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


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

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



Minimally invasive pectus excavatum repair: migration of bar and ossification.  


Minimally invasive repair of pectus excavatum is an effective treatment option, with satisfactory results. Nevertheless, complications may occur during bar removal. We describe the case of a 16-year-old boy operated on for pectus excavatum with the Nuss procedure, who developed bar migration into the rib, with ossification, making its removal very difficult. PMID:23430431

Giacomo, Tiziano De; Diso, Daniele; Francioni, Federico; Anile, Marco; Venuta, Federico



Identifying pectus excavatum in the primary care setting.  


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

Lew, Kathryn Baker



Strategies for Cardiopulmonary Exercise Testing of Pectus Excavatum Patients  

PubMed Central

The purpose of this paper is to provide strategies for cardiopulmonary exercise testing of pectus excavatum patients. Currently, there are no standardized methods for assessing cardiovascular and pulmonary responses in this population; therefore, making comparisons across studies is difficult if not impossible. These strategies are intended for physicians, pulmonary technicians, exercise physiologists, and other healthcare professionals who conduct cardiopulmonary exercise testing on pectus excavatum patients. By using the strategies outlined in this report, comparisons across studies can be made, and the effects of pectus excavatum on cardiopulmonary function can be assessed with greater detail.

Malek, Moh H.; Coburn, Jared W.



Symptomatic pectus excavatum in seniors (SPES): a cardiovascular problem?  

Microsoft Academic Search

Objectives  There is no consensus among physicians as to whether or not pectus excavatum can produce symptoms sometimes even severe enough\\u000a to justify a surgical procedure. The aim of this study was to assess the prevalence and severity of complaints and symptoms\\u000a of senior patients with a pectus excavatum and to evaluate the results of surgical correction of the chest deformation.

H. A. Kragten; J. Siebenga; P. F. Höppener; R. Verburg; N. Visker



Elevation of serum lactate dehydrogenase in patients with pectus excavatum  

PubMed Central

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



Pectus Excavatum and Heritable Disorders of the Connective Tissue  

PubMed Central

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

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



Method of pectus excavatum measurement based on structured light technique  

NASA Astrophysics Data System (ADS)

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

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



Pectus excavatum 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.



Symptomatic Pectus Excavatum in Seniors: An Exploratory Study on Clinical Presentation and Incidence in Daily Practice  

PubMed Central

Objectives. Doctors all over the world consider a pectus excavatum usually as an incidental finding. There is some evidence suggesting that a pectus excavatum may cause symptoms in the elderly. It is not known how often a pectus excavatum occurs and how strong the relation is with symptoms. Methods. In hospitals and general practice data, we searched for evidence of a connection between cardiac symptoms and the presence of a pectus excavatum in a retrospective survey among patients in whom a pectus excavatum was found in a chest X-ray. In radiology reports, we searched for “pectus excavat? ” in almost 160000 chest X-rays. The identified X-rays were reviewed by 2 radiologists. Reported symptoms were combined to a severity sum score and the relation with pectus excavatum was assessed through logistic regression. Results. Pectus excavatum was found in 1 to 2 per 1000 chest X-rays. In 32% of patients (N = 117), we found symptoms that might reflect the presence of symptomatic pectus excavatum. We found a significant relation between the SPES sum score and the radiological level of pectus excavatum. Conclusions. A pectus excavatum found when examining the patient should not be neglected and should be considered as a possible explanation for symptoms like dyspnoea, fatigue, or palpitations.

Winkens, Ron A. G.; Guldemond, Frank I.; Hoppener, Paul F. H. M.; Kragten, Hans A.; Knottnerus, J. Andre



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



Breast radiotherapy in women with pectus excavatum (funnel chest): is the lateral decubitus technique an answer? — a dosimetric study  

Microsoft Academic Search

Breast radiotherapy is a technical challenge in women with pectus excavatum. We aim to assess isocentric lateral decubitus (ILD) technique as a means to irradiate breasts for patients with pectus excavatum. Four women presenting with left- sided breast cancers and found to have pectus excavatum were offered breast- conserving treatments. Post-operative breast radiotherapy was indicated (50 Gy) in two patients,

M. A. Bollet; F CAMPANA; Y. M. Kirova; R. Dendale; M.-G. Saliou; J.-C. Rosenwald; A. Fourquet



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



STRATOS™ system for the repair of pectus excavatum.  


Open techniques represent a valid repair option for severe asymmetric pectus excavatum in adults. The use of metal supports is recommended to reduce the risk of recurrence. A wide variety of metal supports have been proposed, with pre-, trans- or retrosternal fixation. A novel open technique using titanium bars fixed to the ribs with clips has been recently introduced (STRATOS™ system) for chest wall reconstruction, rib fracture fixation and chest wall malformation repair. We employed this technique in two adult patients with severe asymmetric pectus excavatum: after sternal mobilization, one bar is passed below the body of the sternum and secured with clips bilaterally to two ribs. In the first case, the results remained excellent 5 years after surgery. In the second case, the initial results were satisfying but the bar ruptured after 30 months: removal of the bars and clips was performed and a subsequent recurrence of the deformity occurred. The experiences reported in literature are still too limited to draw firm conclusions about the use of the STRATOS™ system in pectus excavatum repair, but it seems that the use of two bars may reduce the risk of rupture. At present, we are the only ones who reported long-term results. PMID:24000315

Stefani, Alessandro; Nesci, Jessica; Morandi, Uliano



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; Belem, Lucia de Sousa; Cavalcante, Camila Pinto; Riera, Andrés Ricardo Pérez; Garcia-Niebla, Javier; Anselm, Daniel D; Baranchuk, Adrian



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.



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


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

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



Intravenous versus epidural analgesia after surgical repair of pectus excavatum.  


Surgical repair of pectus excavatum can be associated with significant postoperative pain. Various analgesic modalities have been suggested including thoracic epidural analgesia and intravenous patient-controlled analgesia (IV PCA). The current study compares the efficacy and adverse efficacy profile of these 2 analgesic modalities. The charts of 18 adolescents who had undergone pectus excavatum repair were retrospectively reviewed and divided into 2 groups: thoracic epidural analgesia (E) or IV PCA (I). Demographic data included age, weight, sex, and anesthesia/surgical times. Treatment days (defined as the number of days the patients received intravenous or epidural analgesia), time to oral intake, and time to discharge from the hospital were also recorded. Pain scores using a visual analogue scale ranging from 0 (no pain) to 10 (worst imaginable pain) and sedation scores were recorded in the postanesthesia care unit and at 6, 12, 24, 36, 48, and 60 hours postoperatively. The charts were also reviewed for side effects including nausea and/or vomiting, pruritus, oxygen desaturation, and respiratory depression. The study cohort included 18 patients divided equally into group E (epidural analgesia) (n = 9) and group I (IV PCA). There were no statistically significant differences between the 2 groups with regard to demographic data, time to oral intake, and time to hospital discharge. Anesthesia to surgery times were longer in group E compared with group I (43 +/- 11 versus 25 +/- 11 minutes, P = 0.004), but there was no difference in overall surgery and anesthesia times. The number of treatment days (days that the patients received intravenous or epidural medications) was decreased in group E versus group I (2.3 +/- 0.7 versus 3.3 +/- 1.0 days, P = 0.027). There was no difference between the 2 groups in regard to the onset of oral intake or hospital discharge time. Pain scores were initially higher in the postanesthesia care unit in group E versus group I (6.78 +/- 2.17 versus 5.78 +/- 3.77); however, after that point, pain scores were lower in group E than in group I. There was no difference between the 2 groups in regard to sedation scores or adverse effect profile. Epidural analgesia provided better pain control than the intravenous route for the management of patients after pectus excavatum repair. No adverse effects related to epidural analgesia were noted. The only issue identified with thoracic epidural anesthesia was a mean increase of 18 minutes for anesthesia time required for catheter placement before the start of the case. PMID:19262363

Soliman, Iris E; Apuya, Jesus S; Fertal, Kathy M; Simpson, Pippa M; Tobias, Joseph D



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

PubMed Central

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



Rib cartilage characterization in patients affected by pectus excavatum.  


Pectus excavatum (PE) is the most frequent anterior chest deformity which may be frequently associated with connective tissue disorders. We performed microscopic analyses to better understand cartilage behavior and obtain clues on its pathogenesis. In 37 PE patients, none with Marfan syndrome, we analyzed costal cartilage by light microscopy, immunohistochemistry and transmission electron microscopy. Control tissue specimens were harvested from four patients without any connective tissue disease. In both control and PE patients, chondrocytes were on the average <15 µm in diameter and occupied <10% of tissue volume; in most cases the extracellular matrix was stained by alcian blue, instead of safranin; no difference between PE and control samples was significant. All samples showed an uneven collagen type II immunolabeling both within the cells and pericellular matrix, and occasionally of the territorial matrix. In all cases numerous cells underwent apoptosis accompanied by matrix condensation as shown by electron microscopy. Our results suggest that matrix composition and the cell number and size of costal cartilage are dependent on the subject and not on the disease; the microscopic organization of cartilage is correlated with the stabilization of the defective shape rather than with the onset of the deformity. PMID:24170345

Tocchioni, Francesca; Ghionzoli, Marco; Calosi, Laura; Guasti, Daniele; Romagnoli, Paolo; Messineo, Antonio



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


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

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



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



Does repair of pectus excavatum improve cardiopulmonary function?  

PubMed Central

A best evidence topic was written according to a structured protocol. The question addressed was ‘Does repair of pectus excavatum (PE) improve cardiopulmonary function?’ One hundred and sixty-eight papers were found using the reported search, 19 level III evidence papers and three meta-analyses were relevant. Studies were divided into four groups based on the surgical technique applied and pulmonary and cardiac functions in these groups were analysed. The meta-analyses show conflicting results for improvements in pulmonary and cardiac functions when comparing surgical techniques, while four more recent studies show improved long-term results using the Nuss technique. The best evidence of papers studying the PE repair using the minimally invasive Nuss technique demonstrates a decrease in pulmonary function during the early postoperative period, however, there is a small but significant improvement during the late postoperative period and after bar removal. The best evidence for cardiac function in this group suggests an early improvement that is sustained during further follow-up. The best evidence of papers studying the PE repair using the Ravitch technique shows that pulmonary function decreased during the early postoperative period, however, there is a small but significant improvement during the late postoperative period. The best evidence for cardiac function in this group suggests an early improvement that is sustained during further follow-up. The best evidence of papers studying the PE repair using other techniques (modified Daniel's technique, modified Baronofsky's technique, sterno-costal turn-over technique and sterno-costal elevation technique) or where surgical techniques used were not described (preceding year 1985) suggests that there is no improvement in pulmonary function after surgery. There is some evidence that certain aspects of cardiac function improved after surgery in this group.

Jayaramakrishnan, Kumara; Wotton, Robin; Bradley, Amy; Naidu, Babu



Repair of Pectus Excavatum Deformities: 30 Years of Experience With 375 Patients  

PubMed Central

Objective To review the surgical experience with pectus excavatum chest deformities at UCLA Medical Center during a 30-year period. Background Pectus excavatum is a relatively common malformation that is often symptomatic; however, children’s physicians often do not refer patients for surgical correction. Methods Hospital records from 375 patients who underwent repair of pectus excavatum deformities between 1969 and 1999 were reviewed. Decrease in stamina and endurance during exercise was reported by 67%; 32% had frequent respiratory infections, 8% had chest pain, and 7% had asthma. The mean pectus severity score (width of chest divided by distance between posterior surface of sternum and anterior surface of spine) was 4.65 (normal chest = 2.56). All patients had marked cardiac deviation into the left chest. Repair was performed with subperiosteal resection of the abnormal cartilages, transverse wedge osteotomy of the anterior sternum, and internal support with a steel strut for 6 months. Repair was performed on 177 children before age 11 years; 38 adults with severe symptoms underwent repair. Results The mean hospital stay was 3.1 days. With a mean follow-up of 12.6 years, all patients with preoperative respiratory symptoms, exercise limitation, and chest pain experienced improvement. Vital capacity increased 11% (mean) within 9 months in 35 patients evaluated. There were no deaths. Complications included hypertrophic scar formation (35), atelectasis (12), pleural effusion (13), recurrent sternal depression (5), and pericarditis (3). More than 97% had a very good or excellent result. Conclusion Pectus excavatum deformities can be repaired with a low rate of complications, a short hospital stay, and excellent long-term physiologic and cosmetic results.

Fonkalsrud, Eric W.; Dunn, James C. Y.; Atkinson, James B.



Late coronary artery and tricuspid valve injury post pectus excavatum surgery.  


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

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



Chest Wall Implants: Their Use for Pectus Excavatum, Pectoralis Muscle Tears, Poland's Syndrome, and Muscular Insufficiency  

Microsoft Academic Search

.   Solid customized and prefabricated silicone implants have been used by the author for 15 years in a wide range of chest wall\\u000a deformities. Chest wall implants are often used in males seeking to augment a muscularly deficient or underdeveloped chest;\\u000a however, their greatest use has come in a variety of deformities both congenital and acquired, such as pectus excavatum,

Darryl J. Hodgkinson



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



Intrapericardial migration of dislodged sternal struts as late complication of open pectus excavatum repairs  

PubMed Central

Abstract We present a case of sternal steel strut dislodgement and migration in a patient undergoing Ravitch repair for pectus excavatum (PE) 37 years ago. Broken struts perforated the right ventricle and right ventricular outflow tract (RVOT) and additionally migrated into the left upper lobar bronchus. Dislodged sternal struts represent rare complications after surgical repair of patients suffering from pectus excavatum. Reviewing the literature, only five cases of intrapericardial migration of dislodged sternal struts or wires have been reported so far. In our case, the first strut was removed from the airways through a left antero-lateral thoracotomy. Using cardiopulmonary bypass, a second strut was removed via ventriculotomy. These life-threatening sequelae underscore the importance of postoperative follow-up and early removal of osteosynthetic materials used in open PE repair. Accurate preoperative localization of migrated materials and availability of CPB support are crucial for successful surgical removal. Introduction The migration of dislodged sternal steel struts or wires into the pericardium and cardiac cavities is a rare but life-threatening complication of open pectus excavatum (PE) repair [1]. Removal of these materials poses a challenge for cardiothoracic surgeons. Herein, the authors report a case of migration of dislodged steel struts through the right ventricle and right ventricular outflow tract (RVOT) into the left upper lobar bronchus in a patient who underwent Ravitch repair 37 years ago.



[The effect of the severity of congenital pectus excavatum on the cardiac morphology in children: evaluation with multislice helical CT].  


This paper is aimed to evaluate the CT manifestation of congenital pectus excavatum and its effect on the cardiac morphology. CT features of 34 children with pectus excavatum were retrospectively reviewed. The Haller index (HI), CT depression index (CTDI), cardiac rotation angle (CRA), pulmonary vein angle (PVA), cardiac compression index (CCI) and cardiac asymmetry index (CAI) were measured from the images on the PACS system. The relationships among these indexes were evaluated. The HI was 4.12 +/- 1.48, the CTDI was 2.39+/- 0.70, CRA was (53.52 +/- 7.68) degrees, PVA was (66.51 +/- 11.02) degrees, CCI was 2.43 +/- 0.95, and CAI was 1.55 +/- 0.56. There was statisti cal significance of CCI and CAI between children with severe or slight pectus excavatum. The HI and CTDI were positively related with CCI and CAI respectively, whereas there was no statistical significance of CRA and PVA between children with severe or slight pectus excavatum. There was no statistical significance of HI, CTDI, CRA, PVA, CCI and CAI among different age groups. The morphological change of the heart compressed in children with pectus excavatum can be accurately evaluated by multislice helical CT. PMID:24645601

Lu, Tao; Deng, Kaihong



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



When it is not an infection: metal allergy after the Nuss procedure for repair of pectus excavatum  

Microsoft Academic Search

PurposeIncreasing use of implantable bars for minimally invasive pectus excavatum repair has introduced metal allergy (nickel and chromium) to pediatric surgeons. Metal allergy is a well-recognized entity in neurologic, orthopedic, and craniofacial surgery. This study was performed to evaluate metal allergy and its effects on treatment with the Nuss procedure in 862 patients.

Gregory D. Rushing; Michael J. Goretsky; Tina Gustin; Maripaz Morales; Robert E. Kelly; Donald Nuss



When it is not an infection: metal allergy after the Nuss procedure for repair of pectus excavatum  

Microsoft Academic Search

Purpose: Increasing use of implantable bars for minimally invasive pectus excavatum repair has introduced metal allergy (nickel and chromium) to pediatric surgeons. Metal allergy is a well-recognized entity in neurologic, orthopedic, and craniofacial surgery. This study was performed to evaluate metal allergy and its effects on treatment with the Nuss procedure in 862 patients. Methods: After institutional review board approval,

Gregory D. Rushing; Michael J. Goretsky; Tina Gustin; Maripaz Morales; Robert E. Kelly; Donald Nuss


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

NASA Astrophysics Data System (ADS)

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

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



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


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

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



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.



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.



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

NASA Astrophysics Data System (ADS)

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

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



Sternocostal dislocation following open correction of pectus excavatum-"stairway phenomenon": complication management by means of sternocostal locking titanium plate osteosynthesis.  


Introduction?Some open surgical methods describe complete sternocostal dissection with subsequent resynthesis. Lack of consolidation with painful sternocostal instability and retrosternal dislocation of sternal rib tips are possible complications. Materials and Methods?Seven patients with symptomatic unilateral sternocostal dislocation were included in this study. After diagnosis, confirmed by three-dimensional computed tomography (CT), patients underwent open surgery. All affected ribs were reset and fixed to the sternum with the aid of titanium implants. Results?The patients had, on average, unilateral dislocation of 3.4 rib joints with 15.4?mm retrosternal dislocation, which was fixed with 2.3 plates. A titanium splint was also employed. The recurrent nature of the problem made procedures very time-consuming (average operation time: 3 hours 25 minutes). One patient suffered strong intraoperative bleeding requiring transfusion of blood products and access enlargement. Follow-up examinations showed high patient satisfaction (grade of 1.7; rating scale 1-6). Remaining rib instabilities were observed just as infrequently as were material failures. The sternocostal rib splint in the costal cartilage became loose and was removed. One patient exhibited a pectoral muscle asymmetry. No other complications were observed. Conclusion?The term "stairway phenomenon" describes the dislocation of sternocostal joints. Observed after open pectus excavatum correction it can trigger substantial physical complaints. Thus, preserving those joints during pectus repair is strongly recommended. Locking titanium plates are a safe alternative to sternocostal suture fixation and is characterized by high patient satisfaction. PMID:24127362

Schulz-Drost, Stefan; Syed, Julia; Besendoerfer, Manuel; Carbon, Roman T



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

NASA Astrophysics Data System (ADS)

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

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



Pulmonary Dysfunction in Pectus Excavatum.  

