Juvenile xanthogranuloma as a differential diagnosis for sellar and suprasellar lesions in child: Case report and review of literature.

Juvenile xanthogranuloma (JXG) is a rare type of non-Langerhans cell histiocytosis. Its systemic form affects 4% of patients. Lesions in the Central Nervous System (CNS) occur in 2% of systemic cases. Sellar JXG should be one of the differential diagnoses for sellar lesions in young. This is a 15-year-old patient with non-specific headache, progressive visual loss and magnetic resonance imaging showing sellar lesion with suprasellar extension. The patient underwent microsurgery by pterional craniotomy with partial resection of the tumor. Pathology evidenced JXG. It progressively evolved with impairment of neuroendocrine functions, new lesions in different CNS locations and death two years after diagnosis. Sellar JXG without cutaneous manifestations is rare. There are no specific findings of the disease. Diagnosis requires additional tests, being defined by pathological analysis. Total resection presents a greater potential control comparing to partial resection. Even so, some patients may have progressive disease with poor clinical outcome.

Effects of eccentric exercise on muscle architecture in adults: a systematic review / Efectos del ejercicio excéntrico en la arquitectura muscular en adultos: una revisión sistemática

SUMMARY: The purpose of this systematic review was to determine the effects of eccentric training on muscle architecture in the adult population. Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statements were followed using keywords associated with architecture muscular and eccentric training. Four databases were used: PubMed, Scopus, SPORTDiscus and Web of Science. Methodological quality was assessed using the PEDro scale. A total of 1260 articles were retrieved, 18 included in this review. The parameters most frequently evaluated in the studies consulted were pennation angle (PA), fascicle length (FL), and muscle thickness (MT). These were assessed mainly in lower limb muscles such as biceps femoris long head (BFlh), vastus lateralis (VL), medial gastrocnemius (MG) and lateral gastrocnemius (LG), respectively. Eccentric training for at least four weeks generates adaptations in these parameters, mainly by increasing MT with FL and decreasing PA, determining muscle function. These results provide evidence on the effects of eccentric training on muscle architecture, which could be helpful to prevent injuries and favor muscle recovery processes.

RESUMEN: El propósito de esta revisión sistemática fue determinar los efectos del entrenamiento excéntrico sobre la arquitectura muscular en la población adulta. Se siguieron las recomendaciones del Ìtems de referencia para publicar Revisiones Sistemáticas y Metaanálisis (PRISMA) utilizando palabras clave asociadas con la arquitectura muscular y el entrenamiento excéntrico en cuatro bases de datos: PubMed, Scopus, SPORTDiscus y Web of Science. La calidad metodológica se evaluó mediante la escala PEDro. Se encontró un total de 1260 artículos, del los cuales, 18 fueron incluidos en esta revisión. Los parámetros más frecuentemente evaluados en los estudios fueron el ángulo de penación (AP), la longitud del fascículo (LF) y el grosor muscular (Gm). Estos fueron evaluados principalmente en músculos de los miembros inferiores como la cabeza larga del bíceps femoral (CLBf), el vasto lateral (VL), el gastrocnemio medial (GM) y el gastrocnemio lateral (GL), respectivamente. El entrenamiento excéntrico durante al menos cuatro semanas genera adaptaciones en estos parámetros, principalmente aumentando el GM con la LF y disminuyendo el AP, determinando de esta manera la función muscular. Estos resultados aportan evidencias sobre los efectos del entrenamiento excéntrico en la arquitectura muscular, que podrían ser útiles para prevenir lesiones y favorecer los procesos de recuperación muscular.

Efficacy and safety of a simplified SBRT regimen for central and peripheral lung tumours.

