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Pectus excavatum  

Microsoft Academic Search

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

Ivan Aloi; Annabella Braguglia; Alessandro Inserra



Simultaneous minimally invasive surgery for pectus excavatum and recurrent pneumothorax  

PubMed Central

A 19-year old male who had a pectus excavatum deformity and recurrent primary spontaneous pneumothorax was admitted to our clinic. An intervention simultaneously combining a videothoracoscopic apical wedge resection and minimally invasive repair of the pectus excavatum deformity was successfully performed.

Bostanci, Korkut; Evman, Serdar; Yuksel, Mustafa



Treatment of pectus excavatum with bioabsorbable polylactide plates: Preliminary results  

Microsoft Academic Search

Background\\/Purpose: Pectus excavatum usually is corrected by thoracoplasty using metal plates. Recently bioabsorbabe polylactide plates have been developed. The aim of this study was to compare outcome after use of metal and bioasorbable plates in thoracoplasty performed for correction of pectus excavatum. Methods: Eighty-three children ([lt ]16 years old) underwent thoracoplasty (Sulamaa's technique). In 75 patients, metallic plates, and in

W. Serlo; O. Linna; T. Pohjonen; T. Waris; N. Ashammakhi



Pectus excavatum in blunt chest trauma: a case report  

PubMed Central

Introduction Blunt cardiac rupture is an exceedingly rare injury. Case presentation We report a case of blunt cardiac trauma in a 43-year-old Caucasian German mother with pectus excavatum who presented after a car accident in which she had been sitting in the front seat holding her two-year-old boy in her arms. The mother was awake and alert during the initial two hours after the accident but then proceeded to hemodynamically collapse. The child did not sustain any severe injuries. Intraoperatively, a combined one-cm laceration of the left atrium and right ventricle was found. Conclusion Patients with pectus excavatum have an increased risk for cardiac rupture after blunt chest trauma because of compression between the sternum and spine. Therefore, patients with pectus excavatum and blunt chest trauma should be admitted to a Level I Trauma Center with a high degree of suspicion.



Method of pectus excavatum measurement based on structured light technique  

NASA Astrophysics Data System (ADS)

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

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



A complication of pectus excavatum operation: endomyocardial steel strut  

Microsoft Academic Search

An 18-year-old patient who had correction of pectus excavatum deformity in our department 4 years earlier was admitted because of stabbing chest pain. He had not attended to postoperative controls and had not come for extraction of the steel strut, although he had been contacted. He was diagnosed to have a broken steel strut, and the strut was noted to

Ertan Onursal; Alper Toker; Korkut Bostanc?; Ufuk Alpagut; Emin Tireli



A fresh approach in the treatment of pectus excavatum  

Microsoft Academic Search

A method of evaluation of possible functional disturbances due to pectus excavatum is presented. With spirometric investigations and the bycicle exercise test in supine and upright position it is possible to distinguish between functional impairment caused by the deformity and a poor physical condition, which allows to select cases for osteoplasty or for augmentation. In a series of 17 cases

J. C. Bruck; H. Hörtnagl; M. Bauer; P. Wilflingseder



Compromised cardiac function in exercising teenagers with pectus excavatum.  


Patients with pectus excavatum complain about fatigue, tachypnea, discomfort and dyspnea, but the existence of an equivalent underlying pathophysiology has been questioned. We investigated 75 teenagers (49 pectus excavatum patients and 26 age matched controls) at rest and during bicycle exercise at submaximal exercise levels. At rest cardiac function was determined using echocardiography. During rest and exercise, cardiac output, heart rate and aerobic exercise capacity were measured using photo-acoustic gas-rebreathing technique for non-invasive determination of the cardiopulmonary function. At rest, no cardiac differences were found between control subjects and patients with pectus excavatum. During submaximal exercise, cardiac index was lower 6.6(6.3-7.0) l/min/m(2) among the pectus patients as compared to the control subjects 8.0(7.3-8.8) l/min/m(2), P=0.0001. The lower cardiac output among the pectus patients was due to a lower stroke index 42(39-45) ml/beat/m(2) as compared to controls 54(44-64) ml/beat/m(2), P=0.0022, whereas heart rate was unchanged. Cardiac function is significantly impaired at submaximal exercise level compared to healthy age matched controls. PMID:21788301

Lesbo, Maj; Tang, Mariann; Nielsen, Hans Henrik; Frøkiær, Jørgen; Lundorf, Erik; Pilegaard, Hans K; Hjortdal, Vibeke E



Imaging diagnosis--acquired pectus excavatum secondary to laryngeal paralysis in a dog.  


A 13-year-old neutered female Labrador retriever had inspiratory dyspnea secondary to bilateral laryngeal paralysis. Radiographically, there was pectus excavatum with a mediastinal shift to the right. Arytenoid lateralization was performed, relieving the upper respiratory obstruction, and the sternal deformity also resolved. Chronic upper respiratory obstruction should be considered in dogs with pectus excavatum. Furthermore, correction of upper respiratory obstruction has the potential to result in resolution of pectus excavatum. PMID:22145690

Kurosawa, Tsumugi Anne; Ruth, Jeffrey D; Steurer, Jeffrey; Austin, Brenda; Heng, Hock Gan



Positional hyperventilation-induced hypoxaemia in pectus excavatum  

Microsoft Academic Search

The presented case is of a young male (aged 19 yrs) with a pectus excavatum who showed significant exercise intolerance, despite normal pulmonary function at rest, including carbon monoxide diffusing capacity. Clinical exercise testing led to a strong suspicion of a right- to-left shunt due to an abnormally wide alveolo-arterial oxygen gradient (26.4 kPa) at peak oxygen uptake, with severe

B. Wallaert; B. Cavestri; C. Fournier; R. Neviere; B. Aguilaniu; Physiologie Clinique



Surgical correction of pectus excavatum deformity and hypomastia  

Microsoft Academic Search

Female patients occasionally present with major pectus excavatum and hypomastia. The aim of this study was to investigate\\u000a the clinical outcome of female patients who had combined surgical correction of both deformities. Since 1990, 12 young female\\u000a patients underwent correction using a modelling sternochondroplasty with osteosynthesis using Borrelly’s slide fastener-handle.\\u000a After 1 year, the material was removed, and the breast implants

F. Bodin; C. Bruant-Rodier; A. Wilk; J. M. Wihlm



Improvement of tracheal compression after pectus excavatum repair.  


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

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



Brugada Phenocopy in a Patient with Pectus Excavatum: Systematic Review of the ECG Manifestations Associated with Pectus Excavatum.  


Brugada phenocopies (BrP) have emerged as new clinical entities that are etiologically distinct from true Brugada syndrome (BrS). BrP are characterized by an ECG pattern that is phenotypically identical to true BrS (type 1 or type 2); however, BrP are caused by various other factors such as mechanical mediastinal compression, myocardial ischemia, pericarditis, myocarditis, pulmonary embolism, and metabolic disturbances. We report a case of an electrocardiographic BrP in a patient with pectus excavatum deformity in the absence of true BrS using currently defined BrP diagnostic criteria. A systematic review of ECG manifestations associated with pectus excavatum is also discussed. PMID:24047484

Awad, Sara F M; Barbosa-Barros, Raimundo; de Sousa Belem, Lucia; Cavalcante, Camila Pinto; Riera, Andrés Ricardo Pérez; Garcia-Niebla, Javier; Anselm, Daniel D; Baranchuk, Adrian



Long term cardiopulmonary effects of closed repair of pectus excavatum.  


The closed or "Nuss" repair of pectus excavatum is widely accepted for correction of moderate to severe deformities. Patients typically report significant subjective improvements in pulmonary symptoms, and short and medium term evaluations (up to 2 years with the bar in place) suggest modest improvement to cardiac function but a decrease in pulmonary function. This study examined the effects at 3 months post-bar removal of closed repair of pectus on pulmonary function, exercise tolerance and cardiac function. Patients were followed prospectively after initial evaluation for operation. All patients underwent preoperative and post-bar removal evaluation with CT scan, complete pulmonary function and exercise testing to anaerobic threshold, as well as echocardiogram. Twenty-six patients have completed the follow up protocol. Preoperative CT index was 4.5 +/- 1.3, average age at operation was 13.2 years, and average tanner stage was 3.5 +/- 0.5. At 3 months or greater follow-up post-bar removal, patients reported an improvement in subjective ability to exercise and appearance (P < 0.05 by wilcoxin matched pairs). Objective measures of FEV1, total lung capacity, diffusing lung capacity, O(2) pulse, VO(2max), and respiratory quotient all showed significant improvement compared to preoperative values, while normalized values of cardiac index at rest did not (All values normalized for height and age, comparisons P < 0.05 by student's paired t test). These results demonstrate a sustained improvement in cardiopulmonary function after bar removal following closed repair of pectus excavatum. These findings contrast with results from previous studies following the open procedure, or with the closed procedure at earlier time points; the long term physiological effects of closed repair of pectus excavatum include improved aerobic capacity, likely through a combination of pulmonary and cardiac effects. PMID:17252283

Sigalet, David L; Montgomery, Mark; Harder, Joyce; Wong, Victor; Kravarusic, Dragan; Alassiri, Ali



Surgical correction of pectus excavatum in two cats  

PubMed Central

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

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



Mechanical factors play an important role in pectus excavatum with thoracic scoliosis  

PubMed Central

Background This study investigated the incidence, imaging characteristics and mechanical factors in scoliotic patients with pectus excavatum. Methods A total of 142 scoliostic patients with pectus excavatum were evaluated prior to operation. The evaluation included a complete physical exam, phenotype and severity of the pectus excavatum, incidence and severity of scoliosis, and analysis of radiological images, including calculation of the Haller index. Results Twenty five out of 142 patients (17.61%) with pectus excavatum had scoliosis with a Cobb angle >10 degrees, and in 80.00% of the cases the spinal column was bent to the right. Seventeen patients had bent-to-the-right spines that involved the 6th to 10 th thoracic vertebrae. We found that 23 out of 25 patients with a Cobb angle more than 10° were teenagers and adults. The incidence of scoliosis was only 6.06% in the children under 11 years whereas it was 21.79% in the teenage group. Conclusions Mechanical forces appear to play a role in the coexistence of pectus excavatum and scoliosis. There is a relationship between age, severity (Haller index), asymmetry and scoliosis. The heart and mediastinum play a role in providing an outward force to the left of the sternum which may be an important reason for the coexistence of pectus excavatum and scoliosis, but the correlation needs further proof.



Dynamic right ventricular outflow tract (infundibular) stenosis and pectus excavatum in a dog  

PubMed Central

This is the first published report of a dog with dynamic right ventricular outflow tract (infundibular) stenosis, right ventricular hypertrophy, and pectus excavatum. A juvenile dog presented with a grade V/VI left base systolic heart murmur, tachycardia, and pectus excavatum. Diagnosis of the aforementioned conditions was based on radiography, electrocardiography, and echocardiography. At 9 1/2 wk of age the heart murmur was no longer audible and the right ventricular stenosis and hypertrophy had dissipated and regressed, respectively. Resolution may be associated with growth of the dog. A good prognosis is foreseen.

Fournier, Tanya E.



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

NASA Astrophysics Data System (ADS)

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

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



Effects of the Nuss procedure on chest wall kinematics in adolescents with pectus excavatum.  


No data are available on the effects of the Nuss procedure on volumes of chest wall compartments (the upper rib cage, lower rib cage and abdomen) in adolescents with pectus excavatum. We used optoelectronic plethysmography to provide a quantitative description of chest wall kinematics before and 6 months after the Nuss procedure at rest and during maximal voluntary ventilation in 13 subjects with pectus excavatum. An average 11% increase in chest wall volume was accommodated within the upper rib cage (p=0.0001) and to a lesser extent within the abdomen and lower rib cage. Tidal volumes did not significantly change during the study. The repair effect on chest wall kinematics did not correlate with the Haller index of deformity at baseline. Six months of the Nuss procedure do increase chest wall volume without affecting chest wall displacement and rib cage configuration. PMID:22688019

Binazzi, B; Innocenti Bruni, G; Gigliotti, F; Coli, C; Romagnoli, I; Messineo, A; Lo Piccolo, R; Scano, G



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

Microsoft Academic Search

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

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



Aesthetic Treatment of Pectus Excavatum: A New Endoscopic Technique Using a Porous Polyethylene Implant  

Microsoft Academic Search

Background  Pectus excavatum is the most frequent malformation of the rib cage. Functional aspects associated with this malformation often\\u000a are absent even in adults not involved in competitive sports activities. Overall, these patients often live with extreme psychological\\u000a discomfort when the malformations are minor. Traditionally, the correction of these malformations has been geared toward interventions\\u000a that modify the architecture of the

Simone Grappolini; Paolo M. Fanzio; Pierluca G. C. D’Addetta; Alberto Todde; Maurizio Infante



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

PubMed Central

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.

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



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

NASA Astrophysics Data System (ADS)

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

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



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


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

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



The Quality of Life After Bar Removal in Patients After the Nuss Procedure for Pectus Excavatum  

Microsoft Academic Search

Background  The goal of this study was to evaluate the outcome of patients who had the Nuss procedure for repair of pectus excavatum.\\u000a \\u000a \\u000a \\u000a Methods  Thirty-nine patients (26 male, 13 female) of 61 (63.9%) who had bar removal after the Nuss procedure agreed to participate\\u000a in an interview. All patients and their parents were asked to complete a questionnaire.\\u000a \\u000a \\u000a \\u000a \\u000a Results  The mean age of

Hyun Koo Kim; Jae Hoon Shim; Kyu Sun Choi; Young Ho Choi


A pilot study of the impact of surgical repair on disease-specific quality of life among patients with pectus excavatum  

Microsoft Academic Search

BackgroundThis study was conducted to determine the ability of 2 questionnaires (ie, child and parent versions) to measure physical and psychosocial quality-of-life changes after surgical repair of pectus excavatum.

M. Louise Lawson; Thomas F Cash; Rachel Akers; Ellen Vasser; Bonnie Burke; Meredith Tabangin; Camille Welch; Daniel P Croitoru; Michael J Goretsky; Donald Nuss; Robert E Kelly



External longitudinal titanium support for the repair of complex pectus excavatum in adults.  


Several techniques exist for the repair of complex pectus excavatum. The placement of retrosternal metal bars improves the results by reducing the recurrence rate, but entails several possible risks, complications and disadvantages. A new method, specifically conceived for the repair of severe, asymmetric forms in adult patients, is reported. The corrected bone is fixed in the proper position by two, patient-customized, titanium struts, externally screwed to the manubrium and sternal body. Any retrosternal bar is thus avoided, reducing possible complications, without hampering the chest wall dynamic. In this particularly difficult issue, this technique provides long-term good functional, mechanical and cosmetic results and does not entail a second surgery for struts removal. PMID:22927563

Puma, Francesco; Vannucci, Jacopo; Santoprete, Stefano



Pectus Excavatum Breast and Chest Deformity: Indications for Aesthetic Plastic Surgery Versus Thoracic Surgery in a Multicenter Experience  

Microsoft Academic Search

Background  Breast and chest wall disfiguration attributable to a funnel chest is an aesthetically and sometimes functionally debilitating\\u000a deformity requiring surgical correction. Whereas extensive and combined deformities of the ventral chest wall are classically\\u000a corrected using a so-called minimally invasive repair of the pectus excavatum, a modified Ravitch repair, or the minimized\\u000a Erlangen repair, plastic surgeons are mostly challenged with alloplastic

Raymund E. Horch; Erich Stoelben; Roman Carbon; Alaa A. Sultan; Alexander D. Bach; Ulrich Kneser



Pectus excavatum  


... rule out suspected disorders. These tests may include: Chromosome studies Enzyme assays Metabolic studies X-rays Pulmonary ... Mattox KL. Sabiston Textbook of Surgery . 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 57. Tzelepis GE, ...


Pain and Anxiety Management in Minimally Invasive Repair of Pectus Excavatum  

PubMed Central

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

Ghionzoli, Marco; Brandigi, Elisa; Messineo, Antonio



Pectus excavatum postsurgical outcome based on preoperative soft body dynamics simulation  

NASA Astrophysics Data System (ADS)

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

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



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

PubMed Central

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.



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

PubMed Central

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

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



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

PubMed Central

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.

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



Congenital Heart Surgery Nomenclature and Database Project: vascular rings, tracheal stenosis, pectus excavatum  

Microsoft Academic Search

The extant nomenclature for vascular rings, tracheal stenosis, and pectus deformities is reviewed for the purpose of establishing a unified reporting system. The subject was debated and reviewed by members of the STS-Congenital Heart Surgery Database Committee and representatives from the European Association for Cardiothoracic Surgery. All efforts were made to include all relevant nomenclature categories using synonyms where appropriate.

Carl L Backer; Constantine Mavroudis



Systemic postoperative pain management following minimally invasive pectus excavatum repair in children and adolescents: a retrospective comparison of intravenous patient-controlled analgesia and continuous infusion with morphine  

Microsoft Academic Search

Purpose  Optimal postoperative pain management following minimally invasive surgical repair of pectus excavatum is not established.\\u000a We compared efficacy and adverse effects in patients treated with patient-controlled analgesia (PCA) with those treated with\\u000a continuous infusion (CI) with morphine in addition to nonsteroidal anti-inflammatory drugs.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  33 patient records were examined retrospectively: 21 given PCA and 12 CI with morphine. Main outcome variables

Danguole Ceslava Rugyte; Arturas Kilda; Aurika Karbonskiene; Vidmantas Barauskas



Continuous thoracic epidural infusions for postoperative analgesia after pectus deformity repair  

Microsoft Academic Search

Purpose: To determine whether continuous epidural analgesia after repair of a pectus deformity is a viable and safe alternative to high-dose narcotics in children. Methods: Data were collected prospectively for 19 children (4 to 17 years of age; 15 boys, 4 girls) who underwent pectus excavatum (14) or carinatum (5) repair between June 1, 1991 and July 1, 1994. Seventeen

Whitney J McBride; Rochelle Dicker; J. Christian Abajian; Dennis W Vane



Use of Macrolane to treat pectus excavatum.  