National Technical Information Service (NTIS)

The study was designed to obtain objective data on 25 Air Force basic trainees referred because of chest symptoms. They were evaluated with spirometry, lung volume measurements, arterial gas studies at rest and with exercise, and diffusion studies. The de...

J. G. Weg R. A. Krumholz L. E. Harkleroad



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

PubMed Central

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

Haje, D. P.



How to avoid pectus bar dislocation in the MIRPE or MOVARPE technique: results of 12 years' experience.  


Bar displacement remains the most common complication of the minimally invasive repair of pectus excavatum (MIRPE). To date, no studies show results from 12 years' experience using a bar fixation technique with only absorbable sutures. Our aim is to show how to stabilize the bar using a modified approach for bar fixation. A retrospective review of 68 patients, who underwent MIRPE or the minor open videoendoscopic assisted repair of pectus excavatum, was performed. To stabilize the pectus bar, both wings of the pectus bar were tied to the ribs in 52 patients with circumcostal absorbable sutures using a Deschamps needle under endoscopic survey and in 16 patients with lateral stabilizers. The stability of pectus bar after the operation was assessed by lateral chest X-ray films and classified as being perfect, incomplete, or poor. No complications were observed in the perioperative period with the circumcostal suture technique. Lateral chest X-rays showed an excellent position of the pectus bar in 50 patients, incomplete position in 1, and poor position in another patient. Our technique seems to be effective in preventing bar displacement following pectus excavatum repair. It does not add any significant cost or time to the operation, and it is fairly simple to perform. PMID:23241769

Del Frari, Barbara; Schwabegger, Anton H



Modified minimally invasive pectus repair in children, adolescents and adults: an analysis of 262 patients.  


In order to achieve safe and successful funnel chest treatment even in older patients and reduce postoperative complications, we modified the procedure of minimally invasive pectus repair using the single-piece pectus bar (PSI Hofer Medical, Austria) with no metal abrasion. The features of modified minimally invasive funnel chest correction (MMIPR) are the following: (a) additional subxiphoidal incision, (b) anterior mediastinal-mediastinoscopic mobilization, (c) mediastinoscopy, (d) elevation of the funnel during pectus bar placement, and (e) fixation of the implant ends in a latissimus dorsi muscle bag, below the anterior margin of the muscle. In older funnel chest patients with a stiff thorax, a curved sternum, marked asymmetry or a mixed pigeon/funnel chest, the minimally invasive correction method has to be supplemented by additional surgical measures (MEMIPR) such as partial sternotomy (23%), slit-rib chondrotomy under thoracoscopic guidance (Rokitansky method; 48%), rib resection (5%), and occasionally rib osteotomy. In 8 patients with residual minor deformities we administered an ultrasound-guided Macrolane injection (5 to 20 cc). 262 patients (mean age: 17.7+/-7 years) were eligible for analysis. The large majority of them underwent MIPR between the age of 14 and 20 years; 6 patients were older than 40 years. The pectus bar implant was left in the chest for a period of 1.4 to 6.5 years. Modified minimally invasive pectus repair (MMIPR) was performed in 121 patients (mean age: 15.2+/-5 years). The majority of patients received one pectus bar; 13.2% received two bars. Modified extended minimally invasive pectus repair (MEMIPR) was performed in 141 patients (mean age: 22.5+/-8 years); two pectus bars were used in 58.1% of cases. We observed no bar dislocation. Minimal bar movements were noted in 1.6% (MEMIPR) and 4.9% (MMIPR) of cases. With the MEMIPR technique, subcutaneous hematoma was observed in 4.1% of patients. No re-thoracotomy was required in the 262 patients who underwent MMIPR or MEMIPR. After a mean period of 3.4 years the implants were removed surgically in 103 patients; recurrences were observed 0.9%. Our procedures of MMIPR and MEMIPR with a single-piece pectus bar permitted safe and successful surgery in patients who required complex funnel chest correction. PMID:24734356

Rokitansky, Alexander M; Stanek, Rainer



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



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.


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



Biochemical and Physiological Studies of Certain Ticks (Ixodoidea). Gonad Development and Gametogenesis in Hyalomma (H.) Anatolicum Excavatum Koch (Ixodidae).  

National Technical Information Service (NTIS)

In Hyalomma (H.) anatolicum excavatum Koch, germinal differentiation begins in the feeding nymph. Sex is recognized in unfed larvae by the presence of one female genital mass and 2 connected male masses. Females have one U-shaped ovary with 3 germinative ...

G. M. Khalil



Neoplasias mielodisplásicas o mieloproliferativas: Tratamiento (PDQ®)

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


Neoplasias mielodisplásicas o mieloproliferativas: Tratamiento (PDQ®)

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


Metatropic Dysplasia  


... pectus excavatum (depressed breast bone) Severe kyphoscoliosis In infancy, “coccygeal tail” can be apparent, which is a ... small, flat, diamond-shaped vertebral bodies in early infancy due to defective ossification . Later, platyspondyly and anterior ...


Fumar durante el tratamiento de cáncer (PDQ®)

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


To Nuss or not to Nuss? Two opposing views.  


Although the issue of the appropriate approach for the repair of pectus excavatum remained unsettled for decades, just when we thought that the consensus was clear, an entirely new method was introduced: the Nuss operation. This technique now challenges not only the previously established standards, but also the basic conceptual views of pectus surgery. In the following text, 2 opposing views on the subject are presented: the angle from which Francis Robicsek, a pioneer in conventional pectus excavatum surgery, views the issue, and the opinion of Andre Hebra, who has extensive experience with the Nuss operation. PMID:19632567

Robicsek, Francis; Hebra, André



Tratamiento adyuvante del carcinoma de recto  

Microsoft Academic Search

Resumen\\u000a Objectivo  Neustro objetivo es analizar los resultados del tratamiento adyuvante en pacientes operados por un carcinoma rectal localmente\\u000a avanzado, tratados con radioquimioterapia concomitante o secuencial.\\u000a \\u000a \\u000a \\u000a Material y métodos  Entre enero de 1994 y septiembre de 1997, 122 pacientes fueron tratados postquirúrgicamente por un adenocarcinoma rectal en\\u000a estadio B2-C. Setenta y siete pacientes fueron tratados siguiendo un esquema alternante de quimiorradioterapia y

Javier Valencia Julve; Ricardo Escó Barón; Javier Sanz Lacalle; Miguel Burillo Cordero; Pedro Mateo de las Heras; Carmen Lainez Baquero



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



A liposuction technique for extraction of Bio-Alcamid and other permanent fillers.  


Bio-Alcamid (Polymekon Research, Brindisi, Italy) is a permanent soft tissue filler that has been injected for the correction of contour deformities. It has a number of indications, including pectus excavatum. Infection and migration seem to be the most common complications with this product. The authors report an illustrative case of pectus excavatum deformity treated with Bio-Alcamid. Results highlight the successful treatment of gel migration with liposuction, which has not been recommended by the manufacturer nor reported in the literature to date. PMID:21385745

Khan, Imran; Shokrollahi, Kayvan; Bisarya, Kamal; Murison, Maxwell S C



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

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


Siga adelante: la vida después del tratamiento del cáncer

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


Siga adelante: la vida después del tratamiento del cáncer

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


[Lady Windermere syndrome].  


We describe the case of a 68 year old lady with a pectus excavatum, chronic cough, dyspnoea, and fever. The CT scan showed fibronodular infiltrates and bronchectases. Bacterial culture revealed a Mycobacterium avium-intracellulare infection. A tritherapy was initiated and, 10 months later, the patient had greatly improved. PMID:22420095

Simon, P; Meurant, F; Degives, R



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



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


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

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



Tratamiento de materiales a temperaturas criogénicas: evolución y aplicaciones  

Microsoft Academic Search

Desarrollados en los últimos años del siglo XX, los tratamientos criogénicos de materiales aún son poco conocidos y apenas utilizados en Europa. Sin embargo, tienen un gran potencial de aplicación ya que aportan mejoras, a veces espectaculares, en determinadas prestaciones entre las que se pueden destacar la resistencia al desgaste y la vida a fatiga. Estos procesos (que no deben

L. A. Alava


Usefulness of infrared thermal imaging camera for screening of postoperative surgical site infection after the nuss procedure.  


Introduction and Objective. The Nuss procedure is widely used in the treatment of pectus excavatum worldwide. Postoperative pectus bar infection is one of the most serious complications associated with this procedure. Therefore, early detection of signs of implant infection is very important. However, this is difficult, and effective methods have yet to be established. Methods. We use a handheld infrared thermal imaging camera to screen patients for postoperative infection following the Nuss procedure. Here, we report a 28-year-old man with recurrent postoperative (Ravitch procedure) pectus excavatum. Results. Infrared thermography camera clearly indicated slight cellulitis in the right chest. Conclusion. Our technique may assist in preventing postoperative bar infection and removal caused by severe bar infection. Furthermore, this camera is potentially suitable for many situations in infection monitoring following subcutaneous implant surgery. PMID:23878757

Fujita, Kenya; Noguchi, Masahiko; Yuzuriha, Shunsuke; Yanagisawa, Daisuke; Matsuo, Kiyoshi



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

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


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



Positioning challenges in mammography.  


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

Peart, Olive



Lanzamiento del estudio de tratamiento personalizado para el cáncer de seno

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


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


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

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



Flail chest stabilization with Nuss operation in presence of multiple myeloma  

PubMed Central

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

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



Left thoracotomy: an ideal approach for mitral valve replacement in patient with severe chest wall deformity.  


We report a 65-year-old woman with chronic diastolic congestive heart failure, pulmonary hypertension, and severe mitral valve regurgitation. She was not a candidate for percutaneous mitral valve repair and was turned down for an open heart operation by 2 institutions based on her severe pectus excavatum deformity. A left posterior lateral thoracotomy approach provided excellent exposure for central cannulation and replacement of the mitral valve. PMID:23992732

Bastidas, Juan G; Razzouk, Anees J; Hasaniya, Nahidh W; Bailey, Leonard L



Roberts SC phocomelia with isolated cleft palate, thrombocytopenia, and eosinophilia.  


The Roberts-SC (Pseudothalidomide) syndrome is a rare autosomal recessive disorder. We present a Roberts-SC Syndrome in a 20-day-old girl with phocomelia of the upper limbs, isolated cleft palate, micrognathia, prominent eyes, pectus excavatum, and pes equinovarus. Peripheral blood smear revealed thrombocytopenia and hypereosinophilia. Premature centromere separation in the child and also in her normal mother was noted. PMID:10422009

Camlibel, T; Mocan, H; Kutlu, N; Kutlu, N



Familial skeletal cardiovascular syndrome (Holt-Oram) in a polygamous African family  

PubMed Central

A polygamous Nigerian family with inherited skeletal cardiovascular anomalies (Holt-Oram syndrome) is described. Common to the affected individuals in this family were pectus excavatum and abnormalities of the thumbs. Atrial septal defect was proven by angiocardiography in one and clinically diagnosed in another member of the family. The mode of inheritance of the abnormalities in this family as in other reported cases is thought to be an autosomal dominant type which is unaffected by the polygamous situation. Images

Antia, Asuquo U.



Distal arthrogryposis with autosomal dominant inheritance and reduced penetrance in females: the Gordon syndrome.  


A family is reported in which camptodactyly, club foot, pectus excavatum and undescended testes are transmitted as an autosomal dominant with reduced penetrance and variable expressivity, affecting 13 members through five generations. Penetrance is more reduced in females than in males and asymptomatic carriers are always females. Similar findings were previously described in two other families reported by Gordon et al. (1962) and Halal & Fraser (1979). PMID:8370149

Ioan, D M; Belengeanu, V; Maximilian, C; Fryns, J P



Increased incidence of thoracic wall deformities in related Bengal kittens.  


Clinical records made during routine vaccinations were compared between populations of domestic shorthair cats and Bengal kittens. An increased incidence (12/244) of thoracic wall deformity was detected amongst the Bengal kittens. Deformities detected were: pectus excavatum (five), unilateral thoracic wall concavity (six) and scoliosis (one). Five-generation pedigrees were analysed for the affected kittens that showed a high degree of common ancestry indicating the likelihood of a familial cause. PMID:22311892

Charlesworth, Timothy M; Sturgess, Christopher P




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


Colocación de marcapasos diafragmático por toracotomía mínima para tratamiento de hipoincoercible  

Microsoft Academic Search

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



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



Sistema de tratamiento y disposicion final de los residuos urbanos en la Region Metropolitana de Salvador, Bahía  

Microsoft Academic Search

Este artículo trata de las innovaciones tecnicas en el tratamiento de los residuos industriales en la región metropolitana de Salvador y las principales medidas adoptadas para una gestión ambiental de la petroquímica en Bahia, Brasil. La adopción de procedimientos y criterios en conformidad con las normativas internacionales añade una nueva dimensión en la gestión del espacio regional.

Hilda Maria de Carvalho Braga



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



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

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


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

Microsoft Academic Search

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

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



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

NASA Astrophysics Data System (ADS)

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

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


Estimation of cartilaginous region in noncontrast CT of the chest  

NASA Astrophysics Data System (ADS)

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

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



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


Congenital dyserythropoietic anemia (CDA) type-1 is a rare genetic disorder of ineffective erythropoiesis, which manifests in macrocytic anemia. We report a CDA1 patient who as a newborn presented with macrocytic anemia and persistent pulmonary hypertension of the newborn (PPHN) requiring mechanical ventilation. Post-infancy, the patient developed acral dysmorphism and pectus excavatum the latter rarely found in CDA1. Patient is a compound heterozygote for a known maternal-derived missense-mutation (c.1796A?>?G/p.Asn589Ser) and a novel paternal-derived deletion-mutation (c.1104_1106del/Phe365del) in CDAN1. This report highlights the importance of recognizing PPHN as a presenting symptom of CDA1 and expands the repertoire of the accompanying mutations and axial skeletal malformations. Pediatr Blood Cancer 2014; 61:1460-1462. © 2014 Wiley Periodicals, Inc. PMID:24420417

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



New syndrome?: MCA/MR syndrome with multiple circumferential skin creases.  


We describe a combination of multiple congenital anomalies, severe psychomotor retardation and symmetrical circumferential skin creases of arms and legs in a 4.5-year-old male. Craniofacial anomalies included: a high forehead, elongated face, bitemporal sparseness of hair, broad eyebrows, blepharophimosis, bilateral microphthalmia and microcornea, severe optic nerve hypoplasia, epicanthic folds, telecanthus, broad nasal bridge, puffy cheeks, microstomia, cleft palate, enamel hypoplasia, micrognathia, microtia with stenotic ear canals and posteriorly angulated ears. Head circumference was on the 10th centile and a CT scan showed dilated lateral ventricles. Intracranial pressure was not increased. Other abnormalities included: short stature, loose skin, hypotonia, pectus excavatum, inguinal and umbilical hernias, severe scoliosis, hypoplastic scrotum, long fingers and overlapping toes. Echocardiography showed tricuspid regurgitation. Chromosomes were apparently normal. Differentiation from "Michelin tire baby syndrome" and amniotic band sequence is discussed. PMID:8779319

Elliott, A M; Ludman, M; Teebi, A S



Gorlin syndrome and bilateral ovarian fibroma  

PubMed Central

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

Pirschner, Fernanda; Bastos, Pollyana Marcal; Contarato, George Luiz; Bimbato, Anna Carolina Bon Lima; Filho, Antonio Chambo



Minimally Invasive Thoracic Surgery in Pediatric Patients: The Taiwan Experience  

PubMed Central

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.

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



[Marfan syndrome and related connective tissue disorders].  


Marfan syndrome is an autosomal dominantly inherited connective tissue disorder with a prevalence of approximately 1:5000 people. Typical manifestations affect the cardiovascular system, eyes, skeleton, lungs, skin and dura mater. Most patients have a so-called marfanoid habitus with tall stature, long and narrow limbs, a long and narrow head shape and other skeletal abnormalities. Of particular medical importance are the possible complications such as severe scoliosis or pectus excavatum, spontaneous pneumothorax, retinal detachment, or an acute glaucoma evoked by lens luxation. However, the most dangerous complication is acute dissection of the ascending aorta, which is usually the result of a slowly progressive aortic dilatation. With the introduction of therapies the average life expectancy of previously just 32 years could be raised to above 60 years. PMID:24280605

Steindl, Katharina



Developing clinically relevant aspects of the nuss procedure surgical simulator.  


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

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



Pulmonary Nontuberculous Mycobacterial Disease  

PubMed Central

Rationale: Pulmonary nontuberculous mycobacterial (PNTM) disease is increasing, but predisposing features have been elusive. Objectives: To prospectively determine the morphotype, immunophenotype, and cystic fibrosis transmembrane conductance regulator genotype in a large cohort with PNTM. Methods: We prospectively enrolled 63 patients with PNTM infection, each of whom had computerized tomography, echocardiogram, pulmonary function, and flow cytometry of peripheral blood. In vitro cytokine production in response to mitogen, LPS, and cytokines was performed. Anthropometric measurements were compared with National Health and Nutrition Examination Survey (NHANES) age- and ethnicity-matched female control subjects extracted from the NHANES 2001–2002 dataset. Measurements and Main Results: Patients were 59.9 (±9.8 yr [SD]) old, and 5.4 (±7.9 yr) from diagnosis to enrollment. Patients were 95% female, 91% white, and 68% lifetime nonsmokers. A total of 46 were infected with Mycobacterium avium complex, M. xenopi, or M. kansasii; 17 were infected with rapidly growing mycobacteria. Female patients were significantly taller (164.7 vs. 161.0 cm; P < 0.001) and thinner (body mass index, 21.1 vs. 28.2; P < 0.001) than matched NHANES control subjects, and thinner (body mass index, 21.1 vs. 26.8; P = 0.002) than patients with disseminated nontuberculous mycobacterial infection. A total of 51% of patients had scoliosis, 11% pectus excavatum, and 9% mitral valve prolapse, all significantly more than reference populations. Stimulated cytokine production was similar to that of healthy control subjects, including the IFN-?/IL-12 pathway. CD4+, CD8+, B, and natural killer cell numbers were normal. A total of 36% of patients had mutations in the cystic fibrosis transmembrane conductance regulator gene. Conclusions: Patients with PNTM infection are taller and leaner than control subjects, with high rates of scoliosis, pectus excavatum, mitral valve prolapse, and cystic fibrosis transmembrane conductance regulator mutations, but without recognized immune defects.

