Decompositions of the polyhedral product functor with applications to moment-angle complexes and related spaces.

This article gives a natural decomposition of the suspension of a generalized moment-angle complex or partial product space which arises as the polyhedral product functor described below. The introduction and application of the smash product moment-angle complex provides a precise identification of the stable homotopy type of the values of the polyhedral product functor. One direct consequence is an analysis of the associated cohomology. For the special case of the complements of certain subspace arrangements, the geometrical decomposition implies the homological decomposition in earlier work of others as described below. Because the splitting is geometric, an analogous homological decomposition for a generalized moment-angle complex applies for any homology theory. Implied, therefore, is a decomposition for the Stanley-Reisner ring of a finite simplicial complex, and natural generalizations.

Double innervation of the brachialis muscle: anatomic-physiological study.

INTRODUCTION: Double innervation of the brachialis muscle has been previously reported in anatomical studies. This study aims to investigate the frequency and clinical significance of double innervation of brachialis by anatomical and electromyographic techniques. MATERIALS AND METHODS: (1) The existence, origin and pattern of distribution of a branch from the radial nerve to brachialis were dissected on 20 cadaveric arms. (2) Nerve conduction studies (NCS) of 100 patients were performed. The radial nerve was stimulated, registering muscle potentials (MP) in the brachialis muscle. Subsequently, another MP was obtained by Erb's stimulation, corresponding to the whole brachialis innervation. The relative percentage of innervation from the radial nerve was calculated. (3) Two patients with lesions of the lateral cord of the brachial plexus and preserved elbow flexion were submitted to NCS. RESULTS: Double innervation was found in 65 % of the anatomical preparations, following different patterns of distribution. In the NCS, 90% of the patients showed MP in the brachialis muscle after stimulating the radial nerve. The mean percentage of relative innervation was 11 %. Two patients with lesions of the lateral cord showed an important contribution from the radial nerve. CONCLUSIONS: Variations in the relative percentage of innervation from the radial nerve could be due to the different sizes and shapes of this branch. The functional significance of this branch can become crucial if the main innervation to the brachialis muscle fails. When planning surgical antero-external approach to the humerus, it should be kept in mind and preserved.

Logistics and safety of edaravone treatment for amyotrophic lateral sclerosis: experience in Argentina.

Since 2015, edaravone is the second drug available for the treatment of Amyotrophic lateral sclerosis (ALS). In this study we analyzed the characteristics and experience of ALS patients treated with this new medication in our country. Sixteen ALS patients were treated with edaravone infusions in three ALS clinics. Most of them were male, had a spinal onset of the disease and a definite diagnosis of ALS. Mean age at first infusion was 53.5 years. Since the diagnosis of ALS, delay in starting treatment with edaravone was five times greater than that of riluzole. Edaravone therapy was usually initiated at a health care facility and was followed by domiciliary cycles. Adverse effects and the need of a special catheter for infusion were rare. Access to edaravone through health insurance was possible in only 43.8% of patients. Altogether, treatment access was limited but feasible and edaravone was well tolerated.

[Principal conclusions of the Argentine Consensus on Arterial Hypertension]. / Principales conclusiones del Consenso Argentino de Hipertensión Arterial.

A summary is presented in this article of the principal concepts of the Argentine Consensus on Arterial Hypertension, which has been carried out for the first time jointly by the three main scientific societies associated with the diagnosis and treatment of arterial hypertension in Argentina (Argentine Society of Arterial Hypertension, Argentine Society of Cardiology and Argentine Federation of Cardiology). Among its main points, is emphasised the need to improve the diagnosis and control of high blood pressure, the use of ambulatory blood pressure measurement techniques, the importance of the risk stratification of the hypertensive patient, and the early use of pharmacological combinations in the treatment as a means to quickly achieve control. Finally, it lists the main recommendations for the management of hypertension in special populations, such as pregnant women, elderly people, diabetics, resistant patients, as well as patients with chronic kidney disease.

[Chronotherapy in arterial hypertension]. / Cronoterapia en hipertensión arterial.

