Is external cephalic version at term contraindicated in previous caesarean section? A prospective comparative cohort study.

OBJECTIVE: To determine if external cephalic version (ECV) can be performed with safety and efficacy in women with previous caesarean section. DESIGN: Prospective comparative cohort study. SETTING: Cruces University Hospital (Spain). POPULATION: Single pregnancy with breech presentation at term. METHODS: We compared 70 ECV performed in women with previous caesarean section with 387 ECV performed in multiparous women (March 2002 to June 2012). MAIN OUTCOME MEASURES: Success rate, complications of the ECV and caesarean section rate. RESULTS: The success rate of ECV in women after previous caesarean section was 67.1% versus 66.1% in multiparous women (P = 0.87). The logistic regression analysis confirmed this result (odds ratio 0.93, 95% CI 0.52-1.68; P = 0.82) adjusted by the variables associated with success of ECV. There were no complications in the previous caesarean section cohort. The vaginal delivery rate in the previous caesarean section cohort was 52.8% versus 74.9% in the multiparous cohort (P < 0.01). There were no cases of uterine rupture. CONCLUSION: Based on our data, we conclude that complications are uncommon with ECV in women with previous caesarean section, with a success rate comparable to that of multiparous women. Uterine scar should not be considered a contraindication and ECV should be offered to women with previous caesarean section with breech presentation at term.

Combined alternating gradient force magnetometer and susceptometer system.

We report the design, fabrication, and characterization of a new system that combines the performances of two different types of magnetic characterization systems, Alternating Gradient Force Magnetometers (AGFM) and susceptometers. The flexibility of our system is demonstrated by its capability to be used as any of them, AGFM or susceptometer, without any modification in the experimental set-up because of the electronics we have developed. Our system has a limit of sensitivity lower than 5 × 10(-7) emu. Moreover, its main advantage is demonstrated by the possibility of measuring small quantities of materials under DC or AC magnetic fields that cannot properly be measured with a commercial vibrating sample magnetometers or AGFM.

Management of breech presentation at term: a retrospective cohort study of 10 years of experience.

OBJECTIVE: To evaluate the impact of management of childbirth (external cephalic version (ECV) plus planned vaginal delivery (PVD)) of breech presentation at term (⩾37 weeks of gestation). STUDY DESIGN: This retrospective cohort study was based on data collected of singleton breech presentations at term in the Obstetrics and Gynaecology Service, Cruces University Hospital (Biscay, Spain), from January 2003 to December 2012. RESULT: We attended 2377 singleton breech pregnancies at term. We attended 1684 singleton breech term deliveries, attempting vaginal delivery after selection in 52.9% of cases and were successful in 57.5% of attempts. A total of 1360 ECV were attempted, with a success rate of 50.3% of those attempted. The use of ECV has decreased the rate of breech presentation at delivery by 39.0%, the rate of breech presentation as a caesarean section (CS) indication by 47.1% (CS due to breech presentation/total of CS) and the rate of CS for breech presentation out of the total of deliveries by 39.1% (CS due to breech presentation/total of deliveries). Early postnatal parameters (5-min Apgar score, umbilical cord arterial pH and acid-base analysis) were significantly lower following PVD compared with planned CS for breech presentation. However, we did not find any differences in the rates of admissions to the neonatal unit or neonatal mortality. CONCLUSION: Management of breech presentation with a protocol that includes ECV, careful selection criteria and active management of vaginal delivery achieve a great decrease in the rate of CS for breech presentation.

Embryonic development of pineal gland vesicles: a morphological and morphometrical study in chick embryos.