Kim, Richard D.; Greenberg, David E.; Ehrmantraut, Mary E.; Guide, Shireen V.; Ding, Li; Shea, Yvonne; Brown, Margaret R.; Chernick, Milica; Steagall, Wendy K.; Glasgow, Connie G.; Lin, JingPing; Jolley, Clara; Sorbara, Lynn; Raffeld, Mark; Hill, Suvimol; Avila, Nilo; Sachdev, Vandana; Barnhart, Lisa A.; Anderson, Victoria L.; Claypool, Reginald; Hilligoss, Dianne M.; Garofalo, Mary; Fitzgerald, Alan; Anaya-O'Brien, Sandra; Darnell, Dirk; DeCastro, Rosamma; Menning, Heather M.; Ricklefs, Stacy M.; Porcella, Stephen F.; Olivier, Kenneth N.; Moss, Joel; Holland, Steven M.



Duplication of chromosome band 12q24.11q24.23 results in apparent Noonan syndrome.  


Noonan syndrome is an autosomal dominant disorder with an estimated incidence of 1 in 1,000 to 1 in 2,500 live births. It is characterized by postnatal-onset short stature, characteristic facial changes, webbed neck, pectus carinatum, or excavatum, congenital heart defects, and bleeding abnormalities. Gain-of-function mutations in the PTPN11, KRAS, SOS1, and RAF1 genes that are components of the RAS/MEPK signaling pathway are identified in about 70-85% of individuals with Noonan syndrome. We report here a case of duplication of chromosome region 12q24.11q24.23 identified by array comparative genomic hybridization (aCGH) that includes the PTPN11 gene in a 3-year-old girl with apparent Noonan syndrome. The patient presented with postnatal-onset failure-to-thrive, developmental delay, microcephaly, velopalatal incompetence, pectus excavatum, coarctation of aorta, atrial and ventricular septal defects, decreased muscle tone, and minor facial anomalies consistent with Noonan syndrome. At 3 years of age her speech, gross and fine motor development were at the level of a 12-18 month old child. This degree of developmental delay was atypical for an individual with Noonan syndrome, raising concerns for a chromosomal abnormality. Array-CGH showed an interstitial duplication of 10 Mb including the PTPN11 gene. Sequencing of PTPN11, KRAS, SOS1 and the coding region of RAF1 did not identify mutations. The increased gene dosage of the PTPN11 gene in the form of duplication is expected to have the same consequence as gain-of-function mutations seen in Noonan syndrome. We propose that at least some of the 15-30% of individuals with Noonan syndrome who do not have a mutation by sequencing may have a gain in copy number of PTPN11 and recommend that comprehensive testing for Noonan syndrome should include analysis for copy number changes of PTPN11. PMID:18348260

Shchelochkov, Oleg A; Patel, Ankita; Weissenberger, George M; Chinault, A Craig; Wiszniewska, Joanna; Fernandes, Priscilla H; Eng, Christine; Kukolich, Mary K; Sutton, V Reid



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



Age-related thoracic radiographic changes in golden and labrador retriever muscular dystrophy.  


Golden retriever and Labrador retriever muscular dystrophy are inherited progressive degenerative myopathies that are used as models of Duchenne muscular dystrophy in man. Thoracic lesions were reported to be the most consistent radiographic finding in golden retriever dogs in a study where radiographs were performed at a single-time point. Muscular dystrophy worsens clinically over time and longitudinal studies in dogs are lacking. Thus our goal was to describe the thoracic abnormalities of golden retriever and Labrador retriever dogs, to determine the timing of first expression and their evolution with time. To this purpose, we retrospectively reviewed 390 monthly radiographic studies of 38 golden retrievers and six Labrador retrievers with muscular dystrophy. The same thoracic lesions were found in both golden and Labrador retrievers. They included, in decreasing frequency, flattened and/or scalloped diaphragmatic shape (43/44), pulmonary hyperinflation (34/44), hiatal hernia (34/44), cranial pectus excavatum (23/44), bronchopneumonia (22/44), and megaesophagus (14/44). The last three lesions were not reported in a previous radiographic study in golden retriever dogs. In all but two dogs the thoracic changes were detected between 4 and 10 months and were persistent or worsened over time. Clinically, muscular dystrophy should be included in the differential diagnosis of dogs with a combination of these thoracic radiographic findings. PMID:22702494

Bedu, Anne-Sophie; Labruyère, Julien J; Thibaud, Jean Laurent; Barthélémy, Inès; Leperlier, Dimitri; Saunders, Jimmy H; Blot, Stéphane



Childhood hypophosphatasia due to a de novo missense mutation in the tissue-nonspecific alkaline phosphatase gene.  


Hypophosphatasia is an inherited disorder due to mutations in the bone alkaline phosphatase (ALPL) gene. We report here a patient with childhood hypophosphatasia diagnosed at 1.4 yr because of pectus excavatum, large anterior fontanel, rachitic skeletal changes, and low serum alkaline phosphatase. Sequencing of the ALPL gene produced evidence of two distinct missense mutations, E174K (c.571G>A), of maternal origin, and a de novo mutation, M45I (c.186G>C). The study of various microsatellite polymorphisms ruled out false paternity and therefore confirmed that M45I occurred de novo in the paternal germline or in the early development of the patient. Site-directed mutagenesis showed that M45I results in the absence of in vitro alkaline phosphatase activity, suggesting that the mutation is a severe allele. In conclusion, childhood hypophosphatasia in this patient is the result of compound heterozygosity for the moderate mutation E174K and a novel severe de novo mutation M45I. PMID:15671102

Taillandier, A; Sallinen, S-L; Brun-Heath, I; De Mazancourt, P; Serre, J-L; Mornet, E



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

PubMed Central

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

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



Bio-alcamid: a novelty for reconstructive and cosmetic surgery.  


Research for new biocompatible and easily implantable materials continously proposes new molecules and new substances with biological, chemical and physical characteristics more and more adapted to aesthetic and reconstructive surgery. Bio-Alcamid (Polymekon, Italy) is a non reabsorbable polymeric material composed of alkylimide-amide groups. This cosmetic agent has been used for the treatment of 2000 patients by a multicentric trial led by different Hospitals and University in Italy and abroad. Very serious aesthetic defects such as pectus excavatum, Poland Syndrome, postoperative traumas, in addition to common aesthetic defects such as lips, cheek-bone and chin hypovolumetry and relaxing of nasolabial sulcus, have been treated by surgical implant of Bio-Alcamid. Aesthetic results were excellent; tissues felt soft and the implants were uniformly distributed. No migration or dislocation of the implants, no granulomas, no allergic response and no kind of intolerance were observed. Only 12/2000 patients had post-operative complications (Staphylococcus infections) and only 3/12 cases could be directly ascribed to the implanted material. For its characteristics Bio-Alcamid can be considered a novelty in the aesthetic and reconstructive surgery; it is absolutely biocompatible, non toxic, non allergenic, easily injectable and quickly removable. Bio-Alcamid can be defined a sort of "endoprosthetis", perfectly suitable for soft tissue augmentation and for the correction of different tissue deficiences, with a long-term safety and efficiency. PMID:12437147

Pacini, Stefania; Ruggiero, Marco; Morucci, Gabriele; Cammarota, Nazareno; Protopapa, Carmelo; Gulisano, Massimo



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


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

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



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


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

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



Gorlin-Goltz syndrome in a child: case report and clinical review.  


Gorlin-Goltz syndrome is a rare autosomal dominant disorder that involves multiple organ systems, including the skin, skeleton and jaws. We report the case of a mild mentally retarded 7-year-old boy who was referred with a swelling of his left mandible. Imaging studies showed a unilocular well-defined lytic mandibular lesion, calcifications of the falx, bifid ribs and fusion anomalies of the ribs. The mandibular lesion was treated with surgical decompression and proved to represent a keratocyst on histological examination. Further clinical examination revealed cutaneous lesions, Sprengel deformity, pectus excavatum and facial dysmorphism. Based on the combination of imaging and clinical findings the diagnosis of Gorlin-Goltz syndrome was made. This was confirmed by genetic tests. During three-year follow-up the boy presented with recurrent and multiple odontogenic keratocysts. The occurrence of multiple and recurrent keratocysts at young age, should alert the radiologist to the potential diagnosis of an underlying Gorlin-Goltz syndrome. This paper reviews the imaging findings in Gorlin-Goltz syndrome, with emphasis on maxillofacial imaging. PMID:19202996

Snoeckx, A; Vanhoenacker, F M; Verhaert, K; Chappelle, K; Parizel, P M



Modern CT applications in veterinary medicine.  


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

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



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



Tratamiento del insomnio en pacientes hospitalizados  

Microsoft Academic Search

Summary Insomnia is a problem affecting many outpatients and inpa- tients. It may result from various causes, from stress to either psy- chiatric or somatic conditions. According to duration, it may be subdivided into transient, short-term and long-term insomnia. Aetiological treatment is best, but hypnotics are indicated for symptom therapy when this is not feasible or adequate. Sleep hygiene is



Avances en el tratamiento de la hipercolesterolemia  

Microsoft Academic Search

Numerous epidemiological and prospective studies have shown a direct relationship between total cholesterol and low-density lipoprotein cholesterol (LDL-C) and cardiovascular disease (cardiovascular morbidity and mortality). In many intervention studies with more than 100,000 subjects, statins have shown a powerful and significant reduction of cardiovascular events and a decrease in cardiovascular and overall mortality, far superior to those produced by any

Juan F. Ascaso



Embarazo ectópico cervical. Tratamiento médico conservador  

Microsoft Academic Search

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

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



Recomendaciones para el tratamiento del estreñimiento funcional  

Microsoft Academic Search

Constipation is common in childhood. It can affect around 5–30% of the child population, depending on the criteria used for diagnosis. The currently recommended treatment is based on three main points: a) explanation, b) disimpaction and c) maintenance therapy consisting of diet changes, behavioural modification, and the use of laxatives.In the last decades treatment on disimpaction have changed radically from

A. Bautista Casasnovas; F. Argüelles Martín; L. Peña Quintana; I. Polanco Allué; F. Sánchez Ruiz; V. Varea Calderón




Microsoft Academic Search

SUMMARY The identification of various pathologic risk factors and a better stratification of patients into risk groups, after primary surgical management of early stage cervical cancer, helps to define the best adjuvant treatment and improve outcomes. Two randomized clinical trials have greatly advanced our understanding of the role of adjuvant treatment in cervix cancer. In patients with clinical stage IA2,

José A. Solis


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

PubMed Central

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

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



Effect of ketamine on intravenous patient-controlled analgesia using hydromorphone and ketorolac after the Nuss surgery in pediatric patients  

PubMed Central

Background Nuss surgery is preferred in pectus excavatum repair because this procedure produces excellent cosmetic results and prevents postoperative distressed pulmonary function. However, the procedure causes severe pain due to thoracic expansion. This study was designed to investigate the analgesic effect of small doses of ketamine on an intravenous patient-controlled analgesia (IV-PCA) using hydromorphone and ketorolac for pain control after Nuss surgery. Methods Forty-four patients undergoing elective Nuss surgery were randomly assigned to receive hydromorphone 3 µg/kg/hr, ketorolac 0.05 mg/kg/hr and ondansetron 0.1 mg/kg/day (Group HO, n = 22) or hydromorphone 3 µg/kg/hr, ketorolac 0.05 mg/kg/hr, ondansetron 0.1 mg/kg/day and ketamine 0.15 mg/kg/hr (Group HK, n = 22) via an IV-PCA pump after surgery. A blind observer evaluated each patient using the Modified Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) for the assessment of pain control. The total administered PCA volume, side effects and parents satisfaction with pain control were assessed at postoperative 1, 4, 8, 12, 24, and 48 hours. Results There were no significant differences in Modified CHEOPS between the groups during postoperative 48 hours. The total PCA volume in group HK was significantly lower than that in group HO (P < 0.05). The side effects in both groups did not significantly differ except for pruritus. The levels of satisfaction from the parents were not significantly different between the groups. Conclusions A small dose of ketamine on IV-PCA reduced the total administered dose of IV-PCA with hydromorphone and ketorolac and reduced the incidence of pruritus after the Nuss procedure in pediatric patients.

Min, Too Jae; Jeong, Won Ju; Choi, Jae Ho; Lee, Yoon Sook; Kim, Jae Hwan; Park, Young Cheol



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

PubMed Central

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



Como Lo Hago Yo: Tratamiento Quirurgico Del Mielomeningocele  

PubMed Central

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

Portillo, Santiago



Tratamiento cognitivo-conductual para niños mexicanos con fobia social  

Microsoft Academic Search

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

Flor Gil-Bernal; Laura Hernández-Guzmán



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



La espiritualidad en el tratamiento del cáncer (PDQ®)

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


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



Criterios de eficacia de los tratamientos según la Task Force  

Microsoft Academic Search

We present the evaluation criteria of the effectiveness of psychological treatments developed by the American Association of Psychology for the evaluation of the Treatments with Empirical Support, distinguishing between: well-established well (effective) treatments, probably effective treatments and experimental treatments. The criteria selected by the experts’ committee (Task Force), appointed by the association, are based on the possibility or not of

A. I. Rosa-Alcázar; E. Rosa-Alcázar



Revisión del tratamiento en pacientes con Esclerosis Múltiple  

Microsoft Academic Search

Multiple Sclerosis (MS) is an inflamatory and demyelinative disease which affects central nervous system myelin. The most characteristic clinic in MS is its variability, with signs and symptoms depending on the localitation of the injuries which can appear in all neuroaxis. Today there isn’t a healing therapy in MS. Thats why physiotherapy acquires an important value to maintain and\\/or improve

A. I. Macías Jiménez; R. Cano de la Cuerda



Tratamiento quirúrgico de la hiperhidrosis: simpatectomía torácica endoscópica bilateral  

Microsoft Academic Search

SUMMARY Many clinical treatments have been used worldwide for the treatment of hyperhidrosis, but all of them are palliative, of temporary effect or have poor results. Recently the surgical procedure is considered definitive. The not surgical alternatives for the treatment of hyperhidrosis are limited and include: dermatological treatments with the application of solutions or astringent creams; electrical baths with salty

Clínica del Sudor


Estenorraquis Lumbar: ¿Tratamiento Médico, Pequeña o Gran Cirugía?  

Microsoft Academic Search

Summary Lumbar spinal stenosis is a disease that is not always symptomatic, with increasing incidence on the population as it ages. Initial treatment must be conservative, based on medicine, physiokinesiotherapy, while compensating general illnesses. A second stage would include the use of steroid injec- tions, as in the epidural or foraminal space, or in the facet joints. If these treatments


Tratamiento de la enfermedad de Hodgkin, esquema MOPP\\/ABV  

Microsoft Academic Search

Resumen  El propósito del presente estudio fue determinar la eficacia de un régimen híbrido de 7 fármacos en pacientes con enfermedad\\u000a de Hodgkin (EH) en estadios avanzados y en estadios tempranos IIB con factores pronósticos desfavorables, y evaluar su toxicidad\\u000a aguda y tardía.\\u000a \\u000a Entre enero del 1988 y diciembre del 1998 fueron tratados 126 pacientes, 70 hombres, promedio de edad de

Greta Corrales; Rosa Somoza Núñez; Jean Desenne Labonardier; Aixa Müller; María Alejandra Torres; Elsa Tovar; Nelson Urdaneta Laffe; Alicia Páez; Mercedes León; Carlos de Jongh García; Esther Arbona; Oswaldo Travieso Travieso



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



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



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



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



Importancia pronóstica de la autoinmunidad durante el tratamiento del melanoma con interferón  

Microsoft Academic Search

ADJUVANT THERAPY WITH INTERFERON alfa-2b (after surgery for deep primary or regionally metastatic melanoma) has clinically significant benefits for patients with melanoma who are at high risk for relapse or death. Patients with American Joint Committee on Cancer (AJCC) stage IIB, IIC, or III melanoma have risks of relapse and death exceeding 40 percent at five years and are candidates

Helen Gogas; John Ioannovich; Urania Dafni




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


Recuperación natural y recuperación con tratamiento del consumo de drogas y alcohol  

Microsoft Academic Search

This study examines the concept of natural recovery (without formal treatment) from problems associated with alcohol, marijuana, cocaine and heroin abuse, each one alone or in any combination. Two groups of males (40 Ss between 18 and 60 years of age) and two groups of females (19 Ss between 18 and 55 years of age) with at least one year


Trastornos alimentarios en el deporte: factores de riesgo, consecuencias sobre la salud, tratamiento y prevención  

Microsoft Academic Search

Eating disorders appear with relative frequency in sports, such as gymnastics, figure skating or resistance sports, in which weight control is important. Their inci- dence is greater in women, frequently appearing a low self-esteem, a distorted body image in which the body is perceived with an excess of weight, inefficiency, perfectio- nism and a sense of control loss, with compensatory

S. Márquez



Comorbilidad del juego patológico: variables clínicas, personalidad y respuesta al tratamiento  

Microsoft Academic Search

IntroductionPathological gambling shows high comorbidity rates, especially with substance use disorders, although affective, anxiety and other impulse control disorders, as well as personality disorders, are also frequently associated.

S. Jiménez-Murcia; R. Granero Pérez; F. Fernández-Aranda; E. Álvarez Moya; M. N. Aymamí; M. Gómez-Peña; B. Bueno; J. J. Santamaría; L. Moragas; E. Penelo; N. Jaurrieta; M. P. Alonso; C. Segalàs; E. Real; J. Labad; F. Bove; J. Vallejo; J. M. Menchón



El tractocile como tratamiento de mantenimiento en la amenaza de parto prematuro en casos seleccionados  

Microsoft Academic Search

Preterm delivery is one of the main causes of perinatal morbidity and mortality. The management of this entity is an unresolved issue in modern obstetrics, since its incidence has not decreased.Currently, tocolytic treatment in acute episodes of preterm labor is maintained for 48h to induce lung maturation pharmacologically. However, the ideal situation is to prolong pregnancy until a healthy, term

M. Pato; C. Varillas; P. Frade; D. Gómez-Sánchez; L. Castro-Vilar; S. Blanco



Tratamiento de la diabetes mellitus tipo 1 con implante pancreático de células madre adultas autólogas  

Microsoft Academic Search

Background and objectiveType 1 diabetes results from the autoimmune destruction of ? cells in the pancreas. Several studies have discussed the ability of adult stem cells to differentiate and function effectively. The aim of this study was to attain fasting glycemia of <100mg\\/dl, or any glycemic value of <200mg\\/dl at any time in the course of the day, and a

Alejandro Daniel Mesples; Basilio Pretiñe; Raúl Bellomo



¿Es efectivo el consejo de enfermería en el tratamiento de la obesidad en niños y adolescentes?  

