Demonstration of Single-Barium-Ion Sensitivity for Neutrinoless Double-Beta Decay Using Single-Molecule Fluorescence Imaging.

A new method to tag the barium daughter in the double-beta decay of ^{136}Xe is reported. Using the technique of single molecule fluorescent imaging (SMFI), individual barium dication (Ba^{++}) resolution at a transparent scanning surface is demonstrated. A single-step photobleach confirms the single ion interpretation. Individual ions are localized with superresolution (∼2 nm), and detected with a statistical significance of 12.9σ over backgrounds. This lays the foundation for a new and potentially background-free neutrinoless double-beta decay technology, based on SMFI coupled to high pressure xenon gas time projection chambers.

Design and tests of a portable mini gamma camera.

Design optimization, manufacturing, and tests, both laboratory and clinical, of a portable gamma camera for medical applications are presented. This camera, based on a continuous scintillation crystal and a position-sensitive photomultiplier tube, has an intrinsic spatial resolution of approximately 2 mm, an energy resolution of 13% at 140 keV, and linearities of 0.28 mm (absolute) and 0.15 mm (differential), with a useful field of view of 4.6 cm diameter. Our camera can image small organs with high efficiency and so it can address the demand for devices of specific clinical applications like thyroid and sentinel node scintigraphy as well as scintimammography and radio-guided surgery. The main advantages of the gamma camera with respect to those previously reported in the literature are high portability, low cost, and weight (2 kg), with no significant loss of sensitivity and spatial resolution. All the electronic components are packed inside the minigamma camera, and no external electronic devices are required. The camera is only connected through the universal serial bus port to a portable personal computer (PC), where a specific software allows to control both the camera parameters and the measuring process, by displaying on the PC the acquired image on "real time." In this article, we present the camera and describe the procedures that have led us to choose its configuration. Laboratory and clinical tests are presented together with diagnostic capabilities of the gamma camera.

[Specific treatment of the acute cerebral infarct. Present and future]. / Tratamiento específico del infarto cerebral agudo. Presente y futuro.

INTRODUCTION: Specific pharmacological strategies in the treatment of the acute phase of a cerebral infarct are directed towards potentiating reperfusion (antithrombotic or thrombolytic drugs) and neuroprotection as early on as possible. DEVELOPMENT: The antithrombotic agents are anticoagulants, hypofibrinogemiant agents (Ancrod) and antiaggregants. The IST was done with anticoagulants, using heparin subcutaneously which causes increased bleeding without any obvious benefit. Others have used heparinoids (TOAST) or low molecular weight heparins (FISS or FISS bis) with no benefit either but with excessive bleeding with the former. Regarding Ancrod, a recent North American study (STAT) with administration of it within three hours showed significant benefit three months later. Another European study is still underway (ESTAT). With regard to antiaggregants, IST and CAST were done using Aspirin, showing a drop in early recurrences and increase in recoveries, so that aspirin has been recommended for use during the first 48 hours. There are studies using abciximab (Reopro), a blocker of the IIb-IIIa glycoprotein receptors, in which phase II data have shown that it is safe and tends to improve the outcome. A study on phase III is currently ongoing. The thrombolytic drugs have been evaluated in various trials. The PROACT study evaluated intraarterial pro-UK and showed significant recanalization of middle cerebral artery occlusions, but with a larger number of hemorrhages and no reduction in mortality and besides, in PROACT II the outcome of treated patients was better. The NINDS trial using intravenous rt-PA (0.9 mg/kg in < 3 hours) showed an improved functional state 3 months later. In the ECASS doses of 1.1 mg/kg of rt-PA in < 6 hours were used and improvement was seen after three months which was countered by an increase in cerebral hemorrhage and mortality. The ECASS II, with similar dosage to NINDS and an identical window to ECASS, showed a favorable tendency in the evolution of the treated group, with no increase in symptomatic intracranial hemorrhages. Neuroprotectors have shown to be effective in experimental models of ischaemia but at the moment there is no definite evidence of their benefit in the numerous trials carried out on humans, although some subgroups of patients seem to benefit from some of them. Studies therefore are still being done. In future their use in combination with thrombolysis may be considered.

[Interleukins and pregnancy: a disputed reality]. / Interleukinas y embarazo: una realidad cuestionada.

