area-wide integrated approach. One option that may improve the effectiveness of the SIT, by increasing the sexual competitiveness of released sterile males, consists of feeding males protein during the post-teneral stage, a diet that increases sexual performance of wild males. We examine the effects of diet on the successive hurdles males must overcome in order to inseminate females, i.e., joining leks, copulating females, having their sperm stored and inhibition of female remating. In addition, we address the effects of diet on post-release foraging success, longevity, and the ability to withstand starvation. While protein feeding universally increases the sexual success of wild males, its effect on sterile males varies with strain, experimental settings, and environmental conditions. In some cases, treatments that resulted in the best sexual performance were significantly associated with increased vulnerability to starvation. However, no particular diet affected the ability of sterile males to find nutrients in the field when these where available. We suggest it may be better to release relatively short-lived flies that are highly competitive, rather than long-lived, sexually ineffective ones. (author) [Spanish] El uso de la tecnica de insecto esteril (TIE) esta aumentando alrededor del mundo para el control de Ceratitis capitata (Wiedemann) (Diptera: Tephritidae), la mosca mediterranea de la fruta como parte de un enfoque integrado por toda el area. Una opcion que puede mejorar la eficiencia de TIE, por medio del aumento de la capacidad de los machos esteriles liberados para competir, consiste en la alimentacion de los machos con proteina durante la etapa de pos-teneral, una dieta que aumenta el desempeno sexual de los machos naturales. Nosotros examinamos los efectos de la 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)

  2. Como Lo Hago Yo: Mielomeningocele En Bolivia

    PubMed Central

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

    2014-01-01

    Introducción: Las malformaciones del tubo neural (MTN) representan la segunda causa más frecuente de anomalías congénitas, luego de las cardiopatías. En este grupo se destaca el mielomeningocele (MMC) por su mayor incidencia, y por ser la más incapacitante y la más compleja entre todas las demás malformaciones del sistema nervioso c`entral (SNC). En Bolivia, como en muchos países de Sudamérica, los bajos niveles socio-culturales y la debilidad en el sistema sanitario, hacen que su incidencia y su morbilidad, sean mayores que en las naciones más desarrolladas. Material y Métodos: Se realizó un estudio retrospectivo y descriptivo de 70 casos de MMC, atendidos por un equipo multidisciplinario en el Hospital Universitario Japonés (HUJ) de Santa Cruz de la Sierra, entre 2008-2011. De ellos, 60 fueron intervenidos quirúrgicamente. Resultados: Se realizaron controles prenatales sólo en 27 mujeres (38.6%), diagnosticándose una disrafia espinal en apenas dos casos (7.4%). La edad de ingreso del MMC en su mayoría fue después de las 24 horas (65.6%), predominando su localización en la región lumbosacra (64.3%). De ellos, 67.2% eran abiertos, presentando un 32.9% un daño neurológico motor parcial mientras que 47.1% tenían paraplejia por debajo de la lesión. De los 70 casos, tres (4.3%) no fueron intervenidos, por presentar defectos congénitos severos o estado general grave. Las principales complicaciones posoperatorias inmediatas fueron: dehiscencia de sutura y/o infección de la herida (16.6%), fístula de líquido cefalorraquídeo (LCR) (10%) e infección del SNC (11.7%). La mortalidad general y postoperatoria fue de 7.1% y 3.3%, respectivamente. Al mes de vida presentaban hidrocefalia un 80% de los pacientes operados, colocándose una derivación ventriculoperitoneal (DVP) de presión media. De 9 pacientes que tuvieron un acompanamiento de dos o más años, seis presentaron una médula anclada, que fueron intervenidas quirúrgicamente. Conclusión: 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