Microsoft Academic Search

Objectives: to assess the effectiveness of a programmed intervention in a nurses's consul- tation for the treatment of primary obesity. Patients and methods: the 115 patients were assigned to two groups (non randomized): the intervention group (56) and the control group (59). A descriptive retrospective study was made, analyzing the epidemiological characteristics and the decrease of the body mass relative

B. Navarra; R. Pinillos; Y. Aliaga; J. Galbe; J. Mengual



Tratamiento quirúrgico del complejo extrofia-epispadias: Revisión y conceptos actuales  

Microsoft Academic Search

SURGICAL TREATMENT OF EXSTROPHY-EPISPADIAS COMPLEX. REVIEW AND NEW CONCEPTS Since earlier descriptions the surgical management of the bladder exstrophy and epispadias complex (BEEC) has experimented gradual changes in the search for good aesthetic and functional results. The ini- tial urinary diversion and bladder plate removal has evolved under various authors either by improving or supplementing the above described advances, until

E. de la Peña; J. Hidalgo; J. Caffaratti; J. M. Garat; H. Villavicencio



Resultados del tratamiento de fracturas intertrocantéricas inestables con clavo cefalomedular bloqueado  

Microsoft Academic Search

Background: pertrochanteric fractures are a serious problem to the geriatric population. We present our one year experience in the treatment of this condition in the Clínica Andes of Barranquilla. Methods: we designed a case series. During the period of April 2005 and April 2006, we treated surgically 25 patients with unstable per- trochanteric fracture (AO 31 A 2.2 and A

Ernesto M. Gari Villa; Peña Vargas; Antonio L. Solano Urrutia


Diagnóstico y tratamiento farmacológico del trastorno por déficit de atención e hiperactividad  

Microsoft Academic Search

. Se asocia con retraso y dificultades del funcionamiento académico y social 2 , y hay evidencia creciente que indica que también se asocia con morbilidad significativa y peor funcionamiento en la edad adulta 3,4 . Además, estudios longitudinales recientes señalan que los niños con TDAH de ambos sexos y de cual- quier edad generan un gasto médico total y

César Soutullo Esperón



Tratamiento de Mostos Utilizando el Filtro Anaerobio (Treatment of Must Using an Anaerobic Filter).  

National Technical Information Service (NTIS)

This study reports on the feasibility of treating the slops from rum distilleries with an anaerobic filter composed of an oxygen free reactor filled with a plastic filtering media, commercially known as 'Actifil' with a diameter of 5/8 inches (16mm). This...

R. M. Negron



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



Doble abordaje para el tratamiento del rinofi ma. Reporte de un caso  

Microsoft Academic Search

Rhinophyma, a word derived from the Greek rhino-nose and phyma-growth, is a deforming and progressive disease characterized by the thickening of the skin of the nose, hyperplasia of the sebaceous glands, occlusion of the ducts with formation of cysts and a certain degree of fi brosis. Diverse factors for the development of rhinophyma have been proposed, such as vitamin defi

Yanko Castro Govea; Hernán Chacón Martínez; Sergio Pérez Porras; Salvador Ángel García; Rafael Orlando; Vallejo Estrella



Gliomas del adulto: acercamiento al diagnóstico y tratamiento Gliomas in adults: diagnostic and therapeutical approach  

Microsoft Academic Search

SUMMARY Gliomas are the most common primary malignancies of central nervous system. Progress in neuroradiology with use of magnetic resonance imaging allows establishing diagnosis in earlier when an opportune treatment can be perfformed. Even though prognosis is poor for this group of patients, evidence has showed that treatments with surgery, radiotherapy and chemotherapy have a significant impact in quality of

Germán Alonso; Reyes Botero


Tratamiento de la queratitis sicca severa e inflamación ocular con ciclosporina A tópica  

Microsoft Academic Search

OBJECTIVE: To determine the efficacy and safety of topical cyclosporine A 0,1% for the treatment of severe queratitis or queratoconjunctivitis sicca (QS) and ocular inflammation. MATERIAL AND METHODS: Descrip- tive and retrospective study. It comprised 24 files of patients that were evaluated in the Ophthalmology Service in Hospital Loayza of Lima in the period from November 2006 to August 2007:

Blanca Alzamora-Barrios; Luis Guerra-Palomino; Hugo Jiménez-Arenas; Milagros Torres-Zavala; Alfonso Cárdenas-Merino; Guillermo Barriga-Salaverry; Maruja Yupari-Capcha; Fernando-Román D'Alessio



Microsoft Academic Search

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

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




Microsoft Academic Search

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




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

Microsoft Academic Search

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

Florentina Marín-Reyes; Martha Rodríguez-Morán



Genetics Home Reference: Loeys-Dietz syndrome  


... pectus carinatum), an inward- and upward-turning foot (clubfoot), or elongated limbs with joint deformities called contractures ... cartilage ; cell ; cell nucleus ; cell proliferation ; cleft palate ; clubfoot ; connective tissue ; craniosynostosis ; differentiation ; DNA ; extracellular ; extracellular matrix ; ...


Epirubicin in advanced endometrial adenocarcinoma: a phase II study of the Grupo Ginecologico Español para el Tratamiento Oncologico (GGETO).  


27 patients with FIGO stage III-IV endometrial adenocarcinoma were entered in a phase II trial evaluating activity and safety of epirubicin given at 80 mg/m2 intravenously every 3 weeks. 2 complete remissions (including a pathological one) and 5 partial responses were observed for a response rate of 26% (95% confidence interval 11-46). The median time to progression and median survival for all treated patients was 6 and 9.5 months, respectively. Treatment was well tolerated. Haematological toxicity was mild. The median total cumulative dose of epirubicin was 480 mg/m2 (160-880) and cardiac toxicity was not observed. Further studies with higher doses of epirubicin in combination with other active drugs are indicated. PMID:1834118

Calero, F; Asins-Codoñer, E; Jimeno, J; Rodriguez Escudero, F; Mendaña, J; Iglesias, J; Matía, F; Armas, A; Díaz-Castellanos, R; Garzón, J



Diseño, análisis y manufactura de un sistema de fijación interna para tratamiento de fracturas en el primer metacarpiano  

Microsoft Academic Search

En la Universidad Central de Venezuela se está desarrollando un sistema intramedular bloqueado para\\u000atratamiento de fracturas diafisiarias en los huesos metacarpianos como una nueva alternativa para este tipo\\u000ade lesiones. El dispositivo es poco invasivo y permite movilidad temprana de la mano al paciente postoperado\\u000aacortando el tiempo de recuperación. En este trabajo se presentan los diferentes procesos que

Gabriela Contreras; Miguel Cerrolaza; Manuel Martínez; Nils Götzen



Evaluación y tratamiento de la fobia social en población infanto-juvenil de los países de habla española y portuguesa  

Microsoft Academic Search

La fobia social o trastorno de ansiedad social se define como un miedo intenso y duradero a una o más situaciones sociales en las que la persona se expone a ser observada por los demás y experimenta el temor de hacer algo o comportarse de una manera que resulte humillante o embarazosa. Se distingue de otros trastornos por el miedo

José Olivares Rodríguez



Edema agudo de pulmón y tratamiento secuencial con nifedipino y ritodrina en la amenaza de parto pretérmino  

Microsoft Academic Search

We report the case of a pregnant woman with threatened premature labor who developed acute pulmonary edema after treatment with nifedipine with inadequate response and subsequent treatment with ritodrine. The intravenous fluids, corticosteroid treatment and the sequential use of both drugs may have contributed to the development of the pulmonary edema. Maternal and fetal outcomes were satisfactory.

L. Aceituno; M. H. Segura; R. Rodríguez-Zarauz; L. Delgado; M. E. Vargas; F. J. Giménez-Ruiz; A. I. Barqueros



Tratamiento de desechos radiactivos liquidos de aplicaciones medicas. (Chemical treatment of radioactive liquid wastes from medical applications).  

National Technical Information Service (NTIS)

This work is a study about the treatment of the most important radioactive liquid wastes from medical usages, generated in medical institutions with nuclear medicine services. The radionuclides considered are P-32, S-35, and I-125. The treatments develope...

J. Castillo



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

Microsoft Academic Search

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

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


Microcistina en plantas de tratamiento de agua para consumo humano en un ambiente tropical: el Área Metropolitana de Costa Rica  

Microsoft Academic Search

Microcystin in plants that treat water for human consumption in a tropical environment: the Metropolitan Area of Costa Rica. We measured microcystin levels in water of the Metropolitan Area of Costa Rica by competitive inhibition ELISA and we quantified total coliforms, fecal coliforms, Escherichia coli (by a Most Probable Number method) and aerobic count. We wanted to identify any cyanotoxin

Adrián Avendaño Lopez; Carolina Arguedas Villa


Diferencias en la calidad de vida: Un estudio longitudinal de pacientes de cáncer recibiendo tratamiento de quimioterapia  

Microsoft Academic Search

Title: Differences in quality of life: Longitudinal study with cancer patients receiving chemotherapy treatment. Abstract: The diagnosis and treatment of cancer causes several psychological and social responses which affect patient's quality of life. Quality of life is a multidimensional construct including functional ability, symptoms from disease and treatment, social and psychological dimensions. In this study we assess the quality of

M. Carmen Terol; Sofía López-Roig; Jesús Rodríguez-Marín; Angeles Pastor; María Mora; Maite Martín-Aragón; José Ignacio Leyda-Menéndez; M. Carmen Neipp; José Lizón



Tratamiento con ribavirina inhalada en el síndrome de dificultad respiratoria aguda inducida por virus respiratorio sincitial en el adulto  

Microsoft Academic Search

Respiratory syncytial virus (RSV) infection-induced acute respiratory distress syndrome (ARDS) in previously healthy adults is rare, but the overall mortality rate is 40-60%. Inhaled ribavirin is approved for the treatment of hospitalized infants and young children with severe lower respiratory tract infections due to RSV. We present the case of an adult female with RSV pneumonia-induced ARDS who was successfully

Yung-Hung Luo; Chu-Yun Huang; Kuang-Yao Yang; Yu-Chin Lee



Hacia una adaptaci?n cultural para el tratamiento de trastornos alimentarios en latinos en Estados Unidos  

PubMed Central

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

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



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...



Evaluación mediante score BAROS de los resultados del bypass gástrico en el tratamiento de la obesidad mórbida* Evaluation of gastric bypass surgery using the BAROS score  

Microsoft Academic Search

SUMMARY Background: Bariatric Analysis and Reporting Outcome System (BAROS) is an integral system to report the results of bariatric surgery. It incorporates the concept of weight loss, improvement in co-morbid conditions, complications of surgery and the quality of life after the surgery. Aim: To evaluate the results of gastric bypass surgery using the BAROS score. Material and methods: Medical records



Acupuntura de compensación (balance): un estudio experimental sobre su eficacia en el tratamiento de los dolores radiculares en un modelo de rata con hernia discal  

Microsoft Academic Search

BackgroundLumbar disc herniation (LDH) is a common clinical disease accounting for lumbocrural pain in the majority of the patients. The incidence of LDH has risen quickly in the past years. The theory of balance acupuncture is a new method firstly established by Dr. Wang Wenyuan and further developed according to a large amount of clinical studies which have come to

Y. Wang; H. Yuan; D. Xu; W. Y. Wang



Aplicaciones de la radiofrecuencia en el tratamiento del dolor crónico benigno. Una revisión de las publicaciones de los últimos 6 años  

Microsoft Academic Search

R a d i o f requency started to be used in the clinical practice at the beginning of the fifties. However, in the past years and after the development of new equipment and material, side effects have been reduced and hence its use has be- c ome more common. Material and methods: We conducted a bibliographic search using as

M. A. López-Rodríguez; M. A. Camba



Microsoft Academic Search

Case report: The effect of a somatostatin analogue in a patient with Graves' ophthalmopathy is presen- ted, including data on the dose requirements and the results of therapy. Discussion: There are few effective options for the management of Graves' ophthalmopathy, a cell- mediated immune co-morbidity of thyroid disease. Somatostatin analogues inhibit lymphocyte prolife- ration and activation, and accumulate in the



Quality of life of people with chronic pain after acupuncture treatment Calidad de vida de portadores de dolores crónicas en tratamiento con acupuntura  

Microsoft Academic Search

Pain is a signal of alert, common in sickness and with negative impact in people's life that search for alternative ways of relief. Acupuncture is used because of its analgesic effect. It was questioned if quality of life (QL) changes after acupuncture's beginning. The study aimed to analyse people's QL after acupuncture treatment to chronic pain relief. It was a

Virginia Visconde BrasilI; Laidilce Teles; Jacqueline Andréia; Bernardes Leão; Antonio Márcio; Teodoro Cordeiro; Daniel Teles ZattaV; Maria Alves



Microsoft Academic Search

Cardiovascular diseases are the main cause of death in the world and Mexico is not exception, since a great number of people suffer of hypertension and the use of synthetic drug for the control of this disease can cause in the organism diverse secondary reactions, such as: cough, taste perturbation, rash in the skin, among others. An alternative for the

J. G. Torruco-Uco; M. A. Domínguez-Magaña; G. Dávila-Ortíz; A. Martínez-Ayala; L. A. Chel-Guerrero; D. A. Betancur-Ancona



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

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


Sistema de aspiración-tracción en el tratamiento de la Fasciitis necrotizante del periné * Negative Pressure wound therapy for the treatment of perineal necrotizing fasciitis  

Microsoft Academic Search

Introduction: We discuss five patients treated at our institution. Besides the initial surgical debridement and antibiotic therapy, we used the negative-pressure wound therapy (NPWT) as part of their treatment. Patients and methods: The NPWT device was constructed with off-the-shelf components. After the diagnosis of perineal necrotizing fasciitis was established, all patients underwent surgical debridement of necrotic tissue. The wound was



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

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


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

National Technical Information Service (NTIS)

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



Quaternary Sea-level Fluctuations and Environmental Change Indicated by Foraminiferal Assemblages, Outer Banks, North Carolina  

NASA Astrophysics Data System (ADS)

A 155-ft. drillcore at the site of a former inlet penetrates several Quaternary depositional sequences previously recognized in seismic records and shorter cores. Several foraminiferal assemblages from the early Pleistocene to the Recent reflect changing environmental conditions that correspond to several high frequency sea-level fluctuations previously described for this region. At the base of the core, low energy, low oxygen, open embayment mud, containing a high diversity fauna dominated by Elphidium excavatum and buliminids (Assemblage 6), and of probable early to mid-Pleistocene age, is overlain at 128 ft by inner to mid shelf, high energy sand containing a high diversity assemblage dominated by E. excavatum, Epistominella sp. and the epifaunal taxon Cibicides refulgens (Assemblage 5). New amino acid racemization (AAR) data suggest a mid-Pleistocene age (ca. 500 to 600 ka) for Assemblage 5. A sparsely fossiliferous, shallow inner shelf sand, containing a low diversity fauna (Assemblage 1) dominated by E. excavatum, follows at 114 ft, and is overlain at 104 ft by a barren, probably non-marine, carbon-14 dead, muddy unit. A moderate diversity, inner shelf fauna, dominated by E. excavatum and Ammonia parkinsoniana (Assemblage 3) characterizes overlying sand (at 95 ft) that is probably of mid-Pleistocene age (530 to 330 ka based on previously published AAR data). Assemblage 2, again dominated by E. excavatum, but containing several miliolid taxa indicative of normal salinities, occurs at 68 ft in the overlying muddy sand and is of similar probable mid-Pleistocene age (carbon-14 dead at 64 ft; new AAR data from 65 ft indicate350 to 420 ka). Assemblage 1 is a high dominance (E. excavatum), low diversity, low abundance fauna occurring in sand that comprises the top 55 feet of the core. This unit represents the shoreface and inlet sands of the modern (late Holocene) barrier island, although correlations with nearby cores suggest that the lower 20 ft of this sequence may represent an earlier, late Pleistocene (78 to 51 ka based on previously published AAR data) barrier island complex.

Culver, S. J.; Riggs, S. R.; Thieler, R. E.; Wehmiller, J. F.; Snyder, S. W.; Mallinson, D. A.; Bratton, J.



Spotted fever group rickettsiae in ticks in Turkey.  


One hundred twenty-six ticks belonging to 12 tick species were collected from humans, domestic and wild animals, and from the ground as unfed (questing ticks) from distinct localities in Turkey in 2011. Ticks were individually tested by polymerase chain reaction (PCR) for Rickettsia spp., amplifying citrate synthase (gltA), and outer membrane protein (ompA) genes. Twenty-five ticks (19.8%) were found to be infected with Rickettsia species. Five SFG rickettsiae were identified, including 4 pathogens: Ri. aeschlimannii in Hyalomma marginatum, Hy. aegyptium, Hyalomma sp. (nymph), and Rhipicephalus turanicus; Ri. africae in Hy. excavatum, Hy. aegyptium, and Hyalomma sp. (nymph); Ri. slovaca and Ri. raoultii in Dermacentor marginatus; and one species with unknown pathogenicity, Ri. hoogstraalii, in Haemaphysalis parva. Rickettsia slovaca and Ri. hoogstraalii were reported for the first time from Turkey. In addition, Ri. hoogstraalii and Ri. africae were detected for the first time in Ha. parva and Hy. excavatum ticks, respectively. PMID:24355764

Orkun, Ömer; Karaer, Zafer; Çakmak, Ay?e; Nalbanto?lu, Serpil



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


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

Samish, M; Alekseev, E; Glazer, I



Freshwater and Atlantic water inflows to the deep northern Barents and Kara seas since ca 13 14C ka  

Microsoft Academic Search

Foraminiferal stable isotopes and assemblages from Franz Victoria and St. Anna troughs provide a valuable record of freshwater and Atlantic Water flows to the northern Barents and Kara seas from deglaciation to present. The ?18O and ?13C of planktonic Neogloboquadrina pachyderma (s) and benthic Elphidium excavatum were up to 1.4‰ lower than present at ca 13, 11.5, and 10 14Cka

D. J. Lubinski; L. Polyak; S. L. Forman



Freshwater and Atlantic water inflows to the deep northern Barents and Kara seas since ca 13 14Cka: foraminifera and stable isotopes  

Microsoft Academic Search

Foraminiferal stable isotopes and assemblages from Franz Victoria and St. Anna troughs provide a valuable record of freshwater and Atlantic Water flows to the northern Barents and Kara seas from deglaciation to present. The d18O and d13C of planktonic Neogloboquadrina pachyderma (s) and benthic Elphidium excavatum were up to1.4 % lower than present at ca 13, 11.5, and 10 14C

D. J. Lubinski; L. Polyak; S. L. Forman



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



A case of trichorhinophalangeal syndrome, type I.  


