Is there a preferred platinum and fluoropyrimidine regimen for advanced HER2-negative esophagogastric adenocarcinoma? Insights from 1293 patients in AGAMENON-SEOM registry.

BACKGROUND: The optimal chemotherapy backbone for HER2-negative advanced esophagogastric cancer, either in combination with targeted therapies or as a comparator in clinical trials, is uncertain. The subtle yet crucial differences in platinum-based regimens' safety and synergy with combination treatments need consideration. METHODS: We analyzed cases from the AGAMENON-SEOM Spanish registry of HER2-negative advanced esophagogastric adenocarcinoma treated with platinum and fluoropyrimidine from 2008 to 2021. This study focused exclusively on patients receiving one of the four regimens: FOLFOX (5-FU and oxaliplatin), CAPOX (capecitabine and oxaliplatin), CP (capecitabine and cisplatin) and FP (5-FU and cisplatin). The aim was to determine the most effective and tolerable platinum and fluoropyrimidine-based chemotherapy regimen and to identify any prognostic factors. RESULTS: Among 1293 patients, 36% received either FOLFOX (n = 468) or CAPOX (n = 466), 20% CP (n = 252), and 8% FP (n = 107). FOLFOX significantly increased PFS (progression free survival) compared to CP, with a hazard ratio of 0.73 (95% CI 0.58-0.92, p = 0.009). The duration of treatment was similar across all groups. Survival outcomes among regimens were similar, but analysis revealed worse ECOG-PS (Eastern Cooperative Oncology Group-Performance Status), > 2 metastatic sites, bone metastases, hypoalbuminemia, higher NLR (neutrophil-to-lymphocyte ratio), and CP regimen as predictors of poor PFS. Fatigue was common in all treatments, with the highest incidence in FOLFOX (77%), followed by FP (72%), CAPOX (68%), and CP (60%). Other notable toxicities included neuropathy (FOLFOX 69%, CAPOX 62%), neutropenia (FOLFOX 52%, FP 55%), hand-foot syndrome in CP (46%), and thromboembolic events (FP 12%, CP 11%). CONCLUSIONS: FOLFOX shown better PFS than CP. Adverse effects varied: neuropathy was more common with oxaliplatin, while thromboembolism was more frequent with cisplatin.

Tomografía fotoacústica y Deep Learning en aplicacionesmédicas

En las últimas décadas, las imágenes fotoacústicas han demostrado su eficacia en el apoyo al diagnóstico de algunas enfermedades, así como en la investigación médica, ya que a través de ellas es posible obtener información del cuerpo humano con características específicas y profundidad de penetración, desde 1 cm hasta 6 cm dependiendo en gran medida del tejido estudiado, además de una buena resolución. Las imágenes fotoacústicas son comparativamente jóvenes y emergentes y prometen mediciones en tiempo real, con procedimientos no invasivos y libres de radiación. Por otro lado, aplicar Deep Learning a imágenes fotoacústicas permite gestionar datos y transformarlos en información útil que genere conocimiento. Estas aplicaciones poseen ventajas únicas que facilitan la aplicación clínica. Se considera que con estas técnicas se pueden proporcionar diagnósticos médicos confiables. Es por eso que el objetivo de este artículo es proporcionar un panorama general de los casos donde se combina el Deep Learning con técnicas fotoacústicas.

In recent decades, photoacoustic imaging has proven its effectiveness in supporting the diagnosis of some diseases as well as in medical research, since through them it is possible to obtain information of the human body with specific characteristics and depth of penetration, from 1 cm to 6 cm depending largely on the tissue studied, in addition to a good resolution. Photoacoustic imaging is comparatively young and emerging and promises real-time measurements, with non-invasive and radiation-free procedures. On the other hand, applying Deep Learning to photoacoustic images allows managing data and transforming them into useful information that generates knowledge. These applications have unique advantages that facilitate clinical application. It may be possible with these techniques to provide reliable medical diagnoses. That is why the aim of this article is to provide an overview of cases combining Deep Learning with photoacoustic techniques.