  3. 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

    We evaluated under semi-natural field cage conditions sexual compatibility and competitiveness of a laboratory strain (LAB) compared to a wild population (TUC) of Anastrepha fraterculus (Wiedemann). The LAB strain is produced under semi-mass rearing conditions at the Estacion Experimental Agroindustrial Obispo Colombres facility (Tucuman, Argentina). Wild flies were obtained at Horco Molle (Tucuman, Argentina) from infested guava fruits. LAB pupae were irradiated ({sup 60}Co) 48 h before adult emergence. The tested doses were 0 (control), 40, 70, and 100 Gy. Twenty-five males and 25 females each of TUC and LAB were released into cages and mating pairs collected. Only 1 irradiation dose was considered at a time. Females were separated and allowed to lay eggs into artificial fruits to estimate induced sterility from the corresponding hatching rate. Copulation start time did not differ significantly between strains nor among irradiation treatments. Copulation duration showed highly significant differences among irradiation doses, but no differences between strains. The index of sexual isolation (ISI) and the relative sterility index (RSI) indices indicated that LAB and TUC are fully compatible, males from TUC and LAB did not differ in mating competitiveness, and irradiation within the range tested did not affect these indices. Non-irradiated LAB females exhibited higher mating propensity than TUC ones. However, a significant reduction in the female relative performance index (FRPI) index was observed with increasing irradiation dose. The analysis of induced sterility indicated that treatment with 40 Gy reduces male fertility from about 80% to 0.75%, and higher doses produce total sterility. In females, the 40 Gy dose reduces fertility to about 2% and higher doses prevent egg laying. (author) [Spanish] Se evaluo bajo condiciones semi-naturales en jaulas de campo la compatibilidad y la competitividad sexual de una linea de laboratorio (LAB) con respecto a una poblacion 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)

  4. 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

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

  5. 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. Las frecuencias fundamentales se han calculado en 208.0 cm-1 (torsión C-C) y 349.9 cm-1 (torsión OH). Se discute el método de cálculo que se ha empleado para la clasificación de los niveles. Los niveles rotacionales se han determinado empleando el método desarrollado para el estudio del ácido acético [2]. Se emplean la base de funciones rotacionales de [3]. A partir de los niveles se han determinado las constantes rotacionales y las constantes de distorsión centrífuga que se comparan con las experimentales de Herbst et al [3].

  6. [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 energéticas. Las grasas son más elevadas en los platos fritos y son estos platos los que más contribuyen al porcentaje total de grasa consumida. Lo mismo ocurre en las guarniciones, donde 100 g de plátano frito o madurito contienen más del 70% de la dosis diaria recomendada. La res asada y el juane tienen el nivel más alto de sodio.Conclusiones: si se desea ofrecer platos más saludables, es necesario cambiar algunos hábitos alimenticios, lo que supone reducir el consumo de alimentos fritos porque probablemente está relacionado con la obesidad y otras enfermedades crónicas cardiovasculares. También se debe reducir la ingesta de sodio. Dos alimentos que podrían ser importantes son la menudencia de pollo, rica en vitaminas del grupo B y baja en grasas, y el frijol hervido, rico en proteínas vegetales, que con platos de arroz, omnipresentes en esta área, incrementaría el valor biológico de las proteínas ingeridas. PMID:27019248