The use of subcutaneous hyaluronic acid injection in cosmetic surgery is a popular and well-accepted technique. A new highly reticulated, nonanimal, stabilized hyaluronic acid has been recently developed for high-volume enhancement, especially breast augmentation. We describe this technique for funnel chest treatment. PMID:22186485

Sinna, Raphael; Perignon, David; Assaf, Nizar; Berna, Pascal



Pulmonary function for pectus excavatum at long-term follow-up  

Microsoft Academic Search

Purpose: The aim of this article was to assess whether and to what extent pulmonary function recovered to normal degree postoperatively and to investigate the changes in pulmonary function after surgical correction and the value of surgical correction.Methods: A total of 27 patients who could be questioned and examined in person at the outpatient department of our hospital were included

Jiang Xiao-ping; Hu Ting-ze; Liu Wen-ving; Wei Fu-kang; Yuan Yu-ru; Fong Jie-xiong; Luo Qi-cheng; Liu Ming; Tang Yun-man



Brace Compression for Treatment of Pectus Carinatum  

PubMed Central

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

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



Potential impact of a toxic dinoflagellate ( Alexandrium excavatum ) bloom on survival of fish and crustacean larvae  

Microsoft Academic Search

We investigated the impact of neurotoxins produced by the dinoflagellateAlexandrium excavatum on survival of Atlantic mackerel (Scomber scombrus) and American lobster (Homarus americanus) larvae, respectively reared from eggs and from female lobster, collected in 1988 from the southern Gulf of St. Lawrence, Canada. Sensitivity to the toxins was first verified by exposing larvae of both species to various concentrations of

B. Robineau; J. A. Gagné; L. Fortier; A. D. Cembella



Excavatoids O and P, New 12-Hydroxybriaranes from the Octocoral Briareum excavatum  

PubMed Central

Two new 12-hydroxybriarane diterpenoids, designated as excavatoids O (1) and P (2), were isolated from the octocoral Briareum excavatum. The structures of briaranes 1 and 2 were established on the basis of extensive spectral data analysis. Excavatoid P (2) is the first metabolite which possesses a 6? -chlorine atom in briarane analogues.

Sung, Ping-Jyun; Li, Gung-Ying; Su, Yin-Di; Lin, Mei-Ru; Chang, Yu-Chia; Kung, Ting-Hsuan; Lin, Chan-Shing; Chen, Yung-Husan; Su, Jui-Hsin; Lu, Mei-Chin; Kuo, Jimmy; Weng, Ching-Feng; Hwang, Tsong-Long



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

PubMed Central

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

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



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

PubMed Central

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

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



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

PubMed Central

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

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



Toxin accumulation and feeding behaviour of the planktonic copepod Calanus finmarchicus exposed to the red-tide dinoflagellate Alexandrium excavatum  

Microsoft Academic Search

The planktonic copepod Calanus finmarchicus is a dominant member of the zooplankton community in the lower St. Lawrence Estuary in eastern Canada. Blooms of the toxic marine dinoflagellate Alexandrium excavatum which produces high cellular levels of paralytic shellfish poisoning (PSP) toxins, occur during the period of high C. finmarchicus production in summer in this region. To study the feeding behaviour

N. Turriff; J. A. Runge; A. D. Cerebella



Tratamiento del cáncer

Información sobre métodos diversos de tratar el cáncer. Cómo encontrar a un doctor o un establecimiento de tratamiento para personas con cáncer, y recursos económicos para ellas. Se incluyen también descripciones y explicaciones de tratamientos convencionales para los tipos específicos de cáncer, y un resumen de la medicina complementaria y alternativa.


Pectus carinatum  


... the heart and lungs. Laboratory studies such as chromosome studies , enzyme assays, x-rays, or metabolic studies ... BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 411.


In vitro acaricidal effect of plant extract of neem seed oil ( Azadirachta indica) on egg, immature, and adult stages of Hyalomma anatolicum excavatum (Ixodoidea: Ixodidae)  

Microsoft Academic Search

Effects of the plant extract of neem seed (Azadirachta indica) on eggs, immature, and adult stages of Hyalomma anatolicum excavatum was studied at concentrations of 1.6, 3.2, 6.4, and 12.8%. The extract was found to have a significant effect on the hatching rate of eggs. It significantly increased the hatching rate during the first 7 days post-treatment (DPT) giving incompletely

S. Abdel-Shafy; A. A. Zayed



Sub-axillary access with the use of costal cartilages articulated bars for correction of pectus carinatum.  


We describe an original technique for correction of pectus carinatum (PC) through a limited sub-axillary incision by chondrectomy and the use of costal cartilages articulated bars to stabilize the chest wall. We have developed this technique in order to improve the cosmetic results in the surgical treatment of even complex sterno-chondral deformities. The surgical incision is made along the lateral edge of the pectoralis major muscle in the sub-axillary region and its length is related to the number of costal cartilages to be treated. This technique is principally indicated for asymmetric PC with unilateral deformities of the costal cartilages, but its application can be extended to bilateral alteration of the parasternal cartilages by performing the sub-axillary incision bilaterally. When more than four cartilages are removed, the chest is stabilized by articulated bars made using cylindrical fragments obtained by the division of the removed costal cartilages. This thoracoplasty technique performed with a minimally invasive sub-axillary access is simple and safe. It allows the effective treatment of severe PC with either unilateral asymmetric or bilateral costal cartilages deformities, avoiding the median sternal incision and the use of the metallic bar. PMID:23111343

Andreetti, Claudio; D'Andrilli, Antonio; Venuta, Federico; Rendina, Erino Angelo



Neoplasias mielodisplásicas o mieloproliferativas: Tratamiento (PDQ®)

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


Opciones de tratamiento y estudios clínicos

Información sobre las opciones de tratamiento de varios tipos de linfoma no Hodgkin, entre ellas, la posibilidad de participar en un estudio clínico. Conozca los conceptos básicos de los estudios clínicos y consulte la lista de los estudios que tienen inscripción abierta.



Microsoft Academic Search

portamentales. Se presentan en este trabajo, distintos tipos de tratamientos psicológicos que en los últimos años han demostrado su efectividad en la reducción de la presión arterial esencial. Se consideraron im­ portantes para individuos hipertensos leves, la implementación de procedimientos tales como: la relajación, el entrenamiento autóge­ no, la retroalimentación biológica, la meditación, el Hatha -Yoga, la reestructuración cognitiva y

Lilia Mabel Labiano; Claudia Brusasca



Tratamientos de la colestasis crónica en niños  

Microsoft Academic Search

ResumenSe dispone de pocos tratamientos específicos para los niños con colestasis crónica. La mayoría de las estrategias terapéuticas alivian la retención de componentes de la bilis o aminoran algunas de las consecuencias de la colestasis crónica. El ácido ursodesoxicólico es el fármaco que con más frecuencia se utiliza en niños con colestasis crónica. Este ácido biliar se administra a la

Fernando Álvarez



Dextroposition of the Heart.  

National Technical Information Service (NTIS)

An 18-year-old male recruit underwent a physical examination to assess fitness for enrollment into the Naval Academy. There was no health complaint. His medical history was significant for a pectus excavatum. His surgical history was notable only for a co...

D. P. Shmorhun R. G. Malish V. B. Ho



The use of a lateral stabilizer increases the incidence of wound trouble following the Nuss procedure  

Microsoft Academic Search

BackgroundA lateral stabilizer has been used to prevent bar displacement during the Nuss procedure for pectus excavatum repair in pediatric patients. We experienced wound troubles in patients who had a stabilizer placed within them. The aim of this study was to examine the effect of a lateral stabilizer and other clinical factors on wound troubles after the Nuss procedure.

Atsushi Watanabe; Toshiaki Watanabe; Takuro Obama; Hisayoshi Ohsawa; Tooru Mawatari; Yasunori Ichimiya; Tomio Abe



Tratamiento del paludismo pediátrico: Papel de las intervenciones nutricionales  

Microsoft Academic Search

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

Akoto Kwame Osei; Davidson H. Hamer



Management of Congenital Chest Wall Deformities  

PubMed Central

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

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




Microsoft Academic Search

RESUMEN. Sobre el tratamiento de Galium L. (Rubiaceae) en Flora Iberica. El estudio taxonómico del género Galium para Flora Iberica ha revelado la existencia en el territorio de 51 especies y 14 subespecies. Éstas han sido agrupadas en 10 secciones, previamente descritas, reconociéndose para algunas de ellas nuevas series: Galium sect. Galium ser. Trichogaliopsis (Lange) Ortega-Olivencia & Devesa, Galium sect.



Off-pump coronary artery bypass in poland syndrome with dextrocardia: case report  

Microsoft Academic Search

Poland Syndrome is a congenital disorder characterised by hypoplasia of the pectoral muscles along with upper extremity deformities.\\u000a We encountered a patient with Poland syndrome associated with dextrocardia and also failed pectus excavatum repairs who presented\\u000a to us with symptomatic ischaemic heart disease requiring intervention. He underwent successful off-pump coronary artery bypass\\u000a surgery (OPCABG). As far as we are aware,

Vivek Srivastava; Ranjit More; Augustine Tang



Tratamiento de la infección de esternotomía media con terapia de vacío  

Microsoft Academic Search

Objetivo: Conocer la aplicabilidad y eficacia de este tratamiento usando un sistema artesanal que nos permite aplicar este concepto terapéutico sin disponer del dispositivo actualmente comercializado (KCI

López Almodóvar; Luis Fernando; Cañas Alfonso; Lima Pedro; Calleja Manuel


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

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


Los tratamientos psicológicos en la fobia social infantil y adolescente: una revisión cualitativa  

Microsoft Academic Search

Se presentan los resultados de un estudio cualitativo de revisión de la eficacia de los tratamientos psicológicos utilizados en la fobia social en niños y adolescentes. Se localizaron 26 investigaciones: 5 artículos son diseños de caso único, 6 presentan los datos de un solo grupo tratado y aportan medidas pretest-postest y 16 informes son grupos de comparación entre tratamientos psicológicos

Ana Isabel Rosa Alcázar; Pablo J. Olivares-Olivares; Marina Iniesta



Tratamiento numérico de la información hidrogeológica: fases de estudio y ejemplos de aplicación  

Microsoft Academic Search

En este trabajo se ha realizado una recopilación de algunos de los métodos estadísticos y geoestadísticos de estimación usados en hidro- geología. En primer lugar, se lleva a cabo una introducción a las características de los datos hidrogeológicos, para pasar a comentar los pasos a seguir en el tratamiento numérico de los mismos, comenzando por las técnicas estadísticas univariantes, y

R. Jiménez Espinosa




Microsoft Academic Search

La estrategia de tratamiento más utilizada en el cáncer de pul- món no microcítico (CPNM) avanzado es la quimioterapia, concre- tamente la combinación de dos drogas, principalmente cisplatino con gemcitabina, vinorelbina, taxanos, irinotecan. En el pasado se han hecho intentos en vano de revertir la resistencia a la quimiote- rapia. La supervivencia en este estadio no suele superar los 8-10

M. Cobo; M. García; F. Páez; J. Torres; R. Arrabal; C. Pagés; J. L. de la Cruz


Recurrent chest wall anomalies.  


Chest wall anomalies are a heterogeneous group of malformations requiring repair. Recurrence and the need for secondary repair may occur. Congenital anomalies, including bifid sternum, pentalogy of Cantrell, Jeunes's syndrome and Poland's anomaly, rarely recur. Pectus carinatum may recur in the original surgical area or an adjacent area and most often recurs in patients who undergo repair before completion of teenage growth. Pectus excavatum may recur in approximately 5% of patients. Simple recurrence, floating sternum, or Acquired Jeune's syndrome may result. All of these would require reoperation. Each chest wall anomaly recurrence requires an individualized approach to timing and type of repair. Overall excellent results should be obtained for operative repair of recurrences. PMID:12728394

Colombani, Paul M



A complex deformity of appendicular skeleton and shoulder with congenital heart disease in three generations of a Jordanian family.  


A sibship is reported of three generations of a Jordanian family of normal intelligence with a complex malformation of upper extremity, shoulder and thorax, which is combined with variously expressed congenital heart disease. The deformity consists of a flat glenoid fossa, a hypoplastic scapula, aplasia of the humerus and/or radius, bony spurs of the elbow joint and in the shoulder region, hypoplasia of the carpal joints and hypodactyly with aplasia of the thumb. The claviculae are short, thick and abnormally curved and there are kyphoscoliosis and pectus excavatum. Four siblings show congenital heart disease. Pelvis and lower extremity are normal. The condition is inherited as a Mendelian autosomal dominant. PMID:2591070

Boehme, D H; Shotar, A O



A simple idea for approximating the volume of filler needed for chest-wall contour-defects.  


Fillers can be used to correct contour-defects. Due to the irregularities of defects, estimating the volume of filler required can be difficult. This frequently results in surgeons taking a step-wise approach to filler-injection, usually occurring over different appointments. Using a patient with pectus excavatum as an example, we provide a simple tip as to estimating the volume of filler required. In this case, normal saline was poured into the chest-wall defect until the adequate level was reached (from the lateral aspect), while noting how much liquid was used. The patient then had a comparable volume of filler injected. PMID:22938009

Sivathasan, Niroshan; Chakrabarty, Kaushik H



Análisis comparativo de 3 regímenes de tratamiento en niños con linfoma de Burkitt  

Microsoft Academic Search

Resumen  De enero de 1980 a junio de 1996 se trataron en nuestra institución un total de 86 pacientes con linfoma de Burkitt. El presente\\u000a estudio es una revisión retrospectiva en el que se comparan las complicaciones y los resultados de sobrevida utilizando 3\\u000a esquemas de tratamiento distintos.\\u000a \\u000a Se trataron 46 pacientes en el régimen 1, 26 con el régimen 2,

Rocío Cárdenas Cardós; Roberto Rivera Luna; Roxana Martínez Agreda; Carlos Calderón Elvir; Amparo Plata García



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

PubMed Central

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

Yano, Terdsak



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


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

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



Índice de Comportamiento Objetivo. Una medida para valorar la respuesta al tratamiento de pacientes con trastornos de personalidad graves  

Microsoft Academic Search

Una medida que capta la frecuencia e intensidad de comportamientos disfuncionales experimentados, así como el uso de los servicios de salud mental, se desarrollaron y probaron como parte de un ensayo de tratamiento controlado de pacientes con trastorno de personalidad borderline. El índice de comportamiento objetivo (ICO) se realizó con 136 individuos diagnosti- cados de trastorno de personalidad borderline antes

Heather Munroe-Blum; Lynn McClearly


[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].  


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

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



Eurysternum (extra-wide sternum)--a rarely recognized developmental anomaly. Scintigraphic appearances.  


A rarely recognized extra-wide sternum was demonstrated by Tc-99m methylene diphosphonate bone scans in two adult patients. One patient was a 53-year-old man with prostate cancer who had no sternal symptoms or known sternal deformity. The second patient was a 41-year-old man with carcinoma of the lung whose extra-wide sternum was associated with a pectus excavatum deformity involving the lower half of the mesosternum (corpus sternum). A proper name for this developmental abnormality, "eurysternum" (eury-Greek word meaning broad; wide), is suggested. Two other patients, one with another type of wide sternum and another with a mesosternal foramen (fenestra sternii) deformity are also described. Related embryology and developmental anatomy of the sternum are reviewed. PMID:7788985

Park, H M; Seifert, M F



A de novo 3.57 Mb microdeletion in 8q12.3q13.2 in a patient with mild intellectual disability and epilepsy.  


A female patient, nine years of age, is reported with a history characterized by delay of psychomotor and speech development, mild to moderate intellectual disability and persistent sleep disturbances since the age of two. The patient showed facial dysmorphisms, a pectus excavatum and a sandal gap. Apart from lowered intelligence, neuropsychological functioning disclosed impaired attentional capacities and executive control as well as weak motor skills. Genome wide SNP array analysis revealed a 3.57 Mb de novo microdeletion in band q12.3 of chromosome 8. The long lasting sleep disorders turned out to originate from a rare juvenile epilepsy, continuous spike-waves during slow sleep (CSWS) syndrome, that includes the electrical status epilepticus in sleep (ESES) phenomenon. MRI-scanning of the brain showed no abnormalities. To the authors knowledge, this is the first report of a de novo 8q12.3q13.2 microdeletion syndrome that presents with ESES/CSWS. PMID:22138216

Verhoeven, Willem M A; Egger, Jos I M; Feenstra, Ilse; de Leeuw, Nicole



Marfan syndrome with acute abdomen: a case report  

PubMed Central

Introduction Marfan syndrome is an autosomal dominant connective tissue disorder characterized by a combination of clinical manifestations in different organ systems. Patients with Marfan syndrome (MFS) whose lifetimes are extended may be encountered as acute abdomen (appendicitis) cases apart from the obligatory reasons and emergencies arising naturally out of their disease, as in the case reported. Case presentation In a 28-year-old Turkish male, arachnodactyly, pectus excavatum, kyphoscoliosis and, according to pulmonary roentgenogram, a density increase in the left apical field were detected. In addition, according to the echocardiographic examination, Ebstein’s anomaly, mitral valve prolapse, pulmonary hypertension, and inferior deficiency of mitral, aorta, and tricuspid valves were present. The patient was planned to be operated on with the prediagnosis of acute abdomen. Conclusion Taking into consideration the pathologies that may accompany MFS and the probable future complications, the patients must be closely monitored during anesthesia applications and required measures should be taken beforehand.

Zencirci, Beyazit



Minimally invasive thoracic surgery in pediatric patients: the taiwan experience.  


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

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



Lipid storage myopathy with clinical markers of Marfan syndrome: A rare association.  


Disorders of lipid metabolism can cause variable clinical presentations, often involving skeletal muscle, alone or together with other tissues. A 19-year-old boy presented with a 2-year history of muscle pain, cramps, exercise intolerance and progressive weakness of proximal lower limbs. Examination revealed skeletal markers of Marfan syndrome in the form of increased arm span compared with height, Kyphoscoliois, moderate pectus excavatum, high arched palate and wrist sign. He also had mild neck flexor weakness and proximal lower limb weakness with areflexia. Pathologic findings revealed lipid-laden fine vacuoles in the muscle fibers. Possibility of carnitine deficiency myopathy was considered and the patient was started on carnitine and Co Q. The patient made remarkable clinical improvement over the next 2 months. This case is reported for rarity of the association of clinical markers of Marfan syndrome and lipid storage myopathy and sparse literature on lipid storage myopathy in the Indian context. PMID:23349609

Ramakrishnan, Subasree; Narayanappa, Gayathri; Christopher, Rita



The management of anterior chest wall deformity in patients presenting for breast augmentation.  