The blood pressure profile in most normo- and hypertensive subjects are currently known, as well as the impact their changes induced on the cardio- and cerebrovascular risk. Ambulatory blood pressure monitoring (ABPM) has contributed greatly to the knowledge of this parameter. It to correct the schedule of drug administration (chronotherapy) with changes in any component of the BP profile that have better correlation with risk. These include the nocturnal decrease and the morning BP surge. Investigations in this direction are still scarce, and multicenter studies need to be conducted that can answer the true preventive impact of such modifications.

Blood pressure control in children of Cordoba, Argentina.

The aims of the present study were 1) to evaluate blood pressure (BP) and its distribution curve in a highly representative population of children and adolescents from Cordoba, Argentina, to determine the normal BP pattern, and 2) to establish the relation between other factors and BP levels. BP data recorded during the years 1984-1987 were evaluated in 280,584 children and adolescents aged 5-15 years (52.1% boys and 47.9% girls) corresponding to the nine sanitary districts of the province (urban, rural, mountain, and plains areas), which represent 75% of the children of the whole province. Recordings were carried out by trained physicians who used pediatric BP cuffs and calibrated sphygmomanometers. Korotkoff periods 1 and 5 were considered as the systolic and diastolic BP, respectively. BP was recorded in groups of three to five students with students in a sitting position as part of the routine physical examination and after a thorough explanation of the methodology. For statistical analysis, the Student's t test and stepwise regression analysis were used. Percentile tables and curves were prepared for each age and sex group. Weight and height values were added to the information obtained. Diastolic BP was greater in girls than in boys between the ages of 11 and 14. Systolic BP was lower and diastolic BP was higher in the US Task Force study compared with these findings. Of all the independent variables evaluated, weight influenced BP the most. Age had less influence on BP when height and weight were normalized by regression analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Cognitive and motor differences among low birth weight infants: impact of intraventricular hemorrhage, medical risk, and social class.

The independent impacts of severe intraventricular hemorrhage, other common medical complications of prematurity, and socioeconomic status on the development in the second year of life of 32 low birth weight subjects were explored. Outcome measures included standard tests of mental and motor development, an evaluation of language competence, and an assessment of information processing ability in a habituation/recovery paradigm. Partial correlations indicated that intraventricular hemorrhage influences cognitive and motor development independently of the other predictor variables. Socioeconomic status predicted language ability and recovery of attention to a novel stimulus independent of the other predictors. Medical complications other than intraventricular hemorrhage also made an independent contribution to the variance in language outcome. Implications of these findings are discussed.

Visitation to a neonatal intensive care unit.

Preterm newborns may experience extended periods of hospitalization which disrupt the normal early contact between the newborn and its family. Variations in the frequency of visits to 164 preterm neonates in a neonatal intensive care unit were examined in relation to infant and family status variables and compliance with follow-up appointments at 3 months postterm. The mean number of visitors decreased from day 2 to day 12 of hospitalization and then remained stable through day 21. There was a corresponding increase in the number of days with no visitors through day 12, and then stabilization. Neonates who had intraventricular hemorrhages, whose parents did not live together, and who were not firstborn had the most days with no visitors. While the mother was hospitalized herself, her condition was the only variable related to percentage of no-visitor days. The sicker the mother, the more likely the newborn had no visitors. The greater the number of days with no visitors, the poorer the likelihood that the infant was brought to a 3-month follow-up clinic appointment.

Treatment of patients with essential hypertension: amlodipine 5 mg/benazepril 20 mg compared with amlodipine 5 mg, benazepril 20 mg, and placebo.