Pineal cell aggregates in 5, 10 and 15 day-old chick embryos have been studied. Cell aggregates were classified into rosettes or vesicles and spheroid and ellipsoid vesicles distinguished. The number of pineal vesicles per unit of surface (vesicle density) was determined in three pineal portions: apical, anterior and posterior. By day 5, only cellular rosettes were found, mainly in the apical portion. After 10 and 15 days, the presence of rosettes was occasional. The posterior wall showed only small spheroid vesicles, while in the apical and anterior areas ellipsoid vesicles were also observed. Moreover, the spheroid/ellipsoid vesicle ratio increased from the 10th to the 15th day of incubation. The vesicle density decreased between the 10th and 15th day because of the increase in both vesicle and pineal size, without changes in the total number of vesicles. The results suggest that changes in vesicle morphology and density could be related to the functional activity of the pineal gland during embryonic development.

Bioguided fractionation from Solanum elaeagnifolium to evaluate toxicity on cellular lines and breast tumor explants / Fraccionamiento biodirigido de Solanum elaeagnifolium para evaluar la toxicidad en líneas celulares y explantes de tumor de mama

Background: Bioactive compounds from the fruit of S. elaeagnifolium were isolated since could be highly potential source to develop functional foods or pharmaceutical products. Objectives: In this study a bioguided fractionation of the methanolic extract from S. elaeagnifolium fruit was carried out to evaluate their cytotoxicity and antitumoral potential on several cell lines and breast tumor explants, respectively. Methods: Microdilution method with A. salina was used to isolate bioactive compounds. Fractionation was performed by vacuum liquid chromatography, and the monitoring from fractions was done by thin layer chromatography. The effect of the fractions on viability in Vero, HeLa, and MCF-7 cells was assessed using WST-1 assay, whereas in breast tumor explants was evaluated by Alamar blue assay. A qualitative phytochemical analysis was performed to partially identify the compounds contained in the fractions and a spectroscopic characterization by RP-HPLC-MS was done to identify the group of compounds responsible for the effect on the cell lines and the mammary explants. Results: Several fractions were isolated from the fruit of S. elaeagnifolim. Notwithstanding, the FVLC7 showed a higher activity in A. salina assay. This fraction reduced the viability at 39 ± 1.67, 15.05 ± 0.09 and 66.10 ± 4 % in Vero, HeLa and MCF-7 cells, at 100 mg/mL, respectively. On the other hand, showed an effect in breast tumor explants obtained from a patient in remission. Qualitative phytochemical analysis showed that FVLC7 contains alkaloids, coumarins, and sesquiterpene lactones. Characterization by RP-HPLC-MS detected quinic acid, chlorogenic acid, dicaffeoylquinic acid as well as presence of an alkaloid. Conclusion: On this basis, our results suggest that cytotoxic effect of FVLC7 isolated from the fruit of S. elaeagnifolium could be mediated by quinic, chlorogenic, and dicaffeoylquinic acids

Antecedentes: Los compuestos bioactivos del fruto de S. elaeagnifolium fueron aislados ya que representan compuestos con un alto potencial para el desarrollo de alimentos funcionales o productos farmacéuticos. Objetivos: En este estudio se realizó un fraccionamiento biodirigido de un extracto metanólico de frutos de S. elaeagnifolium para evaluar la citotoxicidad y el potencial antitumoral en los explantes de tumor de mama. Métodos: Se utilizó el método de microdilución con A. salina para aislar los compuestos bioactivos. El fraccionamiento se realizó mediante cromatografía de líquido a vacío, y la monitorización de las fracciones se realizó por cromatografía en capa fina. La viabilidad de las fracciones en las líneas de células Vero, HeLa y MCF-7 se evaluó usando el ensayo WST-1, mientras que en los explantes tumorales de mama se evaluaron mediante el ensayo azul de Alamar. Así mismo, se realizó un análisis fitoquímico cualitativo para identificar parcialmente los compuestos que contenían las fracciones y una caracterización espectroscópica por RPHPLC-MS de los compuestos responsables del efecto sobre las líneas celulares y los explantes mamarios. Resultados: De todas las fracciones aisladas de S. elaeagnifolium, la fracción FVLC7 (100 µg/mL) tuvo la actividad más alta en el ensayo de A. salina. Por otra parte, redujo la viabilidad un 39 ± 1,67, 15,05 ± 0,09 y 66,10 ± 4,44% en las células Vero, HeLa y MCF-7, respectivamente. Esta fracción mostró un efecto en los explantes de tumor de mama obtenidos de un paciente en remisión. El análisis fitoquímico cualitativo reveló que la FVLC7 contiene alcaloides, cumarinas y lactonas sesquiterpénicas. La caracterización por RP-HPLC-MS detectó ácido quínico, ácido clorogénico, ácido dicafeoilquínico así como presencia de un alcaloide. Conclusión: Nuestros resultados sugieren que el efecto tóxico de la fracción FVLC7 aislada del fruto de S. elaeagnifolium podría deberse a los ácidos quínico, clorogénico y dicafeoilquínico.