Anterior chest wall asymmetry is sometimes encountered in patients presenting for consideration of breast augmentation. The chest wall asymmetry or deficiency may be significant enough to consider reconstruction at the same time as breast augmentation in a small number of cases. Customized and prefabricated chest wall implants have been used in a variety of conditions including Poland syndrome, pectus excavatum, and sunken anterior chest. Careful moulage preparation and on-table implant modification are needed to "seat" these implants on the skeletal chest wall under the pectoralis major muscle. The chest wall implant provides a base for the subsequent breast prostheses and fills up a bony deficit that cannot be camouflaged by the breast prostheses alone. PMID:11932625

Hodgkinson, Darryl J



Tratamiento farmacológico del TOC  

Microsoft Academic Search

Summary The pharmacological management of OCD is based in the serotonin reuptake inhibitors (SRI), which are effective and safe. The SRI are as effective as clorimipramine, produce less collateral effects, are well tolerated and produce more attachment. Their antiobsessive efficacy is independent of their antidepressive actions. It has been suggested that high scores in compulsions predict a poor answer to

Cristina Lóyzaga; Humberto Nicolini


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


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

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



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

PubMed Central

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

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



Partial trisomy 8p (8p11.2-->pTER) and deletion of 13q (13q32-->qTER): case report.  


We report a female infant with partial trisomy 8p (8p11.2-->pter) and deletion of 13q (13q32-->qter). She was born with mild hypotonia, intrauterine growth retardation, microcephaly, micrognathia, large low set ears, pectus excavatum, anteriorly placed anus, and bilateral clinodactyly. Echocardiography showed left ventricular hypertrophy, bicuspid aortic valve, dilatation of the aorta and pulmonary artery, and prolapse of atrio-venticular valve leaflets. Cytogenetic investigation of her sister and her father showed that the altered region resulted from a balanced translocation between the part of the long arm of chromosome 13 and short arm of chromosome 8. In partial trisomy 8p, the clinical picture of the patients comprises hypotonia, structural brain abnormalities, facial anomalies including a large mouth with a thin upper lip, a high arched palate, a broad nasal bridge, an abnormal maxilla or mandible, malformed, low set ears, and orthopedic anomalies. Although patients with proximal deletions of 13q that do not extend into band q32 have mild to moderate mental and growth delays with variable minor anomalies, patients with more distal deletions including at least part of band q32 usually have major malformations such as retinoblastoma, mental-motor growth retardation, malformation of brain and heart, anal atresia, and anomalies of the face and limbs. To our knowledge partial trisomy 8p and partial monosomy of 13q have not been reported previously in the same person. PMID:21614986

Ye?ilyurt, A; Dilli, D; Oguz, S; Dilmen, U; Altug, N; Candemir, Z



Anesthetic management of a child with both Marfan syndrome and Turner syndrome.  


Marfan syndrome is an autosomal dominant heritable disorder of the connective tissue that involves primarily the skeletal, ocular, and cardiovascular systems. Turner syndrome is a genetic disorder resulting from partial or complete X chromosome monosomy. We report the anesthetic management of a case of Marfan-Turner syndrome, which is the first such case to appear in the literature to our knowledge. A 3 year old ASA III girl was scheduled to undergo minor plastic surgery. She had a short webbed neck, prognathism, micrognathia, low-set ears, and a high palate. Her anterior and posterior facial heights were long. She had growth retardation, pectus excavatum, and joint laxity. She also had high-degree mitral insufficiency, mitral valve prolapse, and an atrial septal defect. After sevoflurane induction, the airway was secured using a size 2 LMA without any difficulty in the spontaneously breathing patient. Her blood pressure was within normal limits, no arrthymia occurred, and anesthesia was uneventful. Special care should be given to syndromic patients. Prior medical evaluations and any prior anesthetic history can help to focus preoperative evaluations and planning. Preoperatively targeting relevant organ systems, any anatomic or laboratory abnormalities that can be optimized, and perioperative airway management are all key to a successful outcome. PMID:22349745

Ornek, Dil?en; Ayd?n, Gözde Bumin; Kahveci, Kadriye; Ciçek, Fatma; Dikmen, Bayaz?t



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


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

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



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

PubMed Central

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

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



Interstitial deletions at 6q14.1q15 associated with developmental delay and a marfanoid phenotype.  


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

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



A new X-linked dysplasia gigantism syndrome: follow up in the first family and report on a second Austrian family.  


We report on a new X-linked recessive syndrome in 2 unrelated families, consisting of pre- and postnatal growth excess, typical facial phenotype allowing diagnosis at birth, and usually normal physical and intellectual development. The minor anomalies seen at birth include a "coarse" face with wide nasal bridge, short nose with upturned nasal tip, wide open mouth, thick lips, midline depression of the lower lip, enlarged tongue, highly arched palate, large maxilla and jaw, and a short broad neck. Voice is hoarse and affected individuals have a plump, stocky body with pectus excavatum, thoracic scoliosis, hepatosplenomegaly, umbilical and/or inguinal hernias, broad short hands and feet, and in some cases preauricular dimples, abnormal ears, postaxial hexadactyly, hypoplastic index finger nails, and abnormal dermatoglyphics. Early postnatal death is frequent and pathogenetically unexplained. During infancy and childhood the leading manifestations are the overgrowth (greater than 97th centile), striking facial appearance, hypodontia and/or malposition of teeth, genua valga, hypoplastic calf muscles, and clumsiness. Adolescent and adult patients have well proportioned "gigantism" of athletic build (192-210 cm), large "coarse" face, and a deep voice. General intellectual and motor development are either normal or mildly delayed. Results of routine laboratory tests are normal, as are growth hormone and IGF I levels and chromosomes. Pathogenesis remains unknown. Heterozygotes may show some of the characteristic facial changes. PMID:3177454

Behmel, A; Plöchl, E; Rosenkranz, W


Bronchus cardiacus accessorius dexter.  


The diagnosis of bronchus cardiacus accessorius dexter (BCAD) has occurred in 25 cases during the bronchoscopic investigations of 30,000 adult patients of the authors. In most of the cases, this bronchial anomaly has been revealed as an accessory phenomenon, nevertheless, in one of the patients, it was the source of a considerable hemorrhage. In another case reported here in detail, it occurred together with multiple developmental anomalies, such as tracheobronchomegaly, mitral valve prolapse, pectus excavatum, hypoplasy of sinus frontalis on the right side, inguinal hernia on the left side and hyperlipidemia type IV. Family analysis did not confirm the presence of any chromosomal disorders or accumulation of similar developmental anomalies. The forms and frequency of associations of the anomalies are surveyed on the basis of literary data. The recognition of BCAD is of diagnostic importance, since it may explain the persistence of some bronchopulmonary symptoms; furthermore, the exploration of the associated abnormal vascular branches may be very useful in case of an eventual thoracic surgical intervention. PMID:18493504

Barzó, P; Nagy, B



Bronchus Cardiacus Accessorius Dexter  

PubMed Central

The diagnosis of bronchus cardiacus accessorius dexter (BCAD) has occurred in 25 cases during the bronchoscopic investigations of 30,000 adult patients of the authors. In most of the cases, this bronchial anomaly has been revealed as an accessory phenomenon, nevertheless, in one of the patients, it was the source of a considerable hemorrhage. In another case reported here in detail, it occurred together with multiple developmental anomalies, such as tracheobronchomegaly, mitral valve prolapse, pectus excavatum, hypoplasy of sinus frontalis on the right side, inguinal hernia on the left side and hyperlipidemia type IV. Family analysis did not confirm the presence of any chromosomal disorders or accumulation of similar developmental anomalies. The forms and frequency of associations of the anomalies are surveyed on the basis of literary data. The recognition of BCAD is of diagnostic importance, since it may explain the persistence of some bronchopulmonary symptoms; furthermore, the exploration of the associated abnormal vascular branches may be very useful in case of an eventual thoracic surgical intervention.

Nagy, B.



Patterns of pulmonary perfusion scans in normal subjects  

SciTech Connect

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.

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



Tratamiento sintomático de la EM  

Microsoft Academic Search

SUMMARY. Symptomatic Treatment is the treatment of those symptoms that were found in the evolution of disease and are very impor- tant in the management of Multiple sclerosis. In this articule are referred the most important symptoms of the disease and their possibi- lities treatment that have efficacy in the control of the symptoms.

Miguel Ángel



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


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

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




Microsoft Academic Search

PNEUMONIA not complicated in children: treatment The pneumonia defines pulmonary parenchyma as an acute infection of, with a discharge preva- lencia in countries in routes of development, of clinical and radiological changeable presentation; as well as your diverse etiology in the different stages of the childhood. This work of bibliographical review was proposed by the aim to update the treatment

Ricardo Enrique Martearena


Tratamiento nutricional del niño con trastorno neuromotor  

Microsoft Academic Search

The risk of suffering malnutrition is very high in children and adolescents who suffer a certain type of neuromotor pathology (NP) due to different factors that occur in them: motor coordination disorders in the different stages of deglutition, gastroesophageal reflux, oesophagitis, gastritis, gastrocolic reflex alteration, constipation, anorexia, etc. These disorders alter the desirable proportionality between the amount of food given

Isabel Polanco Allué



Nuevos enfoques del tratamiento de la fenilcetonuria  

Microsoft Academic Search

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

Ronen Eavri; Haya Lorberboum-Galski



Síndrome posneumonectomía izquierda. Tratamiento endoscópico precoz  

Microsoft Academic Search

Postpneumonectomy syndrome is characterized by postoperative bronchial obstruction caused by mediastinal shift. The syndrome is well documented in the medical literature as a late complication of right pneumonectomy; however, it rarely occurs following resection of the left lung, and only 10 cases have been published. The pathophysiology, clinical manifestations, prognosis, and treatment are similar for both sides of the lung.We

Carlos A. Rombolá; Pablo León Atance; Antonio Francisco Honguero Martínez; Juan Luis Rueda Martínez; Ana Núñez Ares; Manuel Vizcaya Sánchez



Tratamiento laparoscópico de los remanentes uracales  

Microsoft Academic Search

ObjectivesThe urachus is a vestigial obliterated structure derived from the alantois. Failure of this involution process originates patent urachal remnants. Surgery is the treatment of choice as it prevents both recurrence of symptoms and malignant transformation. The purpose of this study is to present our experience in the laparoscopic management of this pathology.

M. Castanheira de Oliveira; F. Vila; R. Versos; D. Araújo; A. Fraga


Enuresis, otra perspectiva de su tratamiento  

Microsoft Academic Search

Enuresis in childhood is highly frequent, given that 16 % of 5 year-olds wet the bed at night. The negative effects on children and their families should not be underestimated. The allopathic point of view does not include the possibility of treatments other than behavioral therapy, alarms and drug treatment.The present article aims to broaden the therapeutic options, explaining how

Francisco Javier Ramos Alija



Reinserción laboral tras infarto agudo de miocardio (IAM): tratamiento rehabilitador frente a tratamiento convencional tras IAM  

Microsoft Academic Search

IntroductionAcute myocardial infarction (AMI) produces more morbidity-mortality than any other disease in developed countries. It affects the patient's quality of life and work situation, generating significant economic cost. Among the goals of cardiac rehabilitation are: to prolong the patient's life, reduce symptoms, improve physical function, promote good general state and facilitate the resumption of daily activity. The aim of this

N. Álvarez-Bandrés; M. Malillos-Torán; A. Domínguez-Aragó; C. Lapresta; R. Numancia-Andreu



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

PubMed Central

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.

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



Prevalence of olfactory and other developmental anomalies in patients with central hypogonadotropic hypogonadism.  


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

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



Chromosome 10q tetrasomy: First reported case  

SciTech Connect

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

Blackston, R.D.; May, K.M.; Jones, F.D. [Emory Univ., Atlanta, GA (United States)] [and others



Eficacia del tratamiento con leflunomida en pacientes con artritis psoriásica  

Microsoft Academic Search

Psoriatic arthritis (PsA) occurs in 1-3% of the population and 25% of affected patients require systemic therapy. The drugs used in PsA have been developed for other diseases, mainly rheumatoid arthritis (RA), and there are no clinical trials supporting their efficacy and safety in these patients. Leflunomide (LFN) inhibits the activation and proliferation of T-lymphocytes and is considered to be

Ingrid Möller




Microsoft Academic Search

A brief history review of chromomycosis (formerly called chromoblastomycosis) is featured. The disease is a deep subcutaneous mycosis, which is caused by different black dymorphic fungi species from the Hypomycetos gender and Dematiacea family. These organisms live as saprophytes in the soil. In Latin American countries the most frequent species found are Fonseca pedrosoi in tropical endemic and humid subtropical

Zuño Burstein A



Tratamiento de linfomas cutáneos de células T con bexaroteno  

Microsoft Academic Search

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

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



Tratamiento fisioterapéutico en el linfedema de miembro superior postmastectomía  

Microsoft Academic Search

Mastectomy-associated upper limb lymphedema is a common disorder among patients (mostly woman) who have undergone this type of surgery. Patients at risk of suffering from this complication must be trained in healthcare habits which may lead to a good hygiene; this may help them to prevent eventual development of lymphedema. Once settled, an early physiotherapy treatment using combined manual lymphatic

M. M. de la Fuente Sanz




Microsoft Academic Search

Description of the project, construction and final evaluation of a hotel building already operative, located in the way of an aircraft rising route that reaches 80 m height when intersecting the the building vertical axis. Specters and temporal evolution of noise diffusion in the premises are shown here, as well as criteria adopted concerning maximum sound level allowed, design of

Lic. Juan; C. Giménez de Paz; Decibel Sudamericana


Tratamiento de prúrigo nodular con ultravioleta B de banda estrecha  

Microsoft Academic Search

Summary Prurigo nodularis is an uncommon chronic skin condition characterized by multiple intensely itchy papules and nodules. Both the pruritus and the skin lesions are difficult to treat and are often refractory to many treatments. Local, intralesional and sistemic drugs, criosurgery and phototherapy have been employed, even in combination. Therapy of nodular prurigo with narrow band UVB phototherapy is a

Carolina Cantalejo Rodríguez; Ana María; Carrizosa Esquivel; Francisco Camacho Martínez


Efalizumab: ¿un tratamiento seguro para una enfermedad crónica?  

Microsoft Academic Search

Psoriasis is a chronic disease that has a very negative impact on the quality of life of those suffering it. Therefore, treatments that make it possible to satisfactorily control the disease in the long term and maintain a good safety profile are needed. Efalizumab fulfills both requirements. In this article, the potential risks involved in treatment with efalizumab, specifically the

E. Daudén; M. J. Oñate



El ranelato de estroncio en el tratamiento de la osteoporosis  

Microsoft Academic Search

Strontium (Sr), chemical element number 38, has a content in normal diets of 0.022-0.046 mmol\\/day and its physiological levels are between 0.11-0.31 mmol\\/l. Its behaviour is similar to that of calcium. It is distributed in plasma, extracellular liquid, soft tissues and skeleton. It binds to serum proteins and is eliminated through urine and faeces. If administered alone, 25-30% is absorbed

Antonio Torrijos Eslava; Cristina Bohórquez Heras; D. Peiteado López



Novedades en el tratamiento quirúrgico del cáncer de mama  

Microsoft Academic Search

Summary Adecuate surgical treatment is mandatory in order to achieve cure in patients with breast cancer. Breast surgeons have to choice the best surgical technique over the breast and over the axillary nodes. Two new surgical aproaches have been implemented in the last decade: oncoplas- tic conservative surgery and sentinel lymph node biopsy. Oncoplastic surgery provides oncologic safety results and

FM Regueira; N Rodríguez-Spiteri; M García Manero; G Zornoza


Tratamiento oral con laquinimod en la esclerosis múltiple  

Microsoft Academic Search

IntroductionMultiple sclerosis (MS) is a chronic disease of the central nervous system, probably of autoimmune origin. Its early treatment with interferon beta or glatiramer acetate reduces the number of exacerbations, slows disability progression and improves the quality of life, but these treatments are only partially effective and require parenteral administration.

O. Fernández



Tratamiento fisioterápico de la epicondilitis en un tenista joven  

Microsoft Academic Search

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

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



Tratamiento nutricional de los síndromes colestáticos en la infancia  

Microsoft Academic Search

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

Piotr Socha



Listeriosis durante el embarazo: importancia del tratamiento precoz  

Microsoft Academic Search

Listeria monocytogenes infection in pregnant women may have severe consequences for pregnancy outcome. Early antenatal treatment with ampicillin and gentamicin when there is clinical suspicion is highly recommended to avoid neonatal infection caused by maternal bacteremia. We describe three cases with distinct outcomes due to the different timing of treatment.

D. Montañez; I. Camaño; O. Villar; A. García Burguillo; P. Vallejo



Tratamiento canonico del problema de Poincaré. Movimiento del polo.  

NASA Astrophysics Data System (ADS)

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).

Romero, P.; Sevilla, M. J.


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

...excavatum; (xv) Phenylketonuria; (xvi) Sickle cell disease; (xvii) Tay-Sachs disease; (xviii...Cerebral palsy due to birth trauma, (iii) Facial nerve palsy or other peripheral nerve injury; (iv) Fractured clavicle; and...



Biochemical and Physiological Studies of Certain Ticks (Ixodiodea). Qualitative and Quantitative Studies of Hemocytes.  

National Technical Information Service (NTIS)

Qualitative and quantitative studies were made of the hemocytes of 4 tick species from 2 genera representing the 2 principal tick families: Hyalomma anatolicum excavatum Koch and Hyalomma dromedarii Koch (Family Ixodidae), and Argas (Persicargas) persicus...