A single case of trichorhinophalangeal syndrome, type I, is reported. The patient manifested the complete triad of the syndrome: thin, sparse, slow-growing scalp hairs; a pear-shaped nose; and cone-shaped epiphysis in some interphalangeal articulations of both hands. In addition, tooth decay, pectus carinatum, lumbar scoliosis, and polycystic ovary were observed. This multisystemic disorder is apparently rare, but its prevalence is probably underestimated in the dermatologic literature. PMID:7851130

Braga, D; Manganoni, A M; Gavazzoni, R; Pasolini, G; De Panfilis, G



Inmovilizacion de residuos nucleares de alta actividad en vidrios sinterizados. Evaluacion del grado de desvitrificacion producido con diferentes tratamientos termicos. (Immobilization of high level nuclear wastes in sintered glasses. Devitrification evaluation produced with different thermal treatments).  

National Technical Information Service (NTIS)

This work describes immobilization of high level nuclear wastes in sintered glass, as alternative way to melting glass. Different chemical compositions of borosilicate glass with simulated waste were utilized and satisfactory results were obtained at labo...

N. B. Messi de Bernasconi D. O. Russo M. E. Bevilacqua M. E. Sterba A. D. Heredia




Microsoft Academic Search

The contents of moisture, ash, protein, fat, starch and ascorbic acid present in Cara potatoes, before and after to apply the following culinary processes: fried, boiled, baked and wrinkled («arrugado»), were determined in order to know the real contribution of these nutrients for its consumption. The frying is the culinary treatment that produces a higher water loss, being replaced partly

P. Suárez Hernández; E. M. Rodríguez Rodríguez; C. Díaz Romero



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



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




Microsoft Academic Search

In Maracaibo lake basin, around 20% of crossbred dual pur- pose cows are considered repeat breeders, having long post- partum intervals and impeding the main farm objective of one calf per cow, per year. The aim of this study was to evaluate the effect of the use of an intrauterine infusion with Listerine ® alone or associated with progestins for



Calidad de vida percibida, depresión y ansiedad en pacientes con tratamiento sustitutivo de la función renal Perceived quality of life, depression and anxiety in patients with replacement of the renal function  

Microsoft Academic Search

The quality of life of 60 patients in dialysis and transplant was studied, and associations among quality of life, depression and anxiety were established. A contribution of the study was the adapta- tion and validation of the kidney disease questionnaire (KDQ), including the measurements of the dimensions of physical, psychoemotional, social and occupational functionalities. The de- scriptive analysis reports that

Hecmy García; Nicolina Calvanese



Vertebrectomia posterior isolada no tratamento das deformidades congênitas da coluna vertebral Posterior vertebrectomy for the treatment of spinal congenital deformities Vertebrectomía posterior aislada en el tratamiento de las deformidades  

Microsoft Academic Search

Objective: to report the technique and results of the single-stage posterior vertebrectomy for the treatment of congenital deformities. Methods: six patients with congenital deformities were operated from 2003 to 2006, with a mean age of 9 years and 6 months, a mean kyphosis angle of 41° and mean scoliosis angle of 40°. As for the neurological evaluation 5 patients were

Renato Henriques Tavares; América Limoeiro; Deusdeth Gomes; Luis Claudio Schettino; Luis Eduardo Carelli


Distribution and host-relationship of ticks (Ixodoidea) infesting domestic animals and rodents in Sinai Peninsula.  


Geographical distribution of ticks infesting farm animals in Sinai Peninsula revealed the presence of 12 tick species namely Hyalomma dromedarii, H. impeltatum, H. an anatolicum, H. an. excavatum, H. marginatum rufipes, H. m. turanicum, H. schulzei, Rhipicephalus sanguineus, R. turanicus, Boophilus annulatus, Ornithodors erraticus and Argas persicus. The distribution map of those species is given. The areas of Sinai could be arranged as regards the number of tick species in the following descending order, Beer Lehfin & St. Cathrine (9 spp.), Kosaimah & Nuweibah (8 spp.), Arish & Godirate (7 spp.), Firan (6 spp.) Beer El-Abd, Zowaid, Rafah, Quntara, Wadi Hadra & El Tur (5 spp.), Abu Redis, and Hammam Pharon (4 spp.). PMID:8376863

Shoukry, A; el-Kady, G A; Merdan, A I; el Said, S



Prevalence of ixodid ticks on cattle in Mazandaran province, Iran  

PubMed Central

A survey was carried out to investigate the prevalence of hard tick species (Acari: Ixodidae) on cattle in Mazandaran province, Iran. A total of 953 ticks were collected from 86 infested cattle during activating seasons of ticks during 2004-2005. Nine species were identified: Boophilus annulatus (51.3%), Rhipicephalus bursa (16.8%), Haemaphysalis punctata (6.3%), Ixodes ricinus (6.8%), Hyalomma marginatum (12.5%), Hyalomma anatolicum excavatum (5.2%), Hyalomma asiaticum (0.6%), Hyalomma detritum (0.2 %), and Dermacentor spp. (0.1%). The results show that Boophilus annulatus, Rhipicephalus bursa, and Hyalomma species are dominant tick species in the surveyed area.

Glinsharifodini, Meisam; Sarvi, Shaboddin



Hutchinson-Gilford Progeria Syndrome: A Rare Genetic Disorder  

PubMed Central

Hutchinson-Gilford progeria syndrome (HGPS) is a rare pediatric genetic syndrome with incidence of one per eight million live births. The disorder is characterised by premature aging, generally leading to death at approximately 13.4 years of age. This is a follow-up study of a 9-year-old male with clinical and radiographic features highly suggestive of HGPS and presented here with description of differential diagnosis and dental consideration. This is the first case report of HGPS which showed pectus carinatum structure of chest.

Panigrahi, Rajat G.; Panigrahi, Antarmayee; Vijayakumar, Poornima; Choudhury, Priyadarshini; Bhuyan, Sanat K.; Bhuyan, Ruchi; Maragathavalli, G.; Pati, Abhishek Ranjan



[A 59 year-old patient with acute anterolateral myocardial infarction, complicated by cardiogenic shock, with chest wall deformity caused by Heine-Medin disease].  


We report a case of a 59 year-old patient in a condition of acute myocardial infarction with ST elevation, in a cardiogenic shock, with multiple cardiac arrests in mechanism of ventricular fibrillation with a significant chest wall deformity caused by Heine-Medin disease in childhood. To our knowledge, this is the first case report of a patient in critical condition with a considerable pectus deformity after poliomyelitis who needed to undergo cardiovascular angioplasty. Although severe patient's condition and numerous difficulties during percutaneous coronary intervention, therapy was successful. PMID:22430421

Arazi?ska, Agata; Kr?cki, Rados?aw; Kasprzak, Jaros?aw D



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



Pulmonary non-tuberculous mycobacterial infection in congenital contractural arachnodactyly.  


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

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



Pulmonary Nontuberculous Mycobacterial Infection in Congenital Contractural Arachnodactyly  

PubMed Central

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

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



Dolor (PDQ®)

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


Prurito (PDQ®)

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


Platiquemos un rato...

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


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

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


Cáncer de hígado

Información acerca del cáncer de hígado, lo cual incluye temas como tratamiento, prevención, genética, causas, exámenes selectivos de detección, estudios clínicos y estadísticas del Instituto Nacional del Cáncer.


Complicaciones gastrointestinales (PDQ®)

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


Rickettsial agents in Egyptian ticks collected from domestic animals.  


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

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



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.



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

PubMed Central

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

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



Pliocene paleoceanographic change in the Arctic: foraminifers and stable isotope evidence from ODP 910  

NASA Astrophysics Data System (ADS)

The aim of this study is to provide a detailed Pliocene chronostratigraphic and paleoceanographic record of the Yermak Plateau, Arctic Ocean Margin. The study is based on sediment cores from ODP site 910. New high resolution sampling was carried out, and the samples were analyzed with regard to the planktic and benthic foraminifers using the larger than 100 µm size fractions. The planktic assemblage has low abundances and diversity characteristic of the high latitude setting. The fauna is dominated by Neogloboquadrina atlantica (sinistral) however fluctuations of Globigerina bulloides may suggest intervals of higher sea surface temperatures during the Pliocene. The benthic assemblage consists of arctic species dominated by Elphidium excavatum f. clavata. The assemblages also contain Elphidium hughesi, Globocassidulina grooviaperture, Nonion matchigaricus which are species with Pacific affinities showing water mass exchanges between the Pacific and Atlantic Ocean.

Husum, K.; Knies, J.; Grosfjeld, K.; Fabian, K.; Hald, M.



New tuber species found in Poland.  


New information from a survey of truffles carried out in southern part of Poland in September 2007 is presented. The fruit 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 as: Quercus robur, Corylus avellana, Carpinus betulus, Fagus silvaticus and Tilia cordata. Selection of local inocula of T. aestivum for the propagation of truffles production could be an alternative to the Mediterranean truffles orchards in times when demand for the fungi will be increasing. Fruit bodies of truffles are conserved in the collection of biological material in the Forest Research Institute in Sekocin Stary. PMID:18414906

Hilszcza?ska, Dorota; Sierota, Zbigniew; Palenzona, Mario



Plan Maestro para la Recoleccion, Tratamiento y Reuso de las Aguas Residuales. Creado para el Uso Especifico de la Ciudad de Chihuahua, Chihuahua, Mexico (Master Plan for the Collection, Treatment and Re-Use of Waste Water. Created for the Use of City of Chihuahua, Mexico).  

National Technical Information Service (NTIS)

The report, written in Spanish, presents the results of a feasibility study prepared by Woodward Clyde Associates for the Municipality of Chihuahua, Mexico. The report was undertaken at the request of the Presidencia Municipal de Chihuahus (PMC) concernin...



Proteccion de aceros al carbono en plantas G.S. (Girldler sulphide): Pte. 7. Efectos de la exposicion al medio ambiente de las capas protectoras de sulfuros y posterior tratamiento en condiciones de planta. (Carbon steel protection in G.S. (Girldler sulphide) plants: Pt. 7. Environment exposure effects on iron sulphide scales and subsequent treatment in plant conditions).  

National Technical Information Service (NTIS)

In order to protect carbon steel towers and piping of a GS experimental heavy water plant against corrosion produced by the action of aqueous solutions of hydrogen sulphide, a method, elsewhere published, was developed. Carbon steel exposed to saturated a...

O. Lires C. Delfino E. Rojo




Microsoft Academic Search

Recovery of U from acid leach solutions of phosphate ore was studied. It was found that predictions can be made concerning solids removal and U recovery in the pH adjustment stage, resin U capacity, eluating agent suitability, ion exchange stage eluation velocity and eluate U concentration, and composition of the precipitate formed in the concentration stage. The results are valid

J. E. Aguilar; A. U. Hueda



Estudio comparativo de los hallazgos radiográficos pr e y post tratamiento en pacientes con diagn ó stico clínico de sinusitis maxilar aguda. Comparative S tudy of pre and post treatment radiographic findings in patients with clinical diagnosis of acute maxillary sinusitis  

Microsoft Academic Search

Objective : To determine the radiographic findings pre and post-treatment in patients with clinical diagnosis of Acute Maxillary Sinusitis. Material and methods: We made a pr ospective descriptive study in patients who had the clinical diagnosis of Acute Maxillary Sinusitis. 28 patients were included. All patients had clinical resolution after 10 days of antibiotic treatment. The post-treatment radiograph was made



Efectos del IFN? y del Lymphomyosot sobre el crecimiento del melanoma B16F10 «in vitro» e «in vivo». Tratamiento con IFN? y Lymphomyosot Effects of IFN? and Lymphomyosot on «vitro» and «in vivo» B16F10 melanoma growth. Treatment with IFN? and Lymphomyosot  

Microsoft Academic Search

SUMMARY Introduction: Several cytokines are being tested in the treatment of melanoma. Among them IFN? should be high- lighted, whilst no other experimental studies using homeo- pathic products are underway. Material & Methods: «In vitro»: the cell line B16F10 was treated at 24, 48 and 72 hours with IFN?\\/10 at 1,000,000 IU\\/ml and with Lymphomyosot 1\\/1 and 1\\/3 (v\\/v). Cell

Fernando Pascual Carpe; Vicente Vicente Ortega; Matilde Campos Aranda; Josefa Yáñez Gascón; Juana García Reverte


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

NASA Astrophysics Data System (ADS)

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

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



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

USGS Publications Warehouse

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

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



Reparación laparoscópica de hernia de Morgagni. Reporte de dos casos* Laparoscopic repair of Morgagni hernia. Report of two cases  

Microsoft Academic Search

RESUMEN Presentamos dos pacientes con tratamiento laparoscópico de una hernia de Morgagni. Este es un defecto congénito en el diafragma anterior poco frecuente, que puede ser asintomático o causar síntomas dependiendo del contenido herniario. El tratamiento quirúrgico puede ser a cielo abierto por vía torácica o transabdominal, pero el abordaje laparoscópico también permite su reparación, tanto cuando es simple como

Palma Mallorca



Microsoft Academic Search

Resumen. Las fundiciones blancas de hierro aleadas con cromo son unos productos que se obtienen mediante métodos de moldeo, que poseen una microestructura muy dura en la que sobresale la presencia de una importante cantidad de carburos de cromo intergranulares dispersos en una matriz martensítica. Su tratamiento térmico idóneo consiste en una austenización seguida de un temple y dos tratamientos

I. Fernández Pariente; F. J. Belzunce; C. Rodriguez; J. Riba


Consideraciones clínicas sobre la resorción radicular externa por impactación dentaria  

Microsoft Academic Search

La resorción externa por presión (RREP) consiste en una pérdida de tejido dentinario y cementario de las raíces dentarias que se origina a nivel del ligamento periodontal, ocasionada por presiones prolongadas y mantenidas sobre la raíz. Presentamos tres casos con diferente repercusión y tratamiento. Según el distinto grado de afecta­ ción se describe y clasifica el tratamiento de RREP a

Martínez Lozano MA; Forner Navarro L; Sánchez Cortés JL


Avaliação do tratamento cirúrgico da cifose congênita na mielomeningocele com o uso da via posterior pela técnica de Dunn-McCarthy modificada Study of surgical treatment of congenital kyphosis in myelomeningocele by posterior approach with the modified Dunn-McCarthy technique Evaluación del tratamiento quirúrgico de la cifosis congénita en el mielomeningocele con el uso de la vía posterior por la técnica de Dunn-McCarthy modificada  

Microsoft Academic Search

Objective: to report the results in the treatment of congenital lombar kyphosis related to myelomeningocele with posterior spinal instrumentation and fusion. Methods: data analysis of 12 patients, with mean age of 8 years old treated by posterior approach and internal fixation with a Dunn-McCarthy procedure. Eight patients had implanted pedicular screws and in four were used sublaminar wires like Luques

Ricardo Correa; Ivan Guidolin Veiga; Wagner Pasqualini; Marcus Alexandre Mello Santos; Élcio Landim; Paulo Tadeu; Maia Cavali


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


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

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



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


La Investigación del Cáncer en América Latina

Este programa busca fomentar los esfuerzos locales y mundiales de prevención, diagnóstico y tratamiento del cáncer facilitando la creación de una infraestructura integral para la investigación del cáncer en América Latina.


Náuseas y vómitos (PDQ®)

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


Lo que usted necesita saber sobre? el cáncer de seno

Publicación que describe las opciones de tratamiento, la obtención de una segunda opinión, los cuidados de seguimiento y las fuentes de apoyo para alguien que ha sido diagnosticado recientemente con cáncer de seno.


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

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


Trastorno de tensión postraumática (PDQ®)

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


Delirio (PDQ®)

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


Linfedema (PDQ®)

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


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.


La quimioterapia y usted: Apoyo para las personas con cáncer

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


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.


Fatiga (PDQ®)

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


La radioterapia y usted: Apoyo para las personas con cáncer

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


Cánceres de la A a la Z: M

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.


Cánceres de la A a la Z: W

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.


Cánceres de la A a la Z: E

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.


Cánceres de la A a la Z: P

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.


Cánceres de la A a la Z: L

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.


Cánceres de la A a la Z: V

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.


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.


Cánceres de la A a la Z: N

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.


Cánceres de la A a la Z: R

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.


Cánceres de la A a la Z: U

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.


Cánceres de la A a la Z: F

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.


Cánceres de la A a la Z

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.


Cánceres de la A a la Z: B

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.


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.


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.


Cánceres de la A a la Z: T

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.


Cánceres de la A a la Z: O

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.


Cánceres de la A a la Z: K

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.


Cánceres de la A a la Z: G

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.


Cánceres de la A a la Z: I

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.


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

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


West Nile Virus: Symptoms and Treatment  


... Education Public Service Videos West Nile Virus in Spanish Preguntas frecuentes: Preguntas generales sobre el virus del Nilo Occidental en Español (Spanish) Síntomas y tratamiento en Español (Spanish) Prevención y ...


West Nile Virus: Prevention and Control  


... Education Public Service Videos West Nile Virus in Spanish Preguntas frecuentes: Preguntas generales sobre el virus del Nilo Occidental en Español (Spanish) Síntomas y tratamiento en Español (Spanish) Prevención y ...


FAQ: General Questions about West Nile Virus  


... Education Public Service Videos West Nile Virus in Spanish Preguntas frecuentes: Preguntas generales sobre el virus del Nilo Occidental en Español (Spanish) Síntomas y tratamiento en Español (Spanish) Prevención y ...


Terapia hormonal para el cáncer de seno

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


Delirio (PDQ®)

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


Recursos en su comunidad

Información acerca de las organizaciones que proporcionan apoyo a personas con cáncer. También incluye recursos disponibles en la comunidad, como doctores, centros de tratamiento y otros profesionales de salud.


