Orthokeratology vs. orthokeratology combined with atropine for the control of myopia in children: systematic review.

The purpose of this investigation is to determine the efficacy of orthokeratology (OK) compared to orthokeratology combined with atropine (AOK) for the control of myopia in children. A systematic review that included systematic reviews with meta-analyses, as well as randomized and controlled clinical trials, was carried out in the PubMed, Web of Science, Scopus, Cochrane Library, ProQuest, Taylor & Francis, Science Direct databases, as well as a manual search. Of the Q1-Q4 journals of the Scimago Journal & Country Rank, published in the last 5 years in English and Spanish. Eighteen studies that met the eligibility criteria were considered. The articles selected included 6,866 patients for analysis, where orthokeratology combined with 0.01% atropine was found to be more effective due to its ability to reduce the progression of myopia and axial elongation. In our investigation, it was determined that there could be an additive effect in the combination of 0.01% atropine with orthokeratology in a period of 1-2 years of treatment in patients with mild myopia; however, more multiethnic studies should be carried out, in where a correct evaluation of the progression of myopia, genetic and environmental factors that may influence the results is considered.

Prior MRI-imaging impact of patients submitted to brachytherapy for prostate cancer.

INTRODUCTION: Brachytherapy for the treatment of prostate cancer is a well-established option. Use of Multiparametric Magnetic Resonance Imaging (mpMRI) for staging and diagnosis of prostate cancer has come to change the current paradigm. In this study we aim to assess the impact of performing mpMRI to evaluate the presence of extracapsular lesions before brachytherapy in patients with prostate cancer concerning biochemical recurrence and time to nadir. METHODS: Review data from 73 patients submitted to brachytherapy. The following factors were evaluated: age, initial PSA, MRI local staging results, ISUP, nadir, time to nadir, PSA at one-year, biochemical recurrence, and time to recurrence. RESULTS: Median age was 68 years (51-72) and median follow-up 53 months (30-72). Concerning imaging modality 30,1% (n = 22) patients performed mpMRI. In the mpMRI group, 90.9% (n = 20) had at least one suspect lesion on mpMRI. Time to nadir was 27 months (3-64) in patients where mpMRI was not performed and 23.5 months (2-48) in patients submitted to mpMRI (P = .244). The median value of nadir was 0.42 ng/mL (<0.001-2) in patients submitted to mpMRI and vs 0.28 ng/mL (<0.001-4) in patients without MRI (P = .062) Recurrence utilizing Phoenix criteria was 9% (n = 2) in patients with MRI and 9.2% (n = 5) without mpMRI (P = .456), median follow-up of 43 months (12-72) for the MRI group with 58 months (30-78) for the non-mpMRI group. Both groups were statistically similar. CONCLUSION: Our results allow us to conclude that in our series MRI did not influence biochemical recurrence, time to nadir, or nadir value.

Acute care for elderly patients in a functional impairment prevention unit. / Atención aguda a pacientes ancianos en una unidad de prevención del deterioro funcional.

AIM: To determine whether the care of patients with moderate dependency who were hospitalised in a functional impairment prevention unit (FIPU) was superior to that of a conventional unit (CU) in terms of functional impairment and mean stay. METHODS: We conducted a single-centre, retrospective, controlled intervention study that compared acute treatment in an FIPU and in conventional wards. The study included 466 elderly patients with moderate dependence (Barthel index, 30-70) and older than 75 years. Of these, 280 were included in the intervention group and 186 in the control group. The primary outcomes were loss of functionality attributable to the hospitalisation (measured by the loss of ambulation and urinary continence) and differences in the length of stay. RESULTS: The patients hospitalised in the FIPU showed less functional impairment as determined by the loss of urinary continence (2.1% of the FIPU patients vs. 9.7% of the CU patients; p<.01) and the loss of walking ability (2.1% vs. 25.3%; p<.01). The patients hospitalised in the FIPU had a shorter mean stay (7.4 vs. 8.5 days; p<.05), with 1 day less of stay than the CU patients. CONCLUSION: The acute care of elderly patients with moderate dependency in an FIPU was independently associated with less functional decline and shorter stays.

Anomalous mechanical behavior of nanocrystalline binary alloys under extreme conditions.