Efficiency of selection methods for increased ratio of pupal-larval to adult-larval weight gains in Tribolium.

SUMMARY: Four lines of Tribolium castaneum were selected in each of three replicates for increased ratio of (pupal-larval) to (adult-larval) weight gains, using selection for increased (pupal-larval) weight gain (PL), selection for decreased (adult-larval) weight gain (AL), direct selection for the ratio (R) and linear selection index of larval, pupal and adult weights (I), respectively, for four generations. Linear index was calculated with economic weights of m(2) -m(3) , m(3) -m(1) and m(1) -m(2) , respectively, with m(1) , m(2) and m(3) being the means for larval, pupal and adult weights. Selection to increase the ratio is considered to be a method to maximize the mean response in (adult-larval) weight while controlling the response in (pupal-adult) weight, and as a form of antagonistic selection to increase the weight gain during a given age period relative to the gain at another age period. Larval, pupal and adult weights were measured at 14, 21 and 28 days after adult emergence, respectively. The selected proportion was 20 % in all lines. The response observed for the ratio differed significantly among lines (p < 0.01), with the I and AL lines having the greatest responses. Line R was less effective in improving the objective of selection, while line PL appeared to be inappropriate. The observed responses for the numerator and denominator weight gains were positive in line PL, and negative in the AL, R and I lines. All lines apart from line PL decreased the (adult-larval) weight, holding (pupal-adult) weight constant. Larval weight showed the greatest influence on the response for the objective of selection. The results for this greater than 1 ratio are compared with results of others for smaller than 1 ratios, in which indirect selection for increased numerator is the more efficient alternative to the selection index. ZUSAMMENFASSUNG: Effizienz Selektionsverfahren zur Verbesserung des Quotienten der Gewichtsentwicklung zwischen Puppe/Larve und Käfer/Larve bei Tribolium. In den jeweils drei Versuchsserien zur Erhöhung des Quotienten (Gewicht von Puppe-Larve/Gewicht von Käfer-Larve) wurden vier Versuchsreihen von Tribolium castaneum untersucht: die Versuchsreihe PL wurde gewählt um die Differenz (Puppengewicht-Larvengewicht) zu erhöhen, die Versuchsreihe AL wurde gewählt um die Differenz (Käfergewicht-Larvengewicht) zu reduzieren, die Versuchsreihe R wurde direkt für den Koeffizienten gewählt und die Auswahl der Versuchsreihe I erfolgte über einen linearen Index, errechnet aus dem Gewicht von Larven, Puppen und Käfern über vier Generationen. Der lineare Index wurde berechnet aus den Gewichten von (m(2) -m(3) ), (m(3) -m(1) ) bzw. (m(1) -m(2) ), wobei m(1) , m(2) und m(3) die Mittelwerte für das Gewicht von Larven, Puppen bzw. Käfern sind. Die Auswahl zur Erhöhung des Quotienten ist eine Methode zur Maximierung des Durchschnittsgewichtsverhältnisses Käfer/Larve, sowie eine antagonische Auswahlform zur Erhöhung der Gewichtszunahme während einer bestimmten Wachstumsperiode im Vergleich zur Gewichtszunahme während einer anderen Wachstumsperiode. Das Selektionsverhältnis belief sich auf 20%. Die beim Quotienten beobachtete Antwort wies bedeutende Unterschiede zwischen Versuchsreihen auf (p < 0.01), wobei die höchsten Antworten bei den Versuchsreihen I und AL beobachtet wurden. Versuchsreihe R war am wenigsten effektiv, während Versuchsreihe PL nicht geeignet schien, das Auswahlziel zu verbessern. Die bei Nenner und Zähler beobachteten Antworten waren positiv bei der Versuchsreihe PL und negativ bei den anderen drei Versuchsreihen. Die Ergebnisse für diesen Quotient größer als 1 wurden mit denen anderer Versuche für Quotienten kleiner als 1 verglichen, bei denen die Auswahl zur Erhöhung des Zählers die effizienteste Alternative zum Auswahlindex ist. RESUMEN: Eficiencia de métodos de selección para incrementar el cociente entre la ganancia en peso de pupa-peso de larva y la ganancia en peso de adulto-peso de larva en Tribolium Cuatro líneas de Tribolium castaneum fueron seleccionadas en cada una de tres repeticiones para incrementar el cociente (peso de pupa-peso de larva)/(peso de adulto-peso de larva); la línea PL fue seleccionada para aumentar la diferencia (peso de pupa-pesp de larva), la línea AL fue seleccionada para disminuir la diferencia (peso de adulto-peso de larva), fa línea R fue seleccionada directamente para el cociente, y la línea I fue seleccionada por medio de un índice lineal basado en los pesos de larva, pupa y adulto, durante cuatro generaciones. El índice lineal se calculó con pesos económicos de (m(2) -m(3) ), (m(3) -m(1) ), y (m(1) -m(2) ) respectivamentee, siendo m(1) , m(2) , y m(3) los valores medios para el peso de larva, pupa y adulto. La selección para aumentar el cociente indicado es un método para maximizar la respuesta en (peso de adulto-peso de larva) controlando al tiempo la respuesta en (peso de pupa-peso de adulto), y es una forma de selección antagónica para aumentar la ganancia de peso durante un periodo de edad en relación con la ganancia en peso durante otro periodo. La proporción de selección due el 20 %. La respuesta observada en el cociente difería significativamente entre lineas (p < 0.01), teniendo las líneas I y AL las mayores respuestas. La línea R fue menos efectiva, mientras que la línea PL parecía inapropiada para mejorar el objetiyo de selección. Las respuestas observadas en el denominador y en el numerador fueron positivas en la línea PL, y negativas en las otras tres líneas. Los resultados para este cociente mayor que 1 se comparan con los de otros experimentos para cocientes menores que 1, en los que la selección para incrementar el numerador es la alternativa más eficiente al índice de selección.