Defining the Healthy Infant Metabolome: Liquid Chromatography Tandem-Mass Spectrometry Analysis of Dried Blood Spot Extracts from the Prospective Research on Early Determinants of Illness and Children's Health Trajectories Birth Cohort Study.

Newborn screening using dried plasma spots offers preanalytical advantages over conventional cards for plasma-associated targets of interest. Herein we present dried plasma spot-based methods for measuring metabolites using a 250+ compound liquid chromatography tandem mass spectrometry library. Quality assurance reduced this library to 134, and from these, 30 compounds determined the normal newborn reference ranges.

Chitosan Functionalized with 2-Methylpyridine Cross-Linker Cellulose to Adsorb Pb(II) from Water.

In this study, chitosan was chemically modified with 2-methylpyridine. Subsequently, the modified chitosan was cross-linked to cellulose using succinic anhydride. Additionally, the capacity of cellulose derivatives to adsorb Pb(II) ions in an aqueous solution was studied through the determination of Pb(II) ions concentration in water, using microwave plasma atomic emission spectroscopy (MP-AES). A maximum adsorption capacity of 6.62, 43.14, 60.6, and 80.26 mg/g was found for cellulose, cellulose-succinic acid, cellulose-chitosan, and cellulose-chitosan-pyridine, respectively. The kinetic data analysis of the adsorption process showed a pseudo-second-order behavior. The increase in metal removal from water is possibly due to metal chelation with the carbonyl group of succinic acid, and the pyridine groups incorporated into chitosan.

The Development and Characterization of a Cotton-Chitosan Composite for Lead Removal from Water.

Heavy metals in water are a serious environmental problem due to their accumulation and toxicity; there are several processes we can use to address this issue, but adsorption is the most popular due to its simplicity and efficiency. Polysaccharides such as cellulose have received attention as adsorbents for heavy metals, and cotton-chitosan composites (CCs) were developed here with nontoxic reagents such as carboxylic acids as crosslinkers and NaH2PO4 as a catalyst to achieve chitosan covalent crosslinkage into oxidized cotton textiles with H2O2. The composites were characterized by fourier-transform infrared spectroscopy (FTIR), elemental analysis (EA), X-ray photoelectron spectroscopy (XPS), atomic-force and scanning electron microscopy (AFM and SEM), and tensile strength; the adsorption of lead ions (Pb) was evaluated with cotton-chitosan composites and quantified by microwave plasma atomic emission spectroscopy (MP-AES). The composites showed a maximum incorporation of chitosan of 27.62 mg per gram of cotton textile. A tensile strength analysis of the composite showed a Young's modulus approximately 1 MPa higher than that of cotton textile. The adsorption of lead ions with composites in an aqueous solution at pH 5 and 25 °C was circa 74% after 6 h of contact, as determined by MP-AES. This work is an approach to demonstrate the potential of these polysaccharides, modified by "green" procedures to remove pollutants from water.

[Trauma craneal no accidental en niños: costo económico directo de la atención médica en un hospital de tercer nivel].

INTRODUCTION: Abusive head trauma (AHT) is an extreme form of physical abuse that is produced by abruptly shaking an infant or toddler. OBJECTIVE: To describe the direct economic cost of care during hospitalization of 14 children with confirmed diagnosis of AHT in a pediatric hospital. METHOD: Analysis of the cost of disease in patients with AHT attended to between 2001 and 2010. Partial direct economic cost of medical care (days of hospital stay, laboratory tests and imaging studies, surgical procedures and subspecialist consultations) was calculated adjusting for inflation, with year 2001 taken as base year. Patients were classified in three groups (moderate, severe and fatal AHT). Descriptive and sensitivity analysis was carried out. RESULTS: Patients with severe AHT generated higher medical care costs ($105,794.88 ± 33,201.91) in comparison with the group of moderate ($37,012.95, ± 7,154.87) and fatal AHT ($18,595.04 ± 6424.47) (p <0.05). Total cost was $665,467.98 Mexican pesos ($71,249.25 international dollars). CONCLUSIONS: Total cost for the 14 patients was an elevated figure, as in other parts of the world. The direct economic cost is closely related to the severity of the clinical presentation.