Fundamentally, material flow stress increases exponentially at deformation rates exceeding, typically, ~103 s-1, resulting in brittle failure. The origin of such behavior derives from the dislocation motion causing non-Arrhenius deformation at higher strain rates due to drag forces from phonon interactions. Here, we discover that this assumption is prevented from manifesting when microstructural length is stabilized at an extremely fine size (nanoscale regime). This divergent strain-rate-insensitive behavior is attributed to a unique microstructure that alters the average dislocation velocity, and distance traveled, preventing/delaying dislocation interaction with phonons until higher strain rates than observed in known systems; thus enabling constant flow-stress response even at extreme conditions. Previously, these extreme loading conditions were unattainable in nanocrystalline materials due to thermal and mechanical instability of their microstructures; thus, these anomalies have never been observed in any other material. Finally, the unique stability leads to high-temperature strength maintained up to 80% of the melting point (~1356 K).

Miniature pig model of human adolescent brain white matter development.

BACKGROUND: Neuroscience research in brain development and disorders can benefit from an in vivo animal model that portrays normal white matter (WM) development trajectories and has a sufficiently large cerebrum for imaging with human MRI scanners and protocols. NEW METHOD: Twelve three-month-old Sinclair™ miniature pigs (Sus scrofa domestica) were longitudinally evaluated during adolescent development using advanced diffusion weighted imaging (DWI) focused on cerebral WM. Animals had three MRI scans every 23.95 ±â€¯3.73 days using a 3-T scanner. The DWI imaging protocol closely modeled advanced human structural protocols and consisted of fifteen b-shells (b = 0-3500 s/mm2) with 32-directions/shell. DWI data were analyzed using diffusion kurtosis and bi-exponential modeling that provided measurements that included fractional anisotropy (FA), radial kurtosis, kurtosis anisotropy (KA), axial kurtosis, tortuosity, and permeability-diffusivity index (PDI). RESULTS: Significant longitudinal effects of brain development were observed for whole-brain average FA, KA, and PDI (all p < 0.001). There were expected regional differences in trends, with corpus callosum fibers showing the highest rate of change. COMPARISON WITH EXISTING METHOD(S): Pigs have a large, gyrencephalic brain that can be studied using clinical MRI scanners/protocols. Pigs are less complex than non-human primates thus satisfying the "replacement" principle of animal research. CONCLUSIONS: Longitudinal effects were observed for whole-brain and regional diffusion measurements. The changes in diffusion measurements were interepreted as evidence for ongoing myelination and maturation of cerebral WM. Corpus callosum and superficial cortical WM showed the expected higher rates of change, mirroring results in humans.

Strength and Viscosity Effects on Perturbed Shock Front Stability in Metals.

Computational modeling and experimental measurements on metal samples subject to a laser-driven, ablative Richtmyer-Meshkov instability showed differences between viscosity and strength effects. In particular, numerical and analytical solutions, coupled with measurements of fed-through perturbations, generated by perturbed shock fronts onto initially flat surfaces, show promise as a validation method for models of deviatoric response in the postshocked material. Analysis shows that measurements of shock perturbation amplitudes at low sample thickness-to-wavelength ratios are not enough to differentiate between strength and viscosity effects, but that surface displacement data of the fed-through perturbations appears to resolve the ambiguity. Additionally, analytical and numerical results show shock front perturbation evolution dependence on initial perturbation amplitude and wavelength is significantly different in viscous and materials with strength, suggesting simple experimental geometry changes should provide data supporting one model or the other.

Diagnóstico y tratamiento temprano de la maloclusión clase III / Early diagnosis and treatment of class III malocclusion

El objetivo del presente artículo es hacer una revisión de un tema muy importante como es el diagnóstico y tratamiento de la mal oclusión clase III en etapas tempranas, para lograr este objetivo se reunió a un grupo de residentes de Odontopediatría de diferentes universidades durante 6 meses, el cual realizó una búsqueda de información en las principales revistas y textos llegando a la conclusión de que la mal oclusión clase III es un síndrome dentofacial que genera mucha controversia en la odontología actual debido básicamente a la pregunta constante de los clínicos de cuándo será el momento oportuno para iniciar el tratamiento. La respuesta a esta interrogante dependerá de la gravedad de la mal oclusión y del estadío de crecimiento óseo en el que se encuentre el paciente; pero existen otras dimensiones a considerar como: las características clínicas, el correcto diagnóstico y las alternativas posibles de tratamiento (que serán necesarias para poder decidir acertadamente cuándo y cómo será el tratamiento de nuestro paciente). El objetivo de esta revisión bibliográfica es orientar al clínico sobre diversos aspectos; de esta maloclusión, existentes en la literatura...