Morphology of the lumbar vertebral canal.

In a series of 215 anteroposterior X-ray films, a study was made of the horizontal distance between the pedicles of each lumbar vertebra, first of all sequentially, describing the morphology adopted by the lateral limits of the canal, and secondly determining the absolute value for each level separately and in relation to the variables of sex and age. The absolute value of this distance at each level is related to the thickness of the pedicles and the width of the vertebral bodies of L3 and L4. The values obtained were tested with the appropriate statistics in each case.

Does the type of judgement required modulate cue competition?

According to the comparator process hypothesis (Matute, Arcediano, & Miller, 1996), cue competition in the learning of between-events relationships arises if the judgement required involves a comparison between the probability of the outcome given the target cue and the probability of the outcome given the competing cue. Alternatively, other associative accounts (the Rescorla-Wagner model: Rescorla & Wagner, 1972) conceive cue competition as a learning deficit affecting the target cue-outcome association. Consequently, the comparator process hypothesis predicts that cue competition occurs in inference judgements but not in contiguity ones, for only the first type of judgement implicitly involves such a comparison. On the other hand, the Rescorla-Wagner model predicts cue competition in both inference and contiguity judgements, because it establishes no relevant role for the type of judgement in producing cue competition. In Experiments 1 and 2 we manipulated the relative validity of cues and the type of question (inference vs. contiguity) in a predictive learning task. In both experiments we found a cue competition effect, but no interaction between the relative validity of cues and the type of question, suggesting that the Rescorla-Wagner theory suffices to explain cue competition.