  7. 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

    The present study explored the effects on therapeutic outcomes of training therapists in brief manualized therapy. As part of the Vanderbilt II project, each of 16 therapists (8 psychiatrists and 8 clinical psychologists) treated 2 moderately disturbed adult patients using his or her customary short-term treatment methods; they then received a year of training in a manualized form of brief dynamic therapy, Time-Limited Dynamic Psychotherapy (TLDP); finally, they administered TLDP to 2 additional patients. It was hypothesized that training would result in improved outcomes generally and that differentially greater improvement would be seen in patients commonly considered less suitable for brief dynamic therapy. Outcome data obtained at termination failed to support either hypothesis. Measurements of interpersonal dependency obtained at a one-year follow-up were consistent with the first hypothesis, but the follow-up data were inconsistent with the second. A systematic review of the 32 posttraining cases suggested that the majority of the therapists had not achieved basic competence at TLDP. Die hier beschriebene Studie untersucht die Wirkungen eines Trainings in manualisierter Kurzzeitherapie auf das Therapierergebnis. Als Teil des Vanderbilt II Projektes behandelten jeweils 16 Therapeuten (8 Psychiater und 8 klinische Psychologen) zwei mittelgradig beeinrächtigte erwachsene Patienten mit den ihnen vertrauten Kurzzeitbehandlungsmethoden. Danach wurden sie über ein Jahr in einer manualisierten Form psychodynamischer Kurzzeittherapie ausgebildet und wandten diese Therapie auf zwei weitere Patienten an. Es wurde angenommen, dass die Ausbildung in besseren Ergebnisdaten, die bei Ende der Therapie erhoben wurden, konnten diese Hypothese nicht bestätigen. Maße für die interpersonale Abhängigkeit zu einem Einjahreskatamnesezeitpunkt waren mit der ersten Hypothese konform, aber inkonsistent mit der zweiten. Eine systematische Untersuchung der 32 nach der Ausbildung behandelten Fälle legt nahe, dass die Mehrzahl der Therapeuten keine grundlegende Kompetenz in zeitlich limitierter dynamischer Psychotherapie erworben hatte. Cette éude explore les effets sur les résultats thérapeutiques de la formation des thérapeutes dans une thérapie brève, manualissée. Dans le cadre du projet Vanderbilt II, chacun des 16 thérapeutes (8 psychiatrs et 8 psychologues cliniciens) a traité deux patients adultes modérément perturbés, chacun par sa méthode habituelle de thérapie brève; ensuite ils ont reçu une formation d'une année dans une méthode manualisée de thérapie brève, la Psychothérapie Dynamique Limitée dans le Temps (TLDP); pour finir, ils ont appliqué la TLDP à de meilleurs résultats en général, et qu'une amélioration comparativement plus importante sera observée chez des patients habituellement considérés comme moins adaptés à une thérapie dynamique brè. Les résultats obtenus à la terminaison n'ont pu confirmer aucune de ces hypothèses. Des mesures de la dépendance interpersonnelle une année après étaient consistantes avec la première hypothèse, mais les données catamnestiques étaient inconsistantes avec la deuxième. Une revue systématique des 32 cas après formation a suggéré que la majorité des thérapeutes n'avait pas acquis une compétence de base en TLDP. Este estudio exploró la efectividad del entrenamiento de terapeutas en una terapia breve manualizada. Como parte del proyecto Vanderbilt II, dieciséis terapeutas (ocho psiquiatras y ocho psicólogos clínicos) trataron dos pacientes adultos mooderadamente perturbados con sus métodos habituales de tratamiento a corto plazo. Estos terapeutas recibieron luego un año de entrenamiento en terapia dinámica breve manualizada que se Ilamó Psicoterapia Dinámica de Tiempo limitado (TLDP). Finalmente, administraron esta TLDP a dos pacientes más. La hipótesis fue que el entrenamiento ilevaría, en general, a resultados mejores y que habría mayor mejoramiento en pacientes menos aptos para una terapia dinámica breve. Los resultados a la terminación no apoyaron ninguna de las dos hipótesis. Las mediciones de dependencia interpersonal al año de seguimiento resultaron consistentes con la primera hipótesis, mientras que los resultados de seguimiento fueron inconsistentes con la segunda. Una revisión sistemática de los treinta y dos casos luego del entrenamiento sugiere que la mayoría de los terapeutas no había l. PMID:22239691

  8. 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 modelizacion, y aplicacion en convertidores PWM, esta aun por estudiar y valorar. El primer Capitulo consiste en una breve introduccion al problema de la regulacion cruzada y la impedancia cruzada para posteriormente describir las tecnicas de post-regulacion actualmente mas empleadas, con especial atencion al post-regulador con transformador controlado. El Capitulo segundo trata del estudio de las caracteristicas estaticas del postregulador con transformador controlado. Partiendo de los estudios disponibles sobre el postregulador se plantean mejoras en su modo de actuacion y se discuten tres alternativas diferentes para controlar el transformador. Las dos primeras consisten en emplear un convertidor auxiliar Boost en sus dos modos de funcionamiento, continuo y discontinuo. La tercera consiste en controlar el transformador con una tension PWM directamente, sin filtrado. Finalmente se comprueba experimentalmente, para el estado estacionario, el funcionamiento del post-regulador para cada uno de los tres metodos de control. El Capitulo tercero trata de la dinamica de la salida controlada con el post-regulador cuando este emplea un convertidor auxiliar tipo Boost. Mediante la tecnica de promediado de variables de estado se propone el modelo de pequena senal, tanto para el modo continuo como para el modo discontinuo de funcionamiento del convertidor auxiliar. Los resultados mas significativos de esta seccion son las expresiones analiticas de las impedancias cruzadas y de la impedancia de la salida post-regulada. Como complemento al modelo de pequena senal se plantea un modelo de gran senal implementado sobre el simulador Pspice. Con este nuevo modelo se reproducen los resultados obtenidos con el modelo de pequena senal y ademas es posible simular los transitorios en las tensiones de salida ante cambios de carga. La modelizacion del convertidor cuando el transformador se controla con una tension PWM sin filtrar es el objetivo del Capitulo 4. En las secciones siguientes del Capitulo se plantea el correspondiente modelo de gran senal aplicado a un nuevo prototipo experimental, de mayor tension de entrada y mayores corrientes de salida. El final del Capitulo contrasta los resultados experimentales con los teoricos confirmando la utilidad del modelo de gran senal como una herramienta basica de diseno. Finalmente, en el Capitulo 5, se presentan las conclusiones y la valoracion de los diferentes estudios plateados a lo largo de la Tesis Doctoral.