The aim of this article is to make a review of a very important theme as is the diagnosis and treatment of Class III malocclusion in early stages. To achieve this goal, we gather a group of residents in pediatric dentistry from different universities during six months, this group per formed a search for information in the most important journals and texts, coming to the conclusion that Class III malocclusion is a dentofacial syndrome that generates a lot of controversy in dentistry today, basically due to the constant question of clinicians about when is the correct time to treat this malocclusion. The answer to this question will depend on the severity of the malocclusion and on the bone growth stage of the patient; but there are other dimensions to consider such as: clinical characteristics, the correct diagnosis and possible treatment alternatives (that will be necessary to take into consideration in order to correctly choose when and how the treatment of our patient will be). The aim of this review is to guide clinicians through all the different aspects of this malocclusion that may exist in literature...

Enfermedad de Lhermitte-Duclos o gangliocitoma displásico cerebeloso: reporte de un caso y revisión de la literatura / Lhermitte-Duclos disease or cerebellar dysplastic gangliocytoma: Case report and literature review

La enfermedad de Lhermitte-Duclos o gangliocitoma displásico cerebeloso es una entidad infrecuente que se presenta como un proceso expansivo de la fosa posterior, de lento crecimiento y patogenia desconocida. Puede estar asociada a otras anomalías congénitas. Presentamos el caso de un gangliocitoma displásico de cerebelo en un paciente de sexo masculino, de 77 años de edad, con antecedentes de adenocarcinoma prostático, que fue estudiado por tomografía computada (TC) y resonancia magnética (RM). Los hallazgos característicos, junto con una evaluación neuroquirúrgica y un manejo apropiados, permitieron efectuar el diagnóstico preoperatorio sin necesidad de recurrir a exámenes histopatológicos...

The Lhermitte-Duclos disease or dysplastic cerebellar gangliocytoma is an uncommon disorder that presents as an expansive, slow growing process of the posterior fossa, of unknown pathogenesis, that may be associated with other congenital anomalies.A case is presented of a dysplastic cerebellar gangliocytoma in a 77 year-old male patient, with a history of prostatic adenocarcinoma. A study was made using Computed Tomography (CT) and Magnetic Resonance (MRI), where the characteristic findings enabled a preoperative diagnosis to be made without need for histopathological examination, in addition to a neurosurgical evaluation and appropriate management...

Remating behavior in Anastrepha fraterculus (Diptera: Tephritidae) females is affected by male juvenile hormone analog treatment but not by male sterilization.

The sterile insect technique (SIT) has been proposed as an area-wide method to control the South American fruit fly, Anastrepha fraterculus (Wiedemann). This technique requires sterilization, a procedure that affects, along with other factors, the ability of males to modulate female sexual receptivity after copulation. Numerous pre-release treatments have been proposed to counteract the detrimental effects of irradiation, rearing and handling and increase SIT effectiveness. These include treating newly emerged males with a juvenile hormone mimic (methoprene) or supplying protein to the male's diet to accelerate sexual maturation prior to release. Here, we examine how male irradiation, methoprene treatment and protein intake affect remating behavior and the amount of sperm stored in inseminated females. In field cage experiments, we found that irradiated laboratory males were equally able to modulate female remating behavior as fertile wild males. However, females mated with 6-day-old, methoprene-treated males remated more and sooner than females mated with naturally matured males, either sterile or wild. Protein intake by males was not sufficient to overcome reduced ability of methoprene-treated males to induce refractory periods in females as lengthy as those induced by wild and naturally matured males. The amount of sperm stored by females was not affected by male irradiation, methoprene treatment or protein intake. This finding revealed that factors in addition to sperm volume intervene in regulating female receptivity after copulation. Implications for SIT are discussed.

First autochthonous malaria case due to Plasmodium vivax since eradication, Spain, October 2010.