An azoospermic male with a Y/autosome translocation.

This report describes an azoospermic male carrying a Y/autosome translocation. The patient had a 46,X,t(Y;10)(q12;p13) chromosome complement in a lymphocyte culture. The cytogenetic study of this patient is described, together with testicular histology, spermiogram, hormone levels, and clinical history.

Partial trisomy 14q.

A dysmorphic female born with partial trisomy of the proximal segment of the long arm of chromosome 14 had 47 chromosomes. The extra one was acrocentric, smaller than the D group, and bigger than the G-chromosome group. By GTG banding it was identified as a deleted chromosome 14, the karyotype being 47,XX,+del 14(q24). Chromosome analysis of the parents was normal.

Influence of continuous electromagnetic fields on the stage, weight and stature of the chick embryo.

The influence of continuous electromagnetic fields (0, 181 or 361 Gs/cm2) on the development of chick embryo (n = 144) was studied. Several parameters were determined at days 5, 10 and 15 of incubation: stage (following Hamburger and Hamilton), vertex-coccyx length (size) and weight. At 5 days of incubation, all embryos showed a similar stage. However, at days 10 and 15, the embryos exposed to 181 Gs/cm2 showed a stage significantly superior to that of the others. There were no differences between the exposed embryos and the control ones with regard to weight and stature, except at 15 days when the embryos exposed to 361 Gs/cm2 showed greater weight and stature than those of the controls.

Effects of static electromagnetic fields on chick embryo pineal gland development.

The effects of static electromagnetic fields on the development of the chick embryo pineal gland were studied. A total of 144 fertilized White Leghorn eggs were sacrificed after 5, 10 and 15 days of incubation. The stage of development was determined in all embryos using the Hamburger and Hamilton method [J Morphol 49: 88-92, 1951]. The various morphometric parameters (diameter and distance of the pineal gland and its lumen) were measured on serial 7-micron-thick sections. The data were obtained in a morphometer and processed statistically. The intensities of the static electromagnetic fields were 18 and 36 mT. Control and exposed embryos were equally distributed and randomly assigned. After 5 days of incubation, 25% of embryos exposed to a static electromagnetic field of 18 mT had a more advanced stage of development than controls and embryos exposed to 36 mT. On the 10th and 15th day, embryos exposed to either 18 or 36 mT tended to be more developed than controls. In the morphometric study, results were similar for the controls and exposed embryos after 5 and 10 days of incubation. However, the values of the 15-day-old embryos exposed to static magnetic fields were lower than the values of the controls (p > 0.01). These differences were more pronounced in the embryos exposed to 36 mT. These results seem to indicate that static electromagnetic fields affect the development and growth of embryos unequally, and that their action can depend not only on the intensity of the static electromagnetic field, but also on the length of exposure and the organ which is developing. It may be interesting to use these data in ultrastructural and physiological studies.

[Epidemiologic study of an outbreak of echovirus type-9 meningitis]. / Estudio epidemiológico de un brote de meningitis por echovirus tipo-9.