Terapia hormonal para el cáncer de próstata

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


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

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


El cáncer

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


Cánceres poco comunes en la niñez (PDQ®)

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


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

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


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


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

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



Benthonic foraminiferal faunal and isotopic data for the postglacial evolution of the Champlain Sea*1  

NASA Astrophysics Data System (ADS)

Benthonic foraminiferal faunal and isotopic data from Champlain Sea sediments (approximately 12,500 to 10,000 yr B.P. in age) in two piston cores from Lake Champlain provide a detailed, apparently continuous record of the evolution of the Champlain Sea. Cassidulina reniforme and Islandiella helenae are the dominant benthonic foraminifera during the initial phase of the Champlain Sea, and are replaced by Elphidium excavatum forma clavatum and Protelphidium orbiculare as the dominant species during the remainder of the sea's history. The oxygen-isotopic data show a gradual decrease in ?18O between approximately 12,500 and 10,900 yr B.P., followed by a more rapid decrease during the interval 10,900 to 10,000 yr B.P. The ?13C data have a similar trend as ?18O, with generally decreasing values up the section. The isotopic and faunal data suggest that nearly marine conditions were present in the initial plase of the Champlain Sea, followed by gradually decreasing salinities and increasing temperatures as the sea evolved. The beginning of the rapid isotopic decrease at approximately 10,900 yr B.P. marks the onset of the largest environmental change in the history of the Champlain Sea, probably reflecting a major pulse of meltwater from the Laurentide Ice Sheet.

Corliss, Bruce H.; Hunt, Allen S.; Keigwin, Lloyd D.



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



Ticks of domestic animals in the Macedonia region of Greece.  


A study was carried out on ticks of domestic animals in the Macedonia region of Greece. During 1983-1986, 11,620 tick specimens, belonging to 18 species and subspecies, were collected from cattle, sheep, goats and dogs, in 64 localities throughout Macedonia. Rhipicephalus bursa, the most common tick, and Hyalomma marginatum marginatum occurred in all bioclimatic zones, as well as the two one-host ticks, Boophilus annulatus and H. detritum scupense, which were present in fewer localities. R. turanicus, R. sanguineus, Ixodes gibbosus and H. anatolicum excavatum occurred essentially in the mesomediterranean bioclimatic zone. I. ricinus, Dermacentor marginatus and Haemaphysalis ticks (Hm. inermis, Hm. punctata, Hm. sulcata, Hm. parva) were found frequently in the biotopes of the attenuated mesomediterranean and submediterranean bioclimates. Rhipicephalus adults and the two-host Hyalomma ticks were active in the spring-summer period. Ixodes spp., Haemaphysalis spp., D. marginatus, as well as H. detritum scupense and the immature stages of R. bursa appeared during autumn and winter. Hyalomma and Boophilus ticks fed mainly on cattle. R. sanguineus almost exclusively parasitized dogs, which were also the only hosts from which I. hexagonus has been collected. The infestations were generally weak or moderate. Few heavy infestations were observed on cattle, especially in autumn. Most of the tick species showed a strong preference for some particular sites on the vertebrate body. This predilection could vary according to the host species. PMID:8792578

Papadopoulos, B; Morel, P C; Aeschlimann, 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



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



Stable isotopes in benthic foraminiferal calcite from a river-influenced Arctic marine environment, Kara and Pechora Seas  

NASA Astrophysics Data System (ADS)

Oxygen and carbon stable-isotope compositions of modern benthic foraminifera in the Kara and Pechora estuarine regions of the Arctic continental shelf were compared with water ?18O, ?13CDIC, temperature, and salinity. The foraminiferal ?18O distribution is mostly similar to that of equilibrium calcite, primarily controlled by mixing of runoff and seawater in near-estuarine areas (depth < 15-20 m), with additional temperature control seaward. The ?13C composition is controlled by remineralization of organic matter, mostly imported by rivers, and by water mixing. Most analyses used the common Arctic foraminifer Elphidium excavatum forma clavata, which yields depleted ?13C, as expected for an infaunal species. Isotope records for sediment cores off the Pechora and Yenisey rivers show a decelerating rise in isotope values, of up to 10‰ in ?18O, over the last 10 kyr in a pattern similar to that of rising sea level and concomitant retreat of river mouths, with local complexities probably resulting from glacio-isostatic rebound and changes in sedimentation.

Polyak, Leonid; Stanovoy, Vladimir; Lubinski, David J.



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


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

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



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

USGS Publications Warehouse

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

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



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


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

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



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


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

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



A global meta-analysis of Tuber ITS rDNA sequences: species diversity, host associations and long-distance dispersal.  


Truffles (Tuber) are ectomycorrhizal fungi characterized by hypogeous fruitbodies. Their biodiversity, host associations and geographical distributions are not well documented. ITS rDNA sequences of Tuber are commonly recovered from molecular surveys of fungal communities, but most remain insufficiently identified making it difficult to determine whether these sequences represent conspecific or novel taxa. In this meta-analysis, over 2000 insufficiently identified Tuber sequences from 76 independent studies were analysed within a phylogenetic framework. Species ranges, host associates, geographical distributions and intra- and interspecific ITS variability were assessed. Over 99% of the insufficiently identified Tuber sequences grouped within clades composed of species with little culinary value (Maculatum, Puberulum and Rufum). Sixty-four novel phylotypes were distinguished including 36 known only from ectomycorrhizae or soil. Most species of Tuber showed 1-3% intraspecific ITS variability and >4% interspecific ITS sequence variation. We found 123 distinct phylotypes based on 96% ITS sequence similarity and estimated that Tuber contains a minimum of 180 species. Based on this meta-analysis, species in Excavatum, Maculatum and Rufum clades exhibit preference for angiosperm hosts, whereas those in the Gibbosum clade are preferential towards gymnosperms. Sixteen Tuber species (>13% of the known diversity) have putatively been introduced to continents or islands outside their native range. PMID:21040049

Bonito, Gregory M; Gryganskyi, Andrii P; Trappe, James M; Vilgalys, Rytas



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


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

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



Digital Stereophotogrammetry as a New Technique to Quantify Truncal Deformity: A Pilot Study in Persons with Osteogenesis Imperfecta  

PubMed Central

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

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



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



Physical and functional evaluation in Marden-Walker syndrome: Case report - Review of literature.  


Abstract Objective: To review literature concerning Marden-Walker syndrome (MWS) and describe physical-functional characteristics of a child with a suspected diagnosis of MWS. Methods: Physical examination, laboratory and clinical tests were collected in a two-year-old boy. Bayley Scales of Infant and Toddler Development (BSITD-III) was applied to evaluate motor-cognitive development. Results: Several facial features (blepharophimosis/micrognathia/cleft palate/pectus deformation/kyphoscoliosis), besides delayed physical growth, anemia, hypoplastic muscles, muscle atrophy and arachnodactyly were found; which are typically described in MWS. BSITD-III scaled scores were 1, 2 and 1, respectively, for gross-motor, fine-motor and cognitive skills; representing delays that were slightly more severe for gross-motor and cognitive skills compared with fine motor. We did not find joint contractures, which are strongly associated with MWS. Instead, we observed moderate muscle shortening. Conclusions: The results found could be attributed to the early intervention applied to the child since eight months old; findings that highlight the importance of early intervention. PMID:24649842

Neves Dos Santos, Adriana; Costa, Carolina Souza Neves da; de Campos, Ana Carolina; Rocha, Nelci Adriana Cicuto Ferreira



Clinical Report of a 17q12 Microdeletion with Additionally Unreported Clinical Features  

PubMed Central

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

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



Skeletal dysplasia, global developmental delay, and multiple congenital anomalies in a 5-year-old boy-report of the second family with B3GAT3 mutation and expansion of the phenotype.  


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

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



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


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

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



Coeliac disease causing symptomatic hypocalcaemia, osteomalacia and coagulapathy  

PubMed Central

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.

McNicholas, Bairbre Aine; Bell, Marcia



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



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

PubMed Central

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

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



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

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


Long Island Sound: a Human Dominated Environment  

NASA Astrophysics Data System (ADS)

Long Island Sound (LIS) is a marginally marine urban estuary, with Long Island (NY) as its southern coastline, New York and Connecticut along its northern coast. LIS has a narrow opening to the West (East River), but most exchange with the ocean occurs at its eastern end, resulting in an east-west gradient in salinity. There is also an east-west gradient in indicators of contamination in the surface sediments (e.g., trace metals). Western LIS is close to the main population center (New York City), but also is a focusing region for fine- grained sediments. Since the 1970s, western LIS and to a lesser extent, central LIS, suffer summer hypoxia or even anoxia. We used sediment cores in westernmost and central LIS to document environmental changes over the last millennium, including the time of European settlement, using microfossil, geochemical, sedimentological, and trace element proxies. Sediment ages were determined using metal pollution records and radiometric carbon dating. Before European settlement, the low-diversity benthic faunas were dominated by Elphidium excavatum (feeding on diatoms) at shallow depths (< 12 m, where light penetrates to the bottom), by Elphidium incertum in westernmost LIS and by Buccella frigida and/or Eggerella advena over most of LIS at greater depths. In almost all cores, the absolute abundance of benthic foraminifera and the relative abundance of Elphidium excavatum increased from the early-mid 1800s on. The faunal changes coincided with an increase in contaminant trace metal concentration, with human population growth in the region, with a marked decrease in salinity in westernmost LIS, and with the beginning of low oxygen conditions as indicated by carbon isotope values in foraminiferal tests. At the same time, accumulation rates of organic carbon and nitrogen increased several fold, most extremely so in westernmost LIS. These data thus all indicate that humans influenced LIS and its ecosystems from the mid 19th century on, causing eutrophication, increased fresh water run-off due to urbanization and possibly re-routing of fresh water through waste water treatment plants, and increased organic carbon and trace metal storage in the sediments. A period of additional faunal changes started in the late 1960s, when overall foraminiferal abundance decreased, but Ammonia parkinsoniana, formerly absent or rare, became common to dominant especially in western LIS. This last faunal change might have resulted from even more increased eutrophication, with high N/Si values resulting in decreased dominance of primary producers by diatoms, affecting organisms that feed on them and thus reverberating through the whole ecosystem. We thus document a coastal ecosystem that changed significantly with human population growth in the middle 1800s, and again with more severe eutrophication over the last few decades.

Thomas, E.; Varekamp, J. C.



A survey of ixodid tick species and molecular identification of tick-borne pathogens.  


This study was undertaken in two different climatic areas of Turkey to determine the presence of tick-borne pathogens of medical and veterinary importance. The ticks were removed from humans, pooled according to species and developmental stages, and analyzed by PCR, reverse line blot (RLB) and sequencing. Of the 2333 removed ticks from 10 species, 1238 (53.06%) were obtained from the arid cold zone, and the remaining 1095 (46.93%) were obtained from the humid zone. The removed ticks were identified as Hyalomma marginatum, Hyalomma detritum, Hyalomma excavatum, Rhipicephalus bursa, Rhipicephalus turanicus, Rhipicephalus sanguineus, Dermacentor marginatus, Haemaphysalis punctata, Haemaphysalis sulcata, Ixodes ricinus, Haemaphysalis and Ixodes spp. nymphs. The dominant species was I. ricinus (61.27%) in the humid zone, whereas the Haemaphysalis spp. nymph dominated (30.29%) in the arid zone. Infection rates were calculated as the maximum likelihood estimation (MLE) with 95% confidence intervals (CI). Of the 169 pools tested, 49 (28.99%) were found to be infected with the pathogens, and the overall MLE of the infection rate was calculated as 2.44% (CI 1.88-3.17). The MLE of the infection varied among tick species, ranging from 0.85% (CI 0.23-2.34) in Haemaphysalis spp. nymph to 17.93% (CI 6.94-37.91) in D. marginatus. Pathogens identified in ticks included Theileria annulata, Babesia ovis, Babesia crassa, Anaplasma/Ehrlichia spp., Anaplasma ovis, Ehrlichia canis, Anaplasma phagocytophilum, Hepatozoon canis and Hepatozoon felis. Most tick pools were infected with a single pathogen. However, four pools infected with H. canis displayed infections with B. crassa, A. phagocytophilum and E. canis. The sequencing indicated that Anaplasma/Ehrlichia spp. was 100% identical to the sequence of Ehrlichia sp. Firat 2 and 3 previously identified from Hyalomma anatolicum. PMID:24424312

Aktas, Munir



The abundance of benthic calcareous Foraminifera and other meiofauna at a time series station in the Northeast Water Polynya, Greenland  

NASA Astrophysics Data System (ADS)

Abundance and vertical distribution of living calcareous Foraminifera and associated meiofauna have been estimated during the ice-free period in 1992 and 1993 at a time series station in the Northeast Water Polynya off eastern Greenland. Calcareous forams (>150 ?m) represented on average 28-39% of the meiofaunal size class. The mean abundance for both years was 574 individuals/100 cm2, and the variability of the estimates (Standard deviation = ±140) was relatively modest for benthic samples (Standard error=8.7% of the mean, number of samples=8). The abundance in 1992 was lower than in 1993 (probability <0.05), reflecting a smaller polynya, with less surface water productivity. While 41% of the variation in abundance in 1993 could be explained as a function of time (the estimated mean doubled between May 30 (387 ind/100 cm2) and July 24 (734 ind/100 cm2)), supporting earlier observations elsewhere that Foraminifera respond rapidly to seasonal or pulsed food inputs, the relationship was not statistically significant. The number of species present was low, a characteristic observed in other foram biofacies associated with open water shelf regions of the Arctic. This assemblage was dominated by a few calcareous forms: Elphidium excavatum, Melonis barleeanum, Nonionella labradorica, and Bucella frigida. Green and brown material, which we suspect was freshly settled phytodetritus, was found in numerous individuals of the dominant calcareous species located as deep as 6 cm within the sediment. The dominant species, including those containing "pigments," were encountered at specific, fairly narrow depth ranges within the sediment, with maximum abundances being common below, rather than at the sediment surface. Other meiofauna (nematodes, agglutinated forams, and ostracods) occurred to depths as great as 10 cm in all cores, but their greatest densities were generally confined to surface sediments.

Newton, Adrian C.; Rowe, Gilbert T.



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

NASA Astrophysics Data System (ADS)

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

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



Late Holocene (ca. 4 ka) marine and terrestrial environmental change in Reykjarfjördur, north Iceland: climate and/or settlement?  

NASA Astrophysics Data System (ADS)

Core B997-328PC is from the landward side of a 100-m-deep basin in Reykjarfjördur, a small fjord on the north coast of the northwest peninsula of Iceland. This is an area that can be severely affected by incursions of polar sea-ice but has not suffered marked land erosion during the Settlement period. The core is 422 cm in length and consists principally of fine-grained muds with in situ molluscs. Eleven AMS 14C dates on molluscs indicate a constant sediment accumulation rate of ca. 1 cm 10 yr-1 for the last 4280 +/- 50 yr BP. We measured and derived a variety of proxies for indications of changes in the nearshore environment. These included physical properties and grain size, mass accumulation rates, micropalaeontology (pollen and Foraminifera). Multivariate analysis and constrained clustering were used to define major changes in the proxies. In several parameters the major change in the fjord environment occurred close to 1000 14C yr ago, thus approximately coincident with the onset of the Settlement of Iceland. Other changes are noted at around 1600 and 3400 14C yr ago; Betula pollen disappears from the record ca. 1500 yr BP and there are peaks in marine productivity occurring ca. 2 and 3.4 ka. A major decline in carbonate accumulation and a sharp increase in the cold water benthic foraminifer Elphidium excavatum forma clavata 400 yr ago represents the local marine signature of the Little Ice Age. None of the changes in our data can be explained adequately by a simple call to land-use practices and an increase in land to sea transport, but both the pollen and foraminiferal records indicate a decrease and even loss of warm elements in both flora and fauna over the past 4 kyr.

Andrews, John T.; Caseldine, Chris; Weiner, Nancy J.; Hatton, Jackie



The San Francisco Bay Biota Since the Last Sea Level Maximum: Comparing Fossil and Recent Assemblages of Benthic Foraminifera  

NASA Astrophysics Data System (ADS)

Comparisons of fossil and Recent foraminiferal assemblages in San Francisco Bay can give us information about how the Bay's ecosystems have changed or remained resilient during the glacial cycles of the Pleistocene. This information, in turn, can help us to predict the potential impact of future environmental change on this system. In this study, we compared the species proportions, overall similarity, and species diversity of the Recent foraminiferal assemblage at one site in South San Francisco Bay with the fossil foraminiferal assemblage from Pleistocene samples taken at several sites in South San Francisco Bay, in order to test the hypothesis that the foraminiferal assemblage in San Francisco Bay has not changed significantly since the last interglacial interval. Comparisons of total sample similarity indicate that the upper layer of the Yerba Buena mud was deposited during conditions similar to today's South San Francisco Bay. The presence of a large number of dead tests of Elphidium gunteri Cole and Elphidiella hannai (Cushman and Grant), together with the lack of living populations of these species in South San Francsico Bay, make it difficult to interpret the presence of these taxa in similar abundances in the Plestocene and today. Possibly due to the introduction of the Japanese foraminifer Trochammina hadai Uchio, the modern assemblage has shifted away from the dominance of Elphidium excavatum (Terquem) found in the Pleistocene. Species diversity has neither decreased nor increased between the Pleistocene and the present day in South San Francisco Bay, suggesting that environmental change and human activity has not affected species diversity of the benthic foraminiferal fauna. These data show that comparisons between fossil and Recent assemblages are powerful tools in interpreting paleoenvironments, and may help us to understand the impact of human activity on estuarine and other marine systems. More research is needed on the living populations of E. gunteri and E. hannai today to be able to interpret the significance of these populations in the Pleistocene bay.

Lesen, A. E.; Lipps, J. H.



Variable expression of neurofibromatosis 1 in monozygotic twins.  