R. M. Dolp



White truffles, like black ones, are tyrosinase positive  

Microsoft Academic Search

White truffles, Tuber magnatum Pico and Tuber excavatum Vitt. are both albino tyrosinase positive fungi. Interestingly, while both l-tyrosine-3-monooxygenase and l-3,4-dihydroxyphenylalanine oxidase activities of T. excavatum Vitt. decrease versus time after decompartmentalization, those of T. magnatum Pico increase. The Km of both species for l-tyrosine are lower than those for l-3,4-dihydroxyphenylalanine as substrates, while the Vmax with l-tyrosine are very

Michele Miranda; Osvaldo Zarivi; Antonella Bonfigli; Rocchina Porretta; Pierpaolo Aimola; Giovanni Pacioni; Anna Maria Ragnelli




Microsoft Academic Search

Critical limb ischaemia is the final phase of the peripheral arterial disease. The treatment consists of the revascularización, but sometimes, the medical treatment is the only therapeutic option before the amputation. The cellular therapy allows the possibility of dealing with diseases with the use alive cells. This paper is a review about the utilization of adult staminal cells in patients

Beatriz Cuevas Ruiz; Juan Luis Fonseca Legrand; Gerardo Hermida Fernández; Yolanda Gallardo Hoyos




Microsoft Academic Search

En el proceso de extracción de cloruro de sodio a partir de agua de mar queda una salmuera residual rica en sales de sodio y magnesio que al ser tratadas químicamente y al ser evaporada permite recuperar aproximadamente el 75% del cloruro de sodio que queda en dicho residual, lo que puede reducir la contaminación ambiental del litoral y generar

Mariana Estela Colombat Rodríguez; Amada Lissett Colombat Rodríguez



Documento de consenso sobre el diagnóstico y tratamiento de la faringoamigdalitis aguda  

Microsoft Academic Search

Acute tonsillopharyngitis is one of the most common childhood diseases. Viruses are the most frequent origin. Group A Streptococcus (Streptococcus pyogenes) is the main bacterial cause. A culture or a rapid antigen-detection test of a throat-swab specimen should only be done on the basis of clinical scores, in order to avoid over-diagnosis of bacterial origin and unnecessary antibiotic prescription. The

R. Piñeiro Pérez; F. Hijano Bandera; F. Álvez González; A. Fernández Landaluce; J. C. Silva Rico; C. Pérez Cánovas; C. Calvo Rey; M. J. Cilleruelo Ortega



Las hipersomnias: diagnóstico, clasificación y tratamiento Hypersomnia: diagnosis, classification and treatment  

Microsoft Academic Search

Hypersomnia or excessive daytime sleepiness is common in neurological practice and may have different etiologies. Hypersomnia may be defined as sleepiness at an inappropriate time or in an inappropriate situation. It is important to consider that hypersomnia is at times referred to as tiredness or fatigue. A detailed clinical history is essential to reach an accurate diagnosis. A correct diagnosis

M. E. Erro; B. Zandio



Neumotórax complicado en una gestante a término: tratamiento mediante cesárea y videotoracoscopia simultáneas  

Microsoft Academic Search

Spontaneous pneumothorax rarely occurs during pregnancy. The most common cause is almost always related to the presence of apical blebs or bullae. The most frequent symptoms are chest pain and dyspnea and chest radiography usually confirms the diagnosis. The treatment of choice is insertion of a chest drain and surgery should be considered in recurrent pneumothorax or persistent air leaks.

Pedro Rodríguez Suárez; Margarita Medina Castellano; Elena Cortes Cros; Miguel A. Barber Marrero; Jorge Freixinet Gilart; José A. García Hernández



Tratamiento percutáneo de las bioprótesis aórticas disfuncionantes con la prótesis CoreValve ®  

Microsoft Academic Search

Recently, percutaneous aortic valve replacement has emerged as a therapeutic option for patients with severe symptomatic aortic stenosis and a high surgical risk. We report our initial experience in four patients with percutaneous implantation of a CoreValve aortic prosthesis to treat aortic bioprosthesis dysfunction involving aortic stenosis or regurgitation. In-hospital and medium-term outcomes were analyzed. The procedure was performed under

José M. Hernández-García; Antonio J. Muñoz-García; Juan H. Alonso-Briales; Manuel F. Jiménez-Navarro; Antonio J. Domínguez-Franco; Isabel Rodríguez-Bailón; Eduardo Olalla-Mercadé; Eduardo de Teresa-Galván



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

Microsoft Academic Search

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

María Elena; Mendoza Figueroa




Microsoft Academic Search

The carrying out and publication of studies that assess the efficacy and efficiency of drug-addiction treatment programmes is an im- portant requirement, both in social and economic terms -for health authorities- and in deontological terms -for the psychology profes- sion. The present work offers a brief description of the main methodological characteristics of these studies, outlines the principal aspects of

José Ramón Fernández Hermida; Roberto Secades Villa



Microsoft Academic Search

With the objective to describe the extent of treatment adherence and identify factors that impact antiretroviral treatment among individuals participating in the HIV treatment program of the Ministry of Health in Tamaulipas, Mexico between June 2008 and October 2008. A cross-sectional study including all individuals in the treatment program (117) was carried. To identify non-adherence in the last four days

Maria Isabel Peñarrieta; Tamil Kendall; Norma Martinez; Ana María Rivera; Nora Gonzales; Elva del Angel



Pacientes en tratamiento por desnutrición en atención primaria, estudio sobre 500 pacientes reales  

Microsoft Academic Search

Objective: The worsening of the nutritional status of certain segments of the population has led to frequent si- tuations of chronic undernourishment even in the he- althy population. There are very few data available on the prevalence and causes of malnutrition in Primary Health Care. The present study attempts to provide me- asurable information, obtained at random from the doc-

A. Soto Moreno; E. Venegas Moreno; M. Santos; Rubio M; León Sanz; P. P. García Luna; Virgen del Rocío




Microsoft Academic Search

The recurrent aphthous stomatitis is a painfull ulceration of the oral mucose that appeared in children in school age and in adults and it is observed between 10 and 60% of the population. It has been classified according to the shape of appearance, size and number of lessions and duration. It is a broadly observed pathology in the world population

María Gabriela Acosta; Iraida Labrador



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

Microsoft Academic Search

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

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



El tratamiento de la violencia en el futbol por la prensa deportiva  

Microsoft Academic Search

Journalists are also main players with regard to violence in sports. Many organisms are worried about this issue and have pointed out the need for the mass media to take care of their own behaviour in order not to create a climate of violence. In this report, we exhaustively review those actions carried out by sports journalists that contribute to

JoseBarrero Munoz


Tratamiento supresor de la TSH en el cáncer diferenciado de tiroides. un dogma en revisión  

Microsoft Academic Search

TSH-suppressive therapy (ST) is part of the treatment protocol for differentiated thyroid carcinoma (DTC). There is however little evidence of its clinical effectiveness. On the other side, ST is not free from side effects related to the subclinical hyperthyroidism status induced in patients for a long time period. Because of this, widespread use of ST in all patients has recently

Carles ZAFON


Tacrolimus tópico en el tratamiento de la dermatitis atópica en niños  

Microsoft Academic Search

More than five years have passed since tacrolimus (Protopic®) has been put on the market in Spain. This is sufficient time to reevaluate the successes and failures that this product has had after the great expectations created prior to the time when it was put on the market based on its extensive experimentation in clinical trials and very encouraging results.

A. Torrelo



¿Es útil el ejercicio en el tratamiento de la espondilitis anquilosante?  

Microsoft Academic Search

Ankylosing spondylitis (AS) is a chronic inflammatory disease that affects mainly young men. This disease can affect axial and peripheral joints as well as specific organs, thus impairing quality of life in these patients. There are three types of treatment interventions in these patients: medical treatment, surgical treatment and physical-rehabilitation therapy. Physical-rehabilitation therapy includes distinct modalities such as hydrotherapy, electrothermotherapy,

Alejandra López Robles; Rubén Queiro Silva; Marta Sánchez Menéndez; María Mercedes Alperi López; José Luis Riestra Noriega; Francisco Javier Ballina García




Microsoft Academic Search

Non-small cell lung cancer (NSCLC) is the leading cause of cancer deaths for both men and women in our society. Patients with advanced-stage NSCLC managed with supportive care alone have a median survival of 5 months, and only 10% live 1 year. Treatment with chemotherapy can make a difference, and it is therefore of paramount importance to understand the latest

M. Cobo; M. García; F. Paez; J. Torres; R. Arrabal; C. Pagés



Micafungina en el tratamiento de la infección fúngica en modelos animales  

Microsoft Academic Search

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

Francisco Javier Pastor; Josep Guarro




Microsoft Academic Search

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

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


Consumo de drogas en mujeres asistentes a centros de tratamiento especializado en la Ciudad de México  

Microsoft Academic Search

The most frecuently consumed drugs once in a lifetime were: tobacco (89.3%), alcoholic drinks (77.3%), marijuana (30.4%), crack (18.4%), cocaine hydrochloride (17.0%) and solvents and removers (15.4%). During the last year of use they were: tobacco (82.9%), alcoholic drinks (65.6%), marijuana (19.4%), crack (15.3%), cocaine hydrochloride (10.9%) and solvents and removers (10.1%). During the last month of use they were:

P. Isaías; Castillo Franco; Alma Delia; Gutiérrez López


Creación de ascitis artificial para el tratamiento mediante radiofrecuencia percutánea del hepatocarcinoma cercano al diafragma  

Microsoft Academic Search

Surgical resection is the first-line curative treatment of hepatocellular carcinoma (HCC). However most patients are unable to undergo surgical resection because of advanced tumoral stage, severe liver dysfunction or poor clinical status. Therefore, image-guided tumor ablation techniques have been introduced for the treatment of unresectable HCC. Among them, radiofrequency ablation (RFA) has been demonstrated to be an effective alternative curative

Luisa Adán Merino; Antonio Olveira Martín; Juan Pedro Pérez Robledo; Isabel Prieto; Francisco Gea Rodriguez; Pilar Castillo Grau; Eduardo Martín Arranz; Eduardo Alonso Gamarra; Pedro Mora Sanz



Inmersión en agua para el tratamiento adyuvante de la ascitis refractaria en pacientes con cirrosis hepática  

Microsoft Academic Search

Summary Background: Head-out water immersion has been proposed as an adjuvant treatment in refractory ascites and hepatorenal syndrome. We undertook this study to present the results of management of patients with refractory ascites. Methods: We included 10 patients with diagnosis of hepatic cirrhosis and refractory ascites. Variables were measured in four stages: stage I (basal); II (at the end of

María-Elena López-Ortega; Ernesto Santiago-Luna; Mario Salazar-Páramo; José Luis Montañez-Fernández; Jacqueline Osuna-Rubio; Alejandro González-Ojeda



Tratamiento de la ascitis en pacientes cirróticos Treatment of ascites in cirrhotic patients  

Microsoft Academic Search

Ascites is the most frequent complication of hepatic cirrhosis and its appearance brings a reduction of survival. The treatment aims to mobilise the intraperitoneal liquid and to prevent its reaccumulation. The first step of treatment includes rest in bed, a hyposodic and spironolactone diet, alone or in combination with furosemide or torasemide. However, 10-20% of patients do not respond to

I. Elizalde; J. M. Zozaya


Tratamiento de la tendinopatía calcificante de hombro: ¿iontoforesis con ácido acético u onda corta?  

Microsoft Academic Search

IntroductionCalcifying tendinitis of the shoulder (TCH) is a crippling, painful and common disease with high socio-economic impact. This study has aimed to compare iontophoresis with acetic acid (IAA) with shortwave (SW), both associated with ultrasound (US) and a physiotherapy home shoulder program in two groups of patients with TCH.

D. Jiménez-García; E. López-Dolado; M. C. López-Zarzuela



Hacia la implementación de una guía de práctica clínica para el tratamiento del asma  

Microsoft Academic Search

Abstract. Dados los esfuerzos que el personal sanitario hace para la definición de guías de práctica clínica (CPG) por su elevado impacto en la calidad de los cuidados y la dificultad de su implantación, hemos considerado necesario desarrollar una,solución efectivade cara a laimplantación de CPGsmediante Sistemas de Ayuda a la Toma de Decisiones (DSS). Por la importancia de lo antedicho,

Pikatza F. J; Lopez de Ipiña


Tratamiento Multicomponente de un Caso de Mutismo Selectivo Multicomponent treatment in a case of selective mutism  

Microsoft Academic Search

This study displays the process of evaluation and treatment of a 6 year old girl who fulfi lls the diagnoses criteria for selective mutism according to the DSM-IV-TR. The treatment includes strategies that surpass the individual setting and considers the institutional setting (family and school). With the purpose of reach- ing the proposed therapeutic objectives, two differentiated phases were designed.

José Olivares Rodríguez; José Antonio; Piqueras Rodríguez; Ana Isabel; Rosa Alcázar; Facultad de Psicología


Revisión y recomendaciones sobre la prevención, diagnóstico y tratamiento de la infección posnatal por citomegalovirus  

Microsoft Academic Search

Postnatal cytomegalovirus (CMV) infection in the newborn can occur from exposure to maternal cervical secretions during birth, ingestion of breast milk, transfusion of blood products or transmission by body fluids of infected people. Breast milk is the main source of infection, given the high rate of CMV-positive mothers excreting CMV in milk. Freezing reduces the risk of CMV transmission by

A. Alarcón Allen; F. Baquero-Artigao



Utilidad de la herramienta FRAX en el tratamiento de la osteoporosis en población femenina española  

Microsoft Academic Search

Background and objectiveOsteoporotic fractures involve a significant consumption of health resources. Bone densitometry has been essential in the management of osteoporosis. However, for fracture absolute risk prediction, other important clinical risk factors are also important. WHO published a risk estimation tool (FRAX), and the National Osteoporosis Guideline Group (NOGG) reported thresholds for densitometry assessment based on cost-effectivity criteria. Our goal

Rafael Azagra Ledesma; Daniel Prieto-Alhambra; Gloria Encabo Duró; Enrique Casado Burgos; Amada Aguyé Batista; Adolfo Díez-Pérez



The corophiid amphipods of Tauranga Harbour, New Zealand: evidence of an Australian crustacean invader  

Microsoft Academic Search

Using morphological and molecular techniques we examined the corophiid amphipods in the Waimapu Estuary, Tauranga Harbour in the North Island of New Zealand. Based on morphology we identified two New Zealand endemic species, Paracorophium lucasi and P. excavatum, as well as P. brisbanensis, previously recorded only from the eastern coast of Australia and Corophium sp. which has not been previously

Mark I. Stevens; Ian D. Hogg; M. Ann Chapman



The corophiid amphipods of Tauranga Harbour, New Zealand: evidence of an Australian crustacean invader  

Microsoft Academic Search

Using morphological and molecular techniques we examined the corophiid amphipods in the Waimapu Estuary, Tauranga Harbour in the North Island of New Zealand. Based on morphology we identified two New Zealand endemic species, Paracorophium lucasi and P. excavatum ,a s well asP. brisbanensis, previously recorded only from the eastern coast of Australia and Corophium sp. which has not been previously

Mark I. Stevens; Ian D. Hogg; M. Ann Chapman



Population genetic structure of New Zealand's endemic corophiid amphipods: evidence for allopatric speciation  

Microsoft Academic Search

Allozyme electrophoresis was used to examine population genetic structure at inter- and intraspecific levels for the New Zealand endemic corophiid amphipods, Paracorophium lucasi and P. excavatum. Individuals were collected from estuarine and freshwater habitats from North, South and Chatham Islands. Analyses of genetic structure among interspecific populations indicated clear allelic differentiation between the two Paracorophium species (Nei's genetic distance, D




Uso clínico del agregado de trióxido mineral (MTA) en el tratamiento de lesiones periapicales y perforaciones radiculares  

Microsoft Academic Search

The use of MTA cement (mineral trioxide aggregate) to solve endodontics treatment complications, like pulpar floor camera perforations during root canal treatment, as well as a retrograde obturation material of apicectomy treatment, was the purpose of this investigation. White MTA Angelus, (Industria de productos odontologicos Ltda. Londrina-PR-Brazil) was used wich has 10 - 15 minutes as initial and final hardening

Martha Elena; Pineda Mejía; Silva Infantes; Doris Salcedo Moncada; Antonia Castro Rodríguez; Liliana Terán Casafranca; Ortiz Cárdenas; Julio Ochoa Tataje; Jorge Gaitán Velásquez


El papel de las combinaciones de antirretrovirales a dosis fijas en el tratamiento de la infección por VIH-1  

Microsoft Academic Search

The launch of generic forms of some of the drugs included in fixed-dose combinations of antiretrovirals (FDCA) raises the potential risk of breaking these combinations in order to allow the administration of the new cheaper generic drug. This could result in a step back in some major advances achieved in simplicity and treatment adherence, resulting in an increased risk of

Josep M. Llibre; Antonio Antela; José Ramón Arribas; Pere Domingo; Josep M. Gatell; José López-Aldeguer; Fernando Lozano; Celia Miralles; José Moltó; Santiago Moreno; Enrique Ortega; Melcior Riera; Antonio Rivero; Concepción Villalonga; Bonaventura Clotet




Microsoft Academic Search

El presente trabajo revisa algunos de los aspectos más destacables de la fiscalidad sobre el consumo de bienes nocivos como instrumento de intervención vinculada a las políticas de salud y a la corrección del fallo de mercado. El objetivo no es otro que el de repasar el estado de conocimiento al respecto, destacando las variables que delimitan el marco de

Guillém López Casasnovas; Esther Martínez García




Microsoft Academic Search

A novel alternative with great potential of use is proposed to replace chlorine with another biocide in cooling systems. This alternative has a minimum environmental impact and allows the establishment of a microbiological control of cooling systems by decreasing the bacteria popu- lation commonly present in cooling water. The proposed alternative to be used as biocide is the electrolytically generated




Cólera: Una revisión actualizada. Parte 3. Complicaciones del cólera. Tratamiento. Genética del cólera. Mecanismos de control de la epidemia. Referencias  

Microsoft Academic Search

Cholera: An updated review. Part 3. Cholera complications. Treatment. Genetics of cholera. Mechanisms for the control of the epidaemia. References. This review gives a complete, precise and update information on the cholera disease, from its beginning in the world up to the current seventh pandaemia, which already is present in South America, including Peru, Colombia and Venezuela. Information is given

Pedro José Salinas



Microsoft Academic Search

An experimental study was done at the Clinic for the Develop- ment of Natural and Traditional Medicine with the purpose to com- pare the effectiveness of acupuncture and western medicine in the treatment of sacrolumbalgy in workers exposed to labor risk factors. Patients were assigned, in a probabilistic sequential way, to two treatment groups. The most frequent labor risk factors

Pintos J; Caballero EL; Suárez R; Romero JM; Jesús Pintos Valluerca; Eduardo Lázaro; Caballero Poutou; René Suárez Martínez; Juana María Romero del Sol


Dosis bajas de cinacalcet reducen el calcio sérico en pacientes con hiperparatiroidismo primario no subsidiario de tratamiento quirúrgico  

Microsoft Academic Search

We present our experience with low-dose cinacalcet to normalize serum calcium in patients with primary hyperparathyroidism (PHPT) not eligible for surgery. We analyzed the impact of this drug on various parameters of calcium-phosphorus metabolism and its tolerability profile.We recruited 17 patients diagnosed with PHPT who had hypercalcemia and also met one or more of the following inclusion criteria: elevated risk

Alfonso Arranz Martín; Andrea Azcárate Villalón; Manuel Luque Ramírez; Blanca Santana Durán; Mónica Marazuela Azpíroz; Amalia Paniagua Ruiz; Raffaele Carraro; Antonio Gómez Pan



Fallas en los tratamientos termicos para aceros de herramienta. (Failures on the heat treatments of steels for tools).  

National Technical Information Service (NTIS)

The main objective of the work was to determine the most common defects occuring in tool steels of the AISI D-2, S-1, 0-1 and W-2 series during thermal treatment. Defects were evaluated by metallographic analyses, a method used to determine and recognize ...