INTRODUCCIÓN: El trauma craneal no accidental (TCNA) es una forma extrema de abuso físico que se produce por la sacudida brusca de un lactante o preescolar. OBJETIVO: Describir el costo económico directo de la atención durante la hospitalización de 14 niños con diagnóstico confirmado de TCNA en un hospital pediátrico. MÉTODO: Análisis del costo de la enfermedad en pacientes con TCNA, atendidos entre 2001 y 2010. Se realizó análisis descriptivo y de sensibilidad. Se calculó costo económico directo parcial de la atención médica (días de estancia hospitalaria, exámenes de laboratorio y gabinete, procedimientos quirúrgicos y consultas por subespecialista), ajustado por la inflación, se tomó como año base 2001. Los pacientes se clasificaron en tres grupos: TCNA moderado, severo y fatal. RESULTADOS: Los pacientes con TCNA severo generaron mayor costo en la atención médica ($105 794.88 ± 33 201.91), en comparación con el grupo con TCNA moderado ($37 012.95 ± 7154.87) y fatal ($18 595.04 ± 6424.47) (p < 0.05). El costo total fue de 665 467.98 pesos mexicanos (71 249.25 dólares internacionales). CONCLUSIONES: El costo total de los 14 pacientes fue una cifra elevada como en otras partes del mundo. El costo económico directo se relaciona estrechamente con la gravedad del cuadro clínico.

Drug resistance and treatment failure in leishmaniasis: A 21st century challenge.

Reevaluation of treatment guidelines for Old and New World leishmaniasis is urgently needed on a global basis because treatment failure is an increasing problem. Drug resistance is a fundamental determinant of treatment failure, although other factors also contribute to this phenomenon, including the global HIV/AIDS epidemic with its accompanying impact on the immune system. Pentavalent antimonials have been used successfully worldwide for the treatment of leishmaniasis since the first half of the 20th century, but the last 10 to 20 years have witnessed an increase in clinical resistance, e.g., in North Bihar in India. In this review, we discuss the meaning of "resistance" related to leishmaniasis and discuss its molecular epidemiology, particularly for Leishmania donovani that causes visceral leishmaniasis. We also discuss how resistance can affect drug combination therapies. Molecular mechanisms known to contribute to resistance to antimonials, amphotericin B, and miltefosine are also outlined.

Lauren subtypes of advanced gastric cancer influence survival and response to chemotherapy: real-world data from the AGAMENON National Cancer Registry.

BACKGROUND: The choice of chemotherapy in HER2-negative gastric cancer is based on centre's preferences and adverse effects profile. No schedule is currently accepted as standard, nor are there any factors to predict response, other than HER2 status. We seek to evaluate whether Lauren type influences the efficacy of various chemotherapies and on patient overall survival (OS). METHODS: We have conducted a multicenter study in 31 hospitals. The eligibility criteria include diagnosis of stomach or gastroesophageal junction adenocarcinoma, HER2 negativity, and chemotherapy containing 2-3 drugs. Cox proportional hazards regression adjusted for confounding factors, with tests of 'treatment-by-histology' interaction, was used to estimate treatment effect. RESULTS: Our registry contains 1303 tumours analysable for OS end points and 730 evaluable for overall response rate (ORR). A decrease in ORR was detected in the presence of a diffuse component: odds ratio 0.719 (95% confidence interval (CI), 0.525-0.987), P=0.039. Anthracycline- or docetaxel-containing schedules increased ORR only in the intestinal type. The diffuse type displayed increased mortality with hazard ratio (HR) of 1.201 (95% CI, 1.054-1.368), P=0.0056. Patients receiving chemotherapy with docetaxel exhibited increased OS limited to the intestinal type: HR 0.65 (95% CI, 0.49-0.87), P=0.024, with no increment in OS for the subset having a diffuse component. With respect to progression-free survival (PFS), a significant interaction was seen in the effect of docetaxel-containing schedules, with better PFS limited to the intestinal type subgroup, in the comparison against any other schedule: HR 0.65 (95% CI, 0.50-0.85), P=0.015, and against anthracycline-based regimens: HR 0.64 (95% CI, 0.46-0.88), P=0.046. CONCLUSIONS: As a conclusion, in this registry, Lauren classification tumour subtypes predicted survival and responded differently to chemotherapy. Future clinical trials should stratify effect estimations based on histology.