We are reviewing information concerning to the role of interleukins (ILs) in labor and pregnancy; these substances produce the ignition of the arachidonic acid/prostaglandins cascade to induce labor, this process could be also activated by bacterial lipopolysaccharides in this case we could have preterm labor. The activity and production of IL-2 normally is inhibited, if it does not happen an abortion could result. IL-3 and stimulatory growth factors (SGFs) are implicated in the growth and development of the pregnancy, the alteration in the production of this IL could produce intrauterine growth retardation, both of this ILs are acting in the maternal fetal interface. We consider very important that the gynecologists and obstetricians should have more information about ILs related to normal and complicated pregnancy.

[Testicular and paratesticular tumors during childhood and adolescence]. / Tumores testiculares y paratesticulares en la infancia y adolescencia.

INTRODUCTION: Testicular and paratesticular tumors represent 1-2% of the solid tumors in children. We present a retrospective series of 15 cases in patients less than 18 years of age. RESULTS: The mean age of the patients was 9.7 yrs, 6 of them prepubertal (mean age: 2.08 ± 1 yrs) and 9 pubertal (mean age: 15.1 ± 1.3 yrs). The most common clinical form of presentation was a painless testicular mass. The α-fetoprotein levels were high in 5 patients (yolk-sac tumors and embryonal carcinomas). The pathological study showed 11 primary testicular tumors and 4 paratesticular tumors (rhabdomyosarcomas), with 60% being germinal tumors and the rest non-germinal. Around 60% were malignant tumors (2 from the yolk-sac tumors, 2 embryonal carcinomas, one seminoma and 4 rhabdomyosarcomas). Among the benign tumors, the most common was the mature cystic teratoma. Surgery was the initial treatment in all of the cases (radical orchiectomy in 13 tumors and enucleation in 2 teratomas, with retroperitoneal lymphadenectomy in 4 cases). In 11 patients the tumor was in stage I, while 4 cases (2 embryonal carcinomas and 2 rhabdomyosarcomas) were in stage IV with pulmonary metastasis. Chemotherapy whether or not combined with radiotherapy was applied in 7 patients (4 rhabdomyosarcomas, 2 embryonal carcinomas and one seminoma). CONCLUSIONS: Testicular and paratesticular tumors in prepubertal children show epidemiological, histological, therapeutical and evolutional characteristics well differentiated from postpubertal or adult subjects.

PP078. Total antioxidant capacity in patients with pregnancy induced hypertension: Its relation to maternal and/or perinatal complications.

INTRODUCTION: Pregnancy-induced hypertension (PIH) is a major cause of maternal and perinatal mortality and morbidity, particularly in under-resourced countries, like Mexico. Studies on PIH have shown increased oxidative stress products such as malondialdehyde and decrease of total antioxidant capacity (TAC). In this research we measured one marker of oxidative stress (OS) the TAC in patients with PIH and we associated it with the development of maternal and/or fetal complications. OBJECTIVES: Determine whether the plasma level of total antioxidant capacity (as a marker of oxidative stress) influences the development of maternal and/or perinatal complications in patients with PIH. METHODS: A observational, analytical, clinical study was conducted in patients with gestational hypertension (GH), mild preeclampsia (MP), severe preeclampsia (SP) and normal pregnancy (NP) > or = 28weeks gestational age. Serum samples were collected and stored at -70°C until use for the determination of total antioxidant capacity. It was associated with the development of maternal and/or perinatal complications. RESULTS: TAC level in normotensive patients (NP) was mean of 2679 +/- 2014mEq/L while in hypertensive patients (GH, MP, SP) was on mean of 1502 +/-1340mEq/L (p<0.05), in the GH group was 1620 +/-1042mEq/L, in the MP group was 1977 +/-1865mEq/L, in the SP was 819 +/-305meq/L The mean TAC level in the 29 patients who had maternal and/or perinatal complications was 1521mEq/L, while in the 38 patients who showed no maternal and/or perinatal complications the mean was 2355mEq/L (p<0.05). Of the 29 patients who had complications 15 (52%) had greatly diminished TAC levels (less than 1000mEq/L), 9 (31%) had between 1000 and 2500mEq/L and only 5 (17%)>2500mEq/L. 72% (28/39) of PIH group had one or more maternal and/or perinatal complications, while only 1 patient (3.6%) of 28 patients with NP had one or more maternal and/or perinatal complications (p<0.05). CONCLUSION: Patients with decreased TAC level had a higher percentage of maternal and/or perinatal complications. Patients with PIH classified as mild preeclampsia, showing reduced TAC level should be in close observation as they have the risk of developing life-threatening complications since management is usually as outpatient.