G. Nunez-Gonzalez



Documento de consenso sobre tratamiento con infusión subcutánea continua de insulina de la diabetes tipo 1 en la edad pediátrica  

Microsoft Academic Search

This article reports on the Spanish Position Statement for the Diabetes Pediátric Group for the Spanish Pediatric Endocrinology Society (SEEP) on continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes. The practical issues about their indications, appropriate candidates, feasibility, and limits are outlined. The conclusions are based on the comprehensive review and balanced assessment of the evidence

R. Barrio Castellanos; B. García Cuartero; A. Gómez Gila; I. González Casado; F. Hermoso López; C. Luzuriaga Tomás; M. Oyarzabal Irigoyen; I. Rica Etxebarria; M. Rodríguez Rigual; M. Torres Lacruz




Microsoft Academic Search

Objectives. To compare the efficacy of two treatments of the diabetes mellitus: insulin glargine, an analogue of long-acting insulin (Lantus®), and intermediate acting isophanic insulin (NPH insulin). Method. Modelized retrospective cost-utility analysis, from the pers- pective of the Spanish Health System (considering the direct health costs). It was simulated the evolution during 9 years of the patients with type 1

Carlos Rubio-Terrés; Javier Rodríguez; Bjorn Bolinder; Pedro de Pablos; REES Vol; Cian Magenta; Amarillo Negro


Evidencia Científica actual sobre la utilidad del Ultrasonido de Alta Intensidad (HIFU) en el tratamiento del Adenocarcinoma Prostático  

Microsoft Academic Search

SCIENTIFIC EVIDENCE ON THE USE OF HIGH-INTENSITY FOCAL ULTRASOUND (HIFU) IN THE TREATMENT OF PROSTATIC CARCINOMA Objectives: To evaluate in the literature scientific evidence on the use of High-Intensity Focal Ultrasound (HIFU) in the treat- ment of prostatic carcinoma (PC). Method: Three database are searched: PubMed, Cochrane Library, HTA database. Several articles were selected taking into account number of cases,

E. Lledó García; J. Jara Rascón; D. Subirá Ríos; F. Herranz Amo; J. I. Martínez-Salamanca; C. Hernández Fernández



Construyendo puentes entre la política ambiental y la política de tratamiento de aguas en la cuenca Lerma-Chapala  

Microsoft Academic Search

The sustainable development of a nation does not recognise divisions bet- ween the importance of economical, ecological, social, political and cul- tural factors. However, an analytical review of the water and environ- mental policies in Mexico does show a gap between them. There are divergences between two sector policies that must be, by definition, con- vergent. In order to demonstrate



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

Microsoft Academic Search

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

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




Microsoft Academic Search

The tropical dry forest (TDF), is ones of the types of vegetation were keep high amount of flora and fauna species. TDF is the tropical forest most endangered major ecosystem. Because the biodiversity and uses are high, this forest is interesting for the conservation and to be considering in different development options. Any option of conservation, restoration, rehabilitation or development,

Guadalupe Hernández-Vargas; Lázaro R. Sánchez-Velásquez; Fernando Aragón



Variabilidad en la realización de la espirometría y sus consecuencias en el tratamiento de la EPOC en Atención Primaria  

Microsoft Academic Search

BackgroundSeveral studies have approached the use of spirometry in the treatment of chronic obstructive pulmonary disease (COPD) in Primary Care (PC), but few have analysed its impact on the treatment of the patient with COPD.

Mònica Monteagudo; Teresa Rodriguez-Blanco; Judith Parcet; Núria Peñalver; Carles Rubio; Montserrat Ferrer; Marc Miravitlles



Anaesthetic implications of nemaline rod myopathy  

Microsoft Academic Search

Nemaline rod myopathy is an inherited congenital myopathy first described in 1963. Affected patients characteristically present\\u000a in infancy with a non-progressive hypotonia and symmetrical muscle weakness. The disease affects all skeletal muscles including\\u000a the diaphragm with sparing of cardiac and other muscle. Facial dysmorphism is common as are skeletal deformities, including\\u000a kyphosis, scolosis andpectus excavatum.\\u000a \\u000a We present two sisters with

Mary Cunliffe; Frederick A. Burrows



New Tuber species found in Poland  

Microsoft Academic Search

New information from a survey of truffles carried out in southern part of Poland in September 2007 is presented. The fruit\\u000a bodies of Tuber aestivum, T. excavatum, T. rufum and one unidentified Tuber sp. were found. The soil chemistry of the five T. aestivum sites was analysed. Our inventory showed that T. aestivum prefers the mixed forest with host-trees such

Dorota Hilszcza?ska; Zbigniew Sierota; Mario Palenzona



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


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

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



Validación del Cuestionario de Variables de Interacción Psicosocial (VIP): hacia un modelo de tratamiento de las conductas adictivas «guiado por la personalidad»  

Microsoft Academic Search

ObjectiveThe personality can be studied at three levels: clinical (disorders), traits and the level of interactive variables. There are valid instruments for the measurement of both first, but we do not have any that explores in a combined way the interactional level. We propose a model of «personality guided treatment» for the addictive behaviours in the direction of the one

E. J. Pedrero Pérez; M. Pérez López; S. de Ena de la Cuesta; C. Garrido Caballero



Zoonosis: Principales Enfermedades Transmisibles de los Animales al Hombre - Causas, Tratamiento y Prevencion (Zoonosis: Principal Diseases Transmittable from Animals to Humans - Causes, Treatment and Prevention).  

National Technical Information Service (NTIS)

The document provides causes, treatment and prevention information on 19 zoonoses--animal diseases that can be transmitted to man. These diseases are: mastitis; cowpox; sacropsiliasis; rabies; trichinosis; tapeworm; hedatidosis; 'estomatitis'; distomatosi...

A. M. Tovar



Linfoma cardiaco primario: diagnóstico citológico y tratamiento con respuesta a poliquimioterapia y a autotrasplante de precursores hematopoyéticos. Presentación de un caso y revisión de la literatura  

Microsoft Academic Search

The primary cardiac lymphoma (PCL) is an extremely infrequent tumor suffered by immunocompetents patients with a difficult diagnosis and slow progress leading to a serious prognosis and few therapeutically possibilities. It's a primary-cardiac non-Hodgkin's lymphoma (NHL) in a patient of 46-year-old, immunocompetent, who started with a congestive heart failure and atrial flutter. Some examinations were carried out such as a

C. Porcar Ramells; C. Clemente González; D. García Parés; R. Guardia Sánchez; F. García-Bragado Dalmau



Doxorrubicina liposomal no pegilada en combinación con ciclofosfamida, vincristina, prednisona y rituximab en el tratamiento de linfomas no hodgkinianos: estudio de 26 pacientes  

Microsoft Academic Search

Background and objectivesNon-pegylated liposomal doxorubicin is associated with lower cardiac toxicity than conventional doxorubicin, and for that reason it has been used in the treatment of non-Hodgkin's lymphoma (NHL) in old patients or patients with cardiac disease. The objective of this study was to evaluate the efficacy and safety of chemotherapy schedules including non-pegylated liposomal doxorubicin in patients with NHL.

Miriam Moreno; Juan-Manuel Sancho; Santiago Gardella; Rosa Coll; Olga García; David Gallardo; Josep-María Ribera



Guía de la EAU sobre el cáncer de próstata. Parte II: tratamiento del cáncer de próstata avanzado, recidivante y resistente a la castración  

Microsoft Academic Search

ObjectivesOur aim is to present a summary of the 2010 version of the European Association of Urology (EAU) guidelines on the treatment of advanced, relapsing, and castration-resistant prostate cancer (CRPC).

N. Mottet; J. Bellmunt; M. Bolla; S. Joniau; M. Mason; V. Matveev; H. P. Schmid; T. van der Kwast; T. Wiegel; F. Zattoni; A. Heidenreich



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

Microsoft Academic Search

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

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


Resultados funcionales de la técnica de placa antideslizante versus técnica de placa lateral para el tratamiento quirúrgico de fracturas del maléolo externo tipo Weber B  

Microsoft Academic Search

Introduction: Ankle fractures are frequent. Its treatment could be surgical and not surgical. The main complication is residual instability of the joint. This would affect its biomechanical behaviour resulting in loss of function and arthrosis. The objective of this study was to determine the functional outcome of antiglide plate versus lateral plate for ankle fractures. Methods: We designed an experimental

Esteban Holguín Maldonado; Juan Manuel Herrera Arbeláez; Oscar Reyes Pardo; Jorge Mesa



Evolución de las Teorías Cognoscitivas y del Tratamiento Cognoscitivo Conductual de la Anorexia Nerviosa The Evolution of Cognitive Theories and Behavioral Therapy for Anorexia Nervosa  

Microsoft Academic Search

Anorexia nervosa is the eating disorder (ED) that represents the highest mortality rate among psychiatric disorders, though the interest of investigators has been particularly centered on bulimia nervosa; probably because its incidence is higher, but also because the complexity of the clinical course of anorexia nervosa supposes a frustrating scenario that is constant for the therapist and the patient. The

Ximena Palacios Espinosa



Microsoft Academic Search

Psychological coping with childhood cancer involves the use of strategies and re- sources that help children and their families undergo the disease with the fewest possible emotional and behavioural problems. In the fi eld of Psychology, techniques and programs have been developed and adapted with the aim of minimising the psychological impact of the diagnosis and treatment of childhood and

Juan Manuel Ortigosa; Francisco Xavier Méndez; Antonio Riquelme



Documento de consenso sobre la evaluación y el tratamiento de la psoriasis moderada\\/grave del Grupo Español de Psoriasis* de la Academia Española de Dermatología y Venereología  

Microsoft Academic Search

The treatment of psoriasis has been revolutionized by the introduction of biologic agents; these agents achieve skin clearance and long-term improvement without the risk of toxicity that has limited use of the classic systemic treatments. The role of systemic treatment in the management of psoriasis is being reviewed on the basis of a large volume of scientific evidence on the

L. Puig; X. Bordas; J. M. Carrascosa; E. Daudén; C. Ferrándiz; J. M. Hernanz; J. L. López-Estebaranz; J. C. Moreno; J. L. Sánchez-Carazo; F. Vanaclocha; H. Vázquez-Veiga



Modelo HACCP General para Productos Carnicos y Avicolas no Perecederos, Sin Tratamiento Termico (Generic HACCP Model for Not Heat Treated, Shelf Stable Meat and Poultry Products).  

National Technical Information Service (NTIS)

The Hazard Analysis Critical Control Point (HACCP) system is a scientific approach to process control. It is designed to prevent the occurrence of problems by assuring that controls are applied at any point in a food production system where hazardous or c...



Application of Generalized Linear Models to Data Analysis in Drinking Water Treatment Aplicacion de modelos lineales generalizados al analisis de datos en el tratamiento de agua potable  

Microsoft Academic Search

In drinking water treatment we found appropriate linear models to ex- plain dose and concentration of sulphate, dose of lime, lime application prob- ability and polymer application probability, including as explanatory variables some physical and chemical properties of raw water.

Zulma Cepeda



Treatment of tinnitus in the elderly: a controlled trial of cognitive behavior therapy Tratamiento del acufeno en ancianos: una prueba controlada de terapia conductual cognitiva  

Microsoft Academic Search

The aim of the study was to investigate the effects of cognitive behavioral therapy (CBT) in elderly people with tinnitus (B \\/65 years). Thirty-seven patients were called in for a structured interview. Following exclusion, twenty- three participated in the trial. All participants underwent medical ear, nose, and throat (ENT) examination, audio- metry, and tinnitus matchings. A randomized controlled design with

Gerhard Andersson; Daniel Porsaeus; Magnus Wiklund; Viktor Kaldo; Hans Christian Larsen


Nitroglicerina transdermica en el tratamiento de la tendinopatia aquilea. Mejoría clínica y funcional constatada con test de marcha. A propósito de un caso  

Microsoft Academic Search

Most patients with Achilles tendon injury improve with conservative treatment, reserving surgery for cases that do not respond, although the symptoms may persist after surgery. Such is the case, a 41 year-old patient subject of conservative and surgical treatment, which persisted despite of all the discomfort. We proposed the introduction of transdermal nitroglycerin patches, aiming at the improvement in the

R. García; J. Cervera; I. Martinez; A. Pina




Microsoft Academic Search

When restoring highly degraded areas such as the Mixteca Alta (Oaxaca State, Mexico), it is important to use native species that promote natural succession. To do so, we need to know whether their seeds have dormancy and how to break it. We compared different pre-germination treatments of eight species relevant for restoration. The results were analyzed with a new method




Tratamiento para la Apnea del Sueno: Revision de la Investigacion para Adultos (Treating Sleep Apnea: A Review of the Research for Adults).  

National Technical Information Service (NTIS)

This information is right for you if a doctor said you have mild, moderate, or severe obstructive sleep apnea, or OSA. People with OSA may snore and stop (or pause) their breathing a few or many times when they sleep; If you are looking for ways to treat ...



Metodologías de Pre-procesamiento y Procesamiento Utilizadas en el Tratamiento Cuantitativo de Datos SAR Para el Estudio de Ambientes en el Bajo Delta del Río Paraná, Argentina  

Microsoft Academic Search

From SAR point of view, the Delta of Paraná's river (Argentina), a major fresh water wetland, represents a complex area where the radar backscattered signal has the influence of the structural properties of the landscape elements as well as of the dielectric properties due to the different flooding conditions of the land cover categories. To understand the different mechanisms that



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

PubMed Central

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

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



Identification of a novel uncultured Rickettsia species strain (Rickettsia species strain Tselenti) in Cyprus.  


In a previous study conducted in Cyprus, various spotted fever group Rickettsia species were detected and identified in ticks by molecular analysis. Among them, a partially characterized Rickettsia species was detected in Hyalomma anatolicum excavatum and Rhipicephalus turanicus ticks. We report characterization of this rickettsial strain by using polymerase chain reaction sequencing analysis of partial citrate synthase A, outer membrane protein A, outer membrane protein B, and 17-kD protein genes. We propose a provisional name Rickettsia sp. strain Tselenti for this strain until it is isolated and further characterized. PMID:23438767

Sandalakis, Vassilios; Chochlakis, Dimosthenis; Ioannou, Ioannis; Psaroulaki, Anna



Eficacia y seguridad de la terapia tópica con capsaicina 0,075% versus mentol 1%, en el tratamiento del prurito de la foliculitis eosinofílica asociada al virus de la inmunodeficiencia adquirida  

Microsoft Academic Search

ResumenObjetivo: ? Determinarlaeficaciayseguridaddelaterapiatópicaconcapsaicina ? 0,075% ? versus ? mentol ? 1% ? eneltratamientodelpruritodelafoliculitiseosinofílicaasociadaalvirusdela ? inmunodeficienciaadquirida ? (VIH). ? Diseño: ? Estudioclínicoaleatorizadoydobleciego. ? Lugar: ? ServiciosdeEnfermedadesInfecciosasyTropicales ? (SEIT) ? yDermatología, ? HospitalNacional ? DosdeMayo, ? Lima, ? Perú. ? Participantes: ? Pacientesconfoliculitiseosinofílicaasociadaal ? VIH. ? Intervenciones: ? Lamuestraestuvoconstituidapor ? 40 ? pacientesconfoliculitiseosinofílica ? asociadaalVIH, ? quienesfuerondistribuidosmediantemuestreoaleatoriosistemáticoendos ? grupos: ? elgrupo ?

Carlos Galarza; Willy Ramos; Humberto Chía; Gerardo Ronceros; Jesús Santiani; Ericson Gutiérrez; Marcos Ñavincopa; María Vilcarromero; Jack Ávila; Jorge Hancco; Deny Gámez



Note. Kinetic parameters of Bacillus stearothermophilus spores under isothermal and non-isothermal heating conditions Nota. Parámetros cinéticos del tratamiento isotérmico y no isotérmico de esporas de Bacillus stearothermophilus  

Microsoft Academic Search

Thermobacteriological studies using Bacillus stearotherrnophilus spores were carried out by heating the spores under isothermal and non-isothermal conditions followed by an isothermal period. Ex perimental data obtained after isothermal heating were analyzed using a two-step linear regression procedure and a one-step nonlinear regression method. Results obtained using both analytical tech niques were close, but the 90% interval of confidence for

P. M. Periago; S. Leontidis; P. S. Fernández; C. Rodrigo; A. Martínez



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

PubMed Central

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

Bueno, Hector; Betriu, Amadeo; Heras, Magda; Alonso, Joaquin J.; Cequier, Angel; Garcia, Eulogio J.; Lopez-Sendon, Jose L.; Macaya, Carlos; Hernandez-Antolin, Rosana; Bueno, Hector; Hernandez-Antolin, Rosana; Alonso, Joaquin J.; Betriu, Amadeo; Cequier, Angel; Garcia, Eulogio J.; Heras, Magda; Lopez-Sendon, Jose L.; Macaya, Carlos; Azpitarte, Jose; Sanz, Gines; Chamorro, Angel; Lopez-Palop, Ramon; Sionis, Alex; Aros, Fernando; Garcia-Fernandez, Eulogio; Rubio, Rafael; Hernandez, Felipe; Tascon, Juan Carlos; Moreu, Jose; Betriu, Amadeu; Heras, Magda; Hernandez-Antolin, Rosana; Fernandez-Ortiz, Antonio; Moris, Cesar; de Posada, Ignacio Sanchez; Cequier, Angel; Esplugas, Enrique; Melgares, Rafael; Bosa, Francisco; Garcia-Gonzalez, Martin Jesus; Lezaun, Roman; Carmona, Jose Ramon; Vazquez, Jose Manuel; Castro-Beiras, Alfonso; Picart, Joan Garcia; de Rozas, Jose Dominguez; Fernandez, Jose Diaz; Vazquez, Felipe Fernandez; Alonso, Norberto; Zueco, Jose Javier; San Jose, Jose Maria; San Roman, Alberto; Hernandez, Carolina; Garcia, Jose Maria Hernandez; Alcantara, Angel Garcia; Bethencourt, Armando; Fiol, Miquel; Mancisidor, Xabier; Mancisidor, Xabier; Ruiz, Rafael; Hidalgo, Rafael; Sobrino, Nicolas; Maqueda, Isidoro Gonzalez; Torres, Alfonso; Aros, Fernando; Amaro, Antonio; Jaquet, Michel



Efecto del tratamiento con 8-MOP mas UVA en la supervivencia y reparacion de pBR322. (Effect of 8-MOP plus treatment on survival and repair of plasmid pBR322).  