Neurofibromatosis 1 (NF1) is a common autosomal dominant disorder with high penetrance but extreme variability of expression. Monozygotic (MZ) twins with NF1 who have phenotypic discordances are a useful tool in evaluating which traits are influenced by non-hereditary influences such as second hit somatic events, environmental agents, epigenetic modification, or post-zygotic mutations. We evaluated nine sets of MZ twins and one set of MZ triplets, ages 4-18 years, for NF1 features and calculated probandwise concordance (P(C)) for each feature. MZ twins were highly concordant in numbers of café-au-lait spots (P(C) = 0.89) and cutaneous neurofibromas. IQ scores were within 10 points for all twin pairs tested, and similar patterns of learning disabilities and speech disorders were observed. Twin pairs showed significant discordance for tumors, particularly plexiform neurofibromas (P(C) = 0.40) and malignant peripheral nerves sheath tumors (MPNST), as expected if post-natal second-hit events were contributing to these features. One set of twins was concordant for multiple, large paraspinal neurofibromas, suggesting that there may be more hereditary factors involved in production of paraspinal neurofibromas. Four sets were concordant for pectus deformities of the chest (P(C) = 0.80). Three sets of twins were discordant for scoliosis (P(C) = 0.40); an additional set was concordant for scoliosis but differed in presence of dystrophic features and need for surgery. Our data suggest there are additional non-hereditary factors modifying the NF1 phenotype and causing discordancies between MZ twins. Future studies may focus on differences in epigenetic changes or somatic mosaicism which have been documented for other disease genes in MZ twins. PMID:21337692

Rieley, Margaret B; Stevenson, David A; Viskochil, David H; Tinkle, Brad T; Martin, Lisa J; Schorry, Elizabeth K



A study of the effects of large doses of glutethimide that were used for self-poisoning during pregnancy on human fetuses.  


Animal investigations showed some embryolethal and teratogenic effects of glutethimide, a piperidindion derivative non-barbital hypnotic drug. Thus, the objective of this study was to evaluate the effects of very large doses of glutethimide that were used for a suicide attempt during pregnancy on the embryo-fetal development of exposed children. Self-poisoned pregnant women were identified from the population of female patients of the Department of Toxicology Internal Medicine, Korányi Hospital, Budapest who had been admitted from the 3 million people of Budapest and its surrounding region. The rates of congenital abnormalities, intrauterine fetal development (based on birth weight and pregnancy age at delivery) and cognitive-behavioral status of exposed children born to mothers who attempted suicide with glutethimide alone or in combination with other drugs during pregnancy were compared with their sib controls. Of 1044 pregnant women with self-poisoning during pregnancy between 1960 and 1993, 33 used glutethimide for a suicide attempt sixteen of these women delivered live-born infants. The dose of glutethimide ranged between 1000 and 15,000 mg with a mean of 4234 mg. Of the 16 exposed children, five were male and 11 were female. Three exposed children were affected with congenital abnormalities (atrial septal defect type II, pectus carinatum, fetal alcohol syndrome). Of their 16 matched unexposed sib pairs, two had congenital abnormalities. The mean birth weight of the exposed children was somewhat larger due to somewhat longer pregnancy age at delivery. Cognitive status and behavioral scale of the exposed children did not indicate a fetotoxic (including neurotoxic) effect of large doses of glutethimide. Very large doses of glutethimide used for a suicide attempt by 16 pregnant women did not produce teratogenic or fetotoxic (including neurotoxic) effects in their children. PMID:18818183

Petik, D; Acs, N; Bánhidy, F; Czeizel, A E



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


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

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



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] [National Institute of Arthritis and Musculoskeletal and Skin Disease, Bethesda, MD (United States); and others



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


Variables de personalidad, alteraciones psicopatológicas y trastornos de personalidad en pacientes con dependencia de alcohol en función de la tipología de Cloninger  

Microsoft Academic Search

En este estudio se lleva a cabo una investigación sobre los diferentes tipos de alcohol-dependientes se- gún la tipología de Cloninger en dimensiones de personalidad, características psicopatológicas y tras- tornos de personalidad. La muestra constó de 158 alcohol-dependientes en tratamiento (56 sujetos del tipo I y 102 del tipo II). Se les administraron diversas pruebas de personalidad (la Escala de

Enrique Echeburúa; Ricardo Bravo de Medina; Javier Aizpiri


Fomento de la investigación del cáncer en América Latina

La Oficina para el Desarrollo de Programas de Cáncer en América Latina (OLACPD), fruto de una alianza innovadora entre el Instituto Nacional del Cáncer (NCI) y el Centro Internacional Fogarty (FIC), fue creada en reconocimiento de la oportunidad de apoyar y mejorar la investigación y el tratamiento del cáncer en América Latina.


Lo que usted necesita saber sobre™ el cáncer de pulmón

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



Microsoft Academic Search

Resumen. La corrosión bajo tensión de las armaduras activas está generando problemas de durabilidad en las estructuras pretensadas construidas en la proximidad de ambientes agresivos. En este trabajo se pone de manifiesto la influencia que tienen las tensiones residuales producidas por el proceso de conformado (trefilado) en la fragilización por hidrógeno de los alambres y se propone un tratamiento alternativo

J. M. Atienza; J. Ruiz-Hervías; L. Caballero; M. Elices


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

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



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


Evaluación clínica básica de la malnutrición pediátrica  

Microsoft Academic Search

ResumenEl examen colectivo y la evaluación del riesgo nutricional deben constituir una parte sistemática de la evaluación clínica. Los objetivos de la evaluación nutricional consisten en determinar el riesgo o la presencia de malnutrición y proporcionar normas para el tratamiento a corto y a largo plazo. El estado nutricional se evalúa por medio de un abordaje simple, principalmente clínico, basado

Corina Hartman; Raanan Shamir



Lo que usted necesita saber sobre™ el cáncer de seno

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


28. Modelamiento y Simulación de Fenómenos Astronómicos bajo un Enfoque Sistémico1  

Microsoft Academic Search

La Dinámica de Sistemas como herramienta metodológica para el modelamiento y simulación de fenómenos complejos, surge como una buena alternativa para el tratamiento de determinados fenómenos astronómicos y astrofísicos, a partir de un proceso de comprensión y construcción de un modelo matemático aprovechando las oportunidades que ofrece el pensamiento sistémico y la visualización de su comportamiento dinámico a partir de

Hugo Hernando; Andrade Sosa; Carlos Jaime; Barrios Hernández; Orlando José Katime Santrich



Microsoft Academic Search

RESUMEN Para evaluar el efecto de diferentes niveles de proteína y densidades de siembra sobre el crecimiento de juveniles de camarón Litopenaeus schmitti (0.18+0.03 g de peso inicial medio), se desarrolló un diseño experimental totalmente aleatorizado en estanque de tierra durante 72 días, con 16 tratamientos y 3 repeticiones, combinando 3 niveles de proteína (28, 30 y 35 %) y

Iliana Fraga; José Galindo; Madelín de Arazoza; Anna Sánchez; Bárbaro Jaime; Susana Álvarez


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


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

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


Etapa final de la vida (PDQ®)

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


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

Microsoft Academic Search

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

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



Lo que usted necesita saber sobre™ el cáncer de pulmón

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


Lo que usted necesita saber sobre? el cáncer

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


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

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


Terapias adyuvantes y neoadyuvantes para el cáncer de seno

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


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.


Si tiene cáncer

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


Se lanza Red Nacional de Estudios Clínicos del NCI

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


Association of environmental traits with the geographic ranges of ticks (Acari: Ixodidae) of medical and veterinary importance in the western Palearctic. A digital data set.  


We compiled information on the distribution of ticks in the western Palearctic (11°W, 45°E; 29°N, 71°N), published during 1970-2010. The literature search was filtered by the tick's species name and an unambiguous reference to the point of capture. Records from some curated collections were included. We focused on tick species of importance to human and animal health, in particular: Ixodes ricinus, Dermacentor marginatus, D. reticulatus, Haemaphysalis punctata, H. sulcata, Hyalomma marginatum, Hy. lusitanicum, Rhipicephalus annulatus, R. bursa, and the R. sanguineus group. A few records of other species (I. canisuga, I. hexagonus, Hy. impeltatum, Hy. anatolicum, Hy. excavatum, Hy. scupense) were also included. A total of 10,280 records was included in the data set. Almost 42 % of published references are not adequately referenced (and not included in the data set), host is reported for only 61 % of records and a reference to time of collection is missed for 84 % of published records. Ixodes ricinus accounted for 44.3 % of total records, with H. marginatum and D. marginatus accounting for 7.1 and 8.1 % of records, respectively. The lack of homogeneity of the references and potential pitfalls in the compilation were addressed to create a digital data set of the records of the ticks. We attached to every record a coherent set of quantitative descriptors for the site of reporting, namely gridded interpolated monthly climate and remotely sensed data on vegetation (NDVI). We also attached categorical descriptors of the habitat: a standard classification of land biomes and an ad hoc classification of the target territory from remotely sensed temperature and NDVI data. A descriptive analysis of the data revealed that a principal components reduction of the environmental (temperature and NDVI) variables described the distribution of the species in the target territory. However, categorical descriptors of the habitat were less effective. We stressed the importance of building reliable collections of ticks with specific references as to collection point, host and date of capture. The data set is freely downloadable. PMID:22843316

Estrada-Peña, A; Farkas, Robert; Jaenson, Thomas G T; Koenen, Frank; Madder, Maxime; Pascucci, Ilaria; Salman, Mo; Tarrés-Call, Jordi; Jongejan, Frans



Holocene intermediate and bottom water mass reconstructions of the western Barents Sea  

NASA Astrophysics Data System (ADS)

The Atlantic Meridional Overturning Circulation (AMOC) is an important component of the Earth's climate system. It brings warm and saline water to the northern latitudes by the North Atlantic Current (NAC) and causes the formation of deep water which flows back to the south. Variability in the AMOC can affect the convective formation of deep water in the Nordic Seas and thereby the global ocean circulation. Additionally, the inflow of the NAC is essential for the ecological conditions at higher latitudes as any changes of this warm inflow have large consequences. Hence, it is crucial to establish the natural range of oceanographic fluctuations. During the Holocene both atmospheric and oceanic temperatures generally decreased. However, many smaller temperature fluctuations have been observed superimposed on this general cooling trend. Warm Atlantic water flows into the Barents Sea as the northern continuation of the NAC. The warm Atlantic waters are separated from the colder Arctic waters by the Polar Front. We have chosen a core location close to the Polar Front in order to study any changes in the inflow of Atlantic Water to the Barents Sea during the Holocene. A sediment core from the Kveithola trough, western Barents Sea margin, is studied at decadal to centennial time scale. Benthic foraminiferal assemblages have been analyzed in addition to stable isotopes (?18O and ?13C) and Mg/Ca ratios. The first results of the benthic foraminiferal assemblages show a general Holocene warming trend for the western Barents Sea. Cold water associated species such as Elphidium excavatum are replaced by cooled Atlantic Water associated species (Cassidulina neoteretis, Cassidulina reniforme) around 9500 cal. yr. BP. A lithological shift and a drop in total organic carbon (TOC) is observed around 8400 cal. yr. BP and might indicate a change in water mass. The benthic foraminiferal assemblages show a stable trend during mid-Holocene and the assemblage is dominated by C. neoteretis and C. reniforme. Additionally, we will present data on Mg/Ca ratios and stable isotopes, both measured on the species C. neoteretis, which enables an independent reconstruction of salinity and temperature throughout the Holocene.

Groot, D. E.; Aagaard Sørensen, S.; Husum, K.; Hald, M.



Annual and Seasonal Dynamics of Benthic Foraminifera and Their Sensitivity to Environmental Changes in Arctic Fjord  

NASA Astrophysics Data System (ADS)

Benthic foraminifera are widely used as climatic and environmental proxy in marine records. Their usefulness as proxy of past environmental conditions, however, depends entirely on how well they are calibrated to their biological, chemical, and physical surroundings. From the Arctic regions there is still limited knowledge on how the benthic foraminifera relate to the present polar conditions. In this study we investigate how the benthic foraminifera relate to the present environment, and in particular how rapidly they respond to the changes in the flow of warm and saline Atlantic water into the Arctic. Kongsfjorden (Svalbard, Europen Arctic) is a glaciated Arctic fjord characterized by the presence of Arctic and Atlantic waters. Tidewater glaciers at the head of the fjord discharge freshwater and suspended sediment into the inner parts of the fjord, whereas predominantly marine conditions prevail at the fjord mouth. In summer, frontal instabilities at the outer and inner parts of Kongsfjorden result in the intrusion of warm and saline Atlantic waters into the fjord. The volume of such intrusions varies interannually, and in the 2006 and 2007 they have been significant. Concurrent with CTD measurements we sampled multicore samples annually (years 2005-2007) in a transect from the mouth of the fjord to the inner part of fjord and analysed the content of living (Rosa Bengal stained) benthic foraminifera. The recent alterations in Kongsfjorden hydrology shifting from 'cold' (2005) to 'warm' (2006-2007) years resulted in changes in the relative composition of the benthic fauna. Two common species Elphidium excavatum f. clavata and Cassidulina reniforme known as co-dominant species in harsh glaciomarine environment decrease in abundance during the warmer years in the entire Kongsfjord area. We have also multicore samples from spring (April 2008) and summer (August 2007) that allows for preliminary investigations of the seasonal faunal changes. Comparing spring (April 2008) and summer (August 2007) shows that some species mainly occur during spring which probably is related to different stages of primary production in the fjord. In the early spring one species Silicosigmoilina groenlandica show much higher abundance than during summer, suggesting it is exploiting the early spring bloom and is then successively replaced by other species during the summer.

Wilson, L.; Jernas, P.; Kristensen, D.; Koc, N.



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


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

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



A note on bounds of the size of a sometimes pool test procedure in anova model II  

Microsoft Academic Search

\\u000a Resumen  El presente trabajo se refiere a los tests de hipótesis donde el análisis de la varianza incluye un tratamiento de la media\\u000a cuadrática, un error medio cuadrático y tres errores cuadráticos medios problemáticos. Dos resultados concernientes a los\\u000a limites inferior y superior de la medida, cuando el valor esperado de todas las medias cuadráticas son iguales, han sido derivadas\\u000a en

R. C. Jain; V. P. Gupta



Atlas del Genoma del Cáncer

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


Información sobre el cáncer para hispanos y latinos

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


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

NASA Astrophysics Data System (ADS)

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

Saeidi Ortakand, M.; Hasegawa, S.



[Screeninf for cusching's syndrome in obese patients; is it really necessary?].  


Introducción: El síndrome de Cushing (SC) es más frecuente en pacientes con síndrome metabólico. Estudios previos han sugerido que es necesario realizar un despistaje de SC en pacientes obesos; sin embargo, estudios más recientes sólo recomiendan el despistaje en pacientes con hipertensión o diabetes mal controlados, a pesar de tratamiento. Objetivo: Evaluar la prevalencia de SC oculto en pacientes con obesidad mórbida. Pacientes y métodos: Estudio observacional retrospectivo en el que se incluyeron 399 pacientes que iban a someterse a cirugía bariátrica. A todos los pacientes se les realizó una historia clínica completa, incluyendo exploración física y test de Nugent, como parte del protocolo precirugía. Resultados: 399 pacientes (308 mujeres, edad media 41,9 ± 10,5 años; IMC medio 51,5 ± 8,4 kg/m2). El 10,3% de los pacientes presentaban prediabetes y el 27,8% diabetes. En 21 de los 399 pacientes, el despistaje fue anormal. En 8 pacientes, medimos cortisol libre en orina de 24 horas (CLU), siendo en todos normal al menos en dos ocasiones (CLU < 150 mcg/24 h), lo que descartaba SC. En 13 pacientes, repetimos el test de Nugent; sólo en 3, el test resultó patológico. Dos de los pacientes estaban en tratamiento con carbamacepina, lo que se consideró un falso positivo. El otro paciente se diagnosticó de Enfermedad de Cushing. Conclusión: La prevalencia de SC fue muy baja en pacientes con obesidad mórbida. Nuestros datos sugieren que no se debería realizarse un despistaje de SC de forma rutinaria. PMID:24951980

Alhambra Expósito, María Rosa; Tenorio Jiménez, Carmen; Molina Puerta, María José; Manzano García, Gregorio; Prior Sánchez, Inmaculada; Muñoz Jiménez, Concepción; Gálvez Moreno, María Ángeles




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



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

SciTech Connect

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

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



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

PubMed Central

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



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.


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

PubMed Central

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

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



Risk-adapted treatment of acute promyelocytic leukemia with all-trans retinoic acid and anthracycline monochemotherapy: long-term outcome of the LPA 99 multicenter study by the PETHEMA Group.  


A previous report of the Programa de Estudio y Tratamiento de las Hemopatías Malignas (PETHEMA) Group showed that a risk-adapted strategy combining all-trans retinoic acid (ATRA) and anthracycline monochemotherapy for induction and consolidation in newly diagnosed acute promyelocytic leukemia results in an improved outcome. Here we analyze treatment outcome of an enlarged series of patients who have been followed up for a median of 65 months. From November 1999 through July 2005 (LPA99 trial), 560 patients received induction therapy with ATRA plus idarubicin. Patients achieving complete remission received 3 courses of consolidation followed by maintenance with ATRA and low-dose chemotherapy. The 5-year cumulative incidence of relapse and disease-free survival were 11% and 84%, respectively. These results compare favorably with those obtained in the previous LPA96 study (P = .019 and P = .04, respectively). This updated analysis confirms the high antileukemic efficacy, low toxicity, and high degree of compliance of a risk-adapted strategy combining ATRA and anthracycline monochemotherapy for consolidation therapy. PMID:18664623

Sanz, Miguel A; Montesinos, Pau; Vellenga, Edo; Rayón, Consuelo; de la Serna, Javier; Parody, Ricardo; Bergua, Juan M; León, Angel; Negri, Silvia; González, Marcos; Rivas, Concha; Esteve, Jordi; Milone, Gustavo; González, José D; Amutio, Elena; Brunet, Salut; García-Laraña, J; Colomer, Dolors; Calasanz, María J; Chillón, Carmen; Barragán, Eva; Bolufer, Pascual; Lowenberg, Bob



Causes and prognostic factors of remission induction failure in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and idarubicin.  