[Kawasaki disease in 76 patients. Risk factors for coronary artery aneurysms]. / Enfermedad de Kawasaki en 76 pacientes. Factores de riesgo de aparición de aneurismas coronarios.

INTRODUCTION: Kawasaki disease is an acute systemic vasculitis of childhood, of unknown origin, and is considered the leading cause of acquired heart disease in children. Therefore, it is important to know clinical manifestations and complications in children with Kawasaki disease in our environment and to look for risk factors for the development of cardiac complications. MATERIAL AND METHODS: Retrospective review of 76 children with Kawasaki disease evaluated from January 1997 to May 2008. RESULTS: Of the patients studied, 64.5% were males. The mean age was 3 years and 4 months. The main clinical findings were fever (mean of 8.13 days), rash, bilateral non-exudative conjunctivitis, changes in lips and oral cavity, changes in the extremities, cervical lymphadenopathy and arthralgias. The most important laboratory findings were leucocytosis, thrombocytosis, elevated C-reactive protein and erythrocyte sedimentation rate, hypoalbuminaemia, hyperbilirubinaemia, elevated serum transaminases and sterile pyuria. Twelve of the patients (15.7%) developed coronary artery aneurysms, two patients had a mild mitral insufficiency and one patient with a mild pericardial effusion. There was one case of cholestatic hepatitis. All the complications were resolved without sequelae. Male sex (OR = 1.24), an urticarial exanthem (OR = 10.53) and a C-reactive protein > 10mg/dl (OR = 4.20) were identified as risk factors for coronary aneurysms. CONCLUSIONS: Our patients had the typical clinical and laboratory findings of Kawasaki disease. Mild coronary artery complications were observed in 15.7% of the patients. Male sex, an urticarial exanthem and an elevated C-reactive protein are risk factors for coronary aneurysms.

Evaluation of a haematological analyser for its use in canine clinical pathology.

A semiautomatic electronic system for counting blood cells in veterinary haematology (Sysmex F-800) was evaluated. A total of 100 samples of canine blood were analysed. The results for leucocyte (WBC), erythrocyte (RBC), and platelet (PLT) counts, the haemoglobin concentration (Hb), and haematocrit value (Hct) obtained using the autoanalyser were compared with those obtained using a manual method as a reference. The results show very high levels of correlation for WBC (r = 0.96), Hb (r = 0.97) and Hct (r = 0.95) and high levels for RBC (r = 0.85) and PLT (r = 0.72). The precision is satisfactory in all the parameters studied with the exception of the platelet count (CV = 10.2%) where it is unsatisfactory. Taking into consideration the margin of error associated with manual cell counting methods, we conclude that this haematological analyser is sufficiently accurate for work with blood samples from dogs.

Tumores testiculares y paratesticulares en la infancia y adolescencia / Testicular and paratesticular tumors during childhood and adolescence

Introducción: Los tumores testiculares y paratesticulares constituyen el 1-2% de los tumores sólidos en la infancia. Se presenta una serie retrospectiva de 15 casos en menores de 18 años. Resultados: La edad media de los pacientes fue de 9,7 años, siendo prepuberales 6 (media 2,08 ± 1 año) y puberales 9 (media 15,1 ± 1,3 años). La forma de presentación clínica más frecuente fue una masa testicular indolora. Los niveles de alfa-fetoproteína estaban elevados en 5 pacientes (tumores de saco vitelino y carcinomas embrionarios).El estudio anatomopatológico demostró 11 tumores primarios testiculares y 4 paratesticulares (rabdomiosarcomas), siendo el 60% tumores germinales y el resto de células no germinales. El 60% de ellos fueron tumores malignos (2 tumores de saco vitelino, 2 carcinomas embrionarios, un seminoma y 4 rabdomiosarcomas). Entre los tumores benignos, el más frecuente fue el teratoma quístico maduro. La cirugía fue el tratamiento inicial en todos los casos (orquidectomía radical en 13 tumores y enucleación en 2 teratomas, con linfadenectomía retroperitoneal en 4 casos). En 11 de los pacientes el tumor se encontraba en estadio I y en 4 casos (2 carcinomas embrionarios y 2 rabdomiosarcomas), en estadio IV con metástasis pulmonares. Recibieron tratamiento adyuvante con quimioterapia asociada o no a radioterapia 7 de los pacientes (4 rabdomiosarcomas, 2 carcinomas embrionarios y un seminoma). Conclusiones: Los tumores testiculares y paratesticulares en niños prepuberales son un grupo con unas características epidemiológicas, histológicas, evolutivas y terapéuticas, bien diferenciadas respecto de las encontradas en pacientes pospuberales o adultos(AU)