  9. 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

    Design of a groundwater pumping and treatment system for a wood-treatment facility adjacent to the tidally influenced Fraser River estuary required the development of methodologies to account for cyclic variations in hydraulic gradients. Design of such systems must consider the effects of these cyclic fluctuations on the capture of dissolved-phase contaminants. When the period of the cyclic fluctuation is much less than the travel time of the dissolved contaminant from the source to the discharge point, the hydraulic-gradient variations resulting from these cycles can be ignored. Capture zones are then designed based on the average hydraulic gradient determined using filter techniques on continuous groundwater-level measurements. When the period of cyclic fluctuation in hydraulic gradient is near to or greater than the contaminant travel time, the resulting hydraulic-gradient variations cannot be ignored. In these instances, procedures are developed to account for these fluctuations in the capture-zone design. These include proper characterization of the groundwater regime, assessment of the average travel time and period of the cyclic fluctuations, and numerical techniques which allow accounting for the cyclic fluctuations in the design of the capture zone. Résumé. L'étude d'un système de pompage et de traitement de l'eau souterraine d'une usine de traitement du bois proche de l'estuaire de la rivière Fraser, influencé par les marées, a nécessité la mise au point de méthodologies pour prendre en compte les variations cycliques de gradients hydrauliques. L'étude de tels systèmes doit considérer les effets de ces variations cycliques sur l'extraction des contaminants en phase dissoute. Lorsque la période des variations cycliques est très inférieure au temps de parcours du contaminant dissous entre la source et le point d'émergence, les variations du gradient hydraulique résultant de ces cycles peuvent être ignorées. Les zones d'extraction sont 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 procedimientos para contar con las fluctuaciones en el diseño de las zonas de captura. Ello implica una adecuada caracterización del régimen de las aguas subterráneas, el establecimiento del tiempo de tránsito y del período de las fluctuaciones cíclicas, y el uso de técnicas numéricas que permitan incluirlas en el diseño de la zona de captura.

