[Correlation between demyelinating lesions and executive function decline in a sample of Mexican patients with multiple sclerosis]. / Correlación entre las lesiones desmielinizantes y el deterioro de las funciones ejecutivas en una muestra de pacientes Mexicanos con esclerosis múltiple.

BACKGROUND: Multiple Sclerosis (MS) is characterised by several neurological symptoms including cognitive impairment, which has recently been the subject of considerable study. At present, evidence pointing to a correlation between lesion characteristics and specific cognitive impairment is not conclusive. OBJECTIVE: To investigate the presence of a correlation between the characteristics of demyelinating lesions and performance of basic executive functions in a sample of MS patients. PATIENTS AND METHODS: We included 21 adult patients with scores of 0 to 5 on the Kurtzke scale and no exacerbations of the disease in at least 3 months prior to the evaluation date. They completed the Stroop test and the Wisconsin Card Sorting Test (WCST). The location of the lesions was determined using magnetic resonance imaging (MRI) performed by a blinded expert in neuroimaging. RESULTS: Demyelinating lesions were more frequently located in the frontal and occipital lobes. The Stroop test showed that as cognitive demand increased on each of the sections in the test, reaction time and number of errors increased. On the WCST, 33.33% of patients registered as having moderate cognitive impairment. No correlation could be found between demyelinating lesion characteristics (location, size, and number) and patients' scores on the tests. CONCLUSION: Explanations of the causes of cognitive impairment in MS should examine a variety of biological, psychological, and social factors instead of focusing solely on demyelinating lesions.

Second world record for two Calvatia species (Agaricaceae: Basidiomycota).

Calvatia is a genus of gasteroid fungi, comprising about 47 species worldwide. In this paper we report the second worldwide occurrence of two poorly known species of Calvatia, recorded in the Cerrado biome of Brazil: C. oblongispora and C. nodulata. Detailed morphological descriptions and illustrations, including scanning electron micrographs of hyphae and basidiospores are provided, as well a discussion on their taxonomy and geographic distribution.

Extranuclear signaling by estrogen: role in breast cancer progression and metastasis.

The estrogen receptor (ERa) is implicated in the progression of breast cancer. Hormonal therapies which block ER functions or local and systemic estrogen production are currently used to treat ERa positive breast cancer. Hormonal therapy shows beneficial effects, however, initial or acquired resistance to endocrine therapies frequently occurs, and tumors recur as metastasis. Emerging evidence suggests in addition to exerting its well-studied nuclear functions, ERa also participates in extranuclear signaling that involve growth factor signaling components, adaptor molecules and the stimulation of cytosolic kinases. ERa extranuclear pathways have the potential to activate gene transcription, modulate cytoskeleton, and promote tumor cell proliferation, survival, and metastasis. Cytoplasmic/membrane ERa is detected in a subset of breast tumors and expression of extranuclear components ERa is deregulated in tumors. The extranuclear actions of ER are emerging as important targets for tumorigenic and metastatic control. Inhibition of ERa extranuclear actions has the potential to prevent breast tumor progression and may be useful in preventing ERa positive metastasis. In this review, we summarize the results of recent research into the role of ERa mediated extranuclear actions in breast tumorigenesis and metastasis.

Second world record for two Calvatia species (Agaricaceae: Basidiomycota) / Segundo registro mundial para duas espécies de Calvatia (Agaricaceae: Basidiomycota)

Abstract Calvatia is a genus of gasteroid fungi, comprising about 47 species worldwide. In this paper we report the second worldwide occurrence of two poorly known species of Calvatia, recorded in the Cerrado biome of Brazil: C. oblongispora and C. nodulata. Detailed morphological descriptions and illustrations, including scanning electron micrographs of hyphae and basidiospores are provided, as well a discussion on their taxonomy and geographic distribution.

Resumo Calvatia é um gênero de fungos gasteroides que compreende cerca de 47 espécies em todo o mundo. Neste artigo relatamos a segunda ocorrência de duas espécies pouco conhecidas de Calvatia, registradas no bioma Cerrado do Brasil: C. oblongispora e C. nodulata. Descrições morfológicas detalhadas e ilustrações são fornecidas, incluindo micrografias eletrônicas de varredura de hifas e basidiósporos, bem como uma discussão sobre sua taxonomia e distribuição geográfica.