An understanding of the prognostic factors associated with the various forms of induction mortality in patients with acute promyelocytic leukemia (APL) has remained remarkably limited. This study reports the incidence, time of occurrence, and prognostic factors of the major categories of induction failure in a series of 732 patients of all ages (range, 2-83 years) with newly diagnosed APL who received all-trans retinoic acid (ATRA) plus idarubicin as induction therapy in 2 consecutive studies of the Programa de Estudio y Tratamiento de las Hemopatias Malignas (PETHEMA) Group. Complete remission was attained in 666 patients (91%). All the 66 induction failures were due to induction death. Hemorrhage was the most common cause of induction death (5%), followed by infection (2.3%) and differentiation syndrome (1.4%). Multivariate analysis identified specific and distinct pretreatment characteristics to correlate with an increased risk of death caused by hemorrhage (abnormal creatinine level, increased peripheral blast counts, and presence of coagulopathy), infection (age>60 years, male sex, and fever at presentation), and differentiation syndrome (Eastern Cooperative Oncology Group [ECOG] score>1 and low albumin levels), respectively. These data furnish clinically relevant information that might be useful for designing more appropriately risk-adapted treatment protocols aimed at reducing the considerable problem of induction mortality in APL. PMID:18195095

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



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


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

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



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



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


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

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



Medicinal ethnobotany in Huacareta (Chuquisaca, Bolivia)  

PubMed Central

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



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

SciTech Connect

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

Gomez Cendra, P.; Vilardi, J. [Depto. Ecologia, Genetica y Evolucion, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, (1428) Buenos Aires (Argentina); Segura, D.; Cladera, J. [Instituto de Genetica, INTA Castelar, CC25, (1712), Buenos Aires (Argentina); Allinghi, A. [Comision Nacional de Energia Atomica, CNEA, Buenos Aires (Argentina)



Gender differences in the diagnosis and treatment of left ventricular hypertrophy detected by different electrocardiographic criteria. Findings from the SARA study.  


This study examines the influence of gender on the detection of left ventricular hypertrophy (LVH) by different electrocardiographic (ECG) criteria and the potential changes induced by antihypertensive therapy from the SARA study ("eStudio del trAtamiento con candesaRtan en pacientes con hipertensión Arterial según criterios electrocardiográficos") database. The SARA study was aimed to determine the effect of a 12-month candesartan-based regimen on ECG-LVH. Overall, 264 patients were included. Cornell voltage index (CorV), Cornell product (CorP), Sokolow-Lyon voltage index (SokV), and Sokolow-Lyon product (SokP) were calculated. At baseline, 39.3% of women and 15.4% of men exhibited ECG-LVH by CorP criteria, and 18.2% of women and 30.6% of men had LVH by SokP. When voltage criteria were applied, LVH was detected in 20.5% of women and 5.9% of men by CorV, and in 10.7% and 13.4%, respectively, by SokV. At the end of the study, the proportion of patients with ECG-LVH by CorP was 28.7% in women (P < 0.001) and 14.4% in men (P = not significant [n.s.]), and in 21.2% (P = n.s.) and 22.1% (P = 0.01) by SokP. Left ventricular hypertrophy by CorV were present in 17.9% of women and 9.0% of men (both P = 0.001), and in 10.6% and 13.3%, respectively by SokV (both P = n.s.). In ECG-LVH hypertensive patients, candesartan was an efficacious drug to regress LVH in the clinical practice setting. The voltage-duration product criteria suggestively detected ECG-LVH and its respective changes better than voltage criteria. Although in daily clinical practice the use of both product criteria seemed clearly preferable to voltage for assessment of ECG-LVH, the CorP appeared to be markedly more useful in women and SokP in men. PMID:20091399

Barrios, Vivencio; Escobar, Carlos; Calderón, Alberto; Barrios, Sara; Navarro-Cid, Josefa; Ferrer, Elena; Echarri, Rocio



Moléculas orgánicas no-rígidas  

NASA Astrophysics Data System (ADS)

Se destaca la importancia del estudio espectroscópico ab initio de una serie de moléculas no-rígidas detectadas en el medio interestelar (acetona, dimetil-eter, etanol, metanol, metilamina, ldots), así como los últimos avances del desarrollo de la metodología para el tratamiento teórico de estas especies. Se describe, a modo de ejemplo, el análisis del espectro roto-torsional de la molécula de glicoaldehido que ha sido recientemente detectada en el centro Galáctico Sagitario B2 (N) [1]. Esta especie presenta dos movimientos de gran amplitud que interaccionan, descansan en el Infrarrojo Lejano y le confiere propiedades no-rígidas. La molécula puede existir en posiciones cis y trans y presenta cinco confórmeros estables, tres de simetría Cs (I, II y IV) y un doble mínimo trans de simetría C1 (III) . La conformación favorita, I, presenta simetría Cs y se estabiliza por la formación de un puente de hidrógeno entre los grupos OH y C=O. Los mínimos secundarios II, III, y IV se han determinado a 1278.2 cm-1 (trans, Cs), 1298.8 cm-1 (trans, C1) y 1865.2 cm-1 (cis, Cs) con cálculos MP4/cc-pVQZ que incluyen sustituciones triples. Para determinar que vibraciones interaccionan con las torsiones, se ha realizado un análisis armónico en los mínimos. Las frecuencias fundamentales armónicas correspondientes al mínimo I se han calculado en 213.4 cm-1 (torsión C-C) y 425.7 cm-1 (torsión OH). Es de esperar que tan sólo dos vibraciones, la flexión del grupo C-C-O y el aleteo del hidrógeno del grupo aldehídico puedan desplazar el espectro torsional de la molécula aislada. Para determinar el espectro torsional, se ha determinado la superficie de potencial en dos dimensiones mediante el cálculo ab initio de las geometrías y energías de 74 conformaciones seleccionadas. Estas últimas se han ajustado a un doble serie de Fourier. A partir de la PES y de los parámetros cinéticos del Hamiltoniano vibracional se han obtenido frecuencias e intensidades. Las frecuencias fundamentales se han calculado en 208.0 cm-1 (torsión C-C) y 349.9 cm-1 (torsión OH). Se discute el método de cálculo que se ha empleado para la clasificación de los niveles. Los niveles rotacionales se han determinado empleando el método desarrollado para el estudio del ácido acético [2]. Se emplean la base de funciones rotacionales de [3]. A partir de los niveles se han determinado las constantes rotacionales y las constantes de distorsión centrífuga que se comparan con las experimentales de Herbst et al [3].

Senent Díez, M. L.


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)



[Benefits of decumanum phlebodium intake on the muscle damage in the response to intense physical exercise in sedentary subjects].  


Introducción: El ejercicio intenso provoca un daño muscular inflamatorio que, en sujetos sedentarios provoca un aumento del riesgo cardiovascular. El Phlebodium decumanum (PD) ha evidenciado efectos inmunomoduladores protectores frente a ese daño en los deportistas. Para conocer los efectos del PD en una población sedentaria frente al ejercicio excéntrico, y como modelo del daño muscular inflamatorio. Metodología: Se llevó a cabo un estudio experimental, doble ciego, multigrupo, randomizado, con un grupo experimental (n = 17) al que se le administró una formulación de PD (3,6 g/sujeto distribuidos en 9 dosis de 400 mg desde el día pretest), y un grupo control (n = 16) que tomó sustancia placebo. Se realizaron dos ergoespirometrías en tapiz rodante a cada participante: una previa al estudio (protocolo de Bruce modificado) para descartar signos de isquemia durante el esfuerzo y valorar el VO2max; la segunda, aplicando un protocolo excéntrico (14% de desnivel descendente), durante 10 minutos en estado estable a una intensidad entre 70-80% del VO2max individual, como protocolo experimental. Se efectuaron comparaciones intragrupo e intergrupo del porcentaje de cambio pre-postesfuerzo en variables sanguíneas y de funcionalidad muscular. Resultados: El estudio evidencia aumentos significativos de enzimas musculares MG, CPK y LDH en los dos grupos de estudio, sin cambios para la TncI, siendo significativamente menores en el grupo al que se le administró PD. Se observaron reducciones significativas de los test funcionales SJ, CMJ en ambos grupos, lo que mostró un apreciable menor descenso en el grupo PD. Se apreció una reducción del índice elástico y de la dinamomentría manual solo en el grupo control, aunque las diferencias con el grupo PD no alcanzaron una significación estadística. Conclusiones: El protocolo del ejercicio excéntrico en el presente estudio ha inducido daños musculoesqueléticos y en la funcionalidad muscular, que han resultado significativamente menores en el grupo PD, al mostrar los efectos protectores del Phlebodium Decumanum en tratamientos cortos, frente al daño muscular también en el esfuerzo agudo. PMID:24972482

Vargas Corzo, M C; Aguilar Cordero, M J; De Teresa Galván, C; Segura Millán, D; Miranda Leon, M T; Castillo Rueda, G; Guisado Barrilao, R-





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

Rivera, Souhail Malavé; Díaz, Nelson Varas



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


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

Pavlovsky, Santiago; Lastiri, Francisco



Como Lo Hago Yo: Mielomeningocele En Bolivia  

PubMed Central

Introducción: Las malformaciones del tubo neural (MTN) representan la segunda causa más frecuente de anomalías congénitas, luego de las cardiopatías. En este grupo se destaca el mielomeningocele (MMC) por su mayor incidencia, y por ser la más incapacitante y la más compleja entre todas las demás malformaciones del sistema nervioso c`entral (SNC). En Bolivia, como en muchos países de Sudamérica, los bajos niveles socio-culturales y la debilidad en el sistema sanitario, hacen que su incidencia y su morbilidad, sean mayores que en las naciones más desarrolladas. Material y Métodos: Se realizó un estudio retrospectivo y descriptivo de 70 casos de MMC, atendidos por un equipo multidisciplinario en el Hospital Universitario Japonés (HUJ) de Santa Cruz de la Sierra, entre 2008-2011. De ellos, 60 fueron intervenidos quirúrgicamente. Resultados: Se realizaron controles prenatales sólo en 27 mujeres (38.6%), diagnosticándose una disrafia espinal en apenas dos casos (7.4%). La edad de ingreso del MMC en su mayoría fue después de las 24 horas (65.6%), predominando su localización en la región lumbosacra (64.3%). De ellos, 67.2% eran abiertos, presentando un 32.9% un daño neurológico motor parcial mientras que 47.1% tenían paraplejia por debajo de la lesión. De los 70 casos, tres (4.3%) no fueron intervenidos, por presentar defectos congénitos severos o estado general grave. Las principales complicaciones posoperatorias inmediatas fueron: dehiscencia de sutura y/o infección de la herida (16.6%), fístula de líquido cefalorraquídeo (LCR) (10%) e infección del SNC (11.7%). La mortalidad general y postoperatoria fue de 7.1% y 3.3%, respectivamente. Al mes de vida presentaban hidrocefalia un 80% de los pacientes operados, colocándose una derivación ventriculoperitoneal (DVP) de presión media. De 9 pacientes que tuvieron un acompanamiento de dos o más años, seis presentaron una médula anclada, que fueron intervenidas quirúrgicamente. Conclusión: En esta serie, el diagnóstico prenatal del MMC fue ocasional y la derivación al HUJ de los recién nacidos con esta malformación fue generalmente tardía. No hubo predominio de género y la mayoría de los casos presentaron sus lesiones en la región lumbar y lumbosacra. La mortalidad general y postoperatoria fue similar a la reportada en la literatura. Pocos enfermos realizaron controles posteriores al alta hospitalaria. Igual que otros países de Sudamérica, las falencias en el sistema público de salud y el nivel sociocultural, son factores determinantes para un mal pronóstico en estos niños. Por sus múltiples complicaciones, el MMC requiere de una especial atención gubernamental, sobre todo de carácter preventivo mediante el uso de ácido fólico en mujeres fértiles, como también de un equipo profesional multidisciplinario, a fin de realizar un tratamiento adecuado y oportuno. Al mismo tiempo, trabajos multicéntricos en hospitales de América Latina, ayudarán al mejor manejo de estos pacientes.

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



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

SciTech Connect

We evaluated under semi-natural field cage conditions sexual compatibility and competitiveness of a laboratory strain (LAB) compared to a wild population (TUC) of Anastrepha fraterculus (Wiedemann). The LAB strain is produced under semi-mass rearing conditions at the Estacion Experimental Agroindustrial Obispo Colombres facility (Tucuman, Argentina). Wild flies were obtained at Horco Molle (Tucuman, Argentina) from infested guava fruits. LAB pupae were irradiated ({sup 60}Co) 48 h before adult emergence. The tested doses were 0 (control), 40, 70, and 100 Gy. Twenty-five males and 25 females each of TUC and LAB were released into cages and mating pairs collected. Only 1 irradiation dose was considered at a time. Females were separated and allowed to lay eggs into artificial fruits to estimate induced sterility from the corresponding hatching rate. Copulation start time did not differ significantly between strains nor among irradiation treatments. Copulation duration showed highly significant differences among irradiation doses, but no differences between strains. The index of sexual isolation (ISI) and the relative sterility index (RSI) indices indicated that LAB and TUC are fully compatible, males from TUC and LAB did not differ in mating competitiveness, and irradiation within the range tested did not affect these indices. Non-irradiated LAB females exhibited higher mating propensity than TUC ones. However, a significant reduction in the female relative performance index (FRPI) index was observed with increasing irradiation dose. The analysis of induced sterility indicated that treatment with 40 Gy reduces male fertility from about 80% to 0.75%, and higher doses produce total sterility. In females, the 40 Gy dose reduces fertility to about 2% and higher doses prevent egg laying. (author) [Spanish] Se evaluo bajo condiciones semi-naturales en jaulas de campo la compatibilidad y la competitividad sexual de una linea de laboratorio (LAB) con respecto a una poblacion salvaje (TUC) de Anastrepha fraterculus (Wiedemann). La linea de laboratorio se produce en condiciones de cria semi-masiva en las instalaciones de la Estacion Experimental Agroindustrial Obispo Colombres (Tucuman, Argentina). Las moscas salvajes se obtuvieron de frutas infestadas de guayabos en Horco Molle (Tucuman, Argentina). Las pupas de laboratorio fueron irradiadas ({sup 60}Co) 48 horas antes de la emergencia del adulto. Las dosis utilizadas fueron 0 (control), 40, 70, y 100 Gy. Se liberaron 25 machos y 25 hembras de TUC y LAB dentro de las jaulas y se recolectaron las parejas formadas. Solo se considero 1 dosis de irradiacion por vez. Las hembras apareadas fueron separadas y se les permitio poner huevos en frutas artificiales para estimar la esterilidad inducida a traves del porcentaje de eclosion. La hora de inicio de la copula no difirio significativamente entre poblaciones ni entre los tratamientos de irradiacion. La duracion de la copula mostro grandes diferencias entre dosis de irradiacion pero no entre cepas. Los indices ISI (aislamiento) y el RSI (esterilidad relativa) indican que LAB y TUC son totalmente compatibles, los machos de TUC y LAB no difieren en su competitividad y la irradiacion dentro del rango de dosis utilizadas tampoco afecto este indice. Las hembras LAB no irradiadas muestran una mayor propension para el apareamiento que las hembras de TUC. Sin embargo se observo una reduccion significativa del indice FRPI (actuacion relativa de hembras) a medida que se aumenta la dosis de irradiacion. El analisis de la esterilidad inducida indica que con dosis de 40 Gy la fertilidad disminuye del 80% al 0.75%, y con dosis mayores la esterilidad fue total. Las hembras irradiadas con dosis de 40 Gy tienen una fertilidad de aproximadamente 2% y con dosis mayores no ponen huevos. (author)

Allinghi, A. [Comision Nacional de Energia Atomica, CNEA (Argentina); Calcagno, G.; Gomez Cendra, P.; Vilardi, J.C. [Depto. Ecologia, Genetica y Evolucion, Facultad de Ciencias Exactas y Naturales, Universidad Buenos Aires (1428) Buenos Aires (Argentina); Petit-Marty, N.; Segura, D.; Cladera, J. [Instituto de Genetica, INTA, Castelar (Argentina); Vera, T.; Gramajo, C.; Willink, E. [Estacion Experimental Agro-industrial Obispo Colombres, Tucuman (Argentina)



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.



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

SciTech Connect

The sterile insect technique (SIT) is increasingly being used around the world to control Ceratitis capitata (Wiedemann) (Diptera: Tephritidae), the Mediterranean fruit fly as part of an area-wide integrated approach. One option that may improve the effectiveness of the SIT, by increasing the sexual competitiveness of released sterile males, consists of feeding males protein during the post-teneral stage, a diet that increases sexual performance of wild males. We examine the effects of diet on the successive hurdles males must overcome in order to inseminate females, i.e., joining leks, copulating females, having their sperm stored and inhibition of female remating. In addition, we address the effects of diet on post-release foraging success, longevity, and the ability to withstand starvation. While protein feeding universally increases the sexual success of wild males, its effect on sterile males varies with strain, experimental settings, and environmental conditions. In some cases, treatments that resulted in the best sexual performance were significantly associated with increased vulnerability to starvation. However, no particular diet affected the ability of sterile males to find nutrients in the field when these where available. We suggest it may be better to release relatively short-lived flies that are highly competitive, rather than long-lived, sexually ineffective ones. (author) [Spanish] El uso de la tecnica de insecto esteril (TIE) esta aumentando alrededor del mundo para el control de Ceratitis capitata (Wiedemann) (Diptera: Tephritidae), la mosca mediterranea de la fruta como parte de un enfoque integrado por toda el area. Una opcion que puede mejorar la eficiencia de TIE, por medio del aumento de la capacidad de los machos esteriles liberados para competir, consiste en la alimentacion de los machos con proteina durante la etapa de pos-teneral, una dieta que aumenta el desempeno sexual de los machos naturales. Nosotros examinamos los efectos de la dieta sobre los obstaculos sucesivos que los machos tienen que superar para inseminar las hembras, i.e., unir con otros machos en areas para el apareamiento, copula de las hembras, almacenar esperma e inhibir el re-apareamiento de hembras. Ademas discutimos los efectos de la dieta sobre el exito de su actividad forrajera despues de ser liberados, la longevidad y la habilidad para aguantar la inanicion. Mientras que la alimentacion con proteina universalmente aumentan el exito sexual de los machos naturales, su efecto sobre los machos esteriles varia segun la raza, el lugar de los experimentos y las condiciones ambientales. En algunos casos, los tratamientos que resultaron con mejor desempeno sexual fueron asociados significativamente con el aumento de la vulnerabilidad a la inanicion. Sin embargo, ninguna dieta en particular afecto la habilidad de los machos esteriles para encontrar nutrientes en el campo cuando fueron disponibles. Nosotros sugerimos que puede ser mejor el liberar moscas que tienen una vida relativamente corta y que son mas competidoras, en vez de moscas que tienen una vida larga y sexualmente inefectiva. (author)

Yuval, B.; Maor, M.; Levy, K. [Dept. of Entomology, Hebrew University, PO 12, Rehovot, 76100 (Israel); Kaspi, R. [Dept. of Entomology, University of California, Davis CA 95616 (United States); Taylor, P. [Dept. of Psychology, Macquarie University, NSW 2109 (Australia); Shelly, T. [USDA-APHIS, 41-650 Ahiki Street, Waimanalo, HI 96795 (United States)



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