  10. 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

    Volcanic eruptions generate disturbances that affect hydrological systems (Major, 2003) by depositing large volumes of sediments in watersheds that exceed amounts common to non-volcanic river systems (Montgomery, 2005). If the eruption releases abundant melt water, the river system may respond immediately by forming hazardous flows called lahars. River system recovery following eruptive and laharic impact is an important process, but it has received little attention (Gran and Montgomery, 2005) despite the fact that Major et al. (2000) and Hayes et al. (2002) have shown that these disruptions cause long term instability and their effects persist for decades. Lahar deposits resulting from interaction between volcanic activity and the glacier located above the Huiloac Gorge on the northern slope of Popocatepetl volcano (19°02´ N, 98°62´ W, 5,424 m), have infilled the gorge (Palacios, 1995; Palacios et al., 1998 and 2001; Capra et al., 2004; Muñoz, 2007). All of the major lahars that occurred on the volcano in 1995 (4 km), 1997 (21 km), and 2001 (14 km) have channelled through Huiloac Gorge, and have dramatically altered its morphology and dynamics through erosion and deposition. The present study traces these changes in the aftermath of the laharic events that occurred from 1997-2001. A sector of the channel, located at 3200m-3240m altitude, of 500 m long and 15 to 20 m wide, in the mid-section of the gorge, was chosen as the control site. Precipitation is heaviest there and is most apt to trigger secondary post-eruptive lahars. ArcGis software was used to draw 6 geomorphic maps of the site showing spatial variations in the landforms for the period February 2002 - February 2008. In addition, 29 cross-profiles were made of the gorge for the same time interval, excluding February 2004. The volume of sediment eroded and deposited was calculated for each date by comparing variations in the height of the floor and banks of the gorge depicted in the cross-profile, and estimating the volume of erosion and deposition for a given time interval. Analysis of the geomorphic variations for the period February 2002-February 2008, shows that the banks formed by lahar deposits in 1997 and 2001 at the study site receded from 48.6% to 27.4% in favor of the riverbed, and 31.0% to 52.7%, in favor of the terraces formed by secondary lahars. The time sequence for the cross-profiles depicts a general widening and infilling of the gorge floor, with greater emphasis on erosion from September 2003-February 2008 (1523 m3as compared to 387 m3of accretion). The changes, however, were not homogeneous during the study period, due to varying rainfall patterns that cause fluctuations in runoff. This relationship became evident after comparing geomorphologic and topographic alterations and heavy precipitation (maximum/24 hrs), and variations in monthly precipitation yield and average yield for the period 1971-2000 (data provided by the Mexico's National Meteorological Service). Although both lower slope recession and lahar-induced deposition on the floor of the channel increased during the period February-October 2002, down cutting and evacuation of materials (677 m3) greatly surpassed deposition (145 m3). The predominance of one process in relation to another was much more acute for this period than for any other, even though it occurred during a relatively dry rainy season with below average precipitation. The explanation for this is attributed to the onset of lahar activity in January 2001 and high maximum rainfall late in the rainy season. This was followed by a dry spell and a second very wet rainy season from October 2002 - September 2003. During this time, the slopes continued to recede in favor of the riverbed, where some down cutting and infilling occurred, resulting in a slight net gain in surface area. During the next five months of the dry season, changes in the landforms were proportionally greater, producing a substantial increase in surface area and laharic deposition formations. These features are attributed to an unusually long rainy season with above average values in October, and to atypical precipitation in the normally dry month of January. Modifications in the surface area from February 2004-March 2006 reached 19.2%, a decrease from the previous two-year period (28.1%), which was caused by a slight increase in average precipitation in 2004 and a marked decrease in 2005. Values for erosion (620 m3) and deposition (621 m3) are similar for the period from September 2003 - March 2005, and the slopes receded slowly as new laharic deposits increased the level of the channel floor. The final two-year interval shows an increase in changes (31.1%) where the receding sides of the banks affected the ridges of the levees, and the floor of the channel, marked by areas of deposition and incision, became flatter and wider. The increased activity is associated with the prolonged effect of El Niño (ENSO), more rainfall during the 2006 rainy season, and below reference values for 2007 for the average wet and dry seasons. The volume of material removed and accreted was 1424 m3 and 277 m3, respectively. Changes occurring in the channel to recover equilibrium in the river system included the widening and infilling of the floor, but these alterations were largely conditioned by increased water supply that triggered secondary lahars. The short interval between deposition by the primary lahar and the exceptionally heavy precipitation at the end of the rainy season, contributed to increased erosion of the gorge. The time intervals that registered below average precipitation are characterized by less surface disturbances and greater infilling of the channel floor. The opposite is true for the rainy seasons with above average values when slope erosion caused uneven deposition on the channel floor, or during the dry months that registered the most significant changes in response to episodes of exceptional heavy rainfall. References 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.

  11. The joint in vitro action of polymyxin B and miconazole against pathogens associated with canine otitis externa from three European countries