BACKGROUND: Evaluate the safety, toxicity and efficacy of an institutional-simplified SBRT protocol with two short SBRT regimens (three or five fractions) for the treatment of lung cancer and oligometastases, according to the volume and localization of tumours. METHODS: Patients with stage I (T1 or T2) non-small cell lung cancer or lung oligometastases were treated from August 2011 to October 2015. Patients were required to be considered medically inoperable and were discussed in a multidisciplinary team. RESULTS: 100 patients were analysed, 59 had a peripheral location (P), and 41 a central location (C).All patients finished their SBRT course without interruptions related to acute toxicity. The most frequent acute toxicity was grade 1 asthenia, only one patient developed grade 3 toxicity (pneumonitis) and there were no grade 4 or 5 acute toxicities. Three asymptomatic radiation-induced rib fractures were identified, the 1 and 2-year rib fracture-free survival were 97% and 94%, respectively. Two-year progression-free survival and 2-year overall survival of all patients were 52% and 70%, respectively, with a median PFS and OS of 26 and 43 months. Survival free of local progression (SFLP) at 2 years was 89%. A higher PFS in primary lung cancer compared with metastatic tumours was observed, with a median of 35 months with 19 months (p = 0.01). However, no statistical difference was observed in terms of OS between both diseases. CONCLUSIONS: SBRT in lung cancer with three sessions for peripheral tumours and five sessions for central tumours may be safely delivered, with low morbidity.

Thyroid hormone resistance from newborns to adults: a Spanish experience.

OBJECTIVE: Thyroid hormone resistance (RTH ß) is a rare genetic disorder characterized by an altered response of target tissue to the action of thyroid hormone. Few studies on RTH ß have been carried out in southern European populations. We aimed to describe the clinical and genetic characteristics at the time of diagnosis in a Spanish cohort of patients with genetically confirmed RTH ß, with ages ranging from newborns to adults. METHODS: Retrospective multicenter study of 28 patients who were genetically confirmed as RTH ß. Clinical and biochemical data were collected from the reference centers, and the studied variables included age, sex, anthropometric data, clinical characteristics and biochemical results. In the Basque country, a simultaneous analysis of TSH and T4 is carried out in the program for the screening of inborn errors of metabolism. A molecular analysis of the thyroid hormone beta (THRB) gene was performed. RESULTS: The total cohort included 20 adults and eight pediatric patients (six newborns). Of the total, 5 (17.8%) were diagnosed by clinical characteristics (goiter, hypertension or tachycardia), 13 (46.4%) were analyzed in the context of a family study and 10 (35.7%) were diagnosed after obtaining an altered fT4 and/or TSH level in a biochemical analysis performed due to clinical symptoms unrelated to RTH ß. Four of the newborns included in the series were diagnosed by the result of neonatal screening, which allows us to estimate a minimum local incidence of RTH ß of 1/18,750 live newborns. The genetic analysis showed the presence of 12 different heterozygous mutations in the THRB gene. CONCLUSIONS: We report the clinical and genetic characteristics of a Spanish RTH ß cohort, from neonates to adults. We also describe one novel mutation in the THRB gene as the cause of the disease. The simultaneous analysis of TSH and T4 carried out in the program for the screening of inborn errors of metabolism facilitates the early diagnosis of RTH ß in newborns and has allowed us to estimate a minimum local incidence of RTH of 1/18,750 live newborns.

[Prevalence and typology of patients susceptible of palliative care deceased at home]. / Prevalencia y tipología de pacientes susceptibles de cuidados paliativos fallecidos en el domicilio.

BACKGROUND: Identification of patients susceptible to palliative care (SPC) in the community is essential for improving their clinical management. The objective is to explore the SPC population and their typology of illness, according to sex. METHODS: Cross-sectional study, performed on the population of Malaga who died at home during 2015. Association between type of patient (SCP or identified as palliative by inclusion in the integrated care process (ICP)). Age, sex and type of disease were analyzed with Chi square and t-Student's test. RESULTS: Of 950 patients attended to after dying at home, 417 (43.9%) were SCP and, of them, 277 (66,4%) were included in the ICP. Males were more frequent in both populations (55.6 and 59.9%, respectively, p=0,26), with mean ages 78.6 and 76.2, respectively (p=0.01). The most frequent diseases in SCP patients were: cancer (61.9%), dementia and Alzheimer (19.9%), chronic ob-structive pulmonary disease (COPD) (6.2%) and heart failure (4.1%). People with cancer were more frequently included in the ICP (86.8%), while those with dementia and Alzheimer, COPD and Parkinson were less frequently included (20.5, 38.4 and 0.4% respectively). By sex, men suffered more from cancer and women from dementia. Percentage of inclusion in ICP was similar for men and women, stratified by disease. CONCLUSIONS: Almost half of the people who died at home are SCP although only two out of three are identified as such. Cancer is the most frequent SCP disease and the easiest one to identify, largely affecting men. Three out of four people with dementia died without being identified as PC, and they are mainly women.