Unusual redo mitral valve replacement for bleeding in Glanzmann thrombasthenia.

We report the case of 23-year-old man with mitral valve regurgitation and Glanzmann thrombasthenia, who underwent mechanical mitral valve replacement. Warfarin therapy was devastating, causing bilateral hemothorax, pericardial effusion, gastrointestinal bleeding, and hematuria. Redo mitral valve replacement with a biological prosthesis was required to resolve this critical situation. To our knowledge, this is the first report of mitral valve replacement in Glanzmann thrombasthenia, highlighting the danger of oral anticoagulation in this pathology.

Segmentation and Classification of Bone Marrow Cells Images Using Contextual Information for Medical Diagnosis of Acute Leukemias.

Morphological identification of acute leukemia is a powerful tool used by hematologists to determine the family of such a disease. In some cases, experienced physicians are even able to determine the leukemia subtype of the sample. However, the identification process may have error rates up to 40% (when classifying acute leukemia subtypes) depending on the physician's experience and the sample quality. This problem raises the need to create automatic tools that provide hematologists with a second opinion during the classification process. Our research presents a contextual analysis methodology for the detection of acute leukemia subtypes from bone marrow cells images. We propose a cells separation algorithm to break up overlapped regions. In this phase, we achieved an average accuracy of 95% in the evaluation of the segmentation process. In a second phase, we extract descriptive features to the nucleus and cytoplasm obtained in the segmentation phase in order to classify leukemia families and subtypes. We finally created a decision algorithm that provides an automatic diagnosis for a patient. In our experiments, we achieved an overall accuracy of 92% in the supervised classification of acute leukemia families, 84% for the lymphoblastic subtypes, and 92% for the myeloblastic subtypes. Finally, we achieved accuracies of 95% in the diagnosis of leukemia families and 90% in the diagnosis of leukemia subtypes.

Seasonal Variation of Honeybee Pathogens and its Association with Pollen Diversity in Uruguay.

Honeybees are susceptible to a wide range of pathogens, which have been related to the occurrence of colony loss episodes reported mainly in north hemisphere countries. Their ability to resist those infections is compromised if they are malnourished or exposed to pesticides. The aim of the present study was to carry out an epidemiological study in Uruguay, South America, in order to evaluate the dynamics and interaction of honeybee pathogens and evaluate their association with the presence of external stress factors such as restricted pollen diversity and presence of agrochemicals. We monitored 40 colonies in two apiaries over 24 months, regularly quantifying colony strength, parasite and pathogen status, and pollen diversity. Chlorinated pesticides, phosphorus, pyrethroid, fipronil, or sulfas were not found in stored pollen in any colony or season. Varroa destructor was widespread in March (end of summer-beginning of autumn), decreasing after acaricide treatments. Viruses ABPV, DWV, and SBV presented a similar trend, while IAPV and KBV were not detected. Nosema ceranae was detected along the year while Nosema apis was detected only in one sample. Fifteen percent of the colonies died, being associated to high V. destructor mite load in March and high N. ceranae spore loads in September. Although similar results have been reported in north hemisphere countries, this is the first study of these characteristics in Uruguay, highlighting the regional importance. On the other side, colonies with pollen of diverse botanical origins showed reduced viral infection levels, suggesting that an adequate nutrition is important for the development of healthy colonies.

Immune suppression in the honey bee (Apis mellifera) following infection by Nosema ceranae (Microsporidia).