    PubMed Central

    Pietschmann, Silvia; Meyer, Michael; Voget, Michael; Cieslicki, Michael

    2013-01-01

    Background Canine otitis externa, an inflammation of the external ear canal, can be maintained and worsened by bacterial or fungal infections. For topical treatment, combinations of anti-inflammatory and antimicrobial ingredients are mainly used. Hypothesis/Objectives This study was conducted to elucidate the in vitro activity of polymyxin B and miconazole against clinical bacterial isolates from three European countries, to investigate possible differences in sensitivity and to assess drug interactions. Animals Seventeen strains of Escherichia coli, 24 strains of Pseudomonas aeruginosa, 24 strains of Proteus mirabilis and 25 strains of Staphylococcus pseudintermedius from dogs with diagnosed otitis externa had been isolated in Germany, France and Italy. Methods Drug activities were evaluated by minimal inhibitory concentration (MIC) and minimal bactericidal concentration. The potentiation of polymyxin B plus miconazole was calculated using the fractional inhibitory concentration index (FICI). An FICI ≤0.5 defined synergy. Furthermore, geographical variations in the FICI and MIC were assessed by statistical analysis. Results Bacterial susceptibilities were comparable in different European countries, because there were no significant MIC and FICI variations (P > 0.05). As a single agent, polymyxin B had bactericidal activity against most E. coli and P. aeruginosa strains and, in higher concentrations, against S. pseudintermedius strains. Miconazole was bactericidal against all Staphylococcus strains. Synergy was demonstrated against strains of E. coli and P. aeruginosa (FICI = 0.25 and 0.50, respectively), whereas overall there was no interaction against S. pseudintermedius strains (FICI = 1.25). Proteus mirabilis strains were not inhibited by each of the drugs individually or by their combination. Conclusions and clinical importance In vitro synergy of polymyxin B and miconazole against E. coli and P. aeruginosa isolates indicates a rationale for applying both agents in combination to treat otitis externa when infected with these types of bacteria. Résumé Contexte L'otite externe canine, une inflammation du conduit auriculaire externe, peut être entretenue et aggravée par les infections bactériennes ou fongiques. Pour le traitement topique, les associations d'anti-inflammatoires et d'antimicrobiens sont principalement utilisées. Hypothèses/Objectifs Cette étude a été menée pour déterminer l'activité in vitro de la polymyxine B et du miconazole contre les souches bactériennes cliniques isolées dans trois pays européens, d'étudier les différences possibles de sensibilité et de déterminer les interactions médicamenteuses. Sujets Dix-sept souches d'Escherichia coli, 24 souches de Pseudomonas aeruginosa, 24 souches de Proteus mirabilis et 25 souches de Staphylococcus pseudintermedius ont été isolées de chiens atteints d'otite externe en Allemagne, France et Italie. Résultats L'activité des molécules a été évaluée par la concentration minimale inhibitrice (CMI) et la concentration minimale bactéricide. La potentialisation de la polymyxine B et du miconazole a été calculée par l'indice de concentration inhibitrice fractionnaire (FICI). Un FICI ≤ 0.5 définissait la synergie. En outre, les variations géographiques dans le FICI et la CMI étaient évaluées par analyses statistiques. Résultats Les sensibilités bactériennes étaient comparables dans les différents pays européens parce qu'aucune différence significative n'a été mise en évidence entre les variations de CMI et de FICI (P > 0.05). La polymyxine B en tant que seul agent avait une activité bactéricide contre la plupart des souches de E. coli et P. aeruginosa, et, à plus forte concentration, contre les souches de S. pseudintermedius. Le miconazole était bactéricide contre toutes les souches de S. pseudintermedius. Une synergie a été mise en évidence contre les souches de E. coli et P. aeruginosa (FICI = 0.25 et 0.50, respectivement), alors qu'aucune interaction n'a été mise en évidence contre les souches de S. pseudintermedius (FICI = 1.25). Les souches de Proteus mirabilis n'ont été inhibées par aucune des molécules, individuellement ou en association. Conclusions et importance clinique La synergie in vitro de la polymyxine B et du miconazole contre les souches d'E. coli et de P. aeruginosa justifie l'application de la combinaison des deux agents dans le traitement de l'otite externe lors d'infection par