National survey on airway and difficult airway management in intensive care units. / Encuesta nacional sobre el manejo de la vía aérea y la vía aérea difícil en las unidades de cuidados intensivos.

OBJECTIVE: To know organization, management and training in airway (AW) in Spanish Intensive Care Units (ICUs), with special interest in difficult airway (DAW). DESIGN: Descriptive cross-sectional study and χ2 subanalysis, conducted through a national survey from november 1th to december 15th, 2016. With the SEMICYUC's support, an online questionnaire of 27 items was sent to 179 ICUs. SETTING: ICUs of public, private centers, and consortia. RESULTS: In total, 101 units responded (56.4%), corresponding to 1,827 beds and almost 95,000 incomes/year. The 85.1% are public hospitals, and 83.2% had residents. Of the responders, 22.8% don't use routinely AW assessment scales, being the most frequently used the Cormack-Mallampati association (35.6%). There's not intubation (IOT) protocol in 77.2%, nor DAW protocol in 75.2%. An 82.2% have a DAW cart. The 48.5% have training in IOT, and in VAD 53.5%. Having a DAW expert is significantly associated with greater training in IOT (60% vs. 39.3%; P=.03), DAW (64.4% vs. 44.6%; P=.04), and more AW protocols (73.4% vs. 37.5%; P=.000). Having an specific guideline for DAW management in UCI is considered necessary in 99%. CONCLUSIONS: There is room for improvement in AW management. It's necessary to identify an expert in DAW in each Unit, and the development of an specific guideline for DAW management in critical care.

Numerical method to digital photoelasticity using plane polariscope.

This research aims to find a new way to get the intensity equations for the phase-shifting model in digital photoelasticity. The procedure is based on the rotation of the analyzer itself. From the intensity equations, the isoclinic and isochromatic equations parameters are deduced by applying a new numerical technique. This approach can be done to calculate how many images allow the resolution of the polariscope. Each image indicates the stress forces in the object. In this study the plane polariscope was used. The amount of images will determinate the number of errors and uncertainties of the study, due to the observation that the veracity of the equations increases considerably with a large amout of images. Several analyses are performed with different amounts of photographic images. The results showed the possibility to measure stress forces with high precision using plane polariscopes.

Multiple detectors "Influence Method".

The "Influence Method" is conceived for the absolute determination of a nuclear particle flux in the absence of known detector efficiency and without the need to register coincidences of any kind. This method exploits the influence of the presence of one detector in the count rate of another detector, when they are placed one behind the other and define statistical estimators for the absolute number of incident particles and for the efficiency (Rios and Mayer, 2015a). Its detailed mathematical description was recently published (Rios and Mayer, 2015b) and its practical implementation in the measurement of a moderated neutron flux arising from an isotopic neutron source was exemplified in (Rios and Mayer, 2016). With the objective of further reducing the measurement uncertainties, in this article we extend the method for the case of multiple detectors placed one behind the other. The new estimators for the number of particles and the detection efficiency are herein derived.

Vaginal-cuff control and toxicity results of a daily HDR brachytherapy schedule in endometrial cancer patients.

PURPOSE: To analyze the vaginal-cuff local control (VCC) and toxicity in postoperative endometrial carcinoma patients (EC) underwent high-dose-rate brachytherapy (HDR-BT) administered daily. MATERIALS AND METHODS: 154 consecutive patients received postoperative HDR-BT for EC from January 2007 to September 2011. FIGO-staging I-IIIC2 patients were divided into two groups according to risk classification: Group 1 (94/154) included high-risk or advanced disease patients and Group 2 (60/154) included intermediate-risk EC patients. Group 1 underwent external beam irradiation (EBI) plus HDR-BT (2 fractions of 5 Gy) and Group 2 underwent HDR-BT alone (4 fractions of 5 Gy). Toxicity evaluation was done with RTOG scores for bladder and rectum, and the objective criteria of LENT-SOMA for vagina. RESULTS: With a median follow-up of 46.7 months (36.6-61 months) only two patients developed vaginal-cuff recurrence in Group 1 (2.1 %) and none in group 2 (0 %). Early toxicity in Group 1 appeared 5.3 % in rectum, 7.5 % in bladder (G1-G2) and 2.1 % in vagina (G1); late toxicity was present in 7.3 % in rectum (all G1-G2 but 1 G3) and in 27.7 % in vagina (all G1-G2 but one G4). In Group 2, 6.7 % developed acute G1-G2 bladder and 6.6 % acute vaginal (G1-G2) toxicity. No late rectal or bladder toxicity was observed; 21.7 % of G1-G2 presented late problems in vagina. CONCLUSIONS: The present HDR-BT schedule of 2 fractions of 5 Gy after EBI and 4 fractions of 5 Gy administered daily showed excellent results in terms of VCC and toxicity.