Introduction: Testicular and paratesticular tumors represent 1-2% of the solid tumors in children. We present a retrospective series of 15 cases in patients less than 18 years of age. Results: The mean age of the patients was 9.7 yrs, 6 of them prepubertal (mean age: 2.08 ± 1 yrs) and 9 pubertal (mean age: 15.1 ± 1.3 yrs). The most common clinical form of presentation was a painless testicular mass. The alpha-fetoprotein levels were high in 5 patients (yolk-sac tumors and embryonal carcinomas).The pathological study showed 11 primary testicular tumors and 4 paratesticular tumors (rhabdomyosarcomas), with 60% being germinal tumors and the rest non-germinal. Around 60% were malignant tumors (2 from the yolk-sac tumors, 2 embryonal carcinomas, one seminoma and 4 rhabdomyosarcomas). Among the benign tumors, the most common was the mature cystic teratoma. Surgery was the initial treatment in all of the cases (radical orchiectomy in 13 tumors and enucleation in 2 teratomas, with retroperitoneal lymphadenectomy in 4 cases). In 11 patients the tumor was in stage I, while 4 cases (2 embryonal carcinomas and 2 rhabdomyosarcomas) were in stage IV with pulmonary metastasis. Chemotherapy whether or not combined with radiotherapy was applied in 7 patients (4 rhabdomyosarcomas, 2 embryonal carcinomas and one seminoma). Conclusions: Testicular and paratesticular tumors in prepubertal children show epidemiological, histological, therapeutical and evolutional characteristics well differentiated from postpubertal or adult subjects(AU)

Arritmias auriculares y ventriculares en lactante con tos ferina / Atrial and ventricular arrhythmias in a child with whooping cough

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Enfermedad de Kawasaki en 76 pacientes. Factores de riesgo de aparición de aneurismas coronarios / Kawasaki disease in 76 patients. Risk factors for coronary artery aneurysms

Introducción: La enfermedad de Kawasaki es una vasculitis sistémica aguda de la infancia, de etiología desconocida, considerada la principal causa de cardiopatía adquirida en la infancia en los países desarrollados. Por ello, es importante conocer las manifestaciones clínicas y las complicaciones de pacientes con enfermedad de Kawasaki en nuestro medio y buscar factores relacionados con la aparición de alteraciones cardiológicas. Material y métodos: Estudio descriptivo retrospectivo de 76 niños diagnosticados de enfermedad de Kawasaki desde enero de 1997 hasta mayo de 2008. Resultados: El 64,5% eran varones, con una edad media de 3 años y 4 meses. Las manifestaciones clínicas principales que presentaron fueron fiebre (media 8,13 días), exantema, hiperemia conjuntival bilateral, afectación bucal, afectación de extremidades, adenopatía única y artralgias. Entre los hallazgos analíticos destacaron leucocitosis, trombocitosis, proteína C reactiva (PCR) y velocidad de sedimentación glomerular elevadas, hipoalbuminemia, hiperbilirrubinemia, aumento de transaminasas y piuria estéril. Presentaron alteraciones coronarias12 pacientes (15,7%), 2 insuficiencia mitral leve y 1 derrame pericárdico leve. Hubo una hepatitis colestásica. Todas las complicaciones se resolvieron sin secuelas. Se identificaron como factores de riesgo para la aparición de aneurismas coronarios el sexo varón (OR = 1,24), exantema urticariforme (OR = 10,53) y PCR > 10 mg/dl (OR = 4,20). Conclusiones: Nuestros pacientes presentaron las manifestaciones clínicas y analíticas típicas de la enfermedad de Kawasaki. El 15,7% tuvo alteraciones coronarias leves. Son factores de riesgo de aparición de aneurismas coronarios el sexo masculino, exantema urticariforme y PCR elevada (AU)