Two microsporidia species have been shown to infect Apis mellifera, Nosema apis and Nosema ceranae. This work presents evidence that N. ceranae infection significantly suppresses the honey bee immune response, although this effect was not observed following infection with N. apis. Immune suppression would also increase susceptibility to other bee pathogens and senescence. Despite the importance of both Nosema species in honey bee health, there is no information about their effect on the bees' immune system and present results can explain the different virulence between both microsporidia infecting honeybees.

Caracterización microbiológica de cepas de Vibrio cholerae no-O1 aisladas en Cuba / Microbiological characterization of non-01 Vibrio cholerae isolated in Cuba

Se estudiaron 422 cepas de Vibrio cholerae no-O1 procedentes de 9 provincias del país, de ellas 9 aisladas de un brote de enfermedad de transmisión hídrica. En la totalidad de las cepas se determinó la susceptibilidad antimicrobiana y la presencia de factores de virulencia. En las 9 cepas procedentes del brote, se realizó además, el estudio de macrorrestricción de ADN mediante la técnica de electroforesis de campo pulsado. Se demostró por primera vez en Cuba y el Caribe, la circulación de cepas de V. cholerae no-O1 atípicas (resistentes al compuesto vibriostático O129 y al trimetoprim-sulfametoxazol). El comportamiento de la susceptibilidad antimicrobiana demostró por primera vez la circulación en Cuba de 2 patrones diferentes de resistencia (ampicilina, trimetoprim/sulfametoxazol, sulfonamida y tetraciclina, trimetoprim/sulfametoxazol, sulfonamida). La frecuencia de cepas resistentes al trimetoprim-sulfametoxazol se mantuvo similar en todo el período de estudio. Sin embargo, se produjo un decrecimiento de la resistencia a la ampicilina y un aumento de la resistencia a la tetraciclina. Los principales factores de virulencia que se encontraron fueron la gelatinasa, la hemolisina, la elastasa y la adherencia a células HEp-2. Sin embargo, las cepas del brote mostraron mayores porcentajes que el resto, para la presencia de la toxina termoestable y la presencia de fimbrias. Los resultados de los estudios molecular y epidemiológico permitieron dar una respuesta acelerada y precisa sobre la etiología del primer brote de enfermedad de transmisión alimentaria(AU)

The study of 422 non-01 Vibrio cholerae strains from nine provinces, 9 of them isolated from a water-borne disease outbreak, was performed. All the strains exhibited antimicrobial susceptibility and virulence factors. The nine strains from the outbreak were subjected to a DNA macrorestriction study based on the pulsed field electrophoresis technique. For the first time in Cuba and the Caribbean, the circulation of atypical non-01 V. Cholerae strains (resistent to vibriostatic compound 0129 and trimethoprim/sulfamethoxazole). The behavior of antimicrobial susceptibility evinced for the first time the circulation of two different resistence patterns in Cuba (ampicilline, trimethoprim/sulfamethoxazole, sulfonamide and tetracycline, trimethoprim/sulfamethoxazole, sulfonamide). The frequency of trimethoprim/sulfamethoxazole-resistent strains was similar during the whole period of study. However, resistance to ampicilline decreased whereas resistance to tetracycline increased. The main found virulence factors were gelatinase, hemolysine, elastase and adherence to Hep-2 cells. On the other hand, the outbreak strains showed higher percentages than the others due to the presence of heat-liable toxin and fimbriae. The results of the molecular and epidemiological studies allowed giving a speedy and accurate response that explained the etiology of the first food-borne disease outbreak(AU)

Caracterización microbiológica de cepas de Vibrio cholerae no-O1 aisladas en Cuba / Microbiological characterization of non-01 Vibrio cholerae isolated in Cuba