Second world record for two Calvatia species (Agaricaceae: Basidiomycota) / Segundo registro mundial para duas espécies de Calvatia (Agaricaceae: Basidiomycota)

Calvatia is a genus of gasteroid fungi, comprising about 47 species worldwide. In this paper we report the second worldwide occurrence of two poorly known species of Calvatia, recorded in the Cerrado biome of Brazil: C. oblongispora and C. nodulata. Detailed morphological descriptions and illustrations, including scanning electron micrographs of hyphae and basidiospores are provided, as well a discussion on their taxonomy and geographic distribution.

Calvatia é um gênero de fungos gasteroides que compreende cerca de 47 espécies em todo o mundo. Neste artigo relatamos a segunda ocorrência de duas espécies pouco conhecidas de Calvatia, registradas no bioma Cerrado do Brasil: C. oblongispora e C. nodulata. Descrições morfológicas detalhadas e ilustrações são fornecidas, incluindo micrografias eletrônicas de varredura de hifas e basidiósporos, bem como uma discussão sobre sua taxonomia e distribuição geográfica.

Second world record for two Calvatia species (Agaricaceae: Basidiomycota)

Abstract Calvatia is a genus of gasteroid fungi, comprising about 47 species worldwide. In this paper we report the second worldwide occurrence of two poorly known species of Calvatia, recorded in the Cerrado biome of Brazil: C. oblongispora and C. nodulata. Detailed morphological descriptions and illustrations, including scanning electron micrographs of hyphae and basidiospores are provided, as well a discussion on their taxonomy and geographic distribution.

Resumo Calvatia é um gênero de fungos gasteroides que compreende cerca de 47 espécies em todo o mundo. Neste artigo relatamos a segunda ocorrência de duas espécies pouco conhecidas de Calvatia, registradas no bioma Cerrado do Brasil: C. oblongispora e C. nodulata. Descrições morfológicas detalhadas e ilustrações são fornecidas, incluindo micrografias eletrônicas de varredura de hifas e basidiósporos, bem como uma discussão sobre sua taxonomia e distribuição geográfica.

Puentes mucosos de la cuerda vocal, en la Unidad de Voz del Hospital Clínico de la Universidad de Chile: diagnóstico y manejo desafiante

Resumen Introducción: Los puentes mucosos (PM) corresponden a una banda de mucosa paralela al borde libre de la cuerda vocal, unido por anterior y posterior como un ojal. Su manejo no está estandarizado y la literatura al respecto es escueta, con cirugías con resultados no siempre predecibles. Objetivo: Descripción de las características clínicas de pacientes con PM y las técnicas quirúrgicas para su manejo, en la Unidad de Voz del Servicio de Otorrinolaringología del Hospital Clínico de la Universidad de Chile (HCUCH), discutiendo el desafío para su diagnóstico y manejo. Material y Método: Estudio retrospectivo, descriptivo, incluyendo pacientes con PM, entre los años 2013 y 2019 en HCUCH. La evaluación preoperatoria incluye anamnesis, examen físico, nasofibroscopía y/o telelaringoscopía, junto con estroboscopía. Resultados: Se incluyen 7 casos, con edad promedio de 37,4 años; todas mujeres, con diagnóstico realizado en pabellón, en una sola cuerda vocal. Se asoció a alteración estructural mínima (AEM) en el 100% de los casos y a patología benigna en 75%. Todos los pacientes consultaron por disfonía. El tratamiento fue elegido de acuerdo a cada paciente, con resección en todos los casos, con variadas técnicas de microcirugía laríngea, con infiltración de corticoides y/o grasa, además de fonoterapia. Conclusión: Los PM, deben sospecharse en disfonía crónica con respuesta no favorable a fonoterapia, en asociación a otras AEM, en particular en mujeres, con diagnóstico en el intraoperatorio con equipos adecuados, incluyendo consentimiento informado para eventual manejo quirúrgico. Es una patología poco frecuente, cuyo manejo no ha sido estandarizado, por lo que nuestra experiencia resulta relevante.

Abstract Introduction: Mucosal bridges (MB) correspond to a mucosa loop parallel to the free edge of the vocal fold, which is joined forward and backward. There is not a standardized procedure for its treatment and the literature in this regard is scarce and surgical management have not resulted in predictable outcomes. Aim: Description of clinical characteristics of patients with MB and the surgical techniques, in the Otorhinolaryngology Service at the Clinical Hospital Universidad de Chile (HCUCH), reflecting upon the challenge for its diagnosis and management. Material and Method: Retrospective and descriptive study, including patients with diagnosis of MB, between 2013 and 2019 in HCUCH. The preoperative evaluation includes anamnesis, physical examination, nasofibroscopy and/or telelaryngoscopy, along with the use of stroboscopy. Results: 7 cases were included, with an average age of 37.4 years; all women, with diagnosis made in the operating room, on a single vocal fold. It was associated with another minimal structural abnormality (MSA) in 100% of the cases, and with benign pathology in 75% of them. Dysphonia was the main symptom. The treatment was chosen individually, with resection in all cases, various laryngeal microsurgery techniques, infiltration of steroids and/or fat, in addition to speech therapy. Conclusion: MB should be suspected in cases of chronic dysphonia with an unfavorable response to speech therapy, in association with other MSAs, particularly in women, diagnosed intraoperatively with adequate equipment, including informed consent for eventual surgical management. It is a rare pathology, whose management has not been standardized therefore our experience is relevant.