This multicenter, double-masked, randomized, parallel-group study compared the efficacy, tolerability, and safety of amlodipine 5 mg/benazepril 20 mg, amlodipine 5 mg, benazepril 20 mg, and placebo in patients with essential hypertension. After a placebo run-in period, 308 patients (all white) were randomized to treatment groups and took medication once daily for 8 weeks. Blood pressure was measured after 4 and 8 weeks of treatment in the 23- to 26-hour period after dosing. Patients wore a noninvasive blood pressure monitor for 24 hours before randomization and before the final visit. Investigators recorded adverse experiences at randomization and at study weeks 4 and 8, and obtained specimens for laboratory testing at randomization and at study week 8. Three hundred seven patients were evaluated for efficacy, and 308 for tolerability and safety. At end point (the last postrandomization measurement for each patient), the reduction in mean sitting diastolic blood pressure with the amlodipine 5 mg/benazepril 20 mg treatment was statistically significantly greater than with any comparative therapy. The results of 24-hour monitoring showed that the amlodipine/benazepril treatment, unlike monotherapy, maintained the hourly mean diastolic blood pressure at < or = 90 mm Hg. A responder rate of 87.0% was observed with amlodipine 5 mg/benazepril 20 mg versus 67.5%, 53.3%, and 15.8% with amlodipine, benazepril, and placebo, respectively. This difference between the amlodipine/benazepril treatment group and each comparative single-agent treatment group was statistically significant. Drug-related adverse events occurred in 15.6% of patients in the amlodipine/benazepril group and in 24.7%, 6.5%, and 11.7% of patients in the amlodipine, benazepril, and placebo groups, respectively. Edema occurred less often in the amlodipine/benazepril group than in the amlodipine group. Overall, once-daily therapy with amlodipine 5 mg/benazepril 20 mg provided an antihypertensive effect that was statistically and clinically superior to amlodipine 5 mg alone, benazepril 20 mg alone, and placebo, was well tolerated, and was associated with less edema than the amlodipine treatment.

Arousal modulation in cocaine-exposed infants.

The ability to modulate arousal is a critical skill with wide-ranging implications for development. In this study, the authors examined arousal regulation as a function of levels of prenatal cocaine exposure in 107 infants at 4 months of age using a "still-face" procedure. Facial expressions were coded. A greater percentage of heavily cocaine-exposed infants, compared with those who were unexposed to cocaine, showed less enjoyment during en face play with their mothers and continued to show negative expressions during the resumption of play following a period when the interaction was interrupted. This finding was independent of other substance exposure, neonatal medical condition, environmental risk, maternal contingent responsivity, and concurrent maternal sensitivity and vocalizations.

Cognitive functioning in 8- to 18-month-old drug-exposed infants.

This study examined the cognitive functioning in 236 infants at 8 and 18 months of age. Thirty-seven infants were heavily exposed to cocaine in-utero, 30 were lightly exposed, and 169 were not exposed to cocaine. Cognitive functioning was evaluated with the Bayley Scales of Infant Development (2nd ed.; N. Bayley, 1993) at both ages. Infant information processing was also assessed with an infant-controlled habituation procedure. Results indicated that (a) infants of cocaine-abusing women had higher neonatal medical and environmental risk scores; (b) at 8 months, exposure groups did not differ in Psychomotor Development Index, Mental Development Index (MDI) scores, or recovery to a novel stimulus; and (c) infants heavily exposed to cocaine or high environmental risk had a decrease in MDI scores from 8 to 18 months. These results were obtained when neonatal medical and environmental risk, as well as polydrug exposure, were controlled.

Early language ability as a function of ventricular dilatation associated with intraventricular hemorrhage.

This study examined the impact of right and left lateral ventricle dilatation on early language function associated with intraventricular hemorrhage (IVH). Because language is controlled primarily by the left cerebral hemisphere, it was hypothesized that language ability would be related to extent of left side dilatation more than to right. The relations of the number of other common complications of prematurity and socioeconomic status to language also were explored, and their independent contributions to the variance in the outcome were determined. The receptive and expressive language abilities of 45 low birth weight preterms, 18 of whom suffered IVH, were evaluated at a mean age of 16 months. Correlational analyses indicated that left, but not right, ventricle dilatation was inversely related to the expressive language measure. Partial correlations, holding the effects of medical complications and socioeconomic status constant, indicated that the impact of left ventricle dilatation was independent of these variables. Number of medical complications also had an independent relation to expressive language outcome that was equivalent to that of the left ventricle dilatation. Implications of these findings are discussed.

The impact of birth order on mother-infant interactions in preterm and sick infants.