Se estudiaron 422 cepas de Vibrio cholerae no-O1 procedentes de 9 provincias del país, de ellas 9 aisladas de un brote de enfermedad de transmisión hídrica. En la totalidad de las cepas se determinó la susceptibilidad antimicrobiana y la presencia de factores de virulencia. En las 9 cepas procedentes del brote, se realizó además, el estudio de macrorrestricción de ADN mediante la técnica de electroforesis de campo pulsado. Se demostró por primera vez en Cuba y el Caribe, la circulación de cepas de V. cholerae no-O1 atípicas (resistentes al compuesto vibriostático O129 y al trimetoprim-sulfametoxazol). El comportamiento de la susceptibilidad antimicrobiana demostró por primera vez la circulación en Cuba de 2 patrones diferentes de resistencia (ampicilina, trimetoprim/sulfametoxazol, sulfonamida y tetraciclina, trimetoprim/sulfametoxazol, sulfonamida). La frecuencia de cepas resistentes al trimetoprim-sulfametoxazol se mantuvo similar en todo el período de estudio. Sin embargo, se produjo un decrecimiento de la resistencia a la ampicilina y un aumento de la resistencia a la tetraciclina. Los principales factores de virulencia que se encontraron fueron la gelatinasa, la hemolisina, la elastasa y la adherencia a células HEp-2. Sin embargo, las cepas del brote mostraron mayores porcentajes que el resto, para la presencia de la toxina termoestable y la presencia de fimbrias. Los resultados de los estudios molecular y epidemiológico permitieron dar una respuesta acelerada y precisa sobre la etiología del primer brote de enfermedad de transmisión alimentaria.

The study of 422 non-01 Vibrio cholerae strains from nine provinces, 9 of them isolated from a water-borne disease outbreak, was performed. All the strains exhibited antimicrobial susceptibility and virulence factors. The nine strains from the outbreak were subjected to a DNA macrorestriction study based on the pulsed field electrophoresis technique. For the first time in Cuba and the Caribbean, the circulation of atypical non-01 V. Cholerae strains (resistent to vibriostatic compound 0129 and trimethoprim/sulfamethoxazole). The behavior of antimicrobial susceptibility evinced for the first time the circulation of two different resistence patterns in Cuba (ampicilline, trimethoprim/sulfamethoxazole, sulfonamide and tetracycline, trimethoprim/sulfamethoxazole, sulfonamide). The frequency of trimethoprim/sulfamethoxazole-resistent strains was similar during the whole period of study. However, resistance to ampicilline decreased whereas resistance to tetracycline increased. The main found virulence factors were gelatinase, hemolysine, elastase and adherence to Hep-2 cells. On the other hand, the outbreak strains showed higher percentages than the others due to the presence of heat-liable toxin and fimbriae. The results of the molecular and epidemiological studies allowed giving a speedy and accurate response that explained the etiology of the first food-borne disease outbreak.

[Microbiological characterization of non-O1 Vibrio cholerae isolated in Cuba]. / Caracterización microbiológica de cepas de Vibrio cholerae no-O1 aisladas en Cuba.

The study of 422 non-01 Vibrio cholerae strains from nine provinces, 9 of them isolated from a water-borne disease outbreak, was performed. All the strains exhibited antimicrobial susceptibility and virulence factors. The nine strains from the outbreak were subjected to a DNA macrorestriction study based on the pulsed field electrophoresis technique. For the first time in Cuba and the Caribbean. The circulation of atypical non-01 V cholerae strains (resistent to vibriostatic compound 0129 and trimethoprim/sulfamethoxazole). The behavior of antimicrobial susceptibility evinced for the first time the circulation of two different resistence patterns in Cuba (ampicilline, trimethoprim/ sulfamethoxazole, sulfonamide and tetracycline, trimethoprim/ sulfamethoxazole, sulfonamide). The frequency of trimethoprim/ sulfamethoxazole-resistent strains was similar during the whole period of study. However, resistance to ampicilline decreased whereas resistance to tetracycline increased. The main found virulence factors were gelatinase, hemolysine, elastase and adherence to Hep-2 cells. On the other hand, the outbreak strains showed higher percentages than the others due to the presence of heat-liable toxin and fimbriae. The results of the molecular and epidemiological studies allowed giving a speedy and accurate response that explained the etiology of the first food-borne disease outbreak.