Unexpected bond activations promoted by palladium nanoparticles.

Thioether-phosphines, 1 and 2, were applied for the stabilisation of palladium nanoparticles (PdNPs) synthesised by a bottom-up methodology, using [Pd2(dba)3] as an organometallic precursor. For the phenyl containing ligand 1, small (d(mean) = 1.6 nm), well-defined and dispersed nanoparticles were obtained; however, ligand 2 involving a long alkyl chain led to agglomerates. NMR and GC-MS analyses throughout the synthesis of the nanomaterials revealed partial cleavage of ligands by C-S and C-P bond activations, and XPS spectra of the isolated nanoparticles indicated the presence of both thioether-phosphines and their fragments on the metallic surface. Reactivity studies of molecular palladium systems as well as on extended palladium surfaces pointed out that cluster entities are responsible for C-heteroatom activations, triggering structure modifications of stabilisers during the synthesis of PdNPs.

Catalyst life in imidazolium-based ionic liquids for palladium-catalysed asymmetric allylic alkylation.

A Pd/(S)-BINAP system was successfully applied to the asymmetric allylic alkylation of rac-1,3-diphenyl-3-acetoxyprop-1-ene () using imidazolium-based ionic liquids (ILs) attaining up to 225 h(-1) TOF and 88% ee of the (R)-product. Although the system was barely active in the recycling experiments, the catalyst life was confirmed after recharging the system with substrate/reactants resulting in an alkylated product. In the latter case, the conversion rates and enantiomeric excesses were similar or lower compared to those in the first cycle. In order to explain the observed catalyst performance in the recycling as well as in the recharging experiments, we investigated the reactivity between the catalyst precursors, substrate and reactants in ILs. We were able to identify the species involved in the catalytic reactions under various conditions by means of (31)P NMR analyses. Allylpalladium intermediates () were found to be the active and selective species at a high substrate concentration. When the substrate was consumed, competing reactions took place leading to different palladium complexes. [PdCl(NHC(Bu,Me))((S)-BINAP)]Cl (), together with [Pd((S)-BINAP)2] (), were recognised as the species responsible for the loss of activity, meanwhile, the decrease in enantioselectivity was accounted for by the formation of mixed (NHC)(monophosphine)-palladium species.

Three or four fractions per week in postoperative high-dose-rate brachytherapy for endometrial carcinoma. The long-term results on vaginal relapses and toxicity.

BACKGROUND: High-dose-rate brachytherapy (HDR-BT) is an accepted part of treatment for endometrial carcinoma and is usually performed in 1-2 fractions per week using different total doses and doses per fraction. To reduce the overall treatment time, HDR-BT was administered with a 3-4 days/week schedule. PATIENTS AND METHODS: From June 2003 to December 2008, 164 patients with stage I-IIIc endometrial carcinoma were treated with HDR-BT (4-5 Gy per fraction). The patients were divided into two groups; Group 1 (40/164 patients) was treated with HDR-BT alone (6 fractions; 4 fractions/week) and Group 2 (124/164 patients) was treated with both (External Beam Radiotherapy [EBRT] + HDR-BT: 3 fractions/week). Complications were analyzed using RTOG scores for rectum and bladder and the objective scores of LENT-SOMA for vaginal complications. RESULTS: The mean followup was 48 months. In Group 1, 35 % of patients underwent treatment in ≤10 days and 65 % in >10 days. In Group 2, 53.2 % received treatment in ≤5 days and in 46.8 % in >5 days. Vaginal relapse was observed in only two patients (1.2 %), both having received adjuvant EBRT + HDR-BT. Acute vaginal toxicity appeared in 8.5 % and late vaginal toxicity in 20.7 % of patients with 13.4 % being G1, 6.7 % G2 and only 0.6 % being G4. No statistically significant differences were found in complications in either brachytherapy group regardless of the overall time. CONCLUSION: In our series, three fractions given in 3-5/days after EBRT or six fractions in 10 days, is a safe regimen in terms of complications and local control.