National Technical Information Service (NTIS)

We have studied the lethality produced in pBR322 DNA after PUVA treatment (8-MOP+UVA). As recipients, we used a collection of E. coli strains differing in their repair capacities and analysed the involvement of several DNA repair pathways in the removal o...

C. Bauluz R. Vidania




Microsoft Academic Search

This study compares 100 hypertensive patients in emergency units with those who were seen in outpatient clinics. Hypertensive patients seen at the emergency unit showed to be different (p < 0.05) from those seen at the outpatient clinic regarding: higher blood pressure; lower income; not belonging to the hospital community; greater alcohol intake; became aware of their hypertension because felt

Cristiane Garcia Sanchez; Maria G. Pierin; Décio Mion Jr; Angela Maria Geraldo Pierin



El compostaje como tecnologia para el tratamiento de residuos: compostaje de bagazo de sorgo dulce con diferentes fuentes nitrogenadas. (Composting as a waste treatment technology: composting of sweet sorghum bagasse with different nitrogen sources).  

National Technical Information Service (NTIS)

The purpose of this work is to study aerobic solid fermentation of sweet sorghum bagasse in mixture with other additives as nitrogen sources to evaluate the utilization of this material as a substrate for composting. The characteristics of sweet sorghum b...

J. Vicente J. E. Carrasco M. J. Negro



Evaluacion de Tratamiento de Oxido de Cromo para Absorbedores Solares Applicados por Proyeccion con Sopletes de Plasma (Evaluation of the Chromium Oxide Arc Spraying Treatment on Solar Energy Collectors).  

National Technical Information Service (NTIS)

Accelerated aging tests were performed on steel specimens coated with plasma gun Cr2O3 arc sprays. The chromium oxide coating is attractive due to its radiation absorptance characteristic, especially for solar thermal energy absorption applications. The u...

G. Fernandezarroyo A. Gonzalezgarcia-conde F. Moralespoyato J. M. Arrerajaraiz C. Blancotemprano



Evaluacion de la radiacion ionizante como tratamiento de control cuarentenario de la falsa aranita de la vid (Brevipalpus chilensis Baker). (Evaluation of ionizing radiation applied to quarantine control of the false grape mite).  

National Technical Information Service (NTIS)

The objectives of this study were to evaluate effect of three dosages of ionizing radiation in combination with cold storage (0-2(sup 0) C), and the effect of cold storage without irradiation, establishing time curves for eclosion of eggs and mortality of...

Y. Jadue C. A. Vargas



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

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


Late Holocene benthic foraminifera and paleoenvironments of the Louisiana coast  

SciTech Connect

The foraminiferal assemblages of 5 vibracores from Isles Dernieres on the Louisiana coast indicate significant environmental shifts within the past 1000 years. The cores, 2 offshore and 3 from the back barrier region, represent mainly the progradational phase of the Early Lafourche delta. Overall, Ammonia parkinsoniana and Elphidium excavatum dominate the faunas, except those of marshes and low-salinity interdistributary bays. However, a cluster analysis of species frequencies demonstrate that 5 past environments can be distinguished on the basis of some minor constituents of the assemblages. In both offshore cores, Elphidium poeyanum, Buliminella morgani, and Quinqueloculina seminulum are common in the basal, prodelta part; a reducing environment is indicated by pyrite-filled tests. A low-diversity transition zone above this is characterized by a 85-90% dominance of Ammonia parkinsoniana and Elphidium excavatum. Two delta front environments are represented in the top part of these cores. Elphidium discoidale, E. galvestonense, Hanzawaia concentrica, and Ammontium salsum are common in both, but the species diversity is lower in the upper, shallow-water facies. Marsh and low-salinity interdistributary bay facies, represented in the onshore cores, are characterized by the dominance of agglutinated species. The facies changes in the onshore cores are more complex and represent shorter time spans than in the offshore cores.

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



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

USGS Publications Warehouse

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

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



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

PubMed Central

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.

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



Unilateral spinal anaesthesia in a patient with Osteogenesis Imperfecta with a lower leg fracture: a case report.  


Osteogenesis Imperfecta is a rare, genetically determined disease with several possible complications in anaesthesia. Anaesthesiologists therefore pay special attention to the treatment of patients suffering from Osteogenesis Imperfecta since they commonly suffer from a difficult airway and intraoperative positioning difficulties. We report here the case of unilateral spinal anaesthesia in a patient suffering from Osteogenesis Imperfecta type I. A 28-year-old patient diagnosed with Osteogenesis Imperfecta type I was admitted to the hospital due to lower leg fracture requiring surgical treatment. The patient had blue sclerae, triangular-shaped face, macroglossia, scoliosis of thoracic and lumbar parts of the spine, pectus carinatum and thrombocytopenia. Upon the correction of thrombocytopenia, unilateral spinal anaesthesia with hyperbaric levobupivacain was chosen in order to avoid possible complications typical for general anaesthesia. Consequently, unilateral spinal anaesthesia with a customized local anesthetic could be consdered as a safe anesthetic method for such patients. PMID:24060019

Baranovic, Senka; Lubina, Ivan Zvonimir; Vlahovic, Tomislav; Bakota, Bore; Maldini, Branka



Complete monosomy mosaic of chromosome 21: case report and review of literature.  


Complete monosomy mosaic of chromosome 21 is a rare disorder. The syndromic features are highly variable. This study describes a girl of Mexican origin with complete monosomy 21 in mosaicism with novel findings, including cortical atrophy, macrostomia, pectum excavatum and immune deficiencies. Parental karyotypes were normal. FISH analysis with probes from 21q22.1-q22.2 region and centromere of X DNA probe was performed on peripheral blood lymphocytes whereas 21q22.1-q22.2 and 21q, 4p, 4q subtelomeric DNA probes were tested in fibroblasts. We propose that the monosomy 21 mosaicism is the cause of the survival of children with more than 4 months of age. PMID:22985727

Toral-Lopez, Jaime; Gonzalez-Huerta, Luz Maria; Cuevas-Covarrubias, Sergio A



Tick paralysis: first zoonosis record in Egypt.  


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

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



Isolation and purification procedures for the preparation of paralytic shellfish poisoning toxin standards.  


Paralytic shellfish poisoning (PSP) is caused by mixtures of saxitoxin analogs of which more than eighteen are known. Reliable and sensitive analytical methods and assays for these toxins are essential to protect the consumer and the shellfish industry, but research has been restricted by a shortage of the pure compounds. Only saxitoxin has so far been generally available as a PSP toxin standard, yet sulfated analogs usually occur in higher concentrations than saxitoxin in toxic marine algae and shellfish. Methods are described for the purification of some of the common PSP toxins, in quantities sufficient for the preparation of PSP standards from the dinoflagellate Alexandrium excavatum, the giant sea scallop (Placopecten megallanicus) hepatopancreas, and the cyanobacterium Aphanizomenon flos-aquae. Purity was monitored by high performance liquid chromatography with fluorescence detection (HPLC-FD), ionspray mass spectrometry (ISP-MS), capillary electrophoresis (CE), and proton NMR spectroscopy. PMID:7952941

Laycock, M V; Thibault, P; Ayer, S W; Walter, J A



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

USGS Publications Warehouse

A 3.5-m gravity core (DJ6-93SF-6) from San Francisco Bay reveals a complex paleoclimatic history of the region over the last 3870 cal YBP. A polynomial equation based on 11 AMS 14C ages provides an excellent age model for the core, and environmental proxies for water temperature and salinity are derived from various foraminiferal abundances, stable carbon and oxygen isotopes, and Mg/Ca ratios. Two foraminiferal associations were identified by Q-mode cluster analysis: a colder-water Elphidium excavatum association and the warmer-water Ammonia beccarii-Elphidium gunteri association. The E. excavatum association dominates the core for all but about 600 years out of the last four millennia. At 3870 cal YBP, water temperatures were warm (13.9??C) and freshwater inflow was reduced compared with today. From 3590 to 2860 cal YBP, temperatures dropped 0.5??C and the climate remained dry. This was followed by a period of pronounced lower ??13C values, indicating that conditions became considerably wetter from 2860 to 2170 cal YBP. During this interval, the temperature oscillated frequently, peaking at 13.9??C at 2710 cal YBP, then dropping shortly thereafter to 12.8??C at 2420 cal YBP. Freshwater inflow gradually decreased between 2170 and 1950 cal YBP with a minimal rise in temperature, then changed quickly to colder and wetter conditions at 1900 cal YBP. Drier conditions then prevailed until 1480 cal YBP with water temperatures fluctuating between 13.1??C and 13.8??C, followed by wetter climate from 1480 to 1320 cal YBP. A significant faunal shift from the E. excavatum association to the A. beccarii-E. gunteri association occurred from 1250 to 650 cal YBP, possibly due to regional warming, decreased oxygen availability, and/or a change in the phyto-plankton community. Associated with this change in faunal composition were warm and dry conditions, representative of the Medieval Warm Period (Medieval Climatic Anomaly). A climatic shift coincident with the onset of the Little Ice Age (LIA I and LIA II) is evident from 650 to 280 cal YBP, with the return of the E. excavatum association and an extreme drop in ??18O values, all indicating increased precipitation and fresh water inflow. This was followed by generally drier conditions to the present, except for a brief wet period around 100 cal YBP, and fairly consistent water temperatures in the middle 13??C, except for a drop to 12.8??C at 200 cal YBP. Two significant faunal changes occur near the top of the core. First, there is the reappearance of the A. beccarii-E. gunteri association, suggesting that, once again, regional warming has taken place, oxygen availability has declined, and/or environmental conditions changed such that diatoms have become a scarce food source. Second, there is the first appearance of the invasive Japanese foraminifera Trochammina hadai Uchio, a species that commonly lives in highly polluted areas and is an indicator of eutrophication in its native estuaries. At the same time, freshwater inflow decreased, which may be explained by global warming during the last 100 years, or more likely due to modern water diversion for agriculture in the central valley of California. ADDITIONAL INDEX WORDS: Climate, San Francisco Bay, Holocene, foraminifers, isotopes, trace metals, Medieval Warm Period, Little Ice Age.

McGann, M.



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


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

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



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

PubMed Central

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

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



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)

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.

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



Mecanismos implicados en la reparacion de las lesiones inducidas en pBR322 por tratamiento Puva (8-metoxipsoraleno + luz ultravioleta A). (Mechanisms involved in repairing the lesions induced in pBR 322 by PUVA treatment (8-Methoxypsoralen + ultraviolet A light)).  

National Technical Information Service (NTIS)

This work deals with the genotoxic effects derived from damaging pBR322 DNA through PUVA treatment (8-Methoxypsoralen plus UVA light), both with respect to the lethality and mutagenicity of the lesions produced by the treatment. The mechanisms involved in...

C. Bauluz



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

Microsoft Academic Search

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

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



Los tests de sensibilidad alimentaria no son una herramienta útil para el diagnóstico o el tratamiento de la obesidad u otras enfermedades: Declaración de Postura del Grupo de Revisión, Estudio y Posicionamiento de la Asociación Española de Dietistas-Nutricionistas (GREP-AEDN)  

Microsoft Academic Search

In the face of the growing use of weight-losing strategies as an alternative to conventional methods, the Revision, Study and Positioning Group of the Spanish Association of Dieticians-Nutritionists (GREP-AEDN) has decided to analyse these methods and to provide information on the degree of efficacy, reliability and\\/ or risk involved in their use, specifically of the Food Sensitivity Tests. By means

Mar Garcia-Aloy; Maria Teresa Comas; Julio Basulto; Maria Manera; Eduard Baladia; Núria Ibarrola



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

NASA Astrophysics Data System (ADS)

Over the past decades the Arctic has received more attention due to the rapid warming that is more pronounced there than elsewhere on the globe. Instrumental time series are too short to capture the range of natural variability in the Arctic and we therefore have to rely on proxy records to describe the whole range of natural variability. In this context the late-Holocene climate variations are particularly important because natural forcings and the Earth's boundary conditions have been approximately similar to those operating today. Documenting past natural climate variability has therefore a vital role to play in understanding the present climate and predicting future change. Here we present a high resolution marine record from Kongsfjorden covering the last c. 2000 years. The core site is located in Kongsfjorden situated on the western coast of Spitsbergen (Svalbard). We focus on this region because it lies along the path of inflow of warmer and saline subsurface waters via the West Spitsbergen Current which is one of the important heat sources for the Arctic Ocean. This current is a major regulator of environmental changes and for example sea-ice distribution in the west Svalbard area. Therefore quantification of it's spatially and temporally variations through time are essential for understanding past environmental and climate changes. We have investigated faunal variations in benthic foraminifera from the upper 60 cm (covering the last two millennia) of a gravity core (510 cm total length) sampled with one-cm density. Chronology of the gravity core is established by AMS radiocarbon dating. The core was in addition investigated for grain size analysis and x-ray. The sediment analysis and x-ray show the upper part of the core contains large amounts of IRD from 7 cm - 25 cm corresponding to an age of 150-700 cal yr. It indicates that abundant icebergs melted over the core site depositing IRD. Further down core (1000-1800 cal yr) there is a significant dominance of fine grained sediment and decrease in ice rafting indicating less influence from glaciers. The foraminiferal species composition show decreasing content of agglutinated foraminifera down core caused by their low preservation potential. For this core site it confirms the importance of calcareous foraminifera as a fossil record tool. The two dominant species in the core are Elphidium excavatum and Nonionellina labradorica. During the last 2000 years the percentage of E. excavatum shows a general tendency to decrease while N. labradorica increases toward present. Elphidium excavatum is typical for arctic glaciomarine environments close to glaciers and ice caps, indicating harsh conditions (cold bottom waters temperatures, lower salinity) and probably extensive ice cover. Nonionellina labradorica indicates the vicinity of oceanographic fronts and high productivity. Another species Islandiella spp., often associated with increased productivity and presence of the sea ice edge, shows significant increase in percentage from 1000 to 800 cal yr BP. From 600 to 400 cal yr BP Bucella spp. start to decline suggesting increased sea ice cover and diminished influence of the Coastal Current on the inner shelf of Svalbard.

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




Microsoft Academic Search

Resumen Los tratamientos utilizados para desordenes inmunológicos son de origen empírico, utilizando drogas inmunosupresoras identificadas a través de la selección de un gran número de compuestos natu- rales y sintéticos. Las drogas inmunosupresoras son ampliamente utilizadas en tratamientos clínicos de desor- denes autoinmunes, en la prevención de rechazo a transplantes así como también en desordenes de carácter no autoinmune tales




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

SciTech Connect

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

VanMaldergen, L.; Hilbert, P.; Gillerot, Y. [Institut de Morphologie Pathologique, Loverval (Belgium)] [and others



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)

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.

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



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


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

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



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


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

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


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


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

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



Menkes syndrome: a case report.  


Menkes syndrome is caused by mutation of ATP7A gene that encode copper-binding membrane protein localized to the trans-Golgi membrane. Mutation of this gene causes defective exportation of copper from the cell. Intracellular accumulation of copper does not reach the toxic state, as copper entering the body is trapped in the intestinal epithelium. Copper requiring enzymes are dysfunction and cause multisystemic manifestations. The authors report a Thai boy 8 months of age who had depigmentation and kinky hair at birth. He developed myoclonic jerk at 3 months of age. He had hypopigmentation of the skin, delayed development, hypotonia, pectus excurvatum, loose skin and joints. He had anemia, very low serum copper and ceruloplasmin. X-ray showed Wormian bone of skull, osteopenia of long bones and generalized brain atrophy. The presented case has similar clinical and laboratory findings to 2 previous reports by Songkla University and Siriraj Hospital. Treatment is not effective due to unavailability of copper- histidinate and the patient already had severe brain damage. Genetic counseling is important to prevent the next offspring. Biochemical and molecular diagnosis are available for confirmation and prenatal diagnosis, but these techniques have limitations in Thailand. PMID:16858971

Kamolsilp, Mahattana



Coeliac disease causing symptomatic hypocalcaemia, osteomalacia and coagulapathy.  


A 36-year-old gentleman presented with 6 months of poor energy, tingling in fingers and weight loss with a change in bowel habit. He appeared cachectic and had clubbing, demineralisation of teeth, pectus carinatus, kyphosis, spinal tenderness, proximal muscle weakness and generalised muscle atrophy. Chvostek's and Trosseau's signs were positive. His haemoglobin (Hb) was 8.7 g/dl, MCV 64.7 fl with low iron. Calcium corrected was 1.30 nmol/l, parathyroid hormone 440.4 ng/l, vitamin D <12.5 nmol/l; INR was 2.7 with coagulation inhibitor studies negative. Radiographs of spine and pelvis commented on osteopenia with thoracic kyphosis and mild anterior wedging of thoracic vertebrae. Antitissue transglutaminase was 145 U/ml, and antiendomysial antibodies were positive. An oesophagogastroduodenoscopy was consistent with coeliac disease. A diagnosis of osteomalacia and coagulopathy secondary to coeliac disease was made. The hypocalcaemia was treated with calcium gluconate infusions with symptomatic relief. Coagulopathy was treated with vitamin K intravenously with normalisation of INR. Following treatment with coeliac diet, calcium slowly normalised. PMID:22798310

McNicholas, Bairbre Aine; Bell, Marcia



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


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

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



Preferences of different tick species for human hosts in Turkey.  


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

Kar, S; Dervis, E; Ak?n, A; Ergonul, O; Gargili, A



Spotted fever group Rickettsiae in ticks in Cyprus.  


In two surveys conducted from March 1999 to March 2001 and from January 2004 to December 2006, a total of 3,950 ticks (belonging to ten different species) were collected from seven domestic and wild animals (goat, sheep, cattle, dog, fox, hare, and mouflon) from different localities throughout Cyprus. In order to establish their infection rate with Spotted Fever Rickettsiae (SFG), ticks were pooled and tested by polymerase chain reaction targeting gltA and ompA genes, followed by sequencing analysis. When tick pools tested positive, individual ticks were then tested one by one, and of the 3,950 ticks screened, rickettsial DNA was identified in 315 ticks (infection rate, 8%). Five SFG Rickettsiae were identified: Rickettsia aeschlimannii in Hyalomma marginatum marginatum, Rickettsia massiliae in Rhipicephalus turanicus and Rhipicephalus sanguineus, Rickettsia sibirica mongolotimonae in Hyalomma anatolicum excavatum, and a Rickettsia endosymbiont of Haemaphysalis sulcata (later described as Rickettsia hoogstraalii) in Haemaphysalis punctata. Two additional genes, 17 kDa and ompB, were targeted to characterize a new genotype of "Candidatus Rickettsia barbariae" genotype in R. turanicus, designated here as "Candidatus Rickettsia barbariae" Cretocypriensis. These results confirm the presence of a spectrum of SFG Rickettsiae on the island. Further studies are necessary to gain better knowledge on the epidemiology of SFG Rickettsiae in Cyprus. PMID:21833539

Chochlakis, Dimosthenis; Ioannou, Ioannis; Sandalakis, Vassilios; Dimitriou, Theodoros; Kassinis, Nikolaos; Papadopoulos, Byron; Tselentis, Yannis; Psaroulaki, Anna



A molecular survey of Theileria and Babesia parasites in cattle, with a note on the distribution of ticks in Tunisia.  