ces bactéries. Resumen Introducción la otitis externa canina, inflamación del canal auditivo externo, puede perpetuarse y empeorar debido a la presencia de infecciones bacterianas o fúngicas. Para el tratamiento tópico se utilizan fundamentalmente combinaciones de ingredientes antiinflamatorios y antimicrobianos. Hipótesis/objetivos este estudio se condujo para elucidar la actividad in vitro de polimixina B y miconazol frente a aislados clínicos bacterianos de tres países europeos, investigar posibles diferencias en sensibilidad y analizar interacciones de fármacos. Animales diecisiete cepas de Escherichia coli, 24 cepas de Pseudomonas aeruginosa, 24 cepas de Proteus mirabilis y 25 cepas de Staphylococcus pseudintermedius de perros diagnosticados con otitis externa asilados de Alemania, Francia e Italia. Métodos se evaluó la actividad de los fármacos mediante la concentración inhibitoria minima (MIC) y la concentración bactericida minima. La potenciación de polimixina B y miconazol se calculó usando el índice de concentración fraccional inhibitoria (FICI). Un FICI≤ 0,5 definía sinergismo. Además se analizaron estadísticamente las variaciones en la FICI y MIC dependiendo de la región de origen. Resultados la susceptibilidad bacteriana fue comparable en los diferentes países europeos ya que no hubo diferencias significativas en MIC y FICI (P > 0,05). Como agente único la polimixina B tuvo actividad antimicrobiana frente a la mayoría de cepas de E. coli y P. aeruginosa, y a mayores concentraciones frente a cepas de S. pseudintermedius. El miconazol fue bactericida frente a todas las cepas de Staphylococcus. Se observó sinergismo frente a cepas de E. coli y P. aeruginosa (FICI = 0.25 y 0,50, respectivamente), mientras en general no hubo sinergismo frente a las cepas de S. pseudintermedius (FICI = 1.25). Cepas de Proteus mirabilis no fueron inhibidas por los fármacos individualmente ni en combinación. Conclusiones e importancia clínica el sinergismo in vitro de la polimixina B y el miconazol frente a aislados de E. coli y P. aeruginosa indica un motivo para utilizar ambos agentes en combinación para tratar casos de otitis externa producidos por infecciones con estas bacterias. Zusammenfassung Hintergrund Die canine Otitis externa, eine Entzündung des äußeren Ohrkanals, kann durch eine bakterielle Infektion oder durch eine Infektion mit Hefepilzen aufrechterhalten bzw. verschlimmert werden. Zur topischen Behandlung werden hauptsächlich Kombinationen aus entzündungshemmenden und antimikrobiellen Wirkstoffen verwendet. Hypothese/Ziele Diese Studie wurde durchgeführt, um die in vitro Aktivität von Polymyxin B und Mikonazol gegenüber klinischen Bakterienisolaten aus drei europäischen Ländern zu beleuchten und um mögliche Unterschiede in der Sensibilität zu untersuchen und um Interaktionen von Medikamenten zu beurteilen. Tiere Siebzehn Stämme von Escherichia coli, 24 Stämme von Pseudomonas aeruginosa, 24 Stämme von Proteus mirabilis und 25 Stämme von Staphylokokkus pseudintermedius von Hunden mit einer diagnostizierten Otitis externa waren in Deutschland, Frankreich und Italien isoliert worden. Methoden Die Wirkstoffaktivitäten wurden mittels minimaler inhibitorischer Konzentration (MIC) und minimaler bakterizider Konzentration evaluiert. Die Potenzierung von Polymyxin B plus Mikonazol wurde mittels „Fractional Inhibitory Concentration Index” (FICI) kalkuliert. Ein FICI ≤ 0,5 definierte eine Synergie. Weiters wurden geographische Variationen des FICI und der MIC mittels statistischer Analyse beurteilt. Ergebnisse Die bakteriellen Empfindlichkeiten waren in den verschiedenen europäischen Ländern vergleichbar, da keine signifikanten Unterschiede bei MIC und FICI bestanden (P > 0,05). Als alleiniger Wirkstoff zeigte Polymyxin B eine bakterizide Wirkung gegenüber den meisten E. coli und P. aeruginosa Stämmen und, in höheren Konzentrationen, gegenüber S. pseudintermedius Stämmen. Eine Synergie wurde gegen E. coli und P. aeruginosa Stämme (FICI = 0.25 bzw. 0,50) demonstriert, während insgesamt keine Interaktion gegen S. pseudintermedius Stämme (FICI = 1.25) bestand. Proteus mirabilis Stämme wurden von keinem dieser Wirkstoffe, weder individuell noch in Kombination, inhibiert. Schlussfolgerungen und klinische Bedeutung Eine in vitro Synergie von Polymyxin B und Mikonazol gegenüber E. coli und P. aeruginosa Isolaten bekräftigt die Argumentation dafür, beide Wirkstoffe in Kombination zu verwenden, um eine Otitis externa, bei der diese Bakterien vorkommen, zu behandeln. PMID:23721182