The ground-dwelling arthropod community of Península Valdés in Patagonia, Argentina.

This is the first study based on a planned and intensive sampling effort that describes the community composition and structure of the ground-dwelling arthropod assemblage of Península Valdés (Patagonia). It was carried out using pitfall traps, opened for two weeks during the summers of 2005, 2006 and 2007. A total of 28,111 individuals were caught. Ants(Hymenoptera: Formicidae) dominated this community, followed by beetles (Coleoptera) and spiders (Araneae). The most abundant species were Pheidole bergi Mayr (Hymenoptera:Formicidae) and Blapstinus punctulatus Solier (Coleoptera: Tenebrionidae). Two new species were very recently described as new based on specimens collected during this study: Valdesianacuriosa Carpintero, Dellapé & Cheli (Hemiptera, Miridae) and Anomaloptera patagonica Dellapé& Cheli (Hemiptera, Oxycarenidae). The order Coleoptera was the most diverse taxa. The distribution of abundance data was best described by the logarithmic series model both at the family and species levels, suggesting that ecological relationships in this community could be controlled by a few factors. The community was dominated by predators from a trophic perspective. This suggests that predation acts as an important factor driving the distribution and abundances of surface-dwelling arthropods in this habitat and as such serves as a key element in understanding desert, above-ground community structure. These findings may also be useful for management and conservation purposes in arid Patagonia.

Prevalence, types, and geographical distribution of Listeria monocytogenes from a survey of retail Queso Fresco and associated cheese processing plants and dairy farms in Sonora, Mexico.

In the first part of this study, samples were collected from farms, cheese processing plants (CPPs), and retail markets located in various geographical areas of Sonora, Mexico, over a 12-month period during the summer of 2004 and winter of 2005. Four (all Queso Fresco [QF] from retail markets) of 349 total samples tested positive for Listeria monocytogenes (Lm). Of these four positive samples, three were collected in the northern region and one in the southern region of Sonora. Additionally, two were collected during the winter months, and two were collected during the summer months. For the second part of the study, a total of 39 samples from a farm, a CPP, and retail markets were collected and processed according to a combination of the Norma Oficial Mexicana NOM-143-SSA1-1995.10 method (NOM) and the U.S. Food and Drug Administration (FDA) Bacteriological Analytical Manual method, and 27 samples from these same locations were collected and processed according to the U.S. Department of Agriculture Food Safety and Inspection Service method (USDA-FSIS). The NOM-FDA method recovered the pathogen from 6 (15%) of 39 samples (one cheese and five product contact surfaces), while the USDA-FSIS method recovered the pathogen from 5 (18.5%) of 27 samples (all product contact surfaces). In addition, the 40 isolates recovered from the 15 total samples that tested positive for Lm grouped into five distinct pulsotypes that were ca. 60% related, as determined by pulsed-field gel electrophoresis analysis. The results of this study confirmed a 3.4% prevalence of Lm in QF collected from retail markets located in Sonora and no appreciable difference in the effectiveness of either the NOM-FDA or USDA-FSIS method to recover the pathogen from cheese or environmental samples.

[Photocontacs dermatitis due to dexketoprofen. Report of 2 cases]. / Fotodermatitis de contacto por dexketoprofeno. Descripción de dos casos.

Dexketoprofen is the active isomer of ketoprofen and likewise belongs to the group of non-steroidal anti-inflammatory drugs (NSAIDs) derived from propionic acid. We have recently studied, using patch and photopatch tests, two women with a characteristic clinical picture of contact photodermatitis who had used topical dexketoprofen (Enangel) in the days before onset of the rash. In both cases we used the standard series of GEIDC, a series for NSAIDs, the product itself (Enalgel) and its excipients. On examination of the photopatches of both patients at 96 hours we found positive reactions to dexketoprofen and Enalgel. Furthermore, in one of the women we observed simultaneous photosensitivity to other NSAIDs and to several excipients of Enangel. Reviewing the literature we have found only three references on contact photodermatitis due to dexketoprofen. We describe two new cases, with multiple photosensitivities in one of them. We consider that such patients should be patch tested with dexketoprofen at 0.1-1 % petrolatum, concentrations that are notably inferior to those used in previous publications.