Between October and November 2006, a total of 278 bovine blood samples were examined, and 104 (37.4%) were positive for piroplasms by microscopy. A reverse line blot hybridisation with polymerase chain reaction detected Theileria annulata, T. buffeli, Babesia bovis and B. bigemina in cattle accounting for 48.6% of positive samples. The most frequently found species was T. buffeli, which was present in 39.2% of the samples. T. annulata was found in 48 samples (17.3%). Babesia infections were less frequently detected: B. bovis was found in 6.8% of the samples and B. bigemina in 4.3%. Mixed infections were detected in 45 samples, accounting for seven different combinations of species. Seven Ixodid tick species (Boophilus annulatus, Ixodes ricinus, Hyalomma marginatum, Hyalomma excavatum, Hyalomma detritum, Haemaphysalis punctata and Haemaphysalis sulcata) were collected from examined cattle in the 23 visited farms. I. ricinus was the dominant species (36%), mainly collected in the humid zone, while it seemed to be very rare in the semi-arid zone (where only 15 specimens were collected), whereas B. annulatus was the most commonly collected species in the sub-humid area (68.5% of ticks collected in this zone). PMID:18458949

M'ghirbi, Y; Hurtado, A; Barandika, J F; Brandika, J; Khlif, K; Ketata, Z; Bouattour, A



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


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

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



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


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

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


Foraminiferal biofacies analysis of the Yakataga Formation, Icy Bay, Alaska: Insights into Pliocene glaciomarine paleoenvironments of the Gulf of Alaska  

SciTech Connect

The Upper Miocene to Pleistocene Yakataga Formation of the Gulf of Alaska provides a 5 km thick record of episodic glacially-influenced marine sedimentation. The Pliocene Yakataga Fm. is exposed along western Icy Bay and records the return of glaciomarine deposition in the Gulf of Alaska, after the initiation of glaciation in the Late Miocene, and the onset of major northern hemisphere glaciation by the Late Pliocene. Analysis of foraminifera found in the Yakataga Fm. provides the basis for the interpretation of paleobathymetry and depositional environments from these rocks. Quantitative analysis is used to define eight paleoenvironmentally significant biofacies: (1) Elphidium excavatum clavatum biofacies (inner neritic), (2) Haplophragmoides spp. biofacies (outer neritic--mudline), (3) Cassidulina cf. C. teretis biofacies (outer neritic), (4) Uvigerina juncea biofacies (uppermost bathyal), (5) Elphidiella hannai biofacies (innermost neritic), (6) Epistominella pacifica biofacies (upper bathyal), (7) Cassidulina cf. C. limbata biofacies (outer neritic), (8) Nonionella miocenica biofacies (outer neritic). Paleobathymetric zones defined by these biofacies, which are constrained by modern Gulf of Alaska faunal relationships, indicate bathymetric fluctuations on the order of 100 m in the Icy Bay section. Mixing of biofacies due to downslope transport is common. Analyses of paleobathymetry, benthic formaminiferal biofacies, and sedimentology are used to interpret depositional environments ranging from innermost neritic to upper bathyal for these rocks.

Zellers, S.D. (Univ. of Texas, Austin (USA))




Microsoft Academic Search

The behaviour of two Listeria species (L. monocytogenes and L. innocua) during the elaboration and ripening of Arzua's Cheese from Galicia (North-West of Spain) has been studied. The effect of sodium sorbate against these microorganisms was also evaluated. During the elaboration most of the tested microorganisms were entrapped into the curd. Listeria populations decreased during 55 days of ripening. Populations

C. M. Franco; S. Menéndez; E. J. Quinto; C. Fente; L. Domínguez; A. Cepeda



Uso da prótese vertical expansível de titânio para costela (VEPTR) como opção na instrumentação sem fusão para tratamento da escoliose neuromuscular The vertical expandable prosthetic titanium rib device (VEPTR) as option in spine instrumentation without arthrodesis in the treatment of neuromuscular scoliosis Uso de la prótesis vertical expansible de titanio para costilla (VEPTR como opción en la instrumentación sin fusión para tratamiento de la escoliosis neuromuscular  

Microsoft Academic Search

Objective: report results of vertical expandable prosthetic titanium ribs (VEPTR) surgery in the treatment of neuromuscular scoliosis without spinal fusion. Methods: a total of 17 patients (mean age 8 years; 3 to 13 years) with neuromuscular scoliosis exceeding 40° of scoliosis measured using the Cobb method and presenting a Risser grade of 1 and 2 before VEPTR surgery. The degree

Élcio Landim; Paulo Tadeu; Maia Cavali; Marcus Alexandre; Mello Santos; Wagner Pasqualini; Rodrigo Castello; Branco Manhães



Microsoft Academic Search

National literature on people living with HIV\\/AIDS (PLWHA) perceptions on existing health services they receive is scarce. Objectives: To gather the perceptions of PLWHA on specialized health care services and highly active antiretroviral therapy (HAART) Materials and methods: A cross-sectional study with application of an ad-hoc survey, previously validated, in PLWHA users of the main hospitals that provide HAART in

J. Maziel; Girón V; Eddy R. Segura; Rocío Valverde; Ximena Salazar L; Carlos F. Cáceres



Drug Safety Communication  

Center for Drug Evaluation (CDER)

Text Version... Los profesionales de la salud deben considerar el riesgo de ritmos cardiacos fatales con azitromicina al contemplar las opciones de tratamiento ... More results from


Preguntas para el doctor si tiene un cáncer avanzado

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


Keeping Kids Still during Exams  


... saber acerca de... Nada produce más miedo a un padre que un hijo enfermo, especialmente si su hijo debe someterse ... cada vez más claves en la realización de un diagnóstico e inicio de tratamiento. Los tecnólogos radiológicos ...


Cáncer óseo (hueso)

Información acerca del cáncer óseo (hueso), lo cual incluye temas como el tratamiento de los tumores de Ewing, el osteosarcoma y el histiocitoma fibroso maligno óseo. También se incluye información sobre estudios clínicos.


Cáncer de cabeza y cuello

Información acerca del cáncer de cabeza y cuello, lo cual incluye cánceres de glándulas salivales, hipofaringe, laringe, labio, boca y nariz. Se incluyen temas como tratamiento, prevención, causas, exámenes selectivos de detección y estudios clínicos.


Cáncer de cuello del útero o uterino

Información acerca del cáncer de cérvix (cervical o cuello uterino), lo cual incluye temas como tratamiento, prevención, causas, factores de riesgo, exámenes selectivos de detección, estudios clínicos y estadísticas del Instituto Nacional del Cáncer.


Tomografía computarizada (TC) y exploraciones para cáncer

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


Comunicado de la FDA sobre la seguridad de los ...  

Center for Drug Evaluation (CDER)

... Samsca se usa en el tratamiento de un bajo nivel de sodio en la ... El fabricante de Samsca, Otsuka American Pharmaceutical, Inc., publicó una carta ... More results from


Nueva Publicacion Habla de las Necesidades de los Sobrevivientes de cancer Latinos y sus Familias

Esta publicación gratuita combina la información más actual de los profesionales de la salud con anécdotas personales de sobrevivientes de cáncer latinos, sobre cómo enfrentarse a la vida después del tratamiento del cáncer


El cáncer según su ubicación en el cuerpo: Endocrino y neuroendocrino

Lista de los tipos de cáncer que se forman en los tejidos neuroendocrinos y tejidos del cuerpo que secretan hormonas. Esta página contiene enlaces e información sobre tratamiento, estudios clínicos y otros temas.


Evaluación de la Seguridad de los Productos Biológicos a lo ...  

Center for Biologics Evaluation and Research (CBER)

Text Version... enfermas. Piensen, por ejemplo, en la quimioterapia para un tratamiento contra el cáncer. ... label”). Piensen en el cáncer. ... More results from


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

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


Complicaciones gastrointestinales (PDQ®)

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


Cánceres de la A a la Z: S

Lista de todos los cánceres en orden alfabético, con enlaces a información específica según el tipo de cáncer e información general acerca de la prevención, detección, tratamiento, cuidados médicos de apoyo, estudios clínicos y otros temas.


Paleoenvironmental Change During the Holocene and Last Interglacial in San Pablo Bay, Northern California  

NASA Astrophysics Data System (ADS)

The San Francisco Bay exists as an estuary during sea level highstands and during this time its salinity field reflects the runoff regime of its watershed. Since the latter comprises about 40% of the state of California, study of the changing state of the estuary can provide insight into the climate history of the region. Previous studies have demonstrated significant secular variation in runoff during the late Holocene. The goals of the current work were to extend the record of the estuary's Holocene history and to investigate corresponding variation during the previous interglacial period (ca 130 - 115 ka). Changes at our study site indicative of variation in sediment budgets or tectonic activity were also of interest. Two boreholes were drilled along the southernmost margin of San Pablo Bay, a northern reach of San Francisco Bay. Estuarine sediments were examined for organic constituents; foraminifers were counted and shifts in species assemblages noted; their tests were subjected to stable isotope analysis so that variations in their isotopic signature could be tracked. Beneath recent fill and remnants of marsh deposits, each borehole showed a sequence of three stratigraphic units: Holocene bay mud; alluvial deposits; and estuarine mud. This stratigraphy resembles the typical south Bay sequence: Holocene mud; alluvium deposited during the last glacial period; estuarine mud deposited during the 5e highstand. Foraminifers recovered from the Holocene and older estuarine deposits support the correlation with south Bay deposits. On the basis of stratigraphic position and this correlation, we consider the older estuarine muds to date from the 5e highstand. Foraminiferal assemblages in both the Holocene and Last Interglacial sediments showed systematic variation indicative of environmental change at the site. The 5e samples document a shift in dominant species from Trochammina inflata in the lowermost sample to Elphidium gunteri in the middle of the section and to E. excavatum in the upper samples. This transition indicates a gradual change from shallow intertidal mudflat conditions to a subtidal environment, a shift similar to that indicated by the south Bay sediments. The Holocene interval shows two changes in dominant taxa. T. inflata predominates in the lowermost sample beneath a short non-estuarine interval. E. excavatum is dominant in the middle of the section but gives way abruptly to T. inflata in the upper samples. These shifts indicate sudden changes in water depth that produced rapid transitions from intertidal to subtidal and back to intertidal conditions at the site, likely a result of tectonic movements or changes in sediment input. Stable isotopic measurements of both foraminifers and mollusk shells are in progress. These results are expected to provide information about past salinity at this location, which reflects the volume of freshwater inflow to the estuary. Two 14C dates have been obtained on Holocene shell fragments. These samples, spaced 420 cm apart vertically, show (uncorrected) ages of 3545 and 1775 radiocarbon years, providing an estimated average accumulation rate at the site of about 2.4 mm/yr. If this rate applied throughout the Holocene at the site, the more recent shift noted above occurred about 2760 radiocarbon years (uncorrected for reservoir effect) ago, and the entire 12.8 m thick Holocene unit represents about a 5300 year record.

Schweikhardt, P.; Sloan, D.; Ingram, B. L.



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


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

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



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


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

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



Identifying heritable connective tissue disorders in childhood.  


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

Armon, Kate; Bale, Peter



PTPN11 Mutations in Noonan Syndrome: Molecular Spectrum, Genotype-Phenotype Correlation, and Phenotypic Heterogeneity  

PubMed Central

Noonan syndrome (NS) is a developmental disorder characterized by facial dysmorphia, short stature, cardiac defects, and skeletal malformations. We recently demonstrated that mutations in PTPN11, the gene encoding the non–receptor-type protein tyrosine phosphatase SHP-2 (src homology region 2-domain phosphatase–2), cause NS, accounting for ?50% of cases of this genetically heterogeneous disorder in a small cohort. All mutations were missense changes and clustered at the interacting portions of the amino-terminal src-homology 2 (N-SH2) and protein tyrosine phosphatase (PTP) domains. A gain of function was postulated as a mechanism for the disease. Here, we report the spectrum and distribution of PTPN11 mutations in a large, well-characterized cohort with NS. Mutations were found in 54 of 119 (45%) unrelated individuals with sporadic or familial NS. There was a significantly higher prevalence of mutations among familial cases than among sporadic ones. All defects were missense, and several were recurrent. The vast majority of mutations altered amino acid residues located in or around the interacting surfaces of the N-SH2 and PTP domains, but defects also affected residues in the C-SH2 domain, as well as in the peptide linking the N-SH2 and C-SH2 domains. Genotype-phenotype analysis revealed that pulmonic stenosis was more prevalent among the group of subjects with NS who had PTPN11 mutations than it was in the group without them (70.6% vs. 46.2%; P<.01), whereas hypertrophic cardiomyopathy was less prevalent among those with PTPN11 mutations (5.9% vs. 26.2%; P<.005). The prevalence of other congenital heart malformations, short stature, pectus deformity, cryptorchidism, and developmental delay did not differ between the two groups. A PTPN11 mutation was identified in a family inheriting Noonan-like/multiple giant-cell lesion syndrome, extending the phenotypic range of disease associated with this gene.

Tartaglia, Marco; Kalidas, Kamini; Shaw, Adam; Song, Xiaoling; Musat, Dan L.; van der Burgt, Ineke; Brunner, Han G.; Bertola, Debora R.; Crosby, Andrew; Ion, Andra; Kucherlapati, Raju S.; Jeffery, Steve; Patton, Michael A.; Gelb, Bruce D.



Clinical manifestations in 105 persons with nevoid basal cell carcinoma syndrome  

SciTech Connect

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.

Kimonis, V.E.; Yang, M.L.; Bale, S.J. [National Institute of Arthritis and Musculoskeletal and Skin Disease, Bethesda, MD (United States)] [and others



Species distribution and detection of Crimean Congo Hemorrhagic Fever Virus (CCHFV) in field-collected ticks in Ankara Province, Central Anatolia, Turkey.  


Ticks may act as vectors for a number of infectious diseases including Crimean Congo Hemorrhagic Fever (CCHF). The causative agent is Crimean Congo Hemorrhagic Fever Virus (CCHFV), a member of Bunyaviridae, causing extensive ecchymosis, visceral bleeding and hepatic dysfunction with a high fatality rate in the affected individuals. CCHF was initially recognized in Turkey in 2002 and the current number of reported cases exceeds 4,400. This study was conducted to confirm the presence of tick species established as potential CCHFV vectors and investigate CCHFV activity in ticks at Ankara province, Turkey's second most-densely populated province, where CCHF cases were demonstrated. A total of 1,196 adult ticks, collected from various animals and vegetation in 12 sites located in 5 counties of Ankara during April-July 2010 were identified to species level. Twenty-two tick pools from county K2 were also evaluated for the presence of CCHFV RNA via a one-step real-time RT-PCR assay and reactive results were further confirmed by an in house nested RT-PCR assay. Nine tick species were identified: Rhipicephalus bursa (44.9%), R. sanguineus (18.9%), R. turanicus (18.1%), Haemaphysalis parva (8.3%), Hyalomma marginatum marginatum (5.4%), H. aegyptium (1.4%), H. anatolicum excavatum (1.3%), Hae. punctata (0.3%) and Dermacentor marginatus (0.2%). A total of five tick pools (22.7%) were reactive in real-time and nested RT-PCR assays. The pools included R. bursa, H. m. marginatum and Hae. parva ticks, collected from mammal hosts from two villages in one county. This is the first documentation of CCHFV activity in ticks from Ankara province, which indicates requirement for detailed surveillance to predict high risk zones in the region. PMID:21910017

Hekimoglu, Olcay; Ozer, Nurdan; Ergunay, Koray; Ozkul, Aykut



Topical application of marine briarane-type diterpenes effectively inhibits 12-O-tetradecanoylphorbol-13-acetate-induced inflammation and dermatitis in murine skin  

PubMed Central

Background Skin is the largest organ in the body, and is directly exposed to extrinsic assaults. As such, the skin plays a central role in host defense and the cutaneous immune system is able to elicit specific local inflammatory and systemic immune responses against harmful stimuli. 12-O-tetradecanoylphorbol-13-acetate (TPA) can stimulate acute and chronic inflammation and tumor promotion in skin. TPA-induced dermatitis is thus a useful in vivo pharmacological platform for drug discovery. In this study, the inhibitory effect of briarane-type diterpenes (BrDs) from marine coral Briareum excavatum on TPA-induced dermatitis and dendritic cell (DC) function was explored. Methods Evans blue dye exudation was used to determine vascular permeability. H&E-stained skin section was used to determine the formation of edema in mouse abdominal skin. We also used immunohistochemistry staining and western blot assays to evaluate the activation of specific inflammation makers and key mediators of signaling pathway in the mouse skin. Furthermore, mouse bone marrow DCs were used to determine the relationship between the chemical structure of BrDs and their regulation of DC function. Results BrD1 remarkably suppressed TPA-induced vascular permeability and edema in skin. At the biochemical level, BrD1 inhibited TPA-induced expression of cyclooxygenase-2, inducible nitric oxide synthase and matrix metalloproteinase-9, the key indicators of cutaneous inflammation. This inhibition was apparently mediated by interference with the Akt/NF-?B-mediated signaling network. BrD1 also inhibited TNF-? and IL-6 expression in LPS-stimulated BMDCs. The 8, 17-epoxide of BrDs played a crucial role in the inhibition of IL-6 expression, and replacement of the C-12 hydroxyl group with longer esters in BrDs gradually decreased this inhibitory activity. Conclusions Our results suggest that BrDs warrant further investigation as natural immunomodulatory agents for control of inflammatory skin diseases.



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


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

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



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

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


Caracterización de tintas de titanio dopadas con óxidos metálicos  

Microsoft Academic Search

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



Estudio Comparado de la Tributación del Sector Transporte de Carga en Argentina, Brasil, y Uruguay  

Microsoft Academic Search

En un contexto de creciente integración internacional, caracterizado por la formación de bloques económicos regionales, el sector del transporte de carga cobra cada vez más prominencia. Por ejemplo, el tratamiento tributario conferido al sector por los distintos países participantes de un bloque crea incentivos diferenciados en relación con la ampliación de la integración comercial.