Social cognitions as organizers of autonomic and affective responses to social challenge.

Autonomic and affective responses to children were assessed as a function of adult perceptions of interpersonal control. Women (N = 160) interacted with and provided feedback to computer-simulated children who "behaved" responsively or unresponsively on a computer game. Women were categorized as low in perceived control (PC) if they attributed high control to children but low control to self over negative events on the Parent Attribution Test. As predicted, low-PC women were maximally reactive to child characteristics, manifesting peak levels of defensive arousal (increased level of heart rate and electrodermal activity) and negative affect with unresponsive children and minimal levels of arousal and negative affect with responsive children. Intermediate response levels were shown by high-PC Ss. We interpreted results as suggesting mediating factors that may operate in dysfunctional interaction patterns previously found for low-PC caregivers.

Influencia auditiva de la pared posterosuperior del conducto auditivo externo, en la hipoacusia de conducción postimpanomastoidectomía / Hearing influence of the posterior ear canal wall, in the conductive hearing loss after tympanomastoidectomy

RESUMEN Introducción: El tratamiento de la otitis media crónica (OMC) colesteatomatosa es quirúrgico, cuyo objetivo es erradicar la enfermedad, evitar complicaciones y prevenir recurrencias. El gold standard es la timpanomastoidectomía con canal wall down (TCWD). Estudios en cadáver han definido que TCWD disminuye la audición 1-5 dB en frecuencias <1.000 Hz y 0-10 dB entre 1.000 y 3.000 Hz. De aquí nuestro interés por definir la influencia acústica de la pared posterosuperior del conducto auditivo externo (CAE). Objetivo: Determinar en cuantos decibeles se corrige la audición al reconstituir pared posterior del CAE pos-TCWD. Material y método: Trabajo experimental. A pacientes pos-TCWD se reconstituye de manera transitoria la pared posterior del CAE, realizándose audiometría pre y posprocedimiento. Resultados: 23 pacientes (25 oídos), promedio 48,8 años (18-72 años). En 96% existió una diferencia favorable al reconstruir la pared posterior, presentando una mejoría auditiva entre 1,2 y 10,6 dB (4,2 ± 2,8 dB). En frecuencias <1.000 Hz la mejoría fue de 6,0 dB (p <0,001), entre 1.000-3.000 Hz fue 2,6 dB (p <0,001) y >3.000 Hz no hubo diferencia. Considerando PTP de vía aérea la mejoría fue 4,6 dB (p <0,001). Conclusión: Nuestro estudio demuestra que existe mejoría auditiva en la gran mayoría de oídos evaluados al reconstituir la pared posterosuperior del CAE, alcanzando 6 dB en frecuencias <1.000 Hz y 2,6 dB en frecuencias medias. Si consideramos los PTP de vía aérea la mejoría es de 4,6 dB en presencia de pared posterior.

ABSTRACT Introduction: Cholesteatomas treatment is surgical and the goals are complete resection of it, to prevent complications and recurrences. The gold standard operative technique is canal wall down tympanomastoidectomy (CWDT), which reduces the recurrence rate lower than 2%. Studies on human temporal bones have defined that CWDT causes a decrease of 1 to 5 dB at frequencies below 1000 Hz and 0 to 10 dB between 1000 and 3000 Hz. Aim: To determine how many decibels the hearing is improved by reconstituting the posterior wall of the ear canal (EC) in patients after CWDT. Material and method: Experimental study. In patients after CWDT, the posterior wall of EC was reconstructed temporarily. Audiometry was performed before and after the procedure. Results: 23 patients were enrolled (25 ears evaluated). Average age 48.8 years (range 18 to 72 years). In 96% of the ears there was a difference after the procedure with a hearing improvement of 4.2 ± 2.8dB. In frequencies below 1000 Hz, hearing improvement was 6.0 dB (p<0.001), between 1000-3000 Hz, the improvement was 2.6 dB (p<0.001) and >3000 Hz there was no difference. When considering the airway-conduction pure tone average (PTA), the difference was a 4.6 dB improvement (p<0.001). Conclusions: Our study shows that there is a hearing improvement in the vast majority of ears that were evaluated by reconstituting the posterior wall of the EC, reaching a gain of 6 dB at frequencies <1000 Hz and 2,6 dB at mid frequencies. Considering the airway PTA, the improvement is 4.6 dB in the presence of posterior canal wall.