Introduction: Kawasaki disease is an acute systemic vasculitis of childhood, of unknown origin, and is considered the leading cause of acquired heart disease in children. Therefore, it is important to know clinical manifestations and complications in children with Kawasaki disease in our environment and to look for risk factors for the development of cardiac complications. Material and methods: Retrospective review of 76 children with Kawasaki disease evaluated from January 1997 to May 2008. Results: Of the patients studied, 64.5% were males. The mean age was 3 years and 4 months. The main clinical findings were fever (mean of 8.13 days), rash, bilateral non-exudative conjunctivitis, changes in lips and oral cavity, changes in the extremities, cervical lymphadenopathy and arthralgias. The most important laboratory findings were leucocytosis, thrombocytosis, elevated C-reactive protein and erythrocyte sedimentation rate, hypoalbuminaemia, hyperbilirubinaemia, elevated serum transaminases and sterile pyuria. Twelve of the patients (15.7%) developed coronary artery aneurysms, two patients had a mild mitral insufficiency and one patient with a mild pericardial effusion. There was one case of cholestatic hepatitis. All the complications were resolved without sequelae. Male sex (OR = 1.24), an urticarial exanthem (OR = 10.53) and a C-reactive protein > 10 mg/dl(OR = 4.20) were identified as risk factors for coronary aneurysms. Conclusions: Our patients had the typical clinical and laboratory findings of Kawasaki disease. Mild coronary artery complications were observed in 15.7% of the patients. Male sex, an urticarial exanthem and an elevated C-reactive protein are risk factors for coronary aneurysms (AU)

Tratamiento específico del infarto cerebral agudo. Presente y futuro / Specific treatment of acute cerebral infarction. Present and future

Las estrategias farmacológicas específicas en el tratamiento de la fase aguda del infarto cerebral se orientan a potenciar la reperfusión (antitrombóticos o trombolíticos) y la neuroprotección lo más precozmente posible. Desarrollo: los antitrombóticos son anticoagulantes, hipofibrinogemiantes (Ancrod) y antiagregantes. Con anticoagulantes se realizó el IST, empleando heparinas que causó un aumento de hemorragias sin beneficio neto evidente. Otros usaron heparinoides (TOAST) o heparinas de bajo peso molecular (FISS y FISS bis) y tampoco demostraron ningún beneficio y si un exceso de hemorragia en el primerio. En cuanto a Ancrod, acaba de concluir en ensayo en Norteamérica (STAT) con administración en < 3 horas que ha indicado beneficio significativo a los tres meses. Continúa otro europeo (ESTAT). Respecto a los antiagregantes, con ácido acetilsalicílico se realizaron el IST y el CAST en los que ha aprecido una reducción de recurrencias precoces y un aumento de las repercusiones, por lo que se ha recomendado su uso en las primeras 48 horas. Existen estudios con abcximab, un antagonista de receptores glicoproteína IIb-IIIa, uno en fase II en AVC ha demostrado que es seguro y que los paceintes tratados tienden a evolucionar mejor. Está en desarrollo otro fase III. Los trombolíticos han sido evaluados en diversos ensayos. Por vía IA el estudio PROACT valoró por-UK frente a placebo y demostró repermeabilización significativa en oclusiones de la arteria cerebral media, pero con mayor númer de hemorragias y sin una reducción de mortalidad. En PROACT II aparece mejor evolución en los pacientes tratados. Por vía IV, el ensayo NINDS con rt-PA (0.9 mg/kg en <3h) demostró una mejoría a los tres meses que se contrarrestó con un aumento de hemorragias cerebrales y mortalidad. El ECASS-II, con dosis similares al NINDS e idéntica ventaja que el ECASS, demostró un tendencia favorable en la evolución del grupo tratado sin aumento de las hemorragias intracraneales sintomáticas.