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

    NASA Astrophysics Data System (ADS)

    Neuman, Shlomo P.

    2005-03-01

    Among the current problems that hydrogeologists face, perhaps there is none as challenging as the characterization of fractured rock (Faybishenko and Benson 2000). This paper discusses issues associated with the quantification of flow and transport through fractured rocks on scales not exceeding those typically associated with single- and multi-well pressure (or flow) and tracer tests. As much of the corresponding literature has focused on fractured crystalline rocks and hard sedimentary rocks such as sandstones, limestones (karst is excluded) and chalk, so by default does this paper. Direct quantification of flow and transport in such rocks is commonly done on the basis of fracture geometric data coupled with pressure (or flow) and tracer tests, which therefore form the main focus. Geological, geophysical and geochemical (including isotope) data are critical for the qualitative conceptualization of flow and transport in fractured rocks, and are being gradually incorporated in quantitative flow and transport models, in ways that this paper unfortunately cannot describe but in passing. The hydrogeology of fractured aquifers and other earth science aspects of fractured rock hydrology merit separate treatments. All evidence suggests that rarely can one model flow and transport in a fractured rock consistently by treating it as a uniform or mildly nonuniform isotropic continuum. Instead, one must generally account for the highly erratic heterogeneity, directional dependence, dual or multicomponent nature and multiscale behavior of fractured rocks. One way is to depict the rock as a network of discrete fractures (with permeable or impermeable matrix blocks) and another as a nonuniform (single, dual or multiple) continuum. A third way is to combine these into a hybrid model of a nonuniform continuum containing a relatively small number of discrete dominant features. In either case the description can be deterministic or stochastic. The paper contains a brief assessment of these trends in light of recent experimental and theoretical findings, ending with a short list of prospects and challenges for the future. Parmis les problèmes aucquels font face les hydrogéologues, il y a celui de la caractérisation des roches fracturées (Faybishenko and Benson, 2000). Cet article discute des solutions associées aux quantifications des écoulements et des transports à travers les roches fracturées à l'échelles des essais de puits et des essais de traçage. Une part importante de la litérature traite des roches cristallines, des roches sédimentaires consolidées telles les grés, les calcaires (exeptés les karsts) et la craie. De fait, cet article traitera la même panoplie de roches. La quantification directe des écoulements et du transport dans de tels milieux est généralement abordée via la géométrie des fractures, les données de pression et de traçage, qui déslors sont les objets principaux de notre étude. La géologie, la géophysique et la géochimie (incluant la géochimie isotopique) sont criticables car elles donnent des informations qualitatives sur l'écoulement et le transport des aquifères fracturés, et son intégrées graduellement dans des modèles qualitatifs. La manière d'intégrer ces données dépasse malheureusement cet article. L'hydrogéologie des aquifères de fractures et les autres sciences de la terre s'intéressant aux roches fracturées méritent des traîtements différents. En toute évidence il est suggéré que rarement un modèle d'écoulement et de transport dans une roche fracturée puisse être traité comme un milieu isotropique continu, uniforme ou moyennement non-uniforme. Par ailleurs, il est admis la dépendance entre la forte hétérogénéité erratique et la variété de natures et de comportements des roches fracturées. Une manière de régler le problème est de considérer le milieu comme un réseau de fractures discrètes (avec une perméabilité de matrice ou de bloc). Une 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 en una roca consistentemente fracturada si la considera como una unidad continua isotrópica uniforme o poco uniforme. En vez de adoptar este enfoque, uno tiene generalmente que explicar la heterogeneidad altamente errática, dependencia direccional, naturaleza doble o multicomponente y comportamiento multiescalar de las rocas fracturadas. Una manera de lograr esto consiste en considerar que la roca contiene una redde fracturas discretas (con bloques de matriz permeable o impermeable) y otro modo en considerar la roca como una unidad continua no uniforme (sola, doble o múltiple). Un tercer procedimiento consiste en combinar las dos maneras anteriores en un modelo híbrido el cual consiste de un continuo no uniforme conteniendo un número relativamente pequeño de fracturas principalmente discretas. En ambos casos la descripción puede ser determinística o estocástica. El artículo contiene una evaluación breve de estas tendencias en base a descubrimientos recientes teóricos y experimentales, terminando con una lista corta de prospectos y desafíos para el futuro.