Maternal-infant interaction patterns were observed for high-and low-risk, first-, and later-born infants at 3 months of age. The high-risk subjects included healthy preterm infants, sick preterm infants, and sick full-term infants. "Sickness" at birth was defined as respiratory distress or birth asphyxia. The low-risk group consisted of healthy full-term infants. The subjects were divided into first-born and later-born groups. Birth order was expected to interact with prematurity and illness in affecting maternal behavior. Multivariate analyses of variance indicated that this was the case; birth order had a significant impact among the high-risk but not the low-risk subjects. First-born preterm infants received more overall maternal stimulation than later-born preterms. Sick first-borns had more responsive mothers than sick later-born infants. The results suggest that high-risk later-born infants may be at greater risk as a result of both birth trauma and less optimal maternal interaction patterns.

Effects of intraventricular hemorrhage and other medical and environmental risks on multiple outcomes at age three years.

This study examined the interrelated effects of intraventricular hemorrhage (IVH), neonatal medical condition, and environmental quality on development. At age 3 years, the functioning of 105 preterms was assessed in a variety of cognitive areas. Analyses revealed that IVH was related to gross motor, receptive, and expressive communication ability. However, it was only the subjects who had severe IVH who performed significantly worse than the comparison subjects. Subjects who had hemorrhages confined to a germinal matrix or a small intraventricular bleed did not differ from the comparison subjects who performed at expected age levels. When medical condition, socioeconomic status, and family risk, a composite variable including proximal environmental measures, were examined together with IVH as predictors, IVH remained related to motor and receptive communication ability after controlling for the other variables. The number of other medical complications and the environmental factors had more wide-ranging effects. Each predictor was related to a unique set of outcomes.

Developmental implications of head growth following intracranial hemorrhage.

This study examined the association between head size at birth, discharge, and 1 year and developmental outcome at 1 year in preterm infants, with and without intracranial hemorrhages (ICH) or associated periventricular echodensities (PVE). The data indicated that most sick preterm infants with small heads at discharge achieved appropriate head sizes at 1 year. Analyses of the 1-year mental and motor performances of 125 subjects revealed that for subjects who did not develop ICH, appropriate head sizes at birth and discharge were associated with good developmental outcome, whereas infants with small heads (< two standard deviations below the mean for age) before hospital discharge were more likely to show poorer developmental outcome at 1 year. For subjects with ICH, birth and discharge head circumference were not predictive of 1-year developmental status; however, normal head size at 1 year was associated with better outcome. This was true for children with transient PVE as well. However, persistent periventricular echodensities were associated with both mental and motor deficits at 1 year, regardless of head growth.

Principales conclusiones del Consenso Argentino de Hipertensión Arterial / Principal conclusions of the Argentine Consensus on Arterial Hypertension

El presente artículo resume los conceptos principales del Consenso Argentino de Hipertensión Arterial, realizado por primera vez en forma conjunta por las 3 principales sociedades científicas relacionadas al diagnóstico y tratamiento de la hipertensión arterial en Argentina (Sociedad Argentina de Hipertensión Arterial, Sociedad Argentina de Cardiología y Federación Argentina de Cardiología). Entre sus puntos principales se enfatiza la necesidad de mejorar el diagnóstico y control de la hipertensión arterial, la utilización de técnicas de medición ambulatoria de la presión arterial, la importancia de la estratificación de riesgo del paciente hipertenso y el uso precoz de combinaciones farmacológicas en el tratamiento como medio de alcanzar rápidamente el control. Finalmente se enumeran las principales recomendaciones del manejo de la hipertensión en poblaciones especiales como embarazadas, adultos mayores, diabéticos, hipertensos resistentes y pacientes con enfermedad renal crónica

A summary is presented in this article of the principal concepts of the Argentine Consensus on Arterial Hypertension, which has been carried out for the first time jointly by the three main scientific societies associated with the diagnosis and treatment of arterial hypertension in Argentina (Argentine Society of Arterial Hypertension, Argentine Society of Cardiology and Argentine Federation of Cardiology). Among its main points, is emphasised the need to improve the diagnosis and control of high blood pressure, the use of ambulatory blood pressure measurement techniques, the importance of the risk stratification of the hypertensive patient, and the early use of pharmacological combinations in the treatment as a means to quickly achieve control. Finally, it lists the main recommendations for the management of hypertension in special populations, such as pregnant women, elderly people, diabetics, resistant patients, as well as patients with chronic kidney disease