BACKGROUND: Several agents are able to produce lymphocytic meningitis, but sometimes it's not possible their identification. The viruses are the etiological agents more frequently found, especially enteroviruses, mumps virus and herpes simplex virus, with different epidemiological patterns depending on time and geographic location. Most of the infections caused by enteroviruses are asymptomatics. In general the viral meningitis have a good prognostic with an acute benign course and serious signs of neurological affectation are infrequent. From 1991 it has been observed an increase of nonpolio enteroviral meningitis outbreaks in our Country. Echovirus-4 was isolated in most of the outbreaks notified during that year. Echovirus-9 was not isolated in any of them. METHODS: We describe the epidemiological and clinical characteristics of a lymphocytic meningitis outbreak that took place from June to July of 1993 in Burgos. RESULTS: Forty-eight patients, most of them children, were hospitalized with fever, headache, vomits and stiff neck with an increase in the total cell count in cerebospinal fluid (CSF). Echovirus-9 was isolated from fecal samples in eight patients. CONCLUSIONS: The etiology was attributed to Echovirus-9 because of microbiologic and epidemiologic findings. The incubation period can fluctuate between four an five days and fecal-oral transmission is the most probable mechanism.

Implementación de la entrevista de acceso privilegiado para caracterizar consumidores de pasta base de cocaína / Using privileged access interviewing to identify crack cocaine users

Introducción. En Chile, es posible que parte de los consumidores de pasta base de cocaína (PBC) estén ocultos dada la asociación del consumo de esta sustancia con pobreza y micronarcotráfico. La entrevista de acceso privilegiado es un método utilizado en la exploración de poblaciones ocultas. Objetivo. Implementar en Chile la entrevista de acceso privilegiado para contactar consumidores de PBC sin tratamiento en el último año. Método. Se seleccionaron y entrenaron potenciales entrevistadores de acceso privilegiado (EAPs) en las comunas La Pintana y San Joaquín para la realización de una encuesta de conductas de riesgo a consumidores crónicos de PBC en su medio natural. Resultados. Se contactaron 27 sujetos de los cuales se seleccionaron 17 entrevistadores. Participaron efectivamente en el estudio 9 sujetos (52,9 por ciento) con una edad mediana de 21 años (mín: 20, máx: 28). Un total de 160 encuestas cumplieron los mecanismos de control de confiabilidad en un plazo de 7 meses. Los EAPs de sexo femenino reclutaron el 59,2 por ciento de la muestra. Los EAPs hombres reclutaron sujetos con mayor frecuencia de conductas antisociales y conductas sexuales de riesgo que las entrevistadoras mujeres. Discusión. La utilización de la entrevista de acceso privilegiado fue un método rápido, seguro y confiable para la obtención de información de consumidores de PBC que no han consultado a servicios de rehabilitación, pudiendo constituirse como un método de estudio sistemático de poblaciones ocultas en Chile. Un adecuado proceso de selección de los EAPs puede mejorar el acceso a consumidores de sustancias difíciles de contactar.

Injertos osteocondrales autólogos en mosaico como tratamiento de las lesiones focales del cartílago de la rodilla / Autologous osteochondral mosaic grafts for the treatment of focal lesions of the knee cartilage

La disponibilidad de nuevos procedimientos basados en la evidencia es fundamental para el avance en el tratamiento de las lesiones del cartílago, el capital más valioso que poseen nuestras articulaciones. Los métodos mínimamente invasivos, como la artroscopia, van a jugar un papel determinante en el futuro en este terreno. A la espera de una técnica que permita la regeneración del cartílago hialino con todas sus propiedades, el trasplante osteocondral autólogo por vía artroscópica se presenta como una solución simple, económica, que requiere un solo tiempo quirúrgico y es por lo tanto proporcionada en coste y agresividad para resolver el problema de las lesiones focales del cartílago ya que permite trasplantar un cartílago hialino totalmente formado junto a su hueso subcondral. Se ha comprobado la vitalidad del tejido trasplantado y la técnica se asocia a un alto porcentaje de éxito a corto plazo proporcionando una mejoría del dolor y una buena función articular. Sin embargo, resulta imprescindible disponer de seguimientos a mayor distancia de tiempo y de nuevas valoraciones, tanto del resultado clínico como de su función biomecánica para que pueda desbancar definitivamente a las 'técnicas clásicas' (AU)