Erika Amorim Araujo



El dolor como terapia. La médula común de los campos de concentración nazis y franquistas  

Microsoft Academic Search

Los campos de concentración franquistas y los nazis evidencian un cuerpo común. En ambos se desarrollaba una terapia para los internos que tenía al cuerpo como vehículo de aprendizaje. El tratamiento político prescribía penalidades físicas — la suciedad, el hambre, la sed— y morales que debían conducir a los prisioneros a comprender la finalidad buscada por el Estado totalitario alemán

Mirta Núñez Díaz-Balart




Microsoft Academic Search

, 10 -6 y 10 -3 M) al medio de cultivo, de disminuciones en la tem- peratura de crecimiento (16, 18, 20, 22 y 25ºC) y combinacio- nes de estos factores, en Costa Rica, en 1997. Se encontró que los brotes mantuvieron altos porcentajes de viabilidad después de ser conservados durante seis meses en los tratamientos eva- luados. Debido a

Silvana Alvarenga-Venutolo; Ana Abdelnour-Esquivel; Víctor Villalobos-Aránbula




Microsoft Academic Search

RESUMEN El procesamiento de imágenes es una herramienta común para estudiar proble- mas científicos en muchas áreas diferentes, tales como la imagenología biomédica, televisión, las publicaciones electrónicas, tales como las páginas WEB y la multi- media. Existen muchos sistemas de tratamiento de imágenes en las universidades para la enseñanza a un nivel introductorio y en el nivel de postgrado. Muchos



Mesiodens: presentación de tres casos  

Microsoft Academic Search

Resumen El mesiodens es el diente supernumerario que aparece con mayor frecuencia en la denti- ción definitiva. En la mayoría de ocasiones se trata de un hallazgo casual. El diagnóstico pre- coz permite realizar la extracción de forma temprana, favoreciendo la erupción espontánea de los incisivos permanentes, y evita tener que efectuar otros tratamientos más complejos, quirúrgicos u ortodóncicos. Presentamos

Díaz Ortiz; M. Vicente Rodríguez



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

Microsoft Academic Search

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

Noel W. Solomons




Microsoft Academic Search

En este trabajo se presentan los resultados de un estudio meta-analítico sobre la efectividad de los programas multicomponentes en el tratamiento de sujetos con adicción al tabaco. Una búsqueda exhaustiva de la literatura nos permitió identificar 16 trabajos empíricos realizados en España entre 1980 y 1996, dando lugar a un total de 37 estudios independientes que recogían datos de 1.979

Julio Sánchez Meca; José Olivares Rodríguez; Ana Isabel; Rosa Alcázar



Efecto de la irradiación luminosa en la aclimatación de Mammillaria carmenae Castañeda (Cactaceae) proveniente de cultivo in vitro  

Microsoft Academic Search

Resumen Se reprodujo Mamillaria carmenae por cultivo in vitro a partir de areolas de una planta etiolada in vivo. Se obtuvieron plantas a partir de callos, las cuales se aclimatizaron bajo diferentes tratamientos de irradiación luminosa (50, 150 y 970 µmol m -2 s -1 ) bajo condiciones de invernadero. Durante la acli- matación se registraron la variación en el

Coca Soriano; Ortiz Montiel; Juan Gerardo; Sánchez Correa; Pérez Crisanto Joel


Cómo hacer frente al cáncer

Existen muchos recursos de ayuda y apoyo para las personas con cáncer, sus familiares y amigos. Infórmese sobre las reacciones psicológicas al cáncer y la forma de hacer frente a estas situaciones. Conozca los servicios que ofrecen las comunidades locales y las organizaciones nacionales para ayudarle con los diferentes aspectos del tratamiento y la recuperación del cáncer.



Microsoft Academic Search

Este artículo hace una revisión de las masas sólidas renales bilaterales en niños y sus diagnósticos diferenciales basados en la edad de presentación y en las características observadas en las imágenes diagnósticas. Las lesiones más frecuentes son el tumor de wilms, el linfoma no Hodgkin y la nefroblastomatosis. Conocerlas es importante para la planeación de los tratamientos médico y quirúrgico

Hugo Hernán Ferreira Traslaviña; Gustavo Triana; Jennifer León Martínez; Nelson Bedoya


Enantiómeros puros partiendo de sus racémicos ¿Realmente se beneficia el paciente?  

Microsoft Academic Search

Resumen El objetivo de este artículo es hacer una revisión sobre los medicamentos enantiómeros puros que se han comercializado en nuestro país cuando ya existía el racémico y que sean usados desde atención primaria, centrando especial atención en aquellos estudios que comparen la eficacia y seguridad del racémico con el enantiómero puro en humanos con la enfermedad objeto de tratamiento.

E Carracedo Martínez


Les expériences de santé comme vecteur de l'identité  

Microsoft Academic Search

[spa] Las experiencias de salud coma vector de la identidad . . Para medir el impacto de los problemas de salud sobre la construccion de las identidades, tres preguntas sirvieron . a delimitar una poblacion ataflida por tales problemas: un 4,5 % declaran unicamente limitaciones de su actividad, un 23 % unicamente un tratamiento 0 control regular por motivo médico,

Isabelle Ville; Daniel Ruffin




Microsoft Academic Search

Resumen Los déficit en habilidades sociales luego de traumatismo encéfalo-craneal severo son predominantes. Sin embargo, el desarrollo y la provisión de tratamientos preventivos durante el proceso de rehabilita- ción no han estado a la par de las necesidades en esta área. Este estudio describe el desarrollo conceptual y la provisión inicial de programas intensivos de entrenamiento de habilidades sociales y



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

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


Números: simplicidad conceptual, complejidad curricular  

Microsoft Academic Search

¿De quién es el conocimiento sobre el número?, ¿quién determina su tratamiento curric- ular? Cuestiones similares han sido propuestas recientemente por Michael Apple ( ¿De quién es el conocimiento que más valor tiene?, ¿de quién es este curriculo? ), y se plantean en toda su crudeza cuando, como en la actualidad, se trabaja sobre modificaciones importantes del currícu- lo. En

Luis Rico Romero


El ejercicio físico como terapia complementaria en el cáncer de próstata  

Microsoft Academic Search

Este artículo presenta como el ejercicio físico es una terapia complementaria en el tratamiento del cáncer próstata. En concreto presentamos el diseño e implementación de un programa de ejercicio físico de fuerza-resistencia adaptado al cáncer de próstata. El modelo base corresponde a la guía de la American College Sports Medicine Position Stand (ACSM 1998). La adaptación y transformación del programa

Bernat Carles Serdà Ferrer; Pilar Monreal Bosch; Arantza Del Valle



The Early Geological History of Long Island Sound  

NASA Astrophysics Data System (ADS)

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.

Varekamp, J. C.; Thomas, E.



Nuevo estudio relaciona a los índices de utilización de servicios de atención médica más que a la biología con las desigualdades en salud por cáncer colorrectal

Los índices más altos de incidencia y mortalidad por cáncer colorrectal que experimentan los afroamericanos pueden deberse principalmente a las diferencias en la utilización de servicios médicos y en menor proporción a la biología, según un nuevo estudio dirigido por investigadores del NCI. Índices más bajos de seguimiento podrían resultar en un retraso del diagnóstico y de tratamiento y en un aumento de la mortalidad.


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

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


Impact of estrogen replacement therapy in a male with congenital aromatase deficiency caused by a novel mutation in the CYP19 gene.  


Recent reports of the impact of estrogen receptor alpha and aromatase deficiency have shed new light on the importance of estrogen for bone formation in man. We describe a novel mutation of the CYP19 gene in a 27-yr-old homozygous male of consanguinous parents. A C to A substitution in intron V, at position -3 of the splicing acceptor site before exon VI of the CYP19 gene, is the likely cause of loss of aromatase activity. The mRNA of the patient leads to a frameshift and a premature stop codon 8 nucleotides downstream the end of exon V. Both parents were shown to be heterozygous for the same mutation. Apart from genua valga, kyphoscoliosis, and pectus carniatus, the physical examination was normal including secondary male characteristics with normal testicular size. To substitute for the deficiency, the patient was treated with 50 micro g transdermal estradiol twice weekly for 3 months, followed by 25 micro g twice weekly. After 6 months estrogen levels (<20 at baseline and 45 pg/ml at 6 months; normal range, 10-50) and estrone levels (17 and 34 ng/ml; normal range, 30-85) had normalized. Bone maturation progressed and the initially unfused carpal and phalangeal epiphyses began to close within 3 months and were almost completely closed after 6 months. The bone age, assessed by roentgenographic standards for bone development by Gruelich and Pyle, was 16.5 at baseline and 18-18.5 yr after 6 months of treatment. Bone density of the distal radius (left), assessed by quantitative computed tomography, increased from 52 to 83 mg/cm(3) (normal range, 120-160) and bone mineral density of the lumbar spine, assessed by dual-energy x-ray-absorptiometry, increased from 0.971 to 1.043 g/cm(2) (normal range, >1.150). Osteocalcin as a bone formation parameter increased from 13 to 52 micro g/l (normal range, 24-70) and aminoterminal collagen type I telopeptide as a bone resorption parameter increased from 62.9 to 92.4 nmol/mmol creatinine (normal range, 5-54). Semen analysis revealed oligoazoospermia (17.4 million/ml; normal >20) at baseline. After 3 months of treatment, the sperm count increased (23.1 million/ml) and decreased rapidly (1.1 million/ml) during the following 3 months. The sperm motility was reduced at baseline and decreased further during treatment. Area under the curve of insulin, C-peptide, and blood glucose levels during oral glucose tolerance test decreased after 6 months (insulin: 277 vs. 139 micro U/ml.h; C-peptide 52 vs. 15 ng/m.h; area under the curve glucose: 17316 vs. 12780 mg/d.min). Triglycerides (268 vs. 261 mmol/liter) and total cholesterol levels (176 vs. 198 mmol/liter) did not change significantly, but the low-density lipoprotein/high-density lipoprotein ratio decreased from 5.37 to 3.56 and lipoprotein (a) increased from 19.9 to 60.0 mg/dl (normal range, <30). In this rare incidence of estrogen deficiency, estrogen replacement demonstrated its importance for bone mineralization and maturation and glucose metabolism in a male carrying a novel mutation in the CYP19 gene. PMID:12466340

Herrmann, Burkhard Lorenz; Saller, Bernhard; Janssen, Onno Eilard; Gocke, Peter; Bockisch, Andreas; Sperling, Herbert; Mann, Klaus; Broecker, Martina



Treatment of young patients with Philadelphia chromosome-positive acute lymphoblastic leukaemia using increased dose of imatinib and deintensified chemotherapy before allogeneic stem cell transplantation.  


The main outcomes of the Programa Español para Tratamiento de Hemopatías (PETHEMA)-acute lymphoblastic leukaemia (ALL)-Ph-08 trial were described and compared with those of the historical PETHEMA-CSTIBES02 trial. The trials differed in imatinib dose (600 vs. 400 mg/d) and amount of chemotherapy (one vs. two consolidation cycles) before stem cell transplantation (SCT). All patients (n = 29) enrolled in the ALL-Ph-08 trial achieved complete remission (CR) (vs. 90% in CSTIBES02), and SCT was performed in CR in 90% (vs. 78%). The reduction in early death, relapse before SCT and transplant-related mortality observed in the ALL-Ph-08 trial resulted in an improved 2-year event-free survival (63% vs. 37%, P = 0·009). PMID:22823211

Ribera, Josep-María; García, Olga; Montesinos, Pau; Brunet, Salut; Abella, Eugenia; Barrios, Manuel; González-Campos, José; Bravo, Pilar; Amigo, Maria-Luz; Hernández-Rivas, Jesús-María



Grupos españoles de cálculos ab initio de moléculas de interés astrofísico  

NASA Astrophysics Data System (ADS)

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

Yáñez, M.



PubMed Central

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

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



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

PubMed Central

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



Risk-adapted treatment for low- and intermediate-risk acute promyelocytic leukemia.  


The clinical integration of risk-tailored therapies for patients with acute promyelocytic leukemia (APL) has become a standard treatment approach in recent years. In this article, we will review the risk-adapted strategies designed to treat patients with white blood cell counts ? 10 × 109/L, with platelet counts > 40 × 109/L (low risk), or platelet counts ? 40 × 109/L (intermediate risk), with particular reference to the risk-adapted strategy followed in the LPA99 and LPA2005 trials conducted by the Programa para el Tratamiento de Hemopatías Malignas group. In these studies, the combination of all-trans-retinoic acid (ATRA) and chemotherapy in consolidation therapy resulted in an improved antileukemic efficacy without significantly increasing toxicity in low-risk (LPA2005 trial vs. LPA99 trial) and intermediate-risk (LPA99 trial vs. LPA96 trial) categories. In addition, a decrease in dose intensity of mitoxantrone in low- and intermediate-risk patients (LPA2005 trial vs. LPA99) resulted in a significant reduction of hematologic toxicities and hospital stay without compromising antileukemic activity. We will also discuss whether the use of arsenic trioxide to reinforce consolidation therapy in standard ATRA/chemotherapy regimens can permit a reduction of chemotherapy intensity while maintaining cure rates or confirm the improvement on outcomes currently achieved with optimal ATRA/anthracycline-based protocols. PMID:21115431

Sanz, Miguel A; Montesinos, Pau



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


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

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



Sobre el estado evolutivo de ? Pictoris  

NASA Astrophysics Data System (ADS)

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.

Brunini, A.; Benvenuto, O. G.


Esquizofrenia y trastorno en el consumo de sustancias: prevalencia y character?sticas sociodemogr?ficas en la poblaci?n Latina  

PubMed Central

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.

Jimenez-Castro, Lorena; Raventos-Vorst, Henriette; Escamilla, Michael



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

PubMed Central

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.

Barragan, Eva; Montesinos, Pau; Camos, Mireia; Gonzalez, Marcos; Calasanz, Maria J.; Roman-Gomez, Jose; Gomez-Casares, Maria T.; Ayala, Rosa; Lopez, Javier; Fuster, Oscar; Colomer, Dolors; Chillon, Carmen; Larrayoz, Maria J.; Sanchez-Godoy, Pedro; Gonzalez-Campos, Jose; Manso, Felix; Amador, Maria L.; Vellenga, Edo; Lowenberg, Bob; Sanz, Miguel A.



[In Process Citation].  


RESUMENOBJETIVODeterminar la incidencia de nefropatía inducida por contraste  (NIC) en un grupo de pacientes diabéticos en tratamiento con metformina  a los que se realiza un estudio de tomografía computarizada (TC)  con contraste yodado (civ)MATERIAL Y MÉTODOSEstudio prospectivo de  pacientes diabéticos   incluidos en el protocolo para la prevención de la acidosis láctica   a  los que se hace seguimiento clínico y analítico tras la realización de una TC con civ.RESULTADOSSe recogieron  98 casos.En los  pacientes sin insuficiencia renal previa la incidencia de NIC es del 0%. En los  pacientes con insuficiencia renal previa la incidencia de NIC es del 4,7%. No se registró ningún caso de acidosis láctica.CONCLUSIONESEl riesgo de de NIC en pacientes diabéticos sin insuficiencia renal a los que se administra contraste yodado  es mínimo. Las recomendaciones de retirar la metformina para evitar la acidosis láctica en pacientes a los que se administra civ se podría reservar para los pacientes con  TFG <45. ABSTRACTPURPOSETo determine the incidence of contrast-induced nephropathy (CIN) among diabetic patients treated with Metformin who underwent computed tomography (CT) scan with iodinated contrast media.MATERIAL AND METHODSProspective study of diabetic patients enrolled in a lactic acidosis prevention protocol in whom clinical and analytical follow up after CT scan with intravenous contrast was performed.RESULTS98 cases were collected. The incidence of CIN in diabetic patients without prior renal failure was 0%. In patients with previous renal failure the incidence of CIN was 4.7%. No case of lactic acidosis was registered.CONCLUSIONSThe risk of CIN in diabetic patients with no renal failure undergoing intravenous contrast administration is minimal. Recommendations to stop Metformin to avoid lactic acidosis in patients undergoing intravenous contrast administration may be restricted to patients with GFR <45. PMID:24008523

Gómez Herrero, H; De Arriba Villamor, C; Buldain Parra, M; Arraiza Sarasa, M



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


Eye lenses from human donors with and without Alzheimer's disease (AD) were studied to evaluate the presence of amyloid in cortical cataract. We obtained 39 lenses from 21 postmortem donors with AD and 15 lenses from age-matched controls provided by the Banco de Ojos para Tratamientos de la Ceguera (Barcelona, Spain). For 17 donors, AD was clinically diagnosed by general physicians and for 4 donors the AD diagnosis was neuropathologically confirmed. Of the 21 donors with AD, 6 had pronounced bilateral cortical lens opacities and 15 only minor or no cortical opacities. As controls, 7 donors with pronounced cortical opacities and 8 donors with almost transparent lenses were selected. All lenses were photographed in a dark field stereomicroscope. Histological sections were analyzed using a standard and a more sensitive Congo red protocol, thioflavin staining and beta-amyloid immunohistochemistry. Brain tissue from two donors, one with cerebral amyloid angiopathy and another with advanced AD-related changes and one cornea with lattice dystrophy were used as positive controls for the staining techniques. Thioflavin, standard and modified Congo red staining were positive in the control brain tissues and in the dystrophic cornea. Beta-amyloid immunohistochemistry was positive in the brain tissues but not in the cornea sample. Lenses from control and AD donors were, without exception, negative after Congo red, thioflavin, and beta-amyloid immunohistochemical staining. The results of the positive control tissues correspond well with known observations in AD, amyloid angiopathy and corneas with lattice dystrophy. The absence of staining in AD and control lenses with the techniques employed lead us to conclude that there is no beta-amyloid in lenses from donors with AD or in control cortical cataracts. The inconsistency with previous studies of Goldstein et al. (2003) and Moncaster et al. (2010), both of which demonstrated positive Congo red, thioflavin, and beta-amyloid immunohistochemical staining in AD and Down syndrome lenses, is discussed. PMID:23142516

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



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


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

Pavlovsky, Santiago; Lastiri, Francisco



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

SciTech Connect

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)

Pereira, R.; Silva, N.; Quintal, C.; Abreu, R.; Andrade, J.; Dantas, L. [Programa Madeira-Med, Estrada Eng. Abel Vieira, 262, 9135-260 Camacha, Madeira (Portugal)



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


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

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



Impact of Chloroquine on Viral Load in Breast Milk  

PubMed Central

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

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