Crisis otolítica de Tumarkin: revisión de la literatura / Tumarkin's otolithic crisis: a review

Las crisis de Tumarkin consisten en caídas bruscas al suelo sin pródromos previos ni pérdida de conciencia y de segundos de duración que pueden ocurrir con frecuencia relativa en pacientes con enfermedad de Ménière. Si bien pueden presentarse de manera aislada durante la evolución de la enfermedad, existen casos con crisis recurrentes que comprometen significativamente la calidad de vida de los pacientes. Se postula que las crisis se producen por una alteración de la función del órgano otolítico, específicamente del sáculo. El tratamiento puede ser desde el manejo expectante hasta el uso de laberintectomía química o quirúrgica.

Tumarkin´s otolithic crisis is a sudden fall that comes with no loss of consciousness, and without warning or prodrome. It has a short duration and can occur with relative frequency in patients with Meniere disease. When it is present, it significantly compromises life quality of patients. There is no certainty about its mechanism, but it is assumed that the crises are caused by an otolithic organ disfunction, specifically a collapse of the saccule. Treatment can range from observation to chemical or surgical labyrinthectomy.

Reflujo faringolaríngeo: revisión de los nuevos métodos diagnósticos / Laryngopharyngeal reflux: a review of new diagnostic methods

El reflujo faringo laríngeo (RFL), es una causa común de morbilidad del tracto aerodigestivo superior. A pesar de su alta prevalencia, aún existe controversia respecto de la precisión diagnóstica de esta enfermedad, así como de su fisiopatología y manejo. Los test diagnósticos actuales aún presentan limitaciones significativas, de ahí que surja el interés por encontrar métodos rápidos y eficientes que mejoren su pesquisa. El presente trabajo tiene por objeto la revisión de la literatura actual en cuanto a los métodos disponibles para su diagnóstico.

The laryngopharyngeal reflux is a common cause of morbidity of the upper aerodigestive tract. Despite its high prevalence, there is still controversy regarding the diagnostic accuracy of this disease and its pathophysiology and management. The current diagnostic test still have significant limitations, hence the interest arises to find fast and efficient methods to improve their research. This paper aims to review the current literature regarding available methods for diagnosis.

Interferencia del receptor del factor de crecimiento epidermoide (EGFR) y su utilidad como adyuvante en el tratamiento del cáncer avanzado de cabeza y cuello / Interference of epidermal growth factor receptor (EGFR) and its usefulness in the treatment of advanced head and neck cancer

El receptor del factor de crecimiento epidermoide (EGFR) se encuentra sobreexpresado en más del 90% de los tumores escamosos de cabeza y cuello. Se han desarrollado diversos métodos para interferir con el EGFR entre los cuales el más utilizado es el anticuerpo monoclonal cetuximab. En esta revisión se discuten los resultados disponibles a la fecha del uso de cetuximab como adyuvante al tratamiento de pacientes con carcinomas avanzados de cabeza y cuello.

Epidermal growth factor receptor is overexpressed in more than 90% of the cases of head and neck squamous cell carcinoma (SCCHN). The addition of the monoclonal antibody cetuximab to therapy in patients with advanced SCCHN is discussed in this review.

Physiological reactivity to responsive and unresponsive children as moderated by perceived control.

80 undergraduate women, pretested on the Parent Attribution Test (PAT), watched videotapes of responsive and unresponsive children in anticipation of subsequent interaction with them. Physiological measures (heart rate, skin temperature, and skin conductance) were monitored as subjects viewed videotapes and during a postinterview. Subjects who perceived caregiving failure as uncontrollable (on the PAT) were significantly more reactive to variations in child responsiveness than were those who perceived failure as controllable. The highest level of arousal (elevated heart rate and skin conductance) was manifested by "low-control" women anticipating interaction with unresponsive children. The increased arousal level shown in reaction to unresponsive children was accompanied by decreased skin temperature--suggesting the presence of fear or anxiety. Results were interpreted as indicating the importance of social cognitions as moderators of caregiver response to child behavior.

Priming of perceived control in young children as a buffer against fear-inducing events.