In October 2010, one case of autochthonous malaria due to Plasmodium vivax was diagnosed in Spain. The case occurred in Aragon, north-eastern Spain, where the vector Anopheles atroparvus is present. Although the source of infection could not be identified, this event highlights that sporadic autochthonous transmission of vector-borne diseases in continental Europe is possible and calls for enhanced surveillance and vector control measures.

Risk factors for disease severity among hospitalised patients with 2009 pandemic influenza A (H1N1) in Spain, April - December 2009.

We describe the clinical and epidemiological characteristics of patients hospitalised with confirmed 2009 pandemic influenza A(H1N1) in Spain from April to December 2009 and the risk factors associated with a worse outcome (admission to an intensive care unit or death) in adults. Case-based epidemiological information was collected as part of the national strategy for the surveillance of severe cases. Of 3,025 patients, 852 were admitted to an intensive care unit and overall, 200 died. The median patient age was 38 years (range: 0­94). A total of 662 (26%) patients had no underlying risk conditions. Antiviral therapy was initiated within 48 hours after symptom onset in only 35.2% (n=711); the median length of time before treatment was four days. In a multivariate analysis, the start of antiviral therapy more than 48 hours after symptom onset (odds ratio (OR) 2.39; 95% confidence interval (CI): 1.79 to 3.2), morbid obesity (OR: 2.01; 95% CI 1.38 to 2.94), cardiovascular disease (OR: 1.79; 95% CI: 1.2 to 2.67) and chronic obstructive pulmonary disease (OR: 1.51; 95% CI: 1.03 to 2.2) were significantly associated with a worse outcome in adults.

Localized Kaposi's sarcoma in a patient with pemphigus vulgaris.

We report the case of a patient with a 13-year history of pemphigus vulgaris (PV) treated with immunosuppressive agents, prednisone and mycophenolate mofetil who had developed lesions of Kaposi's sarcoma (KS) on a sole plaque of PV that had been previously treated with intralesional injections of steroids. The lesions were surgically removed and polymerase chain reaction (PCR) demonstrated human herpesvirus-8 (HHV-8) DNA. There were neither recurrences nor later dissemination of KS following gradual decrease of the immunosuppressive therapy. We suggest that the treatment with intralesional steroids may have influenced the local reactivation of a latent infection of the virus, determining the appearance of this localized KS.

Sensitivity to Myroxylon pereirae resin (balsam of Peru). A study of 50 cases.

The Myroxylon pereirae resin (MP; balsam of Peru) is a natural resin used in the local treatment of burns and wounds. M. pereirae extracts and distillates are very often contained in a wide range of cosmetic products and causes frequently allergic contact dermatitis - to the extent of being considered an allergy marker to perfumes. We have carried out a retrospective study of 863 patients who have been submitted to patch tests from January 2002 to June 2004. A total of 50 patients were positive to MP. Thus, the prevalence was 5.79%, slightly higher in men (7.32%) than in women (4.91%). The positive patch tests were relevant in 64%. Over the last years, it appears that there is a clear increase of the prevalence of the sensitization to MP in all the studies published. We observe an increase of the prevalence especially in aged patients, where the sensitization is linked with the use of topical medications secondary to stasis dermatitis. The high frequency of allergy to MP in our area might be associated with manipulation of citrus fruits. The increasing use of cosmetic products by the male population can also be held responsible for the higher sensitization rate in this group of patients.

Strain mapping in nanowires.

A method for obtaining detailed two-dimensional strain maps in nanowires and related nanoscale structures has been developed. The approach relies on a combination of lattice imaging by high-resolution transmission electron microscopy and geometric phase analysis of the resulting micrographs using Fourier transform routines. We demonstrate the method for a germanium nanowire grown epitaxially on Si(111) by obtaining the strain components epsilon(xx), epsilon(yy), epsilon(xy), the mean dilatation, and the rotation of the lattice planes. The resulting strain maps are demonstrated to allow detailed evaluation of the strains and loading on nanowires.

[Evolution study in children with suspected obstructive sleep apnea]. / Datos evolutivos en niños estudiados por sospecha de síndrome de apnea del sueño.

INTRODUCTION: Obstructive sleep apnea syndrome is a common disorder in childhood with an uncertain evolution. OBJECTIVES: Study of children's clinical evolution with suspected diagnosis of OSAS, which was carried out after two years of an overnight polisomnogram. PATIENTS AND METHODS: 73 children were studied. We evaluated if they had been operated and what type of surgery was performed, Brouillete Scale and subjective impressions. We have correlated: age, clinical evolution and surgery. RESULTS: Age was inversely correlated with changes in Brouillete (r=-0.39, p=0.002), standing out that children that underwent surgery were younger (4.1 vs. 7.0 years, Student t: -4.22, p=0.00009). Without the influence of age, the difference between evolution in operated and not operated ones was not significative, statistically speaking, but it was if we analysed the different types of surgery by themselves (Snedecor F: 3.9, p=0.007), tonsillectomy was the larger. CONCLUSION: The middle-term evolution in children with OSAS is good if we use the correct treatment.

[Cognitive evoked potentials in autistic children]. / Potenciales evocados cognitivos en niños autistas.

AIMS: The aim of this study was to examine the latency, amplitude and distribution of N400 potential in order to evaluate the semantic processing capacity in autistic children and in children suffering from Asperger s syndrome (AS), and to compare them with a control group. PATIENTS AND METHODS: 24 autistic children, six boys with AS and 25 controls, aged between 6 and 14 years old. The cases were examined using the DSM IV diagnostic criteria. Auditory stimulation was performed with pairs of congruent and incongruent words: two lists of 20 pairs of semantically related words (congruent) and 20 pairs of words with no semantic relationship whatsoever (incongruent). RESULTS: The most striking parameter is the increase in latency in N400 for the group of autistic children, which did not occur in the group of children with AS. Maximum N400 negativity for the children with autism was found in the left frontocentral region. No significant differences were observed for the amplitude of N400 between the three groups that were studied. CONCLUSION: Neurophysiologically, the autistic children and those affected by AS perhaps use different neuronal networks in semantic processing. The N400 wave can be a valid test for monitoring verbal processing in these children.

[Landau kleffner syndrome]. / Síndrome de Landau Kleffner.

INTRODUCTION: The Landau Kleffner syndrome (SLK) is associated with paroxystic alterations of the electroencephalogram which are intensified during sleep, with acquired aphasia and epilepsy, in 75 83% of the cases. The syndrome is associated with other features, such as personality disorders presenting as autistic behaviour, cognitive regression and in some cases, motor dysfunction. The epileptic activity appears to be responsible for the disorder. Treatment with anti epileptic drugs is ineffective in many cases, although there may be periods of spontaneous improvement, or there may be permanent sequelas of language. Design. A systematic revision of one case. CASE REPORT: A five year old boy with no previous clinical history had, at the age of four years, presented with behaviour changes and aphasia, accompanied by paroxystic changes on the EEG and nocturnal polysomnogram. On cranial CT there was a mid line cyst. He had had no seizures. Treatment. Treatment with carbamazepine led to clinical improvement in behaviour, reduction in the paroxysms and appearance of sleep spindles, but little effect on the degree of aphasia. CONCLUSIONS: The case described is a variant of SLK, with no epileptic seizures, some improvement on carbamazepine and a mid line cyst.

[Significance of emergency care in the elderly patient]. / Importancia de la asistencia urgente en el paciente anciano.

OBJECTIVES: To analyse the statistical and characteristics of the attendance to the elderly patient at the Emergency Department of a General Hospital. METHODS: Retrospective study of patients > or = 65 years assisted at the Emergency Department of the Hospital Clínico San Carlos (Madrid), during 1998, taking into consideration different parameters as age, sex, time of year, referred pathology and final destination; results were compared with data relating to the population under 65. RESULTS: Over 28.4% of the 129,586 subjects that attended the Emergency Department were elderly people. Those ones aged between 65-74 years demanded assistance more frequently, being women's requests higher, particularly among the eldest patients. Assistance requests were higher in winter time, being the most common reason for consultation medical and surgical general troubles (76.4%), followed by trauma emergencies (12.35%). Hospital admission's percentage of elderly people was three times higher than the non-elderly ones, needing more admissions men than women (29 vs 22.7%). CONCLUSIONS: The high statistical of urgent attendance to the elderly patient compared with younger people as well as the higher number of admissions due to this assistance, seem to make necessary the implantation of Geriatric Evaluation Units at the hospital's Emergency Departments.