Nuevas especies de Aeromonas aisladas en Cuba / New species of Aeromonas isolated in Cuba

Se estudiaron 155 cepas de Aeromonas de heces de niños menores de 5 años con enfermedad diarreica aguda. Usando el sistema Aerokey II para la identificación en especies, 47 fueron identificadas como Aeromonas caviae, 58 como Aeromonas hydrophila, 23 como Aeromonas veronii biovar sobria, 14 como Aeromonas trota, 9 como Aeromonas veronii biovar veronii, 2 como Aeromonas jandei y 2 como Aeromonas schubertii. Se enfatiza las ventajas de este método que permitió la clasificación de nuevas especies no identificadas con anterioridad en nuestro país (AU)

Holoprosencefalia (arrinencefalia): espectro morfologico en seis (6) casos de autopsia / Holoprosencephaly (arhinencephaly): morphologic spectrum in six (6) autopsy cases

El síndrome malformativo de la holoprosencefalia (arrinencefalia), caracterizado por anomalías de variable severidad de cerebro y cara, es consecuencia de la morfogénesis incompleta del prosencéfalo y un déficit en el desarrollo de la línea medio-facial. En su etiopatogenia se han incriminado factores genéticos, tóxicos, metabólicos, infecciosos y parasitarios. Describimos 6 casos de autopsia estudiados en el Hospital "Dr. Adolfo Pons", IVSS, de Maracaibo, durante el período 1984-1987. La incidencia general de la malformación para 12.878 nacimientos fue de 0,04%. La edad materna promedio fue de 23 años. La serie se caracterizó por un espectro malformativo cerebro-facial proteiforme: 4 casos correspondieron a malformación cerebral severa, tipo holoprosencefalia alobar en 3 y semilobar en 1. Los encéfalos compartieron las siguientes características: falta de desarrollo de ambos hemiferios cerebrales, ausencia del cuerpo calloso, septum pellucidum y pilares anteriores del fornix, fusión de extructuras diencefálicas y aplasia olftoria. La malformación facial correspondió en 2 casos al tipo III de las categorías de DeMyer (Cebocefalia), nacidos de una misma madre en un mismo año, en otros 2 correspondió al tipo V (labio hendido lateral). Hubo un caso tipo I (ciclopia) y otro tipo IV (labio hendido media). A los casos de aplasia olfatiria (Holoprosencefalia lobar), se asociaron hidrocefalia por estenosis de acueducto de Silvio, bazo accesorio y/o fusión pancreato-esplénica, displasia suprarrenal, estenosis ureteral, vagina doble y polidactilia, anomalias que suguieren alteraciones cromosócas..

Trastornos lipidicos en niños con hepatitis viral / Lipid disorders in children with viral hepatitis

Se investigan diferentes variables lipídicas en 67 niños, menores de 15 años, los cuales se dividen en 2 grupos: el grupo A, integrado por pacientes con la tansaminasa glutámico pivúrica (TGP) y el timol incrementado; y grupo B, donde se presenta la TGP normal y el timol con cifras elevadas. Las variables en estudio fueron, el colesterol total, HDL colesterol, colesterol de beta y pre-beta, beta y pre-beta lipoproteínas, triglíceridos y electroforesis de lipoproteínas. Se demuestra en el análisis comparativo del grupo A, que algunas de las variables en estudio se incrementan de forma significativas, excepto las variables HDL colesterol, las VLDL y HDL. Este grupo también demostró una ausencia de pré-beta (VLDL) en el 36

de los casos y un predominio del tipo II b, así como el 84

de casos con hiperlipoproteinemia (HLP). En el grupo B, el colesterol total, las LDL y VLDL, diminuyen sus valores, al igual que la HDL colesterol (aunque ésta disminuye de forma significativa), el resto de las variables se mantiene aumentado signfificativamente con respecto al control, pero en concentraciones inferiores al grupo A. También se produjo el 40

de niños con HLP, aunque inferior al grupo A (84

) y 8 pacientes con tipo IV. Se estudian además 5 pacientes diagnosticados con hepatitis viral aguda, cuyas variantes lipídicas incrementan significativamente sus valores de forma considerable (AU)