Young children (aged 5 and 6) watched videotaped fairy tales that acted to prime child control versus adult control over frightening events. Subsequently, they watched an ambiguous videotape of a child having a medical exam; tapes were varied for presence or absence of fear cues (facial expressions shown by actors). We predicted that children primed for child control versus adult control would show information-processing error patterns that paralleled those previously found for children who were dispositionally high or low in perceived control. As expected, children primed for child control showed processing enhancement whereas those primed for adult control showed processing deficits after witnessing fear cues. Attentional disengagement was found to mediate processing errors. Perceived control--dispositional or temporary--was interpreted as an important organizer of attention to and processing of potentially threatening events.

Influences of witnessed affect on information processing in children.

Children between the ages of 5 and 10 years watched a videotape of a child having a routine medical exam. Embedded within the scenes were systematic variations of depicted facial affect shown by doctor and child. Measures were taken of autonomic reactions and information-processing errors in response to positive, neutral, and negative affective cues. For 5-6-year-olds, processing errors were greatest in the negative affect condition. Additionally, peak increases in heart rate (HR) and skin conductance level (SCL) were demonstrated by 5-6-year-olds in response to negative affect shown by the witnessed child; increases in HR were in turn predictive of processing errors. Older children (9-10 years) showed trends reflecting reduced processing errors in response to witnessed negative affect. It was suggested that younger children respond to salient threat cues with a "defensive" response pattern that is relatively adaptive at younger but not older ages.

Un instrumento para el registro sistematico de la comunicación no verbal (CONOVER) / An instrument for systematic registration of non-verbal communucation: CONOVER

Se desarrolla un instrumento estructurado (CONOVER), que intenta descifrar la comunicación no verbal, mediante un registro sistemático en los primeros y en los 10 últimos minutos de la primera entrevista, utilizando video-tapes. Para ello, se elaboró una ficha de registro de 113 unidades de conducta no verbal, que están contenidas en 174 itens. Para probar su confiabilidad se hizo un estudio piloto en 10 sujetos (5 varones y 5 mujeres) y se fijó como criterio de confiabilidad el 80% o más de acuerdos interevaluador. Los resultados arrojaron, que de las 174 variables, 153 superaron el 90% de confiabilidad y 21 variables tienen un rango que oscila entre el 80 y 90 por ciento. Así, se homogenizó a los 4 evaluadores y se probó fehacientemente la confiabilidad de la observación

Diagnóstico situacional de los hogares educativos comunitarios: proyecto Wawa-Wasi / Situational diagnosis of the educational community house: wawa-wasi project

El cuidado de sus niños pequeños es una necesidad de la comunidad que ha venido siendo atendida de diverso modo. En 1993 se formaliza la atención de los infantes a través de Hogares Educativos Comunitarios o Proyecto Wawa-Wasi. Paralelamente, el Programa de Salud Mental Comunitario del Instituto Nacional de Salud Mental "Honorio Delgado-Hideyo Noguchi" crea un subprograma específico de salud mental del pre-escolar, a través del cual se realiza un diagnóstico situacional de 34 de tales servicios ubicados en el distrito de Independencia. Los resultados evidencian algunas deficiencias en el ambiente físico así como en la capacitación y desempeño de roles de la madre educadora, para las cuales se sugieren recomendaciones.

The care of children is a social need that has attended in different ways. Since 1993 the care was made official through the Wawa-Wasi project or Educational Community Houses. Complementary, the Community Mental Health Program of the Instituto Nacional de Salud Mental Honorio Delgado-Hideyo Noguchi (Lima, Peru) develops an specific pre-school children subprogram and on this ground a situational diagnosis of 34 of these services located in Independencia district was made. Results show some deficiencies of the physical environment as well as of the level of training and role performance of the educator mother for which recommendations are suggested.

Diagnóstico clínico y características ultrasonográficas del aborto completo / Clinical diagnosis and ultrasound characteristics of complete abortion

En 211 pacientes se estudian las caracteríscas clínicas y ultrasonográficas que permiten plantear el diagnóstico de aborto completo. Se evalúa el rendimiento del diagnóstico clínico y las características al ultrasonido, con el fin de reducir el error diagnóstico y disminuir las complicaciones producto de esa falla. La precisión del diagnóstico clínico de aborto completo fue similar en los dos grupos estudiados (Grupo 1: diagnóstico clínico exclusivo; Grupo: 2: diagnóstico clínico más característica ecográficas): 95,2 por ciento y 94,4 por ciento respectivamente. El grosor endometrial fue el único elemento ultrasonográfico útil para determinar la paciente con riesgo de legrado posterior por restos ovulares. Con grosor mayor de 15 mm hubo un RR de 15,6 y con 